HomeMy WebLinkAboutE2020-0423 - Permitsw ityVoCenteric Drive, Newport Beach ortsha- Building, CA 92660 Division 0IuINIE2 0 2�uI00�ll423��q II
Permit Counter Phone (949)644-3288
NO CONSTRUCTION NOISE
Job Address: 204 43RD ST Bldg: 1 Floor: 1 Suite: A
Description of Work: ELEC/OVERHEAD TO UNDERGROUND
Inspector Area: 1
Legal Description: P M 176-13 PAR 1 UNIT 2 OF PROJECT LOCATED ON AP 423-296-13
TOGETHER
Owner: TORRES ANDREW
Contractor:
Address: 204 43RD ST #1
Address:
NEWPORT BEACH, CA 92663
Phone:
Phone:
Con State Lic:
Issued Date:08/14/2020
Lic Expire:
!
Bus Lic:
Processed By:
Lic Exp Date:
CONTORELLI CONSTRUCTION INC
30832 MARILYN DR
LAGUNA BEACH CA 92651
949-290-4630
319552
08/31/2020
BT30065552
01/31/2021
New Construction
Receptacle/Switch/Outlets
Residential
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 60OV or 1000A:
0
$0.00
Time Clocks:
0
$0.00
O/H to U/G
1
$46.00
Additional Fee:
$0.00
Electrical Permit: E2020-0423
Project No:
Inspection Requests Phone (949)644-3255
M
Code Edit: 2019
e
I
Worker's Compensation Insurance
Carrier: STATE FUND
ryU
V d
Policy No: 9154910
Expire : 03/16/2021
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
WOO
Over 100 HP/KW/KVA:
0
$0.00
Piggy Backlfemp Power: 0 $0.00
Temp Power Pole: 0 $0.00
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:
$37.00
Supplemental Fee:
WOO
11 TOTAL Fee: $83.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $83.00 ii
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday - Friday°7:00 a.m. to 6;30 p•rx and Saturday from 8:00 a.m. to 6:00 p.m.
• s • • ° eao • c a
o • a
o a a
2b
Oa •
• •a a
eaa •ae •e• o � �•• ••
DWNER-BUILDER DECLARATION I
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the mason(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).
J I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions
usiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, throu
nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of c
nproved for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7C
pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contra
] 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 o
ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors.
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://Ww .ii
ignature of Property Owner or Authorized Agent
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perju that I am licensed under provisions of Chapter 9 (commencing with Section 0
nd effect. Q
icense Class License No/O� Date
VORKERS' COMPENSATION DECLARATION
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS 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:
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
oletion, 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).
e year prior to completion of the improvements covered by this permit, I cannot legalh
understand that a copy of the applicable law, Section 7044 of the Business and
linfo.ca.gov/calaw.htmi.
Date
I saPtJIWsion 3 of the Business and Pr sion e, ny ce e' II force
Gv Contractor Signatur
ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS IS100,0001, IN ADDITION TO THE
J I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Dire ctof of Industrial Relations as provided for by Section 3700 of the Labor Code, for
o"ance of the work for which this permit is issued. Policy No.
JI have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for th performance of the work for which this permit is issued. My workers' compensa'
Isurance carrier alidaolicv number ape-,
Is of Agent �LA_l L l2
certify that, in the performance ojtAw rork r wh' h t ' permit ��s iued, I sh of employ any person in any
if I should become s ject t e e me atio provis� of Secti — of the Labor Code, I shall
lature of Applicant
ereby affirm under penalty of1perjury 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 ordinance state ws atin b I g construction.
I authorize representatives of this city or county to ter t abov de I Pe rction purposes.
mature of Property Owner or Authorized Agent rint Property Owner's
Date
Phone # �
so as to become subject to the workers' comp risation la s of California, and agrei
1 comply with those provi ions. r
D
I this permit is issued (Section 3097, ivil Code).
Name
ACTION
DATE
BY
DECLARATION OF COMPLIANCEINITH CODEOF
FOR OFFICE USE ONLY
FEDERAL REGULATI(R^ISPART 61 OFTITLE40AND
AGAW M•.
,%E v40& ...
Q. 35UBMlTTED.QS@€,STO5PdOAFICAIR)NTO.
•'
�' Ql2'6`fi-OY ,qb Vr lJ ?€� G
$ ��t.��}$� lTa SCF
PERM{TEXP{R€D
PERMITCANCECLED
•L❑] ° AOMD • � • ° ` .
❑ ASBESTOS NOTIRCAT ION A NOiAPPLICABL.E TO
PROPOSEODEMOLIMON.
•••#JREf s"•° `e°
PERMITEXTENDED
PERMIT FINAL
V
CERT{F{CATEOF
OCCUPANCY ISSUED.
Sf . s'°
•• . . . °° e