HomeMy WebLinkAboutE2020-0613 - PermitsCity of Newport Beach - Building Division *E2020-0613*
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Job Address: 2828 LIGHTHOUSE LN Bldg: 1 Floor: Suite:
Description of Work: ELEC -VEHICLE CHARGING STATION/DISCONNECT
Inspector Area: 6
Legal Description: N TR 6385 LOT 1
Owner: SANTOS GREGORIO ABAD
Contractor:
ALLISON ELECTRIC
Address: 2828 LIGHTHOUSE LN
Address:
17651 FREMONT ST
CORONA DEL MAR, CA 92625
Receptacles/Outlets:
FOUNTAIN VALLEY CA 92708
Phone:
Phone:
949/887 -
$0.00
Con State Lie:
740707
Issued Date:10/26/2020
Lie Expire:
09/30/2021
$0.00
Bus Lie:
BT30073307
Processed By:
Lie Exp Date:
10/31/2021
New Construction
0 $0.00
Sub Panel:
Receptacle/Switch/Outlets
Residential
0 to 1 HP/KW/KVA:
0
Receptacles/Outlets:
1
$1.75
Multi -Family:
0
$0.00
Fixtures:
0
$0.00
1-2 Family:
0
$0.00
Sep Circuits:
2
$14.00
Low Voltage
0
$0.00
Service
Signs
0-600V up to 20OA:
0
$0.00
Branch Circuit:
0
$0.00
0-600V over 20OA:
0
$0.00
Each Add Circuit:
0
$0.00
Over 600V or 1000A:
0
$0.00
Time Clocks:
0
$0.00
0/H to U/G
0
$0.00
Additional Fee :
$0.00
TOTAL Fee:
Electrical Permit: E2020-0613
Project No :
Inspection RequestfP,tgne (949)644-3255
Code Edit: 2019
Worker's Compensation Insurance
Carrier: WIC EXEMPT
Policy No:
Expire :
FEES
0 $0.00
Sub Panel:
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 Backrfemp Power: 0 $0.00
Temp Power Pole: 0 $0.00
Temp Underground:
0 $0.00
Sub Panel:
0 $0.00
0 $0.00
0 $0.00
Record Mgmt Fee:
$0.00
Plan Check Fee:
$0.00
Investigation Fee:
$0.00
Issuance Fee:
$37.00
Supplemental Fee:
$0.00
Fee Due 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.
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, priorto its issuance, also requires the applicanffor
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).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do L,) all of or U 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
rl-m-roved for the purpose of sale).
l_I 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).
❑ 1 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 legall
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.htmi.
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 Professions Code, and my license is in full force
and effect.
License Class License No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
WARNING: 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 THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 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.
131 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
insurance carrier and policy number are:
Policy Number
Date
is Of Agent rnmle x
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' compensationlaws 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 ""1E
CLARATION REGARDING CONSTRUCTION LENDING AGENCY
?reby 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 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 state laws relating to building construction.
I authorize representatives of this city or county to enter the above -identified property for inspection purposes.
mature of PMDertv Owner or Authorized Aoent _ Print Property Owner's or Authorized Agent's Name
ACTION DATE 8
DECLARATION OF COMPLIANCE IMfTH CODE OF
FOR OFFICE
FEDERAL REGULATIONSPART 69 OF TITLE46 AND
AQMD RULE 9407.
❑ I SUBMITTEDASBESTOS NOTIFICATION TO:.
❑ EPA
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EXTENDEDAQM0
ASBESTOS N077FICA77ON IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
C€RTIFICATEOF
SIGNATURE:
OCCUPANCYISSUED