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Home My WebLink AboutE2021-0414 - Permits (3)Y��swr,A City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 �"�trrUaNia . Job Address: 1430 ANTIGUA WAY Bldg: 1 Floor: Suite: Description of Work: ELECICHANGE OUT (E) SERVICE TO 200 AMP Inspector Area: 3 Legal Description: N TR 4224 LOT 264 "Owner: SPECHT IRIS ELAINE Address: 1430 ANTIGUA WAY Contractor: Address: Phone: NEWPORT BEACH, CA 92660 Phone: Issued Date:07/13/2021 Con State Lic: Lic Expire: Processed By: Bus Lic: Lic Exp Date: IIIIP�!►��►��►►0��►►�►ii►►i►i�►i►iiii►�ii►iiii►glll BLUEMAN ELECTRIC 11843 GEM ST NORWALK CA 90650 562-774-6314 837657 05/31/2022 BT30075873 07/31/2022 Electrical Permit: E2021-0414 Project No : Inspection Requests Phone (949)644-3255 Code Edit: 2019 Worker's Compensation Insurance ' 1 Carrier: NO EMPLOYEES Policy No: Expire: X New Construction Receptacle/Switch/Outlets FEES Residential Motors/Transformers (HP/KVA) Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Multi -Family: 0 $0.00 Temp Underground: 0 1-2 Family: 0 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: p $0.00 $0.00 Sep Circuits: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 Sub Panel: 0 Moo Service Low Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 0 $0.00 Signs Over 100 HP/KW/KVA: 0 $0.00 0 $0.00 0-600V up to 200A: 1 $47.00 $0.00 Record Mgmt Fee: 0-600V over 20OA: 0 Branch Circuit: 0 $0.00 $0.00 Over 600V or 1000A: 0 $0.00 Each Add Circuit: 0 Plan Check Fee: $0.00 $0.00 Time Clocks: 0 $0.00 Piggy Back/Temp Power: 0 $0.00 Investigation Fee: O/H to U/G 0 $0.00 $0.00 Temp Power Pole: 0 $0.00 38.00 Additional Fee: $0.00 Issuance Fee: $38.00 TOTAL Fee : $85.00 Supplemental Fee: $0.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $85.00 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. • Y ♦ f i � ® C B• a0 •O 0 4e.r p ua (p p Y i• G O B i S n •�• �i• .• w . uae ea• NNER-BUILDER DECLARATION I hereby affirm under sinless and penalty of perjury that I am exempt Code: Any cry or oounty that equom the ines a pterndate lto construct, forcense Law the improve, )demlofsh, or repair any structume,rprlor to is ssuanceealso requ1 ealtheapplicant for ection 7031.5, 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 an ofessions 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 it more than five hundred dollars ($500). 11, 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 far sale (Section 7044, isiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, throug Iprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of col (proved for the purpose of sale). 11, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 70A )ply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contrac ] I am exempt from licensure under the Contractors' State License Law for the following reason: y my signature below I acknowledge that, except for my personal residence in which I must have resided for at least on .II a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.ie ignature of Property Owner or Authorized Agent .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio4011 rid effect. Date � icense Class License No VORKERS' COMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE :DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 1 have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Directc )erformance of the work for which this permit is issued. Policy No. :1I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for th nsurance carrier and policy number are: Policy Number employees' or personal effort, builds or improves the property, provided that the aletion. the Owner -Builder will have the burden of proving that it was not built or Business and Professions Code: The Contractors' State License Law does not pursuant to the Contractors' State License Law). year prior to completion of the improvements covered by this permit, I cannot nderstand that a copy of the applicable law, Section 7044 of the Business and Date of Division 3 of the Business and Professions Code, .and my license is in full force Contractor Signaturec\ �— - ,LTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE of Industrial Relations as provided for by Section 3700 of the Labor Code, for performance of the work for which this permit is issued. My workers' Date \lame of Agent certify that, in the performance of the work forwhich nsation provisions permit is sof Selction11not 3700eofthe Labor Code,loy any person ln any menrier so as to I shall forth ith Complywithhose provisions. , anon laws of California, an ogre if I should beco sub' t t PDa P Signature of Applicant DECLARATION REGARD NG CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for w ich this permit is issued (Section 3097, Civil Code). Lender's Address Lender's Name By 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. �G�� L Dom/ I authorize representatives of this city or count toe r-the above-ide d property for in purposes. r-C Signature of Property Owner or Authorized Agent �1 Print Property Owners or Authorized Agent's Name c .,r_��.,,.,,,.... — 7PERMfTEXPIRED CT(ON BY FEEI9L�RAt VEGULAd/ONSPART6,7 QFTLTLE40 AND AQniD RUV 1403", ' ❑ OATbN TO: NLELLEU -0 EPA 0 AOMO ._ ...._ AaTEQF SIGNVORE`;CYiSSUED