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Home My WebLink AboutE2018-0100 - Permits-alw,4 City of Newport Beach - Building Division 111111111111111111111111Jill JJ1JJJ111111111111111Jill 11Electrical Permit : E2018-0100 0�' r 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 1 8 0 1 0 0 Project No : 2358-2014 n Permit Counter Phone (949)644-3288 y � @ r. % Inspection Requests Phone (949)644-3255 Job Address: 3235 OCEAN BLVD Bldg: 1 Floor: Suite: Description of Work: ELEC/TEMP. POWER POLE Inspector Area: 5 Legal Description: TR 1026 LOT 16(AND SELY1/2 -R/S 12-35- LOT 15 Owner: GREEN CITY DEVELOPMENT LLC Contractor: Address: 2901 W COAST HWY #200 Address: NEWPORT BEACH CA 92663 Phone: Phone: Con State Lic: Issued Date:02/12/2018 Lic Expire: Bus Lic: Processed By: Lic Exp Date: New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0-600V up to 20OA: 0 $0.00 0-600V over20OA: 0 $0.00 Over600V or1000A: 0 $0.00 O/H to U/G 0 $0.00 KAZ INVESTMENTS MGT INC 2901 W COAST HIGHWAY SUITE 200 NEWPORT BEACH, CA 92663 (714)787-8097 1023867 02128/2019 BT30058144 0212812018 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 ine Code Edit: 2016 S Worker's Compensation Insurance Carrier: BENCHMARK, $— Policy No: CSTS012192 Expire : 02/0412019 fR .� 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: 1 $36.00 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: $33.00 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. )WNER-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 ie 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 'rofessions 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 of more than five hundred dollars ($500). 1 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Usiness 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 nprovements 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 nproved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). 7 I am exempt from licensure under the Contractors' State License Law for the following reason: ly 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 legally ell 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions C9 d m� a is in ull force nd effect. / icense Class License No Date lrJ Z Contractor Signature VORKERS' COMPENSATION DECLARATION !ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED HOUSAND DOLLARS ($100,000), IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th, erfo ance of the work for which this permit is issued. Policy No. ve -and wi maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatior isurance carrier n�^,1policy numberA. wrier V P\ PrI$kil Expiration Date 'same of Agent J Phone # ]I certify that, in the performance of the 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, sat, if I should become ssubb''ect to th come anon 'dons of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of Applicant? ` DeCe� -reby affirm under penalty oWe"ury that there is a cons)tnatieaJeRdfng agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). lders Name Lender's Address By my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner'sOehalf. I have read this application and the information I have provide r t. I agree to comply with all applicable city and county ordinan sta elati $ to building construction. I authorize representatives of this city or county to nter t o -ide If' d for inspection purposes. / Signature of Property Owner or Authorized Agent Print Property Owners or Authorized Agent's Nam 'tJf!� e iZ ACTION DATE BY —DECLARATION OF COMPLIANCEWITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONSPART 61 OFTITLE40AND AQMO RULE 1403. PERMIT EXPIRED ❑ 1 SUBMITTED ASBESTOS KOTIFICATION TO: ❑ EPA ❑ AQMD PERMITCANCELLED PERMITEXTENDED ASBESTOS NOTIHCA PROPOSED EMOLITION.DONfS NOT APPLICA&ETO PERMITFINAL CERTIFICATE OF SIGNATURE: OCCUPANCYISSUED