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Home My WebLink AboutE2021-0803 - Permits3vnr City of Newport Beach - Building Division i� 100 Civic C6nRir6?ve, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 U: Job Address: 122 26TH ST Bldg: 1 Floor: Suite: Description of Work: ELEC/OVERHEAD TO UNDERGROUND Inspector Area: Legal Description: NEWPORT BEACH CITY BILK 25 LOT 15 Owner: CASEY Contractor: Address: PO BOX 1605 Address: BRECKENRIDGE CO 80424 Phone: Phone: Con State Lic: Issued Date:11/23/2021 Lic Expire: Bus Lic: 101— Processed By: Lic Exp Date: IIIII IIIIIIIIIIIIIIIII1 II IIIIIIIIII0III3III II G R T ELECTRIC 7171 E WARDLOW RD LONG BEACH CA 90808 562-234-3914 954024 10/31/2022 BT30077308 11/30/2022 Electrical Permit: E2021-0803 Project No Inspection Requests Phone (949)644-3255 Code Edit: 2019 J CD Worker's Compensation Insurance Carrier: CLEAR SPRINGS Policy No: CWC00186300 Expire : 09/22/2022 i 0 _ FEES New Construction Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Residential Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $0.00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 0 $0.00 1-2 Family: 0 $0.00 Sep Circuits: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 0 $0.00 Low Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 0 $0.00 Service Signs Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: $0.00 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 Plan Check Fee: $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Piggy Back/Temp Power: 0 $0.00 Investigation Fee: $0.00 Over 600V or 10o0A: 0 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $38.00 O/H to U/G 1 $47.00 Additional Fee : $0.00 Supplemental Fee: $0.00 Plan Check Fee: 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. a° a.a ° °°° •°a aan ° a o e ° T nao c so ono e o a o0 o°a acc c x G89 a°° aa• a • .a• aea OWNER -BUILDER DECLARATION I w. � r 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). LJ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or L) portions Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, throu( improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of cc improved for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 70. apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contra( ❑ 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 or sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.le Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700C and effec t. License Class e 11/t�� ass License No Date COMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL :DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of perjury one of the following declarations: the work, and the structure is not intended or offered for sale (Section 7044, employees' or personal effort, builds or improves the property, provided that the pletion, 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 iderstand that a copy of the applicable law, Section 7044 of the Business and Date Division 3 of the Business and Professions and mmiense is in full force r L Contractor Signatu)� AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,fi6O), IN ADDITION TO THE I have and will maintain 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 ;Ormance of the work for which this permit is issued. Policy No. have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the rance carroragd policy num er /1) ie of Age certify that, in the performance of he work for which this permit is issued, I shall not employ any person in any if I should become subject to thgworkers' corpnsation provisions of Section 3700 of the Labor Code, I shall nature of Applicant vvdAq 40 7v— CLARATION REG RDING CONSTRUCTION LENDING AGENCY �reby affirm unde penalty of perjury that there is a construction lending agency for the performance of the work for Ider'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 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 couriy V enter tbabove4dentifig0 property for inspection purposes. of the work for which this permit is issued. My workers' Date so as to become subject to the workers' compensation laws of California, and agre i comply with those provisions. i this permit is issued (Section 3D97, Civil Code). r ' 'iJ6WA/)NJ' I ACTION DATE LBY DECLARATION OF COMPLIANCE MTH CODE OF FOR OFFICE USE ONLY FEDERAL WPt9.V1ONSPART61 OF TITLE40AND ,AT DRU E1403: r. Q• f S;IShfITTEDY5S8EST05 NOTIFICATION TO: • {] EQZt �• PERMIT EXPIRED •�. .+• • PERMIT CANCELLED • • • •• ❑ AOMO' PERMITIXTENDED • ❑ ASBESTOS NOURCATIONIS NOT APPLICABLE TO PROPOSEDIWOOLITION. o PERMIT FINAL CERTiFICATEOF OCCUPANCYISSUED n ere • e d .S16,UATORE. e o c