HomeMy WebLinkAboutE2021-0656 - PermitsYI, - City of Newport Beach - Building Division *E2021-0656* Electrical Permit: E2021-0656
�4' �+ 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 1604-2021
.. ;?;-, Permit Counter Phone (949)644-3288
r°araa,a�t 1 ECT Inspection Requests Phone (949)644-3255
Job Address: 600 ST JAMES PL Bldg: 1 Floor: Suite: 30* WIDE X 36" DEPTH °
Description of Work: ELECA/C DISCONNECT (H2O21-0569) °°e.m°
e
Inspector Area: 3
Legal Description: N TR 1218 LOT 30
Owner: STROLLO RICHARD
Contractor:
Address: 600 ST JAMES PL
Address:
NEWPORT BEACH, CA 92663
Phone:
Phone:
Con State Lic:
Issued Date:10/01/2021
Lic Expire:
Bus Lic:
Processed By:-6-5 IOR
Lic Exp Date:
New Construction
Residential
Multi -Family:
1-2 Family:
Service
0-600V up to 20OA: 0
0-600V over 20OA: 0
Over 600V or 1000A: 0
O/H to U/G 0
REQUIRED FOR
A/C DISCONNECTS
KLONDIKE AIR INC
1308 LOGAN STE E
COSTA MESA CA 92626
714.979-2070
754456
09/30/2022
BT30060482
09/30/2022
Receptacle/Switch/Outlets
Receptacles/Outlets:
0
$0.00
$0.00
Fixtures:
0
$0.00
$0.00
Sep Circuits:
0
$0.00
Low Voltage
0
$0.00
Signs
$0.00
Branch Circuit:
0
$0.00
$0.00
Each Add Circuit:
0
$0.00
$0.00
Time Clocks:
0
$0.00
$0.00
Additional Fee :
$0.00
$67.00
Plan
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Code Edit: 2019
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Worker's Compensation Insurance
Carrier: FALLS LAKE FIRE & CASUAL
Policy No: FLA00809502
Expire : 0110112022
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,
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
Temp Underground:
0 $0.00
Sub Panel:
1 $29.00
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: Monday- Friday 7:00 a.m. to 6:30 p.m, and Saturday from 8:00 a.m. to 6:00 p.m.
IWNER-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
IS 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
'rofessions 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
of more than five hundred dollars ($500).
7 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,
lusiness 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
nprovements4a g4:ntended or offered for sale. If, however, the building or improvement is'sold with h oge.year of completion; the Owner -Builder will have the burden of proving that it was not built or
�n roved for the purpose of sale).
1'4 ownej 6MMI property, am exclusively contracting with licensed Contractors to construct thL project (Section, 7644„ 4siness and Professions Code: The Contractors' State License Law does not
pplyto an ownel•ofproperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
4a!n exempt from licensure under the Contractors' State License Law for the following reason: ` A
ly my signature' bolow I acknowledge that, except for my personal residence in which I must have feslde'd for at lda6to ng year prior to completion of the improvements covered by this permit, I cannot leg all)
ell a structure "4 Lhave 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
'ro%ssions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
{6j119tpre of Prep"-Dwner or Authorized Agent Date
MENSED CONTRACTOR'S DECLARATION
1:0reby 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 Professions C de, and my license is in full force
nd effect. . .
.IGeaSe Class . • • License No Date 2 Contractor Signature
uORkERS'.(:QMp.ENSATION DECLARATION
rARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
�OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
7 I 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 th
�rformance of the work for which this permit is issued. Policy No.
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 issued. My workers' compensatiol
urance c_q,rrie and policy umber are: 1 p f
;arrier �''\��� v`1 Policy Number � `, k or "0 �'�y� Expiration Date
of Agent
certify that, in the performance of the
if I should become subject to the wo
of
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 agre
compe sation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
�" Date K
DECLARATION REGARDING GUN5I KUG I IUN LCNUINU A�LNCT
I hereby affirm under penalty of perjury that there is a construction lendingage ncy for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Name Lender's Address
By my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owner's behalf.
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and county ordinanc s and state laws relating to building construction.
I authorize representatives of this city or county to mer the ove-identified property for inspection purposes.
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Date < <Z'
AC77ON
LATE
BY
DECLARATION OF COMPLIANCE M TN CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TITLE40 AND
AQMD RULE 1403.
❑ I SUBMITTEDASBESTOS NOTIFICATIONTO:.
❑ EPA
❑ AQMD
PERMIT EXPIRED
P
PERMIT CANCELLED
PERMIT EXTENDED
❑ ASBESTOSNOTIFfCATtONtS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE:
PERMIT FINAL
CERTIFICATEOF
OCCUPANCYISSUED