HomeMy WebLinkAboutE2000-1006 - PermitsCity of Newport Beach
`O Box 1768 Newport Beach, California 92658-8915
Building Department
Permit Counter Telephone (949)644-3288/3289
ELECTRICAL Permit No: E2000-1006
Inspection RequestsTelephone (949)644-3255
J
Job Address:
Inapedor Area:
Owner:
Address:
Phone:
Bldg:1 Floor: Suite:
Code Edh: 98
HOAG MEMORIAL HOSPITAL PRESBY
1 HOAG ORAOX 6100
NEWPORT BEACH,CA928584100
949/648-8901
Legal Dese.:
Contractor:
Address:
BRIGGS ELECTRIC IP
18112 MILUKAN AVEI
IRVINE CA
Phone: 949/8834901
Cow State Lit : 297838
Uc Expire: 08/31/2001
Bus. Lic.: 80003113
Llc. Exp Date:
iltafanskimagn
Etaldentid
Multifamily
1-2 Family
Imaka
0 to 600V up to 200A
0 to 800V over 200A
Over 800A1,000A
O 50.00
O $0.00
0
0
0
50.00
$0.00
$0.00
JtecentacletSwkc1VOullels
Recep/Outl.ts 0 $0.00
Fixtures 54838.70
Sep Circuit 0 $0.00
Rum
Branch Circuit
each Add Circuit
0 $0.00
0 $0.00
TOTAL: 564.88 PAYMENT: 50.00
FEE
Description of Work: crrc I MiYTING
SEE637849--
INSPECTOR NOTES:
Inspector
z2° -
Wtd Ce if.kt
Motors/Transformers (HP/KVAI
0 to 1 HP/KW/KVA
1 to 10 HP/KW/KVA
10 to 50 HP/KW/KVA
50 to 100 HP/KW/KVA
over 100 HPIKWIKVA
Time Clocks
0
0
0
0
0
$0.00
$0.00
$0.00
$0.00
$0.00
0 $0.00
Temp Power Pole
Tarp Underground
Sub Panel
Investigation Fee
Plan Check
Issuance
BALANCE: 564.88
O $0.00
0 $0.00
0 $0.00
O 50.00
0 $0.00
50.00
59.18
519.00
IC,FNRFrl PANTRACTr1Rs DECLARATION
_I hereby ofbm under penalty of perj y that I am licensed under pros/Sons of Chapter 9 larrvronckg with Section 70001 of avislan 3 of the Business and Professions cafe.
and my lcense b W. fulface and effect.
Wane Nit. des Contacts. woos n'CINC *NG
WORKERS COMPENSATION DECLARATION I hereby after under penally of perjury one of the following decaraMM:
I have and wik motion a certificate of consent to self -insure for workers compensation. as Irowkled for by Section 3700 of
of the work for which ttk permit is issued.
I have and will makstan workers compensation Insurance. as required by Section 3700 of the labor cede. for the pedana
My workers' compensation issuance coda and poky numbers Is:
cae.e JINIHNORABoaet Peaty saki: M AA14ft Expire: 97m1i22
This section need not be completed if the permit is for one hundred dollars (S100) or less.
I cerll& Mat in the performance of the work to which this permit b bored. I shall not employ any penes In any manner so as to
of cations, and ere IMt NI should became subject to we workers' conversation provisions of Section 3700 gt,tlp labor code, I
Dalt - p.0 Applicant Signature:
Waning: Fore to secure wakens compensation coverage b unlawful, and Pall sub{ect an
MI00A30h n addition to the cost of compersatkjn.darnages as provided for in Section 3706 of the labor code. merest. and anorllesh fees.
I hereby acknowledge that I have read this application kiwi the information given is correct: and that lam the owner, orduly a lthated agent of the owner. I ogee to
csRlasy wtth etty and stale lows regulating construction; and In doing the work authorized thereby, no person will be employed In violation of the labor code of the state of
California relatkg to workmen's oompensatbn insure'�°
Permittee Name (Print Y� J J /'4/� Address : /li 6z %hit4"(, . c- 3/14,Me-
Signature of permitt
Date: 6,ec°,&C
&armals
en
Grounding Electrode
/41167 AT)
Underground
Underslabfflaor
Rough Conduh Walls
Rough Wking Callings
Rough Service
Temp Power
Utility Co. Notified
Final
WORK MUST BE STARTED WITHIN A PERIOD OF 180
DAYS FROM THE DATE OF VALIDATION OR THIS
PERMIT BECOMES NULL AND VOID .