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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 ° n Worker's Compensation Insurance ® ° m® Carrier: STATE COMP Policy No: 9058423 Expire: 06/01/2015 OO Rn eo°°co G °° co°meo c n ooco:� ceoo 0 0 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