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Home My WebLink AboutE2016-0180 - PermitsNoy City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IIElectrical Permit: E2016-0180 a'� d 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 1 6 0 1 8 0 Project No : 0699-2015 Permit Counter Phone (949)644-3288 / 41ra r f Inspection Requests Phone (949)644-3255 Job Address: 4549 BRIGHTON RD Bldg: 1 Floor: Suite: Description of Work: ELEC/PIGGY BACK Inspector Area: 5 Code Edit: 2013 Legal Description: N TR 3357 LOT 150 New Construction Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Owner: ALB PARTNERS LLC Contractor: BROWN BROTHERS CONST Worker's Compensation Insurance Address: 2222 E 17TH STREET Address: 332 FOREST AVE #26 Carrier: STATE FUND 0 SANTA ANA CA 92705 Temp Underground: LAGUNA BEACH CA 92651 Policy No: 9040746 Multi -Family: Phone: 714-541-1200 X207 Phone: 949-721-0071 Expire : 01/01/2017 $0.00 1 to 10 HP/KW/KVA: Con State Lie: 832642 Sub Panel: 0 Issued Date:03/28/2016 Lie Expire: 02/28/2018 $0.00 Sep Circuits: 0 Bus Lia BT30005066 0 $0.00 Processed By: Lie Exp Date: 07/31/2016 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION • mom cue � ¢ o•• •® m m • c c o 0o m c c m m c m o ec c ,. c mmm mm •om ccy cme co c cm c o o coo goo c c c oc c c c seo coo mm c o oom mom FEES New Construction Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Residential Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 ! $0.00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 0 $0.00 1-2 Family: 0 $0.00 Sep Circuits: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 0 $0.00 Low Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 0 $0.00 Service Signs Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: $0.00 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 Plan Check Fee: $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Piggy Backffemp Power: 1 $35.00 Investigation Fee: $0.00 Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $32.00 O/H to U/G 0 $0.00 Additional Fee : $0.00 Supplemental Fee: $0.00 TOTAL Fee: $67.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $67.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION • mom cue � ¢ o•• •® m m • c c o 0o m c c m m c m o ec c ,. c mmm mm •om ccy cme co c cm c o o coo goo c c c oc c c c seo coo mm c o oom mom 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). ❑ 1, 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 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 Iegalh 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 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 Profes -6 Code, and / 'I!11 a is in full force and effect. License Class License No Date �C� �� 7 Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th perfgrmance of the work for which this permit is issued. Policy No. have and willmai Sin workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' rance carrier ad pD icy number arg: Date of certify that, in the performance 21PIe work for which th loit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre I, if I should become subject rs' c pens ions of Section 37 of the Labor Code, I shall forthwith comply with those provisions. +/ nature of Applicant Date] w " CLARATION REG DING CONSTR ION NDING AGENCY // �"' :reby affirm under penally of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Ider's Name Lender's Address my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. ` I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordina5pirand state la mating to building construction. authorize representatives of this city or county toe ter ve= entifj perty for inspection purposes. „ (,/(�/ nature of Pronertv Owner or Authorized AGent Print Property Owner's or Authorized Agent's Name 5'�Azay " " �— Date_. _ ACTION DATE BY DECLARATIONOFCOMPUAPLCE t+YITNCODEOF FOR OFFICE USE ONLY FEDERAL REGULATiQNSP .6 aFTtTLF$QAND� AQMD RULE 1403. PERMIT£XPU?EO ❑ I SUBMITTEDASBESTOS �NOAJilEA TaTD:: • . ❑ EPA ❑ AQMD PERMITCANCELLED P£RAMT E7fT€NDED ❑ ASBESTOS N077HCAHONJ4 N•Oj-,APIDUCABLE TO PROPOSEDDEMOLfTION. • e • o e e • • 0. o •e • • e PERMITFINAL CER F OCCU ANCYITE OCCUFANCYlSSUED 'C„r� SIGNATURE] • i e • • • • • • • • • • ... e o