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Home My WebLink AboutE2022-0225 - Permits(9) City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II Electrical Permit: E2022-0225 100 Civic Center Drive, Newport Beach, CA 92660 E 2 e 2 2 0 2 2 5 Project No : 2684-2021 Permit Counter Phone (949)644-3288 Job Address: 2411 BAMBOO ST Bldg: 1 Floor: Suite: Description of Work: ELEC/BBQ Inspector Area: 4 Legal Description: N TR 4893 LOT 48 Owner: LA21A LLC Contractor: Address: 26880 ALISO VIEJO PKWY #100 Address: ALISO VIEJO CA 92656 Phone: Phone: Con State Lic: Issued Date:0411212022 Lic Expire: Bus Lic: Processed By:CiTgowww�:-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 TOTAL Fee: $39.75 T J C HOME BUILDERS LLC 26880 ALISO VIEJO PKWY #100 ALISO VIEJO, CA 92656 (949) 481-7026 1025507 04/30/2023 BT30059037 05/31/2022 Receptacle/Switch/Outlets Receptacles/Outlets: 1 $1.75 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 Inspection Requests Phone (949)644-3255 Code Edit: 2019 Worker's Compensation Insurance Carrier: NATIONAL FIRE 8: MARINE INS C " Policy No: 42HB615046601 Expire : 1213112023 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 Plan Check Fee : 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: $38.00 Supplemental Fee: $0.00 Fee Due at Permit 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). ❑ 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 intendedor 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 completion, the Owner -Builder will have the burden of proving that it was not built or improved 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 apply 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). ❑ 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 one year prior to completion of the improvements covered by this permit, 1 cannot legalh 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.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sect on 70 ) Sion 3 of the Business and Prof is sOnd lic e's in full force and effect. License Class License No Date \� Contractor Signature NORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th Derfgrmance of the work for which this permit is issued. Policy No. have and ijiiaintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' rance carrie and policypaffiOFr are: T Date Of �I certify that, in the performance of the' ork for ich this permit is " sued, I shall not employ any person in any manner so as to become subject to the workers' c mpen anon laws of California, and ogre iat, if I should become subj t to the wo ers' co sation pr si Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ))�% Ll � Iignature of Applicant D3— IECLARATION REGA ING CONSTRUCTION LENDING AGENCY hereby affirm under penalty of perjury that there is a construction lendilig agency for the performance of the work forwhich this permit is issued (Section 3097, Civil Code). ender's Name Lender's Address ly my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I hav provided is rrect. I agree to comply with all applicable city and county o"sstto®relatmo building construction. I authorize representatives of this city or county toe tifir inspection purposes. �� Iignature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Na ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL RFGU! 4TIONS PART fit OF T7TLE40 4ND AQMD RULE '403. PERMIT EXPIRED ❑ ISU$'4ITT-E7ASEESTOSNC71Ff.ArION?0: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMITEXTENDED ❑ OPOSFD OSMNOTIRO� 7IONI5 NOT APPLICABLE TO PERMIT FINAL �3 �� CERTIRCATEOF SIGNATURE: OCCUPANCYISSUED