HomeMy WebLinkAboutE2021-0786 - PermitsCity of Newport Beach - Building Division IIII�IIIII�IIIIIIIIIIIIIII�IIIIIIIIIIIIIIIII III
:" �✓ 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 1 0 7 6 6
Permit Counter Phone (949)644-3288
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Job Address: 398 22ND ST Bldg: 1 Floor: Suite:
Description of Work: ELEC 200 AMP SERVICE UPGRADE
Inspector Area: 1
Legal Description: NEWPORT HEIGHTS LOT 296 SWLY 107 FT SELY 100 FT
Owner: MORAN FRANCES
Contractor:
Address: 398 22ND ST
Address:
NEWPORT BEACH, CA 92660
Phone:
Phone:
Con State Lic:
Issued Date:1111512021
Lic Expire:
Bus Lic:
Processed By: �d�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
Over 600V or 1oo0A:
0
$0.00
O/H to U/G
0
$0.00
AP BUILDING MAINTENANCE INC
4341 NESTLE AVE
CYPRESS CA 90630
562-743-7805
1058995
10/31/2023
BT30077254
11/30/2022
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: E2021-0786
Project No :
Inspection Requests Phone (949)644-3255
1PIzCTO`
Code Edit: 2019
Worker's Compensation Insurance
Carrier: STATE COMP .•••a•
•
Policy No:9282576 • �•_••*
Expire : 0812212022 �����• a ••
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:a a
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
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60 J3
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Temp Underground:
.
.Ox]Ea•
0
F9••'
$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
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).
❑ 1, 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 co pletion, 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 704"""��14, 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 Contracpor pursuant to the Contractors' State License Law).
❑ on: 1 am exempt from licensure under the Contractors' State License Law for the following reas
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 Iegall�
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.leinfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTKiCTOR'S DECLARATION
l4viebyaffirm under analty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Prof ssi a Code, and my license is in full force
Sind effebt. " ,
License No
CQMPENSATION DECLARATION
WINGi FAILURE T (TSECgRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
.TOG COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNETS FEES.
�ceby affirm radar penalty of perjury one of the following declarations:
00
Contractor XIture
ES AND CIVIL FINES UP TO ONE HUNDRED DOLLARS ($700,000), IN ADDITION TO THE
P 89ve and wH4 intaln 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
9D"ance of the work for which this permit is issued. Policy No.
shave and wIIL lnainiain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the
iAr?* cpIT fnd pglicy number are:
Mier' .r Policy Number
of Agent
of the work for which this permit is issued. My workers'
Date
LJI 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 agre
that, if I should become subject tot orkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisio
Signature of ant ` d
DECLARATIO AR IN CONST TION ENDING AGENCY
I hereby affirm under penalty f perjury ha here 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
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 too ntrRr��ha above -identified property for inspection purposes. ,� / 1-
Signature of Property Owner or Authorize /yam �— Print Property Owner's or Authorized Agent's Na�ljr✓rd111 (� �✓/i to //_0
ACTION
DATE
17=Y
DECLARATION OF COMPLIANCE IMTH CODE OF
FEDERAL REGULATIONSPARTBT LIFTITt.E40AND
AQMDRULE1403.
❑ I SUBMfTIEDASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD'
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE.
FORDFR EUSEONLY
PERMITEXPIRED
—
PERMIT CANCELLED
PERM7TEXTENOED
PERMITFINAL
CERTIFICATE OF
OCCUPANCYISSUED