HomeMy WebLinkAboutE2001-0657 - PermitsCity of Newport Beach
Building Department ELECTRICAL Permit No: E2001-0657
PO Box 1768/3300 Newport Blvd, Newport Beach, Califemie 92658-8915 Permit Counter Telephone (949)644-3288 inspection RequestsTelephone (949)644-3255
Job Address: 1 HOAG DR Bldg: 1 Floor: Suite:
Inspector Area: 7
New Constr
Residential
Multl-Fa
1-2 Family
Code Edit: 96
BEACH CA 92660
Legal Desc.:
Contractor:
Address:
Phone:
Con. State Lic. :
Lic Expire:
Bus. Lic.:
Lic. Exp Date:
Receptacle/Switch/Outlets
Recep/Outlets 3 $2.79
O $0.00 Fixtures 2 $1.86
O $0.00 Sep Circuit 1 $3.60
Service
0 to 600V up to 200A 0 $0.00
0 to 600V over 200A 0 $0.00
Over 600A/1,000A 0 $0.00
MOTORS DECLARATION
Signs
Branch Circuit 0 $0.00
each Add Circuit 0 $0.00
Time Clocks 0 $0.00
TOTAL: $34.60
PAYMENT: $0.00
BRIGGS ELECTRIC INC
16662 MILLIKAN AVENUE
IRVINE CA 92714
949-863-9901
297836
0/3/31/2001
BT00003629
12/31/2001
FEE
Descriptlon of Work: ELEC/OUTLETS/FIX/SEP CIR(PARKING STRUC)
1109-2001
INSPECTOR NOTES:
Inspector
Motors/Transformers (HP/KVA) Temp Power Pole 0 $0.00
0 to 1 HP/KW/KVA $0.00 Temp Underground 0 $0.00
1 to 10 HP/KW/KVA $0.00 Sub Panel 0 $0.00
10 to 50 HP/KW/KVA $0.00 0 $0.00
50 to 100 HP/KW/KVA $0.00 0 $0.00
over 100 HP/KW/KVA $0.00 Record Managment Fee : $4.59
Investigation Fee $0.00
Piggy Back / Temp Power 30.00 Plan Check $2.06
Issuance $19.70
Supplemental Fee $0.00
BALANCE: $34.60
con 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,
cense is in fullforce and effect.
0: 297836 Clans: Contractor: BRIGGS ELECTRIC INC
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 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 rssued.
My workers' compensation insurance carrier and policy numbers is:
Cartier: FIDELITY E. GUARANTY Policy number: DRE3317400 Expire: 07/01/2001
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 wpt< for which this oermi is Issued, I shall not employ any person in an 'ginner so as to become ct to the workers' compensation laws
of Cakfomia, and at if I shaj d becbme_subjc a tc the'eskers compensation provisions of Section of the labor code, I s hwnth comply with those provisions.
e: (0-7_0( Applicant Signature:
Warning: Failure to secure workers compensation coverage is unla ul, and shall subject an emplo - to criminal pe ,r'- an 'WI belt u one hundred
($100.000), in addition to the cost of compensalion,damanes asprovidc l for LI AYion 3706 of the labor code, interest. and attorney's fees.
I hereby admOMA. dgc tha.. I have read cots ap' icatian; thrt the inhrrr:tio.. give.. is correct; and that I am the owner, or duly authorized agent of the owner. I agree to
comply with city add ware laws regi iatirg.er t,uctior; a..d il. do,g Lie work arnhaizel thereby, no person WAIT be employed in violation of the labor code of the slate of
California r ing tc workmy's compfnsatii...surancu.
ePermittee Name P 'nt)• < C Address
ure of permitter,:
6-7-0 (
Approvals
Grounding Electrode
Underground
U nderslab/Floor
Rough Conduit Walls
Rough Wiring Ceilings
Rough Service
Temp Power
Utility Co. Notified
Final
Inspector/Date
WORK MUST BE STARTED WITHIN A PERIOD OF 180
DAYS FROM THE DATE OF VALIDATION OR THIS
PERMIT BECOMES NULL AND VOID.
ys/f23