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Home My WebLink AboutE2018-0208 - PermitsCity of Newport Beach - Building Division(11IIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIII JillElectrical Permit: E2018-0208 a 7 100 Civic Center Drive, Newport Beach, CA 92660 / E 2 0 1 6 0 2 0 8 Project NO : Permit Counter Phone (949)6443288 �y,Ps Inspection Requests P Vd9�f4B .26 Job Address: 1744 SKYLARK LN Bldg: 1 Floor: Suite: Description of Work: ELEC -250 AMP PANEL UPGRADE Inspector Area: 3 " i C`olPe Edit. 2016 Legal Description: N TR 3097 LOT 3 / "E`er _� •�'� '�' yL^IAS/ Owner: HOLCOMB BEVERLY QUINCY C cto E CON`�Worker's Compensation Insurance Address: 1744 SKYLARK LN d r ss: CAVA CAVA S N i�y' ±,O Carrier: EXEMPT NEWPORT BEACH, CA 926 NOR 60 r Policy No: NO EMPLOYEES Phone: P i °`u Expire: Con State L 9 Issued Date:03/29/2018 10 Li / 2i * ` B Lic: 062697 a w" Processed By: Li xp t 03/31/2019 A. FEES t �+ New Construction ce clel i tlets Motors/Tran for rs HP/j v�1, Residential R cep les/ ets: 0 $0.00 to 1 HP/K l�` $0.00 mp UnderrDu 0 $0.00 Multi -Family: 0 $0.00 F 0 $0.00, 1 10 HP/KW/KVA: 0 $0.00 f �inel� 0 $0.00 1-2 Family: 0 $0.00 ircuits: 0 $ -� 0 to 50 HP/KW/KVA: 0 0:0f1 10�i 0 $0.00 ow Voltage A`�+ 0� 50 to 100 HP/KW/KVA: $0.00'099 0 $0.00 Service igns"' r ^�l Over 100 HP/KW/ 0 Record Mgmt Fee: $0.00 0-600V up to 200A: 1 $41.00 Br C rcu NJ �=��rY Plan Check Fee: $0.00 0-600V over 200A: 0 $0.00 Ea� circuit ,1000, $0.00 Pi ackrremp� r: 0.00 Investigation Fee: $0.00 Iti Over 600V or 1 OOOA: 0 $0.00 Tim ocks: 0 $0.00 emp Powe e: $0.00 Issuance Fee: $33.00 O/H to U/G 0 $0.00 dditional Fee : $Q 0 Supplemental Fee: $0.00 TOTAL Fee: $74.00 k ''r PI ecltfst'�a $0.00 Fee Due at Permit Issuance : $74.00 P,EJti WT'S EE*PIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction our sA7$nday - Friday 7.00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. 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 (_) all of or (_) 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). ❑ 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 legal) 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.htm]. 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 Profession e, and license is in full force and effect. License Class License No Dated/ 2� Contractor Signatur WORKERS' COMPENSATION DECLARATION �� ✓DARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND 4RS ($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 pe jury one of the following declarations: 111 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 the performance 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' ranee carrier and policy number are: Policy Number Date ),Cif of Agent Friona grtify that, in the performance of the work for whit 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 I should become subject to orkers' co sation provisions. of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 2 nature of Applicant Date'X CLARATION REGADING CONSTRUCTIO&LENDING AGENCY :reby affirm under penalty of perjury that th 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 ordinances and stat s relating to building construction. - J I authorize representatives of this city or count 1) o an fi� roperty for inspection purposes. /'Ro / U �'l 1 vl 6 Y` ri `if Print Prooertv Owner's or Authorized Aoent's Name1 T �� Date ACTION I DATE I BY PERMITEXPIRED PERMIT FINAL CERTIFfCATEOF PART 61 OFTIIL.E40AND ❑ I SUBNMTTEDASBESTOS U077FICATION TO. 13 EPA ❑ AQMD ❑ ASBESTOS N077RCA7I0N7S NOT APPLICABLE TO PROPOSEDDEMOLITION, SIGNATURE.