HomeMy WebLinkAboutE2022-0218 - Permitssr� City of Newport Beach - Building Division
o+ 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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Job Address: 417 HELIOTROPE AVE Bldg: 1 Floor: Suite:
Description of Work: ELEC/PIGGY BACK
Inspector Area: 5
Legal Description: CORONA DEL MAR LOT 13 BILK 334(NELY 5 FT LOT 11 BLK334
Owner: 417 HELIOTROPE AVE LLC
Address: PO BOX 10398
FULLERTON CA92838
Phone:
Issued Date:04/07/2022
Processed
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II Electrical Permit: E2022-0218
E 2 0 2 2 0 2 1 8 Project No : 0638-2020
Contractor:
BJ SCOTT & ASSOCIATES INC
Address:
P 0 BOX 297
YORBA LINDA CA 92885
Phone:
714-779.8886
Con State Lic:
718333
Lic Expire:
01/31/2022
Bus Lic:
BT30067214
Lic Exp Date:
04/3012023
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:
0
$0.00
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
FEES
Inspection Requests Phone (949)644-3255
Code Edit: 2019
Worker's Compensation Insurance°
Carrier: NO EMPLOYEES
Policy No: BRADLEY SCOTT
Expire
ii
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: 1 $41.00
Temp Power Pole: 0 $0.00
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:
$0.00
Supplemental Fee:
$12.00
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.
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OWNER -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 th7civilPenalty
ble 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 ree applicant for
the 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 Divisioe 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 applicivil penalty ofnot more than five hundred dollars ($500).
I,as owner of the property, or my employees with wages as their sole compensation, will do `) all of or U portions of the work, and the structure is not intended or offered for son 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 propided that theimprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner-Builderwill have the burden of proving ts not built or
improved 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.htmi.
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 Professions Code, and my license is in full force
and effect.
License Class License No Date L/ 1 Contractor Signate
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED 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:
❑ 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
performance of the work for which this permit is issued. Policy No.
❑1 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' compensatio
insurance carrier and policy number are:
Carrier Policy Number Expiration Date
14 Name of Agent Phone #
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 agre
th , if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provi
Signature of Applicant AV' D el ? Z
DECLARATION R Gf RDTNG CONSTRUCT0NNFEENEMING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency 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 ordinances and state laws relating to building construction. j-� ZIA t ` 7
I authorize representatives of this city or co to enter the above -identified property for inspection purposes. �> 6:, �7 z
Signature of Pro ert Owner or Authorized Age - Print Property Owner's or Authorized Agent's Nam Date
ACTION DATE BY DECLARATION OF COMPLtANCEINITHCODE OF FOR OFFICE USE
ONLY
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PERM17'.EXPIRED
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