HomeMy WebLinkAboutE2020-0097 - PermitsCity of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Job Address: 1021 BALBOA BLVD W Bldg: 1 Floor:
Description of Work: ELEC TEMP POWER POLE
Inspector Area: 1
Legal Description:
Suite:
Owner: DA LIU DAVID & PENG TINA Contractor:
Address: 1021 W BALBOA BLVD Address:
NEWPORT BEACH CA 92663
Phone: Phone:
Con State Lic:
Issued Date:02/19/2020 Lic Expire:
Bus Lic:
Processed By: Lic Lic Exp Date:
New Construction
Residential
Multi -Family:
1-2 Family:
Service
0-600V up to 20OA: 0
0-600V over20OA: 0
Over 600V or1000A: 0
O/H to ]JIG 0
Fee
I II �IE II I VIII 0�I � ILII III �I�III 0�III 0�II� I I II7 II
GONTERMAN CONSTRUCTION
1842 PARK ST
NEWPORT BEACH CA 92648
949-697-0746
858073
04/30/2021
BT30048414
09/30/2020
Receptacle/Switch/Outlet
Electrical Permit: E2020-0097
Project No: 2519-2019
Inspection Requests Phone (949)644-3255
Code Edit: 2016
Worker's Compensation Insurance
Carrier: STATE COMP. INS
Policy No: 9259518
Expire : 08/22/2020
Receptacles/Outlets:
0
$0.00
Fixtures:
0
$0.00
Sep Circuits:
0
$0.00
Low Voltage
0
0
Signs
$0.00
$0.00
Branch Circuit:
0
$0.00
Each Add Circuit:
0
$0.00
Time Clocks:
0
$0.00
Additional Fee :
$0.00
Electrical Permit: E2020-0097
Project No: 2519-2019
Inspection Requests Phone (949)644-3255
Code Edit: 2016
Worker's Compensation Insurance
Carrier: STATE COMP. INS
Policy No: 9259518
Expire : 08/22/2020
Plan Check
Temp Underground:
FEES
$0.00
Sub Panel:
s
Motors/Transformers (HP/KVA)
$0.00
0 to 1 HP/KW/KVA:
0
$0.00
$0.00
1 to 10 HP/KW/KVA:
0
$0.00
$0.00
10 to 50 HP/KW/KVA:
0
$0.00
$0.00
50 to 100 HP/KW/KVA:
0
$0.00
Over 100 HP/KW/KVA:
0
$0.00
$0.00
$0.00
Piggy Back/Temp Power:
0
$0.00
$0.00
Temp Power Pole:
1
$39.00
$0.00
Plan Check
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:
$35.00
Supplemental Fee:
$0.00
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.
Issuance:
INER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 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 items)
ction 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).
I, as owner of the property, or my employees with wages as their sole compensation, will do (•_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
liness 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
ily to an owngl•dNbfaperty 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 Mlicensure under the Contractors' State License Law for the following reason:
m9 Sonature.ITekly?: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 legalll
a structure thehl 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
�fesgiGns Code, is available upon request when this application is submitted or at the following Web site:http://www. leginfo.ca.gov/calaw. html. ate
natlfre of Propgrty Owner or Authorized Agent
'f NgED CONTIFRCTOR'S DECLARATION
weby affirm ander penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with action 7000) of Division 3 of the Business an Profes ' Code, and my license is in full force
,;�P. Class •"�'• License No Date �v`� Contractor Signatur
JRK6�LRS' COMPENSATION DECLARATION
2911,10 rAILURE.TO SFC&E WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED OUSAND DOLLARS ( IN ADDITION TO THE
iT OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
e...
�� b y affirm under"nalty of perjury one of the following declarations:
I have and will Wiintain 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
Jonnance of the work for which this permit is issued. Policy No.
Nyave 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' compensatio
urance carrier and policy number are:
EtD t
ra on a e
rier Policy Number xplI
Phone #
ne of Agent
certify that, in the pertgrmance f t e work for which this permit is issued, I shall not employ any person in any manner so as to become subject tot a workers' compensation laws of California, and agre
I, if I should become s bject t the orkers' compensation provisions
of Section 3700 of the Labor Code, I shall forthwith comply with those provis10 s.
!�v
Applicant
Date
nature of
CLARATION REGA DING C N LENDING AGENCY
ereby affirm under penalty o erj ry that there is nstruct' ertYt rig agency for the performance of the work for which this permit is issued ( action 3097, Civil Cade).
Ider's Name
Lender's Address
my signature below, I certif to ach of the following
I am the property owner I orized to act on the prope
wner's behalf.
I have read this application and the information I have vi
ed is correct.
I agree to comply with all applicable city and county ina ces and state laws relating to building construction. _
to er t above -identified property for inspection purposes.
I authorize representatives of this city or county
nature of PropertOwner or Authorized A ant
Print Property Owner's or Authorized Agent's Name
By
DECLARATION OF COMPLIANCEMTHCODEOF
FOR OFFICE USE ONLY/
AC770AI DATE
FEDERAL REGULATIONS PART 61'OFTITLE40AND
AQMD RULE 1403.
❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO.
❑ EPA .
❑ AQMD
❑ ASBESTOS N077RCA110NIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMITEXPIRED
PERMITCANCELLED
PERMIT EXTENDED
I ERMITRNAL
CERTIFICAT€OF
SIGNATURE:
OCCUPANCYISSUED
_