HomeMy WebLinkAboutE2000-1364 - PermitsCity of Newport Beach
Building Department
ELECTRICAL Permit No: E2000-1364
PO Box 1768/3300 Newport Blvd, Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288 Inspection RequestsTelephone (949)644-3255
Job Address:1 HOAG DR
Inspector Area: 7
Owner:
Address:
Phone:
Bldg: 1 Floor: Suite:
Code Edit: 96 Legal Desc.:
HOAG MEMORIAL HOSPITAL
1 HOAG DR
NEWPORT BEACH CA 92658
949/574-4488
Receipt #: 10/18/2000
Processed By
Desatption of Work: SITE LIGHTING "LOWER CAMPUS"
2266-2000
INSPECTOR NOTES:
Contractor: _ WATSON INVESTMENT DEVELOPMENT
Address: 18182 SERRANO AVENUE 4-4-1,- "elai7 vv®L/
VILLA PARK CA 92667 ��1+9 6!
43602
436023 t P.Z ,4t44) o&T /Yc,zry o
714/974-6421
BT98038807 ,j ,j� 03/31/2001 & 4 n iuuda
10/31/2000 - - -
FEE
Phone:
Con. State Lic.
Lic Expire:
Bus. Lic.:
Lic. Exp Date:
New Construction
Residential
Multi -Family
1-2 Family
0
0
Receptacle/Switch/Outlets
Recep/Outlets 57 $38.95
$0.00 Fixtures 57 $38.95
$0.00 Sep Circuit 3 $10.80
rvrce Skins
0 to 600V up to 200A 0 $0.00 Branch Circuit 0 $0.00
0 to 600V over 200A 0 $0.00 - each Add Circuit 0 $0.00
Over 600A/1,000A 0 $0.00 Time Clocks 0 $0.00
TOTAL: $130.85
Motors/Transformers (HP/KVA)
0 to 1 HPIKW/KVA
1 to 10 HP/KW/KVA
10 to 50 HP/KW/KVA
50 to 100 HP/KW/KVA
over 100 HP/KW/KVA
Piggy Back / Temp Power
PAYMENT: $130.85
Temp Power Pole 0 $0.00
$0.00 Temp Underground 0 $0.00
$0.00 Sub Panel 0 $0.00
$0.00 0 $0.00
$0.00 0 $0.00
$0.00 Record Managment Fee : $0.27
Investigation Fee $0.00
$0.00 Plan Check $22.18
Issuance $19.70
Supplemental Fee $0.00
BALANCE: $0.00
I ICENSED CONTRACTORS DECLARATION
_I hereby affi-m under penalty of perjury that I am licensed under provisions of Chapter 9 icommencing with Section 7000) of Division 3 of the Business and Professions code,
and my license is in fullforce and effect.
License No: 436023 Claw: Contractor: sy/1RON INVESTMENT DEVELOPMENT
WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations:
_I have and will maintain a certificate of consent to self -insure for workers compensation, as provided for by Section 3700 of the labor code, for the performance
of the work for which this permit is issued.
I have and wil! 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 compensation insurance carrier and policy numbers
Curter - racy number. WC EXEMPT Expire : - - - - - - - -
This section need not be completed if the permit is for one hundred dollars ($100) or less.
I 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 compensation laws
of California, and agree that if 1 should became subject to the workers' compensation provisions of Section 3700 of the tabor code, 1 shall forthwith comply vath those provisions.
Date: Applicant Signature:
Warning: Failure to secure workers compensation coverage is unlawful, and shall subject an employer to amino] penalties and civil fines up to one hundred
($100,000), in addition to the cost of compensation.damages as provided for in Section 3706 of the labor code. interest, and attorneys fees.
hereby acknowledge that I have read this application; that the information given is correct: and that I am the owner, aduly authorized agent of the owner. I agree to
comply with city and state laws regulafing construction; and in doing the work authorized thereby, no person will be employed in violation of the labor code of the state of
California relating to workmen's compensation insurance. - -- - - - - - - - -
Permittee Name (Print) - Address :
Signature of permittee: Date:
Approvals
Grounding Electrode
Underground -.
Underslab/Floor
Rough Conduit Walls
Rough Wiring Ceilings
Rough Service
Temp Power
Utility Co. Notified
Final
Inspector/Date
/e
WORK MUST BE STARTED WITHIN A PERIOD OF 180
DAYS FROM THE DATE OF VALIDATION OR THIS
PERMIT BECOMES NULL AND VOID..