HomeMy WebLinkAboutE2021-0367 - Permitsa City of Newport Beach - Building Division `E2021-0367` Electrical Permit: E2021-0367
'I'r,yr
100 Civic Center Drive, Newport Beach, CA 92660 PfOJBCt NO
WPermit Counter Phone (949)644-3288 IN�PiECTOR
Job Address: 3622 BLUE KEY Bldg: 1 Floor: Suite:
Description of Work: ELEC PANEL UPGRADE 200 AMPS
Inspector Area: 6
Legal Description: N TR 6152 LOT 30
Owner: BYNDER ALAN
Contractor: OWNER/BLDR
Address: 3622 BLUE KY DR
Address:
CORONA DEL MAR, CA 92625
Phone: 949-689-3698
Phone:
Con State Lic: 018
Issued Date:06/1412021
Lic Expire:
Bus Lic:
Processed By: Syr-Lic
Exp Date:
New Construction
Residential
Multi -Family: 0 $0.00
1-2 Family: 0 $0.00
Service
0-600V up to 20OA: 1 $46.00
0-600V over20OA: 0 $0.00
Over 600V or 1000A: 0 $0.00
O/H to U/G 0 $0.00
TOT
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
Plan
Inspection Requests Phone (949)644-3255
Code Edit: 2019 ,
Worker's Compensation Insurance
Carrier:
Policy No:
Expire
FEES
Motors/Transformers (HPIKVA)
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
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:
$37.00
Supplemental Fee:
$0.00
Due at Permit Issuance:
$83.00
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.
1 hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason (a) in
(Section 7031.5, Business and Professions. Code: Any city or county that requires a permit to construct, alter, improve, de
the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License
Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Sec
.not more than five hundred dollars ($500).
`1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through
improvemcr;b are not intended or offered for sale. If, however, the building or improvement is sold within one year of corr
`(<1y
ed f,r toe purpose of sale).
s cA;)a, of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044
ao an ovir.er of property who builds or improves thereon, and who contracts for the projects with a licensed Contract<
m exempt from licensure under the Contractors' State License Law for the following reason:
By my signature Lelow I acknowledge that, except for my personal residence in which I must have resided for at least one
sell a structule tnet I have built as an owner -build r if it has not been constructed in its entirety by licensed contractors. I u
Professions Code, is available upon request when s appll'ej�' is su ted or a e following Web site: http://www.legi.
Signature of Prcperty Owner or Authorized Agent (��
LICENSED CONTRACTOR'S DECLARATI��
Ihereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) 1
snd affect.
License Class License No Date
NCKKERS' COMPENSATION DECLARATION
Mgr J:ING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE Is UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAI
COST 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 e
)erformance of the work for which this permit is issued. Policy No.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the p
nsurance carrier and policy number are:
rner Policy Number
me of Agent
ad below by the checkmark(s) I have placed next to the applicable items)
:h, or repair any structure, prior to its issuance, also requires the applicant. Nor
' (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
7031.5 by any applicant for a permit subjects the applicant to a civil -penalty of
work, and the structure is not intended or offered for sale (Section 7044,
ployees' or personal effort, builds or improves the property, provided that the
on, 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).
3ar prior to completion of the improvements covered by this permit, I cannot legal
lerstand that a copy of the applicable law, Sect n 7044 of the B loess and
o.ca.gov/calaw.html.
Dat /
Division 3 of the Business and Professions Code; and my license is in full force
Contractor Signature
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
Industrial Relations as provided for by Section 3700 of the Labor Code, for
of the work for which this permit is issued. My workers'
Date
I certify that, in the performance of the work 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
t, if I should beco bject to orkers' c pensation provisions of Section 3700 of the Labor Code, I shall forthwit[ comply with those pr ���iyyyyyyions/
nature Of Applicant -
CLARATION REGARDING CO TRUCTION NDING AGENCY �
:reby affirm under penalty of perjury that therelfs a construction lending agency for the performance of the work for whit this permit is issued (Se tion 3097, Civil Code).
ider's Name
my signature below, I certify to each of the following: Lender's Address
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 Roupty ordinances and state laws relating to building construction.
I authorize representatives of this city or count'( jb entey/thp above " entifie property for inspection purposes.
nature of Property Owner or Authorized Agent xx /,/`!1f/1 /�YA� Print Prooertv Owner
ACTION
I PERMITEXPIREO
PERM ITCANCELLEO
PERMIT FXTENOEO
DATE 1 BY
PERMIT FINAL
CERTIRCATE OF
OCCUPANCYISSUED
rcUtnaL HLGULA DONS PART 510FlTITLE 40 AND
AQMD RULE 1403. II
❑ I SUBMITTED ASBESTOS NOTIFICATION To:
❑ EPA
❑ AQMD
❑ ASBESTOS NOTIFICATION IS NOT APPLfCADLE TO
PROPOSED DEMOLITION,
SIGNATURE:
OFFICE