HomeMy WebLinkAboutE2022-0003 - PermitsCity of Newport Beach - Building Division
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100 Civic Center Drive, Newport Beach, CA 92860
w r h Permit Counter Phone (949)644-3288
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111111111111111111111111111111$11111111111Electrical Permit: E2022-0003
E 2 0 2 2 0 0 2 3 Project No : 1563-2021
Job Address: 5201 SEASHORE DR Bldg: 1 Floor: Suite:
Description of Work: ELEC -TEMP POWER POLE (X2022-0034) C
Inspector Area: 1
Legal Description: OCEAN F
Owner: THE GOALPOST T
Address: 16000 VENTURA E
ENCINO CA 91436
Phone:
Issued Date:01/10/2022
Processed
LW
NO CONSTRUCTION NO10
)NT I BLK 52 LOT 1
�ST Contractor: GONTERMA0 N ON L7 qr; War�ery
b STE 900 - Address: 1842 PARK S r7_, 'i "` ` Parr
Inspection Requests Phone (949)644-3255
- NE.WPORT BEACH CA 92648 Policy No: 9259518
Phone: - ;r 949-697 0746 i 7y to WhOM- Expire: 08/22/2022
Con State Lic: 858073
Lic Expire: 04/30/2023
Bus Lic:, BT30048414
Lic Exp Dater 09/30/2022 0..� `"zeay�x
New Construction
Residential
Receptacle/Switch/Outlgs
Receptacles/®LLthts: i✓'@k
�Y�_ ""
Multi -Family:
1-2 Family:
0
0
$0 00 J�, - Fixtures:
$0 30/i 1--:ep irc is ,.a
a
iF�$'
$0.00
Low t s a'r4d)
$0.00
r*fcJe"
Service
Signs
0-600V up to 20OA:
0
$0. 0�I
Branch Circuit:
0 $0.00
0-600V over 20OA:
0
$0. OIYOte.
Over 600V or 1000A:
0
$0. 0
Time Clocks:
0 $0.00
O/H to U/G
0
So. 0
TOTAL Fee:
FEES
Moto sf ets HP KKV
a to 1 HP! / A 1 'Pi
1 to 1 W A: 0 $0.00
10 to 50 HP/KWQ4fj�:wcWK stm0i;t'G )
50 to 100 HP/K /KVA: 0 $0.00
Over 100 HP/KW/KVA: 0 $0.00
Piggy BackrTemp Power: 0 $0.00
Temp Power Pole: 1 lnssmjnitie(f•:
Plan Check Fee :
Panel
Record
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. fn 6:00 p.m.
F
S
3
:!1
M1t >
>
und: 0
$0.00
1
0
$0.00
0
$0.00
0
$0.00
se:"`
$0.00
$0.00
$0.00
$38.00
3
$0.00
it Issuance :
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 cheOKmarK(s) I have placed next tome applicable ilem(s)
Gaon 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
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
torsions Code) or that he or she is exempt from licensure and the basis forth a alleged exemption. Any violation of Section 7031-6 by any applicant for a permit subjects the applicant to a cfvif 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 L) all of or L) portions of Me work, and the structure Is not intended or offered for sale (Section 7044,
knees antl Professions Code: The Contractors' State License Law does not apply to an owner of properly who, through employees' or personal effort, builds or improves the property, provided that the
pavements are not intended or offered for sale. If, however, the building or improvement is sold wrthln one year of Completion, the Owner -Builder will have the burden of proving mat it was not built or
roved for the purpose Of sale).
I, as
,ry to
lam
my si
a str
hereby of
nd effect.
hereby
certify to
, IT I s11OL
lature of
;LARATI
reby affir
der's NEI
By signal
I am the
1 have rs
I agree t
I authon
lature of
Are exclusive , conj/�gting pvitifyigens�pntractors to Construct the or
he builtls �Ipm a her tlw o ontracts for the projects wrina
that I have built as an owner-buiRfer if it pas not been constructed in its entirety by licensed
de, is available upon request-vigan this application is *mited oral [Ile following Web site
operty OvinerorAuthanzed Agent_ _
ONTRACTOR'S DECLARATION -
under penalty of perjury that I am licensed under provisions of chapter 0 (commend 11
an ss -= --License No a
;OM1�"NSATION DECLARATION
(Section 7044, Business and Professions Code: The Contractors' State License taw does not
Con[r HEMP'
ant to the Contractors' Sate License Low).
��app�ica`�Y�.
)rat least one year prior to completion of the improvements covered by this permit, I cannot lel
eairaetoreeW nderstand tbat-a.-copy oftheaoplicable law. Section 7044 of the Business and
Date
license is in full farce
SECURE WORKERSCOMPENSATION COVERAGE IS UNLAVPFut, AND.SFWl1 SUBJECT AN ENIPWYER To CRIMINAL PENALTIES AND CNIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), M ADDITION TO
5 PROVIDED FOR IN SECTION 3706 OFTHE LABOR CODE INTEREST, AND ATTORNEYS FEE&
perjury one. of 010 following declarations:
mfain a certificate of consent to self -insure for workers' compensation, issued by the Director of Indusinal Relations as provided for by Section 3700 of the Labor Code, Tor
e yr far wash this permit is. issued. Policy No.
_..
Will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the worK for which mis permit is: issued. My workers' compensal
ler and policy number are:
Policy
��SJSJJetl, I snail not kMla-eny persondn-any mg9a�nerntllso as
provisions of Section 3700 of the Labor�nde,e, IWOrnns lal l
Date
subject to the R'orKers'. compensation laws of California, and agm
se provisions.
1/5/2022
under penalty of perjury that there is a construction lending agency Tor the performance of the worK for which this permit is issued (Section 3097, Civil
nI— ♦—- Lender's Address
PERMIT CANCELLED
mvner or authorized to act on the property owner's behalf.
aplication and the information I Flow
w all applicable city and county ordinances and state Tawas relating to
., r e-I en ied property For inspection purposes.
Owner or Authorized Agent la.'u.a .. — Print Proti Owner's or Authorized ADent's Na
DECLARATION OF COMPLIANCE WITH CODEOF FEDERAL
REGULATIONS PART 61 OFTITLE 40 ANDACLMD RULE
1403
I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT FINAL IJASBESTOS NOTIFICATION IS NOT APPCCABLE TO
CERTIFICATE OF PROPOSED DEMO"TION _�
OCCUPANCYISSUEO arsen:ac\/�'D,—i..... /' -.
Brenton
1/5/2022