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Home My WebLink AboutE2021-0356 - Permits8w1`r.1y, City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 ss Job Address: 700 COAST HWY W Bldg: 1 Floor: Suite: Description of Work: ELEC/ OUTLET ONLY Inspector Area: 7 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Electrical Permit: E2021-0356 Legal Description: TR 1210 LOT 18 ALL -SLY OF MWD LINE -(AND ALL -SLY OF MWD LINE- LOT Owner: MC DONALD'S CORPORATION Contractor: Address: PO BOX 182571 Address: COLUMBUS, OH 43218 Phone: Phone: Con State Lie: Issued Date:06/0212021 Lie Expire: Bus Lie: Processed By: Lie Exp Date: WCCSINC 9021 RANCHO PARK COURT RANCHO CUCAMONGA CA 91730 909-952.6979 655509 06/30/2021 BT30075465 06/30/2022 Project No: Inspection Requests Phone (949)644-3255 Code Edit: 2019 Worker's Compensation Insurance Carrier: TRAVELERS INS Policy No: UBBP9084102126G Expire : 04/01/2022 AmmOS( eaee. maove C 4 O OU.�9 i0 O . 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. FEES New Construction Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Residential Receptacles/Outlets: 1 $1.75 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 Mgmt Fee: $0.00 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 Plan Check Fee: $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Piggy Back/Temp 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: $37.00 O/H to U/G 0 $0.00 Additional Fee : $0.00 Supplemental Fee: $0.00 TOTAL Fee: $38.75 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $38.75 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. 1INER-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) 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 )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). 1, 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, siness 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 )rovements 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 )1y 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: 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 legally I 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 ffessions Code, ls'a'vailable upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.html. nature, of Proptsft90wner or Authorized Agent Date R1114ED CQ",%CTOR'S DECLARATION :reby affirm vnderpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professi s Code, a y license is in full force feet. ar%9 Class License No Date 0602 /4A21 Contractor Signature )RISERS' G'OMPETISATION DECLARATION —� WING: FAILURE 10 SFC}IRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,0001, IN ADDITION TO THE iYOf COMPENlATION, VAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. neby affirm under penalty of perjury one of the following declarations: i have and will mnlntain 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 rmance oftlip.,RorP forwhich this permit is issued. Policy No. . ,... Aave and wilt 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 rce carrier and Dplicy number are: Policy Number 1e of Agent Date certify that, in the perfor nce of the work for which thi mit 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 t, if I should become But ect t/o�1�e�v0rkers' com to s of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant ////4-' �/ py Date Abblnt loo CLARATION DIN CONSTRUCTICKLENDINCrAGENCY :reby affirm under penalty of perjury that there is a construction lending agency for the performance of the work forwhich 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 ands to laws relating to building construction. _ authorize representatives of this city or county e r the abov en operty for inspection purposes. p,,`�/_ T / /,,f, nature of PmDertv Owner or Authorized ADent /�ti Print Prooertv Owner's or Authorized AOent's Name S�rplYe2 IYQ,Y me,`u' Q Date 06 120 ACTION DATE L BY U€CLAHALION OF COMPUANCL Wf f H COU) OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40AND AQMD RULE 1403. PERMIT EXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO:. ❑ EPA El AQMD PERMIT CANCELLED PERMfT EXTEhfDED POSED DASBESTOEMOLITION. 770N f5 NOT APPLICABLE TO SIGNATURE-,, PERMIT FINAL -ZI OCCUICATEOF OCCUPANCYISSUED