HomeMy WebLinkAboutE2019-0651 - Permits9City of Newport Beach - Building Division IIIIIII IIIIIIIIIIIIIIIIIIIIillllllllllllllllllll Electrical Permit: E2019-0661
cs 100 Civic Center Drive, Newport Beach, CA 92660 E 0 1 9. 0 6 5 1 Project No: 0003-2018
,X Permit Counter Phone (949)644-3288
c�4 riNi"�r. Inspection Requests Phone (949)644-3255
NO CONSTRUCTION NOISE
Job Address: 437 ACACIA AVE Bldg: 1 Floor: Suite:
Description of Work: ELEC PIGGYBACK
ON THE WEEKEND
Inspector Area
Legal Description:
5
N TR 682 LOT 51
Owner: ACACIA PROPERTIES I LP
Contractor:
J R C COMPANY
Address: 437 ACACAI AVE
Address:
21822 KANEOHE LN
NEWPORT BEACH, CA 92625
Fixtures:
HUNTINGTON BEACH CA 92641
Phone:
Phone:
714-625-1551
0
Con State Lic:
656317
Issued Date:09/25/2019
Lic Expire:
11/31121120
$0.00
Bus Lic:
BT30063997
Processed By:
Lic Exp Date:
07/31/2020
New Construction
Residential
Multi -Family: 0
1-2 Family: 0
Service
0-600V up to 20OA: 0
0-600V over20DA: 0
Over 600V or 11000A: 0
O/H to U/G 0
TOTAL Fee
Code Edit: 2016 f w .SPECT.O
Worker's Compensation Insurance
Receptacle/Switch/Outlets
;' ° ° ° °
Receptacles/Outlets:
0
$0.00
$0.00
Fixtures:
0
$0.00
$0.00
Sep Circuits:
0
$0.00
0
Low Voltage
0
$0.00
$0.00
Signs
•. °
$39.00
$0.00
Branch Circuit:
0
$0.00
$0.00
Each Add Circuit:
0
$0.00
$0.00
Time Clocks:
0
$0.00
$0.00
Additional Fee:
$0.00
Code Edit: 2016 f w .SPECT.O
Worker's Compensation Insurance
• •
;' ° ° ° °
Motors/Transformers (HP/KVA)
eeoo
°
Carrier: EXEMPT
1 to 10 HP/KW/KVA:
• o
Policy No: no employees
e
e °
Expire `
°
0
$0.00
c o0
0
$0.00
. eme
•. °
$39.00
Temp Power Pole:
0
$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:
1
$39.00
Temp Power Pole:
0
$0.00
Plan Check Fee : $0.00
Temp Underground:
Sub Panel
Record Mgmt Feer
Plan Check Fee:
Investigation Fee:
Issuance Fee:
Supplemental Fee:
e at Permit Issuance:
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.
0
0
0
0
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$35.00
$0.00
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)
ction 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
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
fessions 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 u 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).
1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale 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).
U I am exempt from licensure under the Contractors' State License Law for the following reason:
By my signature b%llow I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the in
sell a structure that I.have built as an owner -builder if it has not been constructed in its entirely by licensed contractors. I understand that a copy of the app]
Professions CEQC? Is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
$igrj;Aure of PWpgrtt Owner or Authorized Agent
LICEAISED•OONTRACTOR'S DECLARATION
I nal effe affirm undecti
Limiter penalty of perjury that I am licensed under provisions of Chapter 9 (commencing wi S��n 7000) of Division 3 of the Business and
and effect.///
Gicease Class% • • License No Date �� �� Contractor Signature _
AFORKERS'AQM'P)ENSATION DECLARATION
WARNING: FAILURE %ICCURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPL YER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE H�
•5T QR COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LA60R CODE, INTEREST, AND ATTORNEY'S FEES.
he rept' affirm under penalty of perjury one of the following declarations:
law, Section
Date
and
license is in full force
DOLLARS ($100,000), IN ADDITION TO THE
J'I have an&*111" intain 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
)gawwwnce of the wqk for which this permit is issued. Policy No.
!2F+,Sr a and %4 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' compensa
nsurance carrier and policy number are:
ITer Policy Number Expiration Date
y�ia of Agent Phone #
I Certify that, in the performan of e w fo is 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
t,f lI should become subject o tp or rs' anon provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisio S.
mature of Applicant l DateZ.
CLARATION REGARDI C ON LENDING AGENCY
;reby affirm under penal of perjury there is a is
lending agency for the performance of the work for which this permit is issued ( action 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 beh .
I have read this application and the information I have provide s orre
I agree to comply with all applicable city and cou�y of an S e laws
I authorize representatives of this city or county e t r a- tified p}
ACTION
PERMIT€XPIREO
PERMITCANCELLED
P€RMITEXTENDED
PERMIT FINAL
CERTIRCATEOF
OCCUPANCYISSUED
DATE /iY 1/ By
building construction.
nspection purposes. ,)�
od,.I o.�,.ed„ n,.l,.e.le ,. 6„H...ri ed AnanP...
e Nle
AWINU KULC 14VJ.
❑ I SUBMITTED ASBESTOS IVODFICATIONTO.
❑ EPA
❑ AQMD
❑ ASBESTOS NOTIRCATIDNIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE.