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Home My WebLink AboutE2016-0109 - Permits.gWPp4 oA City 'Vo Center Dport Beach rive, NewportBeach, oBuilding Division100 IIIIIIIIIIIIIIIi1III IIIIIIII�l 0�li ll 0lll9l II� ti v Permit Counter Phone (949)644-3288 V na4rox�r 10 Electrical Permit: E2016-0109 Project No 1796-2015 Inspection Requests Phone (949)644-3255 Job Address: 620 ORCHID AVE Bldg: 1 Floor: Suite: ¢¢�v � Description of Work: ELEC-300 AMP SVC - 200 AMP METER & 100 AMP METER (X2015-2364) i �" �, Inspector Area: 5 Code Edit: 2013 Legal Description: DEL MAR BLK 642 LOT 22 OF PROJECT 939-82 LOCATED ON AP Owner: BARKOURAS TRINA Address: 620 ORCHID AVE CORONA DEL MAR CA 92625 Phone: Issued Processed 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 over20OA: 1 $81.00 Over600V or1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee : $113.00 Contractor: Address: Phone: Con State Lic: Lic Expire: Bus Lic: Lic Exp Date: DOMINIC THE ELECTRICIAN 2616 17TH STREET #3 HUNTINGTON BEACH CA 92648 714-969-3164 836576 04/30/2016 BT30016665 09/30/2016 Rece ptac I e/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 Worker's Compensation Insurance Carrier: TWIN CITY FIRE INS Policy No: 72WECDU4424 Expire : 10/08/2016 FEES Motors/Transformers (HP/KVA) 0 to 1 HP/KW/KVA: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 Over 100 HP/KW/KVA: 0 $0.00 Piggy Back/Temp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Plan Check Fee : $0.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Temp Underground: Sub Panel: Record Mgmt Fee: Plan Check Fee: Investigation Fee: Issuance Fee: Supplemental Fee: Fee Due at Pennit 0 0 0 0 13.00 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I an 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 sinned 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 Cude) 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,mp,'e than five hundred dollars ($500). ❑ I, as owns. of t:ie 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, dusir,ess 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-Builderwill have the burden of proving that it was not built or 'mprnved for the pw pose of sale). ❑ !, 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 a.pp)', to an owl,Er property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ ' am exempt Lom licensure under the Contractors' State License Law for the following reason: Py rn, signature below 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 legally sell a structure 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 Professions Coos, ,s available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No Date Contractor Signature NORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($'100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: have and will maintain 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 IN Be mance of the work for which this permit is issued. Policy No. ve 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' compensatior ns ante carrier and policy number are: Tier Policy Number Expiration Date me of Agent Phone # certify that, in the erformance of the work forwhich this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agrer t, if I should becom subject to the workers' compensa 'on provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provlsl ns. '7 nature of Applicant CLARATION I G CONSTRUCTION LENDING AGENCY V areby affirm under p art of perjurythat there is a construction lending agency for the performance of the work for which this permit is issued (Se ion 3097, Civil Code). Ider's Name Lender's Address 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 coLVtY o dinances and state laws relating to building construction. I authorize representatives of this city or county t e-iden " property for inspection purposes. nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Na e 2 Z _ % G Date ACTION DATE OY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART fit OFTIILE40 AND AQMDRULE 1403. PERMIT EXPf,4ED ❑ I SUBMITTED ASBESTOS IV077FICATION TO: ❑ EPA ❑ AQMD PERMLTCANCELEED PERMITEXTENDED ❑ ASBESTOS N07713CATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL CERTIFICATEOF SIGNATURE: OCCUPANCYISSUED