HomeMy WebLinkAboutE2019-0223 - Permitsvt, City of Newport Beach - Building Division
` o 100 Civic Center Drive Newr�rt Beach, CA 92660
w Permit Counter Phone (949)644-3288
Job Address: 17 (PM) BODEGA BAY DR Bldg: 1 Floor: Suite: -
Description of Work: ELEC -PEDESTAL METER (100 AMP)
Inspector Area: 4
Legal Description:
Owner: REGENT ASSOCIATION Contractor:
Address: 2740 N GRANDE AVE Address:
SANTA ANA CA 92705
Phone: 714-634-0611 Phone:
Con State Lie:
Issued Date:04/16/2019 Lie Expire:
Bus Lie:
Processed By: Lie Exp Date:
New Construction
Residential
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KORE ELECTRIC
2175 CALLE OLA VERDE
SAN CLEMENTE CA 92673
949-793-3262
745565 i
02/29/2020
BT30066180
02/29/2020
Receptacle/Switch/Outlets
Receptacles/Outlets: 0 $0.00
Multi -Family:
0
$0.00
Fixtures:
0
$0.00
1-2 Family:
0
$0.00
Sep Circuits:
0
$0.00
$0.00
50 to 100 HP/KW/KVA:
0
Low Voltage
0
$0.00
Service
Piggy Back/Temp Power:
0
Signs
Temp Power Pole:
0
0-600V up to 20OA:
1
$43.00
Branch Circuit:
0
$0.00
0-600V over 20OA:
0
$0.00
Each Add Circuit:
0
$0.00
Over 600V or1000A:
0
$0.00
Time Clocks:
0
$0.00
O/H to U/G
0
$0.00
Additional Fee:
$0.00
TOTAL Fee:
Electrical Permit: E2019-0223
Project No :
Inspection Requests Phone (949)644-3255
5 y
� r
Code Edit: 2016 h_ q
''yrs
Worker's Compensation Insurance
Carrier: STATE COMP
Policy No: 9210652
Expire : 03/01/2020
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0 0 0
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FEES
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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
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.
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Temp Underground:
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Sub Panel
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001811,
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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 Issuance: $78.00
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.
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¢,4hav6 placed next to the applicable items)
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
is 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
Irofessions 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
of 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 U portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
nprovements 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
In 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
pply 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).
I am exempt from licensure under the Contractors' State License Law for the following reason:
ly 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 legally
ell 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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
lignalure of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
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 Co aond m_y license is innffull force
is effect.
ic/ /1f✓+'��✓
ense Class License No Date �� � Contractor Signature / iC
VORKERS' CaMPMSATION DECLARATION
INwepnAILURE l6SECURE 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
T OF CCMPENSATIOV-4D`I AGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
te�by-a firm underpenalty of perjury one of the following declarations:
I have and wilLmainiain 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 th1
%m9rilDe of tHbM&R Ior which this permit is issued. Policy No.
•.
yea and will llieintain 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'
ice.carrierenJ policy number are:
Policy Number
Date
refs ity that, in the pellormancpof 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 agree
a j illould bildb?V Objec the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
iature of Applicant Date 7
:LARATION REGAR6ING CONSTRUCTION LENDING AGENCY
"eby 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).
1er's Name Lender's Address
ny 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 my ordinances and state laws relating to building construction.
I authorize representatives of this city or c ty enter th ab - ntified propert I action purposes. `�� %f/ i.� �� Dated �� �/
ature of Pronerty Owner or Authorized ant tint Prooerty Owner's or Authorized Aaent'S Name /` !/r
ACTION DATE BY
UECLARAIIUN OF CUMPLIANCL WI I H CUUL UI-
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61OF TITLE40AND
AQMD.RULE 1403.
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PERMIT CANCELLED
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PROPOSED DEMOLITION.
PERMITFINAL
CERTIFICATE OF
SIGNATURE:
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