HomeMy WebLinkAboutE2019-0098 - PermitsCity of Newport Beach Building Division
100 Civic center Drive, Ve+$pUBe&h•CA 92660
Permit.(; ount ephone (J49j6,t4-328V
IIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIII IIElectrical Permit: E2019-0098
E 2 0 1 9 0 0 9 8 Project No: 0156-2018
Inspection Requests Phone (949)644-3255
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Job Address: 660 . RARAOR
ISakNDegR
QVg: 1Ftoor.< Suite:
Description of Work: EI -9 -
400 AMP PANEL UPGRADE (NEXT TO EXISTING LOCATION)
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Inspector Area: 2
Code Edit: 2016
Legal Description: N TR 3867 LOT 20
Owner: HALCOVICH FRANK & WENDY
Contractor:
OWNER/BLDR
Worker's Compensation Insurance
Address: 81161 INDIO BLVD
Address:
BAYNE GRANT
Carrier:
INDIO CA 92201
Policy No:
Phone: 760-343-2704
Phone:
Expire
Con State Lic:
O/B
Issued Date:02/22/2019
Lic Expire:
Bus Lic:
Processed By:
Lic Exp Date:
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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 MgmtFee:
$0.00'
0-600V up to 20OA: 0
$0.00
Branch Circuit:
0 $0.00
Plan Check Fee:
$0.00
0-600V over 20OA: 1
$88.00
Each Add Circuit:
0 $0.00
Piggy Backrremp Power:
0
$0.00
Investigation Fee:
$0.00
Over 600V or 1000A: 0
$0.00
Time Clocks:
0 $0.00
Temp Power Pole:
0
$0.00
Issuance Fee:
$35.00
O/H to U/G 0
$0.00
Additional Fee :
$0.00
Supplemental Fee:
$0.00!
TOTAL Fee:
$123.00
Plan Check Fee: $0.00
Fee Due at Permit Issuance:
$123.00
PERMITS EXP/RE 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.
INER-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 ch J*aiarkJgJ I (nave Vaced next todhe 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 $•o ifs issuanae,,als4requires 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 (commerICIng Afh Section 7000) Of DI41s1bn 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 (_) all of or U portions of the work, and the struCtui,'e ispbt iipterded sr offered�forsale• FSection 7044,
�iness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personBFeffortf builds oc imprevesih(rprop0rt)t 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 wil4iiave ttlis,&r4caofpr(;vjrjq to§Pit was not built or
rovedfor 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"lo 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 a exempt from licensure under theAontractors' State License Law for the following. reason:
my 'gnature below I acknowledge that, except fo= y p sonal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I. cannot legal
a st ucture that I have built as an owner -builder it has of been constructed in its entirety by licensed contractors. I understand that a copy of the applicableJaw, Section 7044 of the Business and
ons Code, is available upon request when I i Is su fitted or at the following Web site: httpi!/www.leginfo.ca.gov/calaw.html. )
nature of Property Owner or Authorized Age Date / � ^% % r
TENSED CONTRACTOR'S DECLARA
reby affirm under penalty of perjury that I am licensed oder provi 'ons of Chapt r 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
Class License too Date Contractor Signature
COMPENSATION DECLARATION
NG: 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
OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
iby affirm under penalty of perjury one of the following declarations:
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
Tnance 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'
rance carrier and policy number are:
Agent
in the
jnature of Applica
:CLARATION RE RDIt]I' NS GF t LENT
ereby affirm under penal yperjury that t re is a c
nder's Name
imy signature belo , I certify to each of the following
I am the properg owner r authorized to act on the
I have read this application and the information I h•
I agree to comply with all applicable city an
j I authorize representatives of this city or county
ACTION I DATE
FINAL
Policy Number
:ion Date
ermit 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
provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Date Ail Z-22— — L�
GENCY
ion lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Address
owner's behalf.
is correct.
afid,state laws relating to building construction.
ve
ntified property for inspection purposes.
Print Property Owner's or Authorized Agent's Name
ECLARATION OF COMPOANCEMRTH CODEOF
DERAL REGULATIONS PART 61 OFTITLE40AND
AQMDRULE 1403.
❑ I SUBMITTEDASBESTOS NOTfFiCATIOAI TO.'
El EPA
❑ AQMD
[3 ASBESTOS MODFICATIONIS NOT APPLICABLE TO.
PROPOSED DEMOLITION. -
SIGNATURE.
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