HomeMy WebLinkAboutE2022-0081 - Permits�«+r, City of Newport Beach - Building Division
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�0 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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Job Address: 20182 KLINE DR Bldg: 1 Floor: Suite:
Description of Work: ELEC/UPGRADE (E) SERVICE PANEL 200 AMP
Inspector Area: 3
Legal Description:
11111111111111111111111111111ill111111111111Electrical Permit: E2022-00811111111Project 202
Owner: TELLER ROBERT
Contractor:
SUNRUN
Address: 20182 KLINE DR
Address:
225 BUSH ST #1400
NEWPORT BEACH CA 92660
SAN FRANCISCO, CA 94104
Phone: 949/723-6665
Phone:
855-478-6786
Con State Lic:
750184
Issued Date:02/10/2022
Lic Expire:
06/30/2022
Bus Lic:
BT30066837
Processed By:
Lic Exp Date:
0413012022
New Construction
Residential
Multi -Family:
0
$0.00
1-2 Family:
0
$0.00
Service
0-600V up to 20OA:
1
$47.00
0-600V over 20OA:
0
$0.00
Over 600V or 1000A:
0
$0.00
O/H to U/G
0
$0.00
TOTAL Fee:
Re c epta c I e/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
Inspection Requests Phone (949)644-3255
Code Edit: 2019
Workers Compensation Insurance
Carrier: ZURICH AMERICAN INS CO
Policy No: WC614287600
Expire : 1010112022
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
Sub Panel: 0
0
0
Record Mgmt Fee:
Plan Check Fee:
Investigation Fee:
Issuance Fee:
Supplemental Fee:
Fee Due at Permit
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday - Friday 700 p.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m.
$0
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, priorto ih: 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 L) 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).
❑ I am exempt from licensure under the Contractors' State License Law for the following reason:
By my signature below 1 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 legally
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 Section 7000) of Division 3 of the Business and Profes o s ode, and license is in full force
and effect. n
License Class License No Date l! v� Contractor Signatur L2
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:
❑ 1 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
performance of the work for which this permit is issued. Policy No.
Pr'have and will m intain workers' pensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatiol
nsurance carrier an licy numb are:
Tier _o tiNu a
Expiration Date
me of Agent
Phone #
certify that, in the performance of the w k for which t ' 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
, s' compe ati provisions of Section
t, if I should becom"ofpoe�ury
3700 of the Labor Code, I shall forthwith comply with those ovisions.
nature of Applican
CLARATION REGT ON L ING AGENCY
areby affirm underthere is a construction 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.
'
n;.y
d
I agree to comply with all applicable city and county o inances and state laws relating to building construction. V`
I authorize representatives of this city or county to er th a ov Identifi
y for inspection purposes. i
maturePrint
mature of Property Owner or Authorized Agent
Property Owner's or Authorized Agent's Nam Ur D
FOR OFFICE USE ONLY
ACTION
DATE
BY
DECLARATION OF COMPLIANCE KITH CODE OF
rcl )ERAI. REGuLATIOhS L'API FF OF TIME 40 AND
AOMDRL'LE 14C3.
I SUtJM'TTE') ASBE5T'DS NCRRCATION TO:
❑ EPA
❑ AOMD
PERMIT EXPIRED
PER441T CANCELLED
PERMIT EXTENDED
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PkOdOSEO DEM011001V.
tiIGNA TL'4E'
PERMIT FINAL
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CEIMRCATE OF
CCCUPANCYISSUED