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HomeMy WebLinkAboutE2021-0842 - Permits0G., City of Newport Beach - Building Division *E2021-0842* Electrical Permit: E2021-0842 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 1796-2021 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 INPEQT Job Address: 412 HELIOTROPE AVE Bldg: 1 Floor: Suite: Description of Work: ELEC TEMP POWER POLE Inspector Area: 5 Legal Description: CORONA DEL MAR BILK 335 LOT 14 Owner: GREWAL KRISPAL Contractor: Address: 412 HELIOTROPE AVE Address: CORONA DEL MAR, CA 92625 Phone: Phone: Con State Lie: Issued Date:12/09/2021 Lie Expire: c Bus Lie: Processed By: l J Lic Exp Date: New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0-600V up to 20OA: 0 $0.00 0-600V over 20OA: 0 $0.00 Over 600V or 1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: $79.00 D & J ROOFING INC P.O. BOX 8788 MAMMOTH LAKES CA 93546 760-937.5636 886300 10/31/2022 BT30038799 03/31/2022 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Signs Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee : $0.00 Code Edit: 2019 Worker's Compensation Insurance Carrier : ESG Policy No: WC018974903 Expire : 12/31/2021 • . FEES Motors/Transformers (HP/KVA) 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 0 $0.00 Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: $0.00 Plan Check Fee: $0.00 Piggy Back/Temp Power: 0 $0.00 Investigation Fee: $0.00 Temp Power Pole: 1 $41.00 Issuance Fee: $38.00 Supplemental Fee: $0.00 Plan Check Fee : PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ 1 am exempt from Pcensure under the Contractors' State License Law for the following reason: By my signature JGIow I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall) Jell a s4: ucture that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and i0rofess'ons Cade, i, mailable upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date �,_IGENSED CONTRACTOR'S DECLARATION I hereby affirm ur-de. penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business an Profs Code, and 'e in full force 3n ' effect. c� License Class License No Date (2Z - 1 -.2-Qz ( Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING: FAILURE Tn SECURE WORKERS' COMPENSATION COVERAGE Is UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO O UNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE v' T Cr COMPENSATION, DAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereb} affirm JndE: p.malty of perjury one of the following declarations: I have and will melntain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th peron nance of ti ie wulx for which this permit is issued. Policy No. have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatiol nsuranca carrier and policy number are: Policy Number of Agent Date 11 certify that, in the performance of the work for which this perm' s issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre Tat, if I should become subject to th or ers' compen Isians of Section 3700 of the Labor Code, I shall forthwith comply with those prov"U7. 7 ''7 signature of Applicant - Date /\�/ ^ Z / IECLARATION REGA DI STRu N LENDING AGENCY hereby affirm under penal perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Ender's Name Lender's Address ly my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state s relating to building construction. I authorize representatives of this city or count)f\t/enter#qabove;'4C ed property for inspection purposes. ACTION DATE RY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART B1 OF TITLE40 AND AQMD RULE 1403, PERMfTEXPdRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERP✓IT CANCELLED PERMIT EXTENDED ❑ ASBESTOS NOTIHCATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL 1� CERTIF7CATEOF SIGNATURE:. OCCUPANCYISSUED