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Home My WebLink AboutE2021-0719 - Permits(9) City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 113 (MP) BAYSIDE P� Bldg: 1 Description of Work: DOCK ELECIRICAAa: •(', LED IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II Electrical Permit: E2021-0719 E 2 0 2 1 e 7 1 9 Project No : 2471-2021 20A BREAKER & Inspector Area: Legal Description: CORONA DEL MAR LOT BILK D FOR OF BILK Owner: LAZKANI NANCY Contractor: ASSOCIATED PACIFIC CONST Address: 113 BAYSIDE PIL __ Address: 495 EMBARCADERO CORONA DEL MAR A 92$25 MORRO BAY CA 93442 Phone: Phone* 805-772 7472 z Con State Lic 394886 Issued Date:10122/2021 ` Lic Expire `- 1T/30/2022 Bus Lic: BT30047194 Processed BY: Lic Exp Date: 05/31/2022 New Construction Residential Multi -Family: 1-2 Family: Service 0-600V up to 20OA: 0-600V over20OA: Over600V or1000A: O/H to U/G TOTAL Inspection Requests Phone (949)644-3255 If aPliq& l� o e Edit: 2019 ❑ 80% or ❑ 100% refund o-� to Wi offiGrker's Compensation Insure Ca ce 4 A4IANio Policy No: 2020010391755 .` �j� Expire:10/01/2022 �a n I Receptacle/Switch drl[lets Motors/TransifprIners (HP/KVA)_ ! a ± Receptacles/Outlets: 2 $3.50 0 to 1 HP/KW/KVA: 0 $0.00 1OI�Q'` 0 ��• —F 41ices 29 $44.00 1 to 10 HP/KW/KVA: 0 $0.00 0 0.00 Sep Circuits: 1 KVA ._0 .__ $0.00 I a e 1 $1.00 50 to 100 HP/KW/KVA 0 $0 60 F 1-04-HPXW/KVA 0 $0 00 �_• . 1 $47 00 Branch Circud: - 0 $0.00 Each Add Circuit 0 $0.00 Piggy Back/Temp Power: 0 $0.00 0 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 0 $0.00 Additional Fee : $0.00 Fee : Temp Und ground: Sub Panel 0 $0.00 A $0,00 cord Mg t Fee: $0.00 nGhec Fee;' $89.'R Investigati Fee: $0'.00 Issuance Fee: $38.00 Supplemental Fee: $0.00 Fee Due at Permit Issuance : PERMITS EXPIRE 180 DAYS AFTER ISSI/ANCE 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. DWNER-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 items) ;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 ;he 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 ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with lice e C act r two ct the project (Section 7044, Business and Professions Code: The Contractors St to Llpense Law does not apply to an owner of property who builds or improves thereon, and w l c n of tF pr ects with a licensed Contractor pursult��6s' State License Law) ❑ I am exempt from licensure under the Contractors' State License La for th��w`ing reason. By my signature below I acknowledge that, accept for my personal residence in which I must have resided for at least one year pr�or� tQq-.ccpprrppgletion OQE-�teqit ment$ cover d y this -permit, I cannot legal sell a structure that I have built as an own err,puilderif'it has not been constructed in its entirety by licensed coFfE'a`eFr1T.'s. Lt�nderstalDdjtl3�ta".Cdp�if the ap�l $ 70 4 of the Business and Professions Code, is available upon requE !!hen this application is submitted or at the following Web site http//www.leginfo.ca.gov/calaw.htm]. ` Signature of Property Owner or Authorized Agent -:- - Date LICENSED CONTRACTOR'S DECLARAT I hereby affirm under penalty of perjury that I.am and effect. License Class k I WORKERS' COMPENSATION DECL A' NARNING: FAILURE TO SECURE WORKERS' COMPE AT COST OF COMPENSATION. DAMAGES AS PROVIDED R 11 hereby affirm : r.da ;penalty of perjury one I have ar iP Eaintain a certificate c a� ,rice of the work for which this pern- L, /have and wil' maintain workers' compe 2Rurence carrier and policy number are: le of Agent certify that, In the perform ce of the if I should become gublj tot ey+o latrre of Aroliccnt / 5 f under provisions of Chapter 9 (commencing -; LU VVIIU!11. 7000) of Division 3 of the Busin ss and �L Contractor Sigrure -) 8IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND 96 OF THELABOR LODE, INTEREST, AND Ai7(ORNEY•SFEES the following declarations: consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section is is 11c! im �. . sati0,10 ece. a quN ;pyiSechon 370O d cpe Labor Code for the performance of the work for which this permit :is iE E e e u Policy N Expiration Date Phnne # this permit is issued, I shall not employ any person in any manner so as to become subject to the w at on provisions of Section 3700 of the Labor Code.l shall folihwith comply with those. provisions, - Date ;reb, affirm p'dder penalty of perjury that tgW,i&a .g,Os}r t•nn lending_agency for the performance of the work for which this permit is issued (Section 3097, Civil Code) Ider'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 county ord' nces and state laws relating to building construction. I authorize representatives of this city or county to nt r e b°�e If' d property for inspection purposes. nature of Property Owner or Authorized Agent /CAA /✓ Print Property Owner's or Authorized Agent's 1\14e license is in full force ($100,060), IN ADDITION TO THE of the Labor Code, for My workers' of California, and /z/ ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART Bf OFTITLE40AND AQMD RULE 1403. PERMIT EXPIRED ❑ ISUBMITTED ASBESTOS NOTIFICATIONTO: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMIT EXTENDED ❑ ASBESTOS M077FICA77ON IS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL CE,RT(FCATE OF SIGNATURE: OCCUPANCYISSUED