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Home My WebLink AboutE2021-0229 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIII Electrical Permit: E2021-0229 (9) 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 1 0 2 2 9 Project ND : 2708-2019 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 23 HARBOR ISLAND Bldg: 1 Floor: Suite: Description of Work: ELEC/FOR FUTURE INSTALLATION OF SPA EQUIPMENT Inspector Area: 2 Code Edit: 2019 Legal Description: TR B02 LOT 23 ALL -INC BET SAME & HIGH TIDE LINE - Owner: PICKUP TODD Contractor: FLUID DYNAMICS POOL & SPA Worker's Compensation Insurance Address: 23 HARBOR ISLAND Address: 620 E WALNUT AVE, #B Carrier. INS CO OF THE WEST NEWPORT BEACH, CA 92660 FULLERTON CA 92831 Policy No: WSD504pya8g3 Phone: 8047 NO CONS C-g r�� k 3 U1815 ia� �2b�'n.6tl Con State Lic: 809954 9°a V Issued Date:0312912021 Lic Expire: 12/31/2022 Bus Lic: BT30055899 Processed By:zz Lic Exp Date: 07131/2021 �5 A y �l�r�y �/ �1�! �Y4�6J1lLJr�l1 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 over 20OA: 0 $0.00 Over600V or1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Rec epta c I e/Switch/Outlets Receptacles/Outlets: 4 $7.00 Fixtures: 4 $7.00 Sep Circuits: 2 $14.00 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 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 BackFFemp 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: $0.00 e at Permit Issuance : $65.00 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. ER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the resson(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 U all of or U portions of the work, and the structure is not intended or 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, I cannot legall) 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.htmi. 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 Section 7000) of Division 3 of the Business and PItTeRsions Code, and my license is in full force and effect. License Class License No D e o Z Contractor Signatur /o WORKERS' COMPENSATION DECLARATION WARNING: 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 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I 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 thi p ormance of the work for which this permit is issued. Policy No. and will 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' carrier and policy number are: Policy Number is of Agent Date I certify that, in the performs f 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 agree It, if I should become sub`Ha t e workerrssue/e9 ens do rovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. � mature of Applicant IFAGENCY CLARATION REGA ONSTRUCTION DING AGE Y :reby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ides 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 I authorize representatives of this city or pu of Property Owner or Authorized relating to building construction. lspecoon purposes. Print Property Owner's or Authorized ACTION UA BY DECLARATION OF COMPLIANCE KgTHCOOEOF FOR OFFICE USE ONLY _ FE GERAL REGULATONSPART 610E 7ITLE40 AND ACMD RULE 1403. PERMfTEXPfRED Q I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMO PERMfTCANCELLED — PERMfTEXTENDED ASBESTOS NO RONfS NOT APPLICABLE 70 _ I-POPOSED DEMOLITION. PERMfT FINAL /�, ,'ZI ,2'S Y./� CERTIFICATEOF SIGNATURE:. OCCUPANCYISSU€D