HomeMy WebLinkAboutE2020-0383 - PermitsCity of Newport Beach - Building Division I�IIIIIII�III�II�III�III�III�III�IIIIIIII�III Electrical Permit: E2020-0383
0 100 Civic Center Drive, Newport Beach, CA 92660 Project No
Permit Counter Phone (949)644-3288
c:�z anK''a Inspection Requests Phone (949)644-3255
Job Address: 1218 DOVER DR Bldg:1 Floor: Suite: ,�
Description of Work: ELEC PANEL UPGRADE 200 AMPS SP
Inspector Area: 3 Code Edit:2019 �7c
Legal Description: N TR 3000 LOT 72
Owner: BRUNWICK BRYAN Contractor:
Address: 1218 DOVER DR Address:
NEWPORT BEACH, CA
Phone: Phone:
Con State Lie:
Issued Date:07/30/2020 Lie Expire:
(� Bus Lie:
Processed By: L` Y Lie Exp Date:
NEW QUEST ELECTRIC INC
Worker's Compensation Insurance
......
1891 SOUTH RESERVOIR ST
Carrier: NORGUARD
°
m
POMONA, CA 91766
Policy No: NEWCD74346
°
909-6705199
Expire:0912712020
1044759
09/30/2022
°a°Aa
BT30072577
"wm«.aa
07/30/2021
as
°°°°°m
unm
romxe°A
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
$45.00
Branch Circuit:
0
$0.00
0-600V over 20DA:
0
$0.00
Each Add Circuit:
0
$0.00
Over 600V or 1000A:
0
$0.00
Time Clocks:
0
$0.00
OM to U/G
0
$0.00
Additional Fee:
$0.00
TOTAL Fee:
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 Backrremp Power: 0 $0.00
Temp Power Pole: 0 $0.00
Plan Check 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:
$36.00
Supplemental Fee:
$0.00
Fee Due at Permit Issuance :
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday- Friday7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m, to 6:00 p.m.
I hereby affirm under penally of perjury that I am exempt from the Contractors' State License Lawfor the reason(s) indicated below by the checlanark(s) I have placed next to the applicable itsm(s)
Section 7031.6, 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
to permit to file a signed statement that he or she is licensed pursuant to the previsions of the Conhaetare' State License law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
'rofeesions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.9 by any applicant for a pemtit subjects the applicant to a ciYP penalty of
of more than five hundred dollars (5500).
1, as owner of the properly, 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 forsale (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, bulds or improves the property, provided that the
nprovements are not intended or offered for sale, If, however, the building or improvement is sold within one year of completion, the OwnervBullderwill have the burden of proving that it was not built or
nproved for the purpose of sale).
31, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044. Business and Professions Code. The Contractors' Stab•. License Law does not
ipplyto an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contactor pursuant to the Contractors' State License Law).
] lam exempt from ficensure underthe ContracWrs'Slate License Law for the following reason:
ly my signature below 1 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 bythis permit, I cannot legally
ell a SWChure 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
'iofessions Code, is amicable upon request when this application is submitted or at the following Web slte:http:/Avww leg'rrrto.cagov/giaw.hfml.
ilgnature of Property Owner orAutharized Agent Date
JCENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing wVh S fort 7000) of Division 3 of the Business d Professions Cod and m' tic= se is in full force
nd effect
.lcense Class C 1 0_ License No 1044759 Data /30/2020 Contractor Signature
PORKERS' COMPENSATION DECLARATION
iARNING: FAILURR TO SECURE WORKERS'COMPENBAnON Cowa AGE1a UNLAWFUL, AND SMALL SUe3EC MEMPLO T CRIN14ALPBNALTIESANDCMLMNESUPTC011NUN RfDiNOUSAN0n0tIARRI$IW*MO INAOOnIONTO'me
OSTOFCOWENBATON, aAMAGESAS PROVIDED RORINSECTION 3MG OF TUELABCRCODE,MnF,WT, ANDATrOf WErSFEES.
hereby affirm under penalty of perjury one of the following declarations:
7 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
efiforrnance of the work for which this permit is Issued. Policy No.
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'
or Nor Guard Insurance Co Policy Number Newc074346 Expiration Date 09/27/2020
e of Agent Phone A
certify that, in the perform ace, of the work forwhich permit is issued, I shall not employ any person in any mannerso as to become subject to_ t e workers' compensation laws of California. and agree
if I should become,s`ubj to the workers' pe at provisions of Section 3700 ofthe Labor Code, I shall forthwith complywith those pr r s1
ature afAppitca/i, _ Date 07/30/2020
LARATION REnt_ \ G CQNSTRIUCMN LENDING AGENCY
_by affirm under perplity\of perjury that them is a construction lending agencyforthe performance of the work forwhich this permit is issued (Section 3097, Civil Code)
By my signature below, I certify to each of the foilowing:. _........ _..
1 am the property owner or authorized to act on the property owner's behalf.
1 have read this application and the information I have provided is correct.
1 agree to compywth all applicable city an$d�oou99��Py ordinances a state laws relating to building construction.
authorize representatives ofthis city or cout�,yiyr"r ab entitled property for inspection purposes.
Signature of Property Owner orAuthor¢ed Agent \\\0 Print Property Owner's orAutholizeciAgertt's Name Drl
ACTION
OA}E
BY
DECLARA770N PIJAfIC tWTN COD€D
FSDER41 REGMATIWSPART Bf OFTI7LE44AND
AQMDRULEI40M
❑ 1SLBMffFIfDASSESTOSNONFICAi7ON7iT,
❑ EPA
3ASBESTOS NT�M71'ONIS NOTAPPUCA8LE 70
SIGNATURE.
FDR40ERCEWEMY
PERNIff'EKPIREO
PeWITCANCELEM
PERM((F
�. Zp
CER77FWATEOf
OCCUPANCYI SSUED