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Home My WebLink AboutE2019-0592 - PermitsCity of Newport Beach - Building Division 111111111111111111111111111111111111111111111111111111111 Electrical Permit: E2019-0592 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 1 9 0 5 9 2 Project No Permit Counter Phone (949)644-3288 Job Address: 2126 ARALIA ST Bldg: 2 Floor: Suite: Description of Work: ELEC - PANEL UPGRADE Inspector Area: Legal Description: 8 N TR 4705 LOT 27 Owner: STOLIAR TINA Contractor: Address: 2126 ARALIA ST Address: NEWPORT BEACH CA 926 0 Phone: Phone: Con State Lic: Issued Date:0812612019 Lic Expire: Bus Lic: Processed By: Lic Exp Date: New Construction Res!Jertial Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0-600V up to 20OA: 1 $45.00 0-600V over20OA: 0 $0.00 Over600V or1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: Inspection Requests Phone (949)644-3255 ,AAk3p Code Edit: 2016 C BEN MARC ELECTRIC Worker's Compensation Insurance ' 24601 GLEN IVY RD Carrier: MARKEL INS CO " CORONA CA 92883 Policy No: MWC0139863 714-713-0721 Expire:01101/2020 591584 03/31/2020 BT30068657 0813112020 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 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 Backrremp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Plan Check Fee : Temp Underground: 0 $0.00 Sub Panel: 0 $0.00 0 $0.00 0 $0.00 Record Mgmt Fee: $0.00 Plan Check Fee: $0.00 Investigation Fee: $0.00 Issuance Fee: $35.00 Supplemental Fee: $0.00 Fee Due at Permit 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 (_) all of or (_) 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 im roved for the purpose of sale). 1, 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 licensure under the Contractors' State License Law for the following reason: By my 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 Iegall 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 Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Properly Owner or Authorized Agent Date LICENSED CoNTR4'CTOR'S DECLARATION I hPr=h"'affirm under a -natty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business an Professions Code, and my license is in full force mid effece. — �/ Licic�nsnsE Class License No Date � Contractor Signature WORKERS' COMPENSATION DECLARATION WAI<NING: FAILURE r0 S'�CL RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE C1ST OF COMPENSAI ION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hPr>h,, affirm unuer penalty of perjury one of the following declarations: I,a✓e 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 p rna-Ice of the work for which this permit is issued. Policy No. � ave' and Wh1` nail,tain 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' compensatio �Jeaao carrier and policy number are: Corder _ _ _ Policy Number Expiration Date Name of Agent Phone # I certify that, in the performance of the work for which 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 agre that, if I should become subje to the workers' compensation provisions of Section 3700 of the Labor Code, I,shall forthwith comply with those provisions. Signature of Applicant�� Date DECLARATION REG DING CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name Lender's Address By 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 laws relating to building construction. I authorize representatives of this city or cou y to enter the above -identified property for inspection purposes. Signature of Property Owner or Authorized A t Print Property Owner's or Authorized Agent's Name Date ACTION DA BY DECLARATION OF COMPLIANCE iM7H CODE OF FOR OFFICE USE ONLY 6_ FEDERAL REGULATIONS PART 61 QFTFTLE44AN0 A4MD RULE 1403. PERMIT EXPIRED ❑ f 5USMtTTEDASBES TOS lVOI7FICATfON TO: ❑ EPA ❑ AOMD PERM/TCANCELLED PERMITEXTENDED ❑ ASBESTOS MOT7RCA770Nf5 NOT APPLICABLE TO PROPOSED DEMOLITION. PERMITFINAL J l CERTdFfCA7E OF SIGNATURE: OCCUPArVCY1S5UED