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HomeMy WebLinkAboutE2022-0388 - Permitsw1f,r City of Newport Beach - Building Division o'� 6 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 .„ cr Job Address: 601 HILVANAR Bldg: 1 Floor: Suite: Description of Work: ELEC - 200 AMP SERVICE UPGRADE, 100 AMP SUBPANEL Inspector Area: Legal Description: TR 5798 (L.L.84-245722) PAR 50 Owner: SWCC LLC Contractor: Address: 14311 YORBA ST Address: TUSTIN CA 92780 Phone: Phone: Con State Lic: Issued Date:06/28/2022 Lic Expire: / Bus Lic: Processed By: S I Lic Exp Date: II III III I�� 0I�II III III II IIIII I� 8IIII I� II G N S CONSTRUCTION P 0 BOX 141 BALBOA ISLAND CA 92662 949-370-7200 486187 01/31/2024 BT30054739 04/30/2023 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 0/H to U/G 0 $0.00 Additional Fee : $0.00 TOTAL Fee: $114.00 pig., Electrical Permit: E2022-0388 Project No: 0103-2022 Inspection Requests Phone (949)644-3255 Code Edit: 2019 Worker's Compensation Insurance Carrier: EVEREST NATIONAL INS CO Policy No: 7600014956221 Expire : 05/31/2023 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 Backfremp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Fee : 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 Due at Permit Issuance : $114.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Cor{s#cu ,ton Hours: Yonday-,Fridgy 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. 0 O 9 A� a 1© N ro O pry O Boa sHa n • ao� ae� .c,e 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 iot 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 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 legally 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.html. 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 C de, and my license is in n full force and effect. \ /_�8 l/ �r/J License Class License No Date !�! Contractor Signatul%� WORKERS' COMPENSATION DECLARATION WARNING: 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 ($100,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 1 ereby 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 ance of the work for which this permit is issued. Policy No. veand 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�Dran ance carrier and policy number are: Policy Number Date ie of Agent rimm e 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 , if I should become subje to the workers' c mpensation provisions '-offSSection 3700 of the Labor Code, I shall forthwith comply with those provisions. �J lature of Applicant � ti ✓/,r Date ,,2� ___ ------------- ------------ ;reby affirm under penalty of perjury that the 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 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. I authorize representatives of this city or county to ent�er��h/�d bove-identified p ert or inspection purposes. ,��(/ nature of Property Owner or Authorized Agent �/ ✓ /.!/Y/ Print Property Owners or Authorized Agent's Name ACTION DATE BY DECLARATION OFCOMPLIANCE iMTHCODEOF FOR OFFICE USE ONLY FEDERAL REGULATI0MSPART5:!9f TJWF40 13' ••• AQMD RULE 1403. • • • • ❑ 1 SUDMfTTEDASBESTOS NOF+FttrtlON'TO: ❑ EPA • • • • • `' ❑ AQMD' :•• ••• •s •`a PERMIT€XPfRFD PERMIT CANCELLED PERMITEX7EM1lD€D ❑ ASBESTOS N077FICA770N IS NOT APPLICABLE TO PROPOSED DEMOLITION. f 1 Y •`f •• • PERA41T FINAL 2 2. CER7FICATEOF SIGNATURE: `. '. 'a ` OCCUPANCYISSUED e,° s a �. • •