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Home My WebLink AboutE2019-0821 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive. Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 200 MARSALA DR Bldg: 1 Floor: Suite: Description of Work: ELEC *BLDG 6* REPLACE DISCONNECTS (H2O19-0785) UNITS 200-215 Inspector Area: 8 Legal Description: TR 12309 LOT 5 POR OF LOT IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II Electrical Permit: E2019-0821 E 2 0 1 9 0 8 2 1 Project No : Owner: IAC AT JAMBOREE LLC Contractor: U M AIR INC Address: PO BOX 2450 Address: 12211 WOODRUFF AVE NEWPORT BEACH CA 92658 DOWNEY CA 90241 Phone: Phone: 562-413-1235 Receptacles/Outlets: Con State Lie: 1050013 Issued Date• 2/06 019 Lie Expire: 02/28/2021 0 $0Colo, 0 Bus Lie: BT30061455 Processed y: Lie Exp Date: 12/31/2019 New Construction Residential Multi -Family: 1-2 Family: Service 0-600V up to 20OA: 0 0-600V over20OA: 0 Over 600V or1o00A: 0 O/H to U/G 0 TOTAL Fee: Inspection Requests Phone (949)644-3255 Worker's Compensation Insurance Carrier: NATIONAL LIABILITY Policy No: A9WC045079 Expire : 09/13/2020 ° c000°c D Plan Check Fee : 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. FEES Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $0Colo, 0 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: ,z � $324.0&, $0.00 Sep Circuits: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 0 $0°R0, ° Low Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 °0 WWI Signs Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: °°°o° $0,U00 ` $0.00 Branch Circuit: 0 $0.00 Plan Check Fee: ° $0,11%. $0.00 Each Add Circuit: 0 $0.00 Piggy Back/Temp Power: 0 $0.00 Investigation Fee: $010>° $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $35.00 $0.00 Additional Fee : $0.00 Supplemental Fee: $0.00 Plan Check Fee : 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. 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). ❑ 1, 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 legalh 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.html. 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. ///fff License Class License No ,��,,,��_.61/ `1 / Contras iter Signature WORKERS' COMPENSATION DECLARATION 1 V NARNING: 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 9706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm uodarpenalty of perjury one of the following declarations: 0 I�F�ave 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 th P40 Df-t he'work for which this permit isissued. Policy No. 2A% e and wig maintain workers' compensation insurance, as required y Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatioi am��r and olij� umbe are �/}(y� /'� Cgrri2r aPl�a' %i'�A�/a� . i �t � olicy Number V 4—rfe- -57 r_9 Expiration Date Naf g of Agent, Phone # •.... ®I0ce6rtify 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 agre t%sf° if I should become subt the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. l b l� Sif natyre i-Qate !y Ql59bARATIO117GARDING CONSTRU CTION LENDING AGENCY I hereby affirm d gr Qenalty of perjury that there is a construction lending agency for the performance of the work for which this permit is iss Ction 3097, Civil Code). I'antpr'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 represe flues -D his cit ¢.tWe� he above -identified property for inspection purposes. nature of Property Owner or Aut orized Agent G Print Property Owner's or Authorized AgrA's Name ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODLjOF FOR OFFICE FEDERAL REGULATIONS PART 61 OFTITLE4 PERMITEXPIRED AQMDRULE1403. ❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO: PERMITCANCELLED ❑ EPA PERMITEXTENDED ❑ AQMD ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PERMf(ANAL t( 1.t PROPOSED DEMOLITION. OCCUPANCYISSU€D SIGNATURE: