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HomeMy WebLinkAboutE2021-0707 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 113 25TH ST Bldg: 1 Floor: Suite: Description of Work: ELEC OVERHEAD TO UNDERGROUND Inspector Area: 1 Legal Description: NEWPORT BEACH CITY BILK 25 LOT 29 Owner: 133 25TH ST LLC Contractor: Address: 113 25TH Address: NEWPORT BEACH, CA 92660 Phone: Phone: Con State Lic: Issued Date:10/1812021 Lic Expire: us Processed By: Lic Exp Date: New Construction Residential *E2021-0707* Electrical Permit: E2021-0707 Project No : Inspection Requests Phone (949)644-3255 �N Code Edit: 2019 . . • B I D ELECTRIC Worker's Compensation Insurance °°®° a°.aaa 4550 CAMPUS DR #151 Carrier: WIC EXEMPT NEWPORT BEACH, CA 92660 Policy No: (NO EMPLOYEES) 949-903-4591 Expire: °• ° 730445 12/31/2022 •• BT30076892 0 0 0 oaoao 10/31/2022 °@ • •°° ° . .• Receptacle/Switch/Outlets 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 1 $47.00 Additional Fee : $0.00 TOTAL Fee: $85.00 pi.., 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 Backrremp Power: 0 $0.00 Temp Power Pole: 0 $0.00 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: $38.00 Supplemental Fee: $0.00 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 Iicensure 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). y I, as owner of the property, or my employees with wages as their sole compensation, will do U 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 -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). I am exempt from Iicensure 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 Cod,'islaLOilable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. S1WVgJ of Propery,Owner or Authorized Agent Date LICENSED CONJUeACTOR'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, d license is in 11 force Lirpnse;Class _'_ _ License No Date /Q Contractor Signature VOORS' COMPENSATION DECLARATION wpFMIgIG: FAILURE•TS•SMiRE 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 COST OF (POMPENSAWIOR,OAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ••• I herebybt affirm under penalty of perjury one of the following declarations: rha4 and wit rpiatain 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 the pg!IQT arce of the ivork-for which this permit is issued. Policy No. . i 08)0e and will maiollin 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' compensation insurance carrier and policy number are: Policy Number of Agent Date f/�I certify that, in the performance of the work for which t t is Issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree lat�f should become ubject to the workers' com isio ien'3700 of the Labor Code, I shall forthwith comply with those provi�i/gns. /' ignature of Applican Date A / © IECLARATION RE*RD-hG CONSTRUCTION LENDING AGENCY T� 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). 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 have provided is correct. I agree to comply with all applicable city and county ordinances and laws relating to building construction. /� I authorize representatives of this city or coun�yFo enter the d tifie property for inspection purposes. / ,� �LT'U/ ''f l�- kmature of Property Owner or Authorized Agent �( Print Property Owners or Authorized Agent's NamV t� � Da ACTION DATE BY DECLARATION OFCOMPLIANCE WITH COOEOF FOR OFFICE USE ONLY FEDERAL REGULATIONSPART 51 OF TITLE 40 AND AQMD RULE 9403, nERMITEXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMITEXTENDED ❑ ASBESTOS M077RCA170NISNffTAPPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL Z- -Z CER7TFICATEOF SIGNATURE' OCCUPANCYISSUED