HomeMy WebLinkAboutE2014-0344 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIII'lllll'IIII�IIIIIIIIIIIIII II
100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 1 4 0 3 4 4
Permit Counter Phonc (949)0644-3288
Job Address: 10 SAIL VISTA Bldg: 1 Floor: Suite:
Description of Work: ELEC -VEHICLE CHARGER
Inspector Area: 6
Legal Description:
Owner: EL-GAMAL YASSER Contractor:
Address: 10 SAIL VISTA Address:
NEWPORT BEACH CA 92657
Phone:
Phone:
Con State Lic:
Issued Date:07/23/2014
Lic Expire:
Bus Lic:
Processed By:
Lic Exp Date:
LIVE WIRE ELECTRIC INC
14158 ALBERS WAY
CHINO CA 91710
909-606-8555
804762
02/28/2016
BT30047948
07/31/2015
Electrical Permit: E2014-0344
Project No :
Inspection Requests Phone (949)644-3255
Code Edit: 2013
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Worker's Compensation Insurance ® °
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Carrier: STATE COMP
Policy No: 9058423
Expire: 06/01/2015
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PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
FEES
New Construction
Receptacle/Switch/Outlets
Motors/Transformers (HP/KVA)
Residential
Receptacles/Outlets:
1
$1.00
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:
1
$6.00
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 Mgmt Fee:
$0.00
0-600V up to 200A:
0
$0.00
Branch Circuit:
0
$0.00
Plan Check Fee:
$5.04
0-600V over 20OA:
0
$0.00
Each Add Circuit:
0
$0.00
Piggy BackfTemp 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
0/H to U/G
0
$0.00
Supplemental Fee:
$0.00
TOTAL Fee:
$47.04
Plan Check Fee: $47.04
Fee Due at Permit Issuance :
$0.00
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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 checkmark(s)9 haoe placed next to the applicable 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, 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
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 `) 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
movements 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
fly 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 exemptfjon licensure under the Contractors' State License Law for the following reason:
my signature below.l 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 structure tAall 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 applicable law, Section 7044 of the Business and
IfOSEjons Code, &%ailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
nasure of Property Owner or Authorized Agent Date
BEN6ED CONTRACTOR'S DECLARATION
areby affirm ed er penalty 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
I effect. .. .
efft Class License No Date Contractor Signature
5MKERS' f CftRENSATION DECLARATION
IAIAG: FAILURE TQ 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 THE
rAOPCOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
ireb)paffirm upderQenalty of perjury one of the following declarations:
'I'I}4e and.Wig ,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 thf
formance of thg Ivo rk 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
trance carrier and policy number are: _
Policy Number
Date
is of Agent I I"""
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
, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant Date
CLARATION REGARDING CONSTRUCTION LENDING AGENCY
areby affirm under penalty of perjury that there 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 owners 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 state laws relating to building construction.
I authorize representatives of this city or county to enter the above -identified property for inspection purposes.
—h— 13--d,, n,.,ne.,.r A,, hnrivnd Ancn1 Print Prooertv Owner's or Authorized Agent's Name
ACTION DATE BY..r.-,,,..,.......-.-...... ____ -
FEDERAL REGULATIONS PART 61 OF TITLE40 AND
PERMIT EXPIRED AQMD RULE 4403.
❑ ISUBMITIEDASBESTOSNORFICATIONTO:
PERMITCANCELLED ❑ EPA
PERMITEXTENDED ❑ AQMD
❑ ASBESTOS NOTIFICARONIS NOT APPLICABLE TO
PERMITFINAL, PROPOSED DEMOLITION.
C€RTIFICATEOF
SIGNATURE:
Date