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Home My WebLink AboutE2019-0770 - Permitsw,a City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II Electrical Permit: E2019-0770 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 1 9 0 7 7 0 . Project No: µ .T Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Description of Work: EILEC AIC DISCONNECTFIoor: Suite: INSPECTOR Inspector Area: 8 Legal Description: N TR 7083 LOT 16 Owner: JOHANSSON KURT I Contractor: Address: 300 VISTA MADERA Address: NEWPORT BEACH, CA 92660 Worker's Compensation Insurance Phone: Phone: 555 VANGUARD Con State Lic: Issued Date:11/18/2019 Lic Expire: BREA, CA 92821 Bus Lic: Processed By: Lic Exp Date: New Construction Code Edit: 2016 m m meeoom ° Receptacle/Switch/Outlets ECONO AIR Worker's Compensation Insurance m ° mmmomo m mmeeco m o 555 VANGUARD Carrier: STARNET INSURANCE CO e • •°° BREA, CA 92821 Policy No: BNUWC149340 0 me 714-695-6661 Expire: 10/01/2020 $0.00 ° m m < 445220 $0.00 $0.00 Investigation Fee: Low Voltage o e o •0000 02/29/2020 $35.00 Signs BT30064026 0-600V up to 20OA: om000 0813112020 Branch Circuit: oo moo mo m 0-600V over 20OA: 0 $0.00 mmmm°� 0 $0.00 o eo 0 $0.00 Time Clocks: 0 o m ococ oommr New Construction 0 $0.00 Receptacle/Switch/Outlets Residential $0.00 10 to 50 HP/KW/KVA: 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 Investigation Fee: Low Voltage 0 $0.00 Service $35.00 Signs Supplemental Fee: 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Over 600V or 1 o00A: 0 $0.00 Time Clocks: 0 $0.00 O/H to U/G 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 Back/Temp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Temp Underground: 0 $0.00 Sub Panel: 1 $27.00 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 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. 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 applrtable item(s) action 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, priorto its issuance, also requires the applicant for 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 Ifessions 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 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, ;iness 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 )rovements 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 )roved 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 )ly 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 li ensure under the Contractors' State License Law for the following reason: my signature•balow 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 a stweture that I hAbe 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 (%%Sons Cogetjs q,4ailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm]. nature of Property Owner or Authorized Agent Oat )EASED COLIMTRACTOR'S DECLARATION :reby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with S coon 7000) of Division 3 of the Business aJProSion e, and my license is in full force 4effept. " * * *: .rye Class License No Date (t Contractor Signature 7RK�RS' CljMF9PISATION DECLARATION MIN& FAILURE TSECURE 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 S 05 COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. �4ebyaffirm un1pr prinalty of perjury one of the following declarations: tulle and will.maiptain 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 thl rornrance of the work for which this permit is issued. Policy No. have 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 stance carrier and policy number are: Carrier olicy Number Expiration Date Name of Agent A Phone # I certify that, in the performAnce o the w f whi this permit is issued, I shall not employ any person in any manner so as to become subject So the workers' compensation laws of California, and agre that, if I should become subj ct to th wor nsation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant Date DECLARATION REGARDING C ING AGENCY I hereby affirm under penally of perjury that rhere is a construction lending agency for the performance of the work for which this permit is issu d (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 ow Shelf. I have read this application and the information I hak�e rovided s rrect. I agree to comply with all applicable city and coun�/or nanc a sta aws relating to building construction. I authorize representatives of this city or county t�dant the v ntified rty for inspection purposes. Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Na 4/ Ln Dto ACTION DATE / BY DECLARATION OF COMPLIANCE WITHCODE OF / FOR OFFICE USEON FEDERAL REGULATIONS PART 61 OF TfTLE40AND l ADMORULE 1403. PERMITEXPIRED ❑ I SUBM(TiEDASDESTOS N07IFICATION TO: PERMIT CANCELLED ❑ EPA ❑ AQMD ❑ ASBESTOS N077RCATIONIS NOT APPLICABLE TO PERMITEXTENDED PERMIT FINAL PROPOSED DEMOLITION. CERTIRCATEOF OCCDPAIVCYISSU£D SIGNATURE: