HomeMy WebLinkAboutE2021-0432 - Permitsoy City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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Job Address: 4435 COAST HWY W Bldg: 1 Floor: Suite:
Description of Work: ELEC -PANEL UPGRADE TO 200 AMP (X2021-1235)
Inspector Area: 1
Legal Description: TR 7530-LOT 1 UNIT 16 OF PROJECT LOCATED ON AP 423-031-01
TOGETHER
Owner: KENNEDY CHRISTINA Contractor:
Address: 4435 COAST HWY W Address:
NEWPORT BEACH, CA 92663
Phone: Phone:
Con State Lic:
Issued Date:07/20/2021 Lic Expire:
Bus Lic:
Processed By: Lic Exp Date:
New Construction
Residential
Multi -Family:
0
$0.00
1-2 Family:
0
$0.00
Service
0-600V up to 20OA:
1
$47.00
0-600V over20OA:
0
$0.00
Over600V or1000A:
0
$0.00
O/H to U/G
0
$0.00
TOTAL Fee:
BC HOME BUILDERS.
3202 W WARNER AVE
SANTA ANA CA 92704
714-754-0709
940362
05/31/2023
BT30075504
06/30/2022
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
Electrical Permit: E2021-0432
Project No : 1089-2021
Inspection Requests Phone (949)644-3255
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Code Edit: 2019
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Worker's Compensation Insurance
Carrier: CYPRESS INS CO
Policy No:BCWCO21844
Expire : 12/26/2021
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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: 0 $0.00
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:
$0.00
Supplemental Fee:
$12.00
Fee Due at Permit Issuance:
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).
111, 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 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).
❑ 1, 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).
❑ I 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 Ihave 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 Cod, I es• available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signatur¢ of Prople"'Owner or Authorized Agent Date
=I MED CON,TS2RCTOR'S DECLARATION
'I fyereby affirm Crider 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 license is in full force
an&ef mt.
License Class License No Date Contractor Signature
WGAERS' C®NIP6NSATION DECLARATION VJ
WARNING: FAILURE iOSaCWORKERS' 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
CQSTOFFOMPENSATiON, DAMAM AGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
affirm under penalty of perjury one of the following declarations:
fare and will me;ntaln 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
nonce ofl",kor& for which this permit is issued. Policy No.
iave and wilt m airRain 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'
ance carrier ana policy number are:
Policy Number Expiratic
of Agent Phone #
certify that, in the performance of the work for which this
, if I should become suo6ct to the
workers' compensat/ip
tatureofApplicant/
/ Ai
Date
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
'ons o ' n 3700 of the Labor Code, I shall forthwith comply with those provision
Date *�20 /71
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 owners 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 too eiiter the above-i tified rty for inspection purposes. 1�,
Signature of Property Owner or Authorized Agent / ^Myir� Print Property Owners or Authorized Agent's Name _�AO& k -f'&kT�t ate 6 \
ACTION
DATE
tZ BY
DECLARATION OF COMPLIANCE KITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONSPART 61 OF TITLE40 AND
AQMD RULE 1403.
PERMdT EXPIRED
❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERMITCANCELLED
PERMIT EXTENDED
❑ ASBESTOS NOTIFICATIONIS NOT APPUCABCE TO
PROPOSED DEMOLITION.
PERMIT FINAL
CER77FICATEOF
SIGNATURE:.
OCCUPANCYISSUED