HomeMy WebLinkAboutE2019-0094 - PermitsI City of Newport Beach - Building Division *E2019-0094* Electrical Permit E2019-0094
o 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 0394-2019
L, Permit Counter Phone (949)644-3288 - )
wixans�°5` Inspection Requests Phone (949)644-3255
Y
New Construction
Residential
Multi -Family: 0 $0.00
1-2 Family: 0 $0.00
Service
0-600V up to 20OA: 0 $0.00
0-600V over20OA: 1 $88.00
Over 600V or1000A: 0 $0.00
O/H to U/G 0 $0.00
TOTAL Fee:
Receptacle/Switch/Outlets
Receptacles/Outlets: 0 $0.00
Fixtures:
0
$0.00
Sep Circuits:
0
Job Address: 2300 PORT CARLISLE PL
Bldg: 1 Floor: Suite:
0
$0.00
Signs
Description of Work: ELEC/SERVICE UPGRADE 225 AMPS
10 to 50 HP/KW/KVA:
Branch Circuit:
0
$0.00
Inspector Area: 4
0
$0.00
Code Edit: 2016
0
$0.00
Legal Description: N TR 7845 LOT 64
$0.00
Owner: DEBBASH BERNARD
Contractor:
ESP CONTRACTING
Worker's Compensation Insurance
Address: 2300 PORT CARLISLE PL
Address:
970 W 190TH ST #215
Carrier: STATE COMP
IE RT ACH,CA92660
TORRANCECA 90502
Policy No: 9152657
`mmmm°
Phone: 9-310-7146
Phone:
310-904-6139
Expire : 02/11/2020
m ° ° `°
Con State Lic:
619149
Issued bat:02/20/2019
Lic Expire:
11/30/2019
Bus Lic:
BT30066145
Processed B . /
Lic Exp Date:
02/29/2020
mm
°
mmmti°
Y
New Construction
Residential
Multi -Family: 0 $0.00
1-2 Family: 0 $0.00
Service
0-600V up to 20OA: 0 $0.00
0-600V over20OA: 1 $88.00
Over 600V or1000A: 0 $0.00
O/H to U/G 0 $0.00
TOTAL Fee:
Receptacle/Switch/Outlets
Receptacles/Outlets: 0 $0.00
Fixtures:
0
$0.00
Sep Circuits:
0
$0.00
Low Voltage
0
$0.00
Signs
$0.00
10 to 50 HP/KW/KVA:
Branch Circuit:
0
$0.00
Each Add Circuit:
0
$0.00
Time Clocks:
0
$0.00
Additional Fee:
$0.00
FEES
°
Temp Underground:
Motors/Transformers (HP/KVA)
Sub Panel:
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
Record Mgmt Fee:
Plan Check Fee:
Investigation Fee:
Issuance Fee:
Supplemental Fee:
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.
Issuance:
commc�o
U,Doo
$0.00'
$0.00'
$0.00
$0.001
$0.00
$0.00
$35.00
$0.00'
°
Temp Underground:
o 0 * %O
Sub Panel:
"° 0
0
0
Record Mgmt Fee:
Plan Check Fee:
Investigation Fee:
Issuance Fee:
Supplemental Fee:
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.
Issuance:
commc�o
U,Doo
$0.00'
$0.00'
$0.00
$0.001
$0.00
$0.00
$35.00
$0.00'
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 L) 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).
❑ 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).
❑ I 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 legally
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:hftp://www.leginfo.ca.gov/calaw,htmi.
Signature of Property Owner or Authorized Agent Date
LICENSED CWTRACTOR'S DECLARATION
I�ereffeotffirm undaltpEnalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
amd
License Class • • License No _Zzgn Date Contractor Signs ur
INORARS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMrrjj OYER TO CRIMINAL PENALTIES AND CNIL FINES UP TO ONE HUNDRED DUSAND DOLLARS ($100,000), IN ADDITION TO THE
CQ9r•OFCpMPENSA IOP}, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATT9RNETSFEES.
ITere"affirm unlelpgnalty of perjury one of the following declarations:
�•A'Ve and Aaviaintain 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 the
a once of the Work for which this permit is issued. Policy No.
�I••
Me:
h e.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
ns nce carrier a poky number _are: -
• • • •'' / _,A�iWJ y ��.f� O ,S�i Expiration Date 2 l// le�
..arrler �%�
Policy Number p 1
••.s
Vame of Agent
• • • • Phone #
:1I 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 agree
.hat, if I should become subject to th rs' c nsation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pro isio
3ignature of Applicant Da
)ECLARATION REGA INC NST TION LEND G AGENCY
hereby affirm under penalty erju that there is nstruction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
_ender's Name Lender's Address
3y 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 incorrect.
'. I agree to comply with all applicable city and county ordinances ap4tate laws relating to building construction. f3
'... I authorize representatives of this city or county to abo a dentified property for inspection purposes
of Property Owner or Authorized AgentPrint Property Owner's or Authorized
ACTION
DATE
DECLARATION OF COMPLIANCE WITH CODEOF
FOR OFFICE USE ONLY
FEDERAL REGULATIONSPART 61 OFTITLE40AND
AQMDRULE1403.
P€RA41TEXPIRED
❑ f SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERMIT CANCELLED
'.P€RMITEXTENDED
❑ ASBESTOS NORFIC4170NISNOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMITFiNAL
5 ala
CERTIFICATEOF
SIGNATURE:
OCCUPANCYISSUED