HomeMy WebLinkAboutE2022-0181 - PermitsCity of Newport Beach - Building Division I 1111111111111111111111111111111111p11111p11111111111 Electrical Permit: E2022-0181
100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 2 0 1 8 1 Project No
Permit Counter Phone(949)644-3288
Job Address: 821 HIBISCUS CT Bldg: 1 Floor: Suite:
Description of Work: ELEC EV CHARGER IN GARAGE
Inspector Area: 6
Legal Description: N TR 12245 LOT 28
Owner: PROKOCKI BETH
Contractor:
Address: 821 HIBISCUS CT
Address:
CORONA DEL MAR, CA 92625
Phone:
Phone:
Con State Lic:
Issued Date:03/22/2022
Lic Expire:
Bus Lic:
Processed By:
Lic Exp Date:
INO
THE ELECTRIC CONNECTION
9937 COMMERCE AVENUE
TUJUNGA CA 91042
818.446-0888
406002
09/30/2023
BT30073295
10/31/2022
Inspection Requests Phone (949)644-3255
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Code Edit:2019
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Worker's Compensation Insurance
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Carrier: INS. CO. OF THE WEST
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Policy No: WVE505631101
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Expire : 07/01/2022
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FEES
New Construction
Receptacle/SWitch/Outlets
Motors/Transformers (HP/KVA)
Residential
Receptacles/Outlets:
2
$3.50
0 to 1 HP/KW/KVA:
0
$0.00
Temp Underground:
0
$0.00
Multi -Family:
0
$0.00
Fixtures:
0
$0.00
1 to 10 HP/KW/KVA:
0
$0.00
Sub Panel:
0
$0.00
1-2 Family:
0
$0.00
Sep Circuits:
2
$14.00
10 to 50 HP/KW/KVA:
0
$0.00
0
$0.00
Low Voltage
0
$0.00
50 to 100 HP/KW/KVA:
0
$0.00
0
$0.00
Service
Signs
Over 100 HP/KW/KVA:
0
$0.00
Record Mgmt Fee:
$0.00
0-600V up to 20OA:
0
$0.00
Branch Circuit:
0
$0.00
Plan Check Fee:
$0.00
0-600V over 20OA:
0
$0.00
Each Add Circuit:
0
$0.00
Piggy Back/Temp Power:
0
$0.00
Investigation Fee:
$0.00
Over 600V or 10o0A:
0
$0.00
Time Clocks:
0
$0.00
Temp Power Pole:
0
$0.00
Issuance Fee:
$38.00
O/H to U/G
0
$0.00
Additional Fee :
$0.00
Supplemental Fee:
$0.00
TOTAL Fee:
$55.50
Plan Check Fee : $0.00
Fee Due at Permit Issuance :
$55.50
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.
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 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
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 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
not 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 (_) 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-Builderwill have the burden of proving that it was not built or
improved fo T�tN@ Qtrpose of sale).
I�as ownetbf Pile property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
applvo an cv npr Cf"property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I am exe4t Cram licensure under the Contractors' State License Law for the following reason:
Fly 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 legalh
set t structuresthabl-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
Profe,isions Cq,W, i?available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
gara Lire of Propegy"Owner or Authorized Agent Date
LIGENSED CONTI,CACTOR'S DECLARATION
ber#8y affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with ec ion 70 0) of Division 3 of the Businessiand Profes� n my icense Is In full force
a;�gffect.
License Classi ': License No Date z� Contractor Signatur
W"O,IjiERS' CAMP"ENSATION DECLARATION
NARNING: FAILUI?TQSEGURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
C"d$t bF COMPENWKION!DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
Z�ce
m under penalty of perjury one of the following declarations:
nd 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
of the work for which this permit is issued. Policy No.
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'
carrier and policy number are: —�
Policy
Date
ame of Agent rnone x
I certify that, in the performance oft rk for i 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
Iat, if should becom bject t e r compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ignature of Applicant
Date
DECLARATION REG CTION LENDING AGENCY
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 (Secti n 097, Civil Code).
ender's Name Lender's Address
y my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owners behalf.
I have read this application and the information I hav provided is correct.
I agree to comply with all applicable city and co�unty ordinances and St
s relating to building construction. �7
I authorize representatives of this city or countyY nter the a o ' entifiad property for inspection purposes. !i L
ignature of property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Date
ACTION
DATE
BY
DECLARATION OF COMPLIANCE IMTH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OFTITLE 40AND
AQMD RULE 1401
PERMIT EXPI RED
❑ I SUBMITTEDASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERMIT CANCELLED
PERMIT EXTENDED
❑ ASBESTOS NOTIFICABON IS NOT APPLICABLE TO
PROPOSEDDEMOUTION:
PERMITFINAL
—2Z— LL
CERTIFICATEOF
SIGNATURE:
OCCUPANCYUSUED