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Home My WebLink AboutE2019-0691 - Permitst City of Newport Beach - Building Division ��pIIIIIIII1IIIIIIIIIIIIIIIIIIDIIIIIIIll Jill III JillElectrical Permit: E2019-0691 d 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 1 9 0 6 9 1 Project No : 1157-2019 Permit Counter Phone (949)644-3288 °grt' Inspection Requests Phone (949)644-3255 Job Address: 214 COLLINS AVE Bldg: 1 Floor: Suite: - - Description of Work: ELEC TEMP POWER POLE (X2019-3278) Inspector Area: 2 Legal Description: BALBOA ISLAND SEC 2 BLK 11 LOT 11 Owner: MAGNUM PROP INVS LLC Contractor: Address: PO BOX 517. Address: AGOURA HILLS CA 92662 Phone: Phone: Con State Lie: Issued Date:10/15/2019 Lie Expire: Bus Lie: Processed By:C)ck Lie Exp Date: New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0-600V up to 20OA: 0 $0.00 0-600V over20OA: 0 $0.00 Over600V or1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: $74.00 Code Edit: 2016 INS 1 EC I OR r 65mpensation Insurance B D R INCQQ�� g izon IUCTION 489 AG arrier : EVEREST NATIONAL A NIln 0ST Policy No: BDWC019614 818-435-7775 Expire : 03/26/2020 735996 d°m® 05/31/2021 o. mb°m mmom+° `THE WEEKEND dY�G�f\ VV BT30051626 ON m °mOOOO 07/31/2020 ® ° ° m ..,.cam m Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Signs Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee: $0.00 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: 1 $39.00 Plan Check Fee : m000cam ° ° Temp Underground: ° ° 0 $0.09 a Sub Panel mo.aa 0 $0.00• . m�mm 0 �1s.98ma ®ammo 0 $0.00 s Record Mgmt Fee: ° $0.00 Plan Check Fee: $0.00 Investigation Fee: $0.00 Issuance Fee: $35.00 Supplemental Fee: $0.00 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. ✓'• 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 ac Icant 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 Bind 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 L) all of or L) 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, 1 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.L 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 siness and Professions Code, and my license is in full force and effect. - License Class License No Date Con a W,�"O''R'KELRS' C(JI DUSATION DECLARATION ,ryyayWg':=AILURE -O SECISRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER T MINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DRMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY' ES. eemby effirm under penalty of perjury one of the following declarations: :X663ve and willemain rtaJeate f_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 t;, �vtl�forwhich this permit is issued. Policy No. nd wil 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 Car number are: 5;Pmig1. 0 Policy Number Expiration Date of*Agent i514e,pdtformance of the work for which this permit is issued, I shall not employ any person in any manner so as to become sub,gg;1o4h"orkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply CLARATION REGARDING STAR GTf@N'L�NDING AGENCY ;reby affirm under penalt ury that there is a construction lending agency for the performance of the work for which this permit I ued lder'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 behal I have read this application and the information I have provided is COTS . I agree to comply with all applicable city and county ordinances Ind s to laws relating to building construction. I authorize representatives of this city or county to enter the above-1 ed property for inspection purposes. mature of PropertyQwgaor Authorized.Agent L / 6 d/N 'y i�S a N Print Property Owner's or Authoryed-AlgeQt's Name to the workers' 3097, Civil Code). laws of California, and ACi70M DATE BY DECLARATION OF COMP7IANCEMTB WQEgE FOR OFF7 ONLY FEDERAL REGULATIONS PART 61 OF T17L ET AQMDRULE 1403. PERMIT€XPIR€D ❑ 1 SUBMtTTEDASBESTOS NO77FICA7ION TO: ❑ EPA ❑ AQMD P€RMITCANC€LIED P€RMITEXTEND€D ❑ ASBESTOS M077FICA770MISNOTAPPLICASLETO PROPOSED DEMOLMON. PERMTTFINAL d CERTIFICATEQF SIGNATURE: OCCUPANCYISSUED