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Home My WebLink AboutE2021-0435 - Permits�w City of Newport Beach - Building Division ' 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 �'�LSri1A�`3 Job Address: 1121 KINGS RD Bldg: 1 Floor: Suite: Description of Work: ELEC/CHANGE OUT (E) SERVICE PANEL TO 200 AMP[ Inspector Area: 3 Legal Description: P BK 51 PG 7 PAR 1 Owner: AZADIAN GHASSEM Contractor: Address: 1121 KINGS RD Address: NEWPORT BEACH, CA 92663 Phone: Phone: Con State Lic: Issued Date:07/22/2021 Lic Expire: Bus Lic: Processed By: Lic Exp Date: II �E III II�II 0�I�� I��I III �I�III 0��II 4I III�I 5I II J P T CONSTRUCTION INC 409 62ND ST NEWPORT BEACH CA 92663 714-336-1966 879360 06/30/2022 BT30014788 01/31/2022 New Construction Receptacle/Switch/Outlets Residential Receptacles/Outlets: 0 $0.00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1-2 Family: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Service Signs 0-600V up to 20OA: 1 $47.00 Branch Circuit: 0 $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 O/H to U/G 0 $0.00 Additional Fee : $0.00 TOTAL Fee: $85.00 Ptnn Electrical Permit: E2021-0436 Project No : Inspection Requests Phone (949)644-3255 Code Edit: 2019 d Worker's Compensation Insurance Carrier: WESCO M Policy No: WWC3520405 Expire : 04/07/2022 X FEES Motors/Transformers (HP/KVA) 0 to 1 HP/KW/KVA: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 Over 100 HP/KW/KVA: 0 $0.00 Piggy Back/Temp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Fee : 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: $38.00 Supplemental Fee: $0.00 Fee Due at Permit PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Wnday - Fri06y 7®QQ a.m,tq%3,0,p.m. and Saturday from 8:00 a.m. to 6:00 p.m. m o 4 O O O Of 4 �O 4 A 6.d£ 00 4 00 O G[O O G OY• WO OUC 094 rOG U G C4.0 yI (.V DWNER-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 :he 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 :lot more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U 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 mproved 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 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 legal) 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.htm]. 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 Profess do s Co e a y lice y se is in full force and effect. License Class License No Date "r �" 2 ` Contractor SignatW� WORKERS' COMPENSATION DECLARATION \ NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HU ED THOUSAND DOLLARS ($100,000(, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the Vperfor ante of the work for which this permit is issued. Policy No. have and will maintain workers' compensation insWance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier afiftolicy number are: ,_ / \ /) le of Agent certify that, in h rprfrmace f the if I should become subjpeYto the wo of Date er�ssued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. )ZZ 1,L CLARATION REOARD penaA �fSG N RUCTION LENDING AGENCY AGENCY r�ee+'S L :reby affirm under penal/ty,�f fury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Ider's Name Lender's Address my signature below, I ertify to each of the following: I am the property owner or authorized to act on the property ow I have read this application and the information I have provided I agree to comply with all applicable city and county ordi nce I authorize representatives of this city or county to �e a� of Property Owner or Authorized elating to building construction. property for inspection purposes. Owner's Name ACTION DATE BY DECLARATIONOF COMPLIANCE VATH CO FEDERAL RE NSPARj 6? OF TITLE 4VAIn AQMDRULE9 03. - ❑ isuBmiM4)4s$ES'TctstioDF1GA*'i(il TOi ❑ EPA* ❑ AQMD' ❑ ASBESTOS NOTIFICATIONIS NOT APPLICABLE TO PROPOSED DEARJLffM.• , • e •. o , SIGNATURE: •• ••• • • •• •• ••+ FOR OFFICE USE ONLY PMITEXPIRED ER PERMIT CANCELLED PERMITEX7ENDE0 PERMITFINAL CERTIFICATEOF OCCUPANCYf55UED