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Home My WebLink AboutE2021-0247 - PermitsCity of Newport Beach - Building Division II III IIIIII�IIIIIIIIIIIIUIIIVIII�IIIIIIIullll II Electrical Permit: E2021-0247 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 1 0 2 4 7 Project No E Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 2024 -GALAXY DR Bldg: 1 Floor: Suite: Description of Work: ELEC/A/C DISCONNECT (H2O21-0246) Inspector Area: 3 4 - / Code Edit 2019 sU Legal Description: N TR 4224 LOT 11 Date % ° "i e R„ V 0 v1 J t "%_1 F1 p , �p Owner: MAHAFFEY DOUGLAS/JOANNE �" r: E�N V1Y�gk s;C&Mp surance a Address: 2024 GALAXY DR 5, �r�.ddres . � V l '`` - � ena= "' Carder : SERVICE AMERICAN NEWPORT BEACH, CA 92660 'nd /#A Policy No: SAMTWC0041100 Phone: 714-695-6661 �a Expire : 10/01/2021 Con State Lic 4452 � A c Issued Date:04/09/2021 r _ 6/FQ4i G'a- ic: :i100fi4 6Sam Boo Processed By: \r e: /2 i EWE New Construction Recap e/ i tom- a �� tNkft�s ransformers (HP/KVM,0 Residential Recep utl D 4 $0 00 r;,�6`0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: � . $0.00 Multi -Family: 0 $0.00 FiAur s: (w4 j(r$0 00 • t 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: $0.00 1-2 Family: 0 $0.00 Sep Circuits: 1 $7.00 10 to 50 HP/KW/KVA: 0 0 ,'$0.00 Lo 'Voltage 50 Service S g slog �: 0 $0.00 Over 100 HP/KW/KVA: 0 $0.00 � ' lZdco�d Mgmt Fee: _-- $0.00 0-600V up to 20OA: 0 $0.00 Bra ' ircuit: 0 $0.00 'Its E $0.00 0-600V over 20OA: 0 $0.00 Eac Add Circuit: 0 iggy Bac .00 Investigation Fee: $0.00 Over 600V or 1000A: 0 $0.00 Tim e.C4oc 0 — p ower Pole: 0 $0.00 Issuance Fee: $37.00 O/H to U/G 0 $0.00 Addi$0.00 Supplemental Fee: $0.00 TOTAL Fee: $44.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $44.00 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. ° o oe eoo o °w° 0 0 0 0 0 o e a ® o 0o aoo o • o0 00 •.• rNER-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) 1 have placed next to the applicable I ction 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 applica 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 Divis on 3cl the Business a fessions 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 more than five hundred dollars ($500). I, 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, iness 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 rovements 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 roved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7 44, Business and Professions Code: The Contractors' State License Law does not ly to an owner of property who builds or improves thereon and who contracts for the projects with a licensed Contragloursuant to the Contmctors' State License -Law),_____ LJ I am exempt from licensure under the Contractors' State License Law for followi reaso ' 1 4 By my signature below I acknowledge that, exit' pt for my personal residen I t h e de at least o' a year prior (¢ completion of the improvements covered by t is permit, I cannot legal) sell a structure that I have built as an owner-b lder'I�'I 7��E b^en construct n Rs irety is ed contractors. f understand k!(ia t( �ilicable law, Section 7044 of the Business and Professions Code, is available upon request w en this application 1s submitte'd or at th f (lowing Web site:http:fAvww.lf!ginfo.ra.gov/cal� Signature of Property Owner or Authorized Ag 0 t ., Daatte 3 LICENSED CONTRACTOR'S DECLARATION �` I`" `3= - 0 f .1 o eTU I hereby affirm under penalty of perjury that I ark lice ised and - rovis ' s of Char ,(cogng'r'ith Sect! ))IT vision 3 of the Business and Professions Code, and license is in full force and effect. License Class Lice �, _ �� to � � t Cdb nOav`r�tu WORKERS' COMPENSATION DECLAPj TION ARNING: FAILURE TO SECURE WORKERS' COMPENSA ON C NLAWF SX EMWf RI AF3A ND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS t15'100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FO N SE ION ] HE I hereby affirm under penalty of perjury one oft a foil i e lion - k I have and will maintain a certificate of c sen re fo lionIby ig_e trial Relations as provided for by Section 3700 d the Labor Code, for th perfo nce of the work for which this permit i iss have and will ma' ain workers' corri ion insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatio nsurance carrier and ' y number Carrier n k i r _ IaHar sra Name of Agent 6 L�j1Sp 9 s y,= I certify that, in the performance of the work which this permik p��1 g p¢}qt ploy any person in any manger soM q q1b' tp tll��yorkers' compensation I�ua ofCalifornia, and agre that, if I should become subject to the workers' m ation provl��bt`€ 65M 3FO the Labor Code, I shall fortbwith c8h rk�$epib3lrldn�J Signature of Applicant Dat 1� �2 f DECLARATION REGA I STRUCTIO LM AGENCY I hereby affirm under p alty of perjury that the is a construction lenaing agency tor the performance of the work for Which this perm d 1s issue (Section Lender's Name Lender's Address` By my signature below, 1 certify to each of the I I am the property owner or authorized to a III PEOPREIIIE RI la=z 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 to enter -the above-identifi property for inspection purposes. Signature of Property Owner or Authorized Agent JC Print Property Owners oi� Authorized Agent's Name l� ✓r��F /�� r D'a e H y Zl AEON DATE DECLARATION OF COMPLIANCE WITH CODE OF FOROFR EUSEONLY FEDERA1,REGUL4JK jlf$,PART6?OFTJTLE40AND AQ140&° ,R 4SU90TTEDA68E5T05 M017FICATION TO. • • 0 ' ,rPA ° • ° ❑ AQMD ❑ ASBESTOS NOTIFICATION IS NOT APPUCABLE TO - PROPOSEQDEKVWN. • • • ° ° ° °e e PERMITFXPIRED rC. : •. PERMIT CANCELLED PERMITEXTENDED PERMITFINAL CERTIFICATEOF • OCCUPANCYISSU€D o SdGN�i1RG: o 0 o c o A 0 0 0 0 0