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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 _