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Home My WebLink AboutE2018-0065 - PermitsCity of-Newpor(�Beach - Building Division *E2018-0065* r 100 Civic Center Drive, Newport Beach, CA 92660 Y n Permit Counter Phone (949)644-3288 t,r<iA Electrical Permit: E2018-0065 Project No Inspection Requests Phone (949)644-3255 Job Address: 1423 HIGH BLUFF DR Bldg: 1 Floor: Suite: " '°u Description of Work: ELEC (2) DISCONNECTS (H2O18-0082) ! ; u 33 'v 3 i a m Inspector Area: 8 Code Edit:2016 Legal Description: N TR 15243 LOT 11 Owner: NICANOR ISSE Contractor: GREENSTAR Worker's Compensation Insurance Address: 1423 HIGH BLUFF DR Address: 1951 N MAIN ST Carrier: LIBERTY INS NEWPORT BEACH, CA 92660 ORANGE CA 92865 Policy No: WA763D508631017 „ Phone: Phone: 949-885-0102 Expire : 1010112018 Con State Lic: 795556 Issued Date:01/31/ 18 Lic Expire: 08/28/2018 Bus Lic: BT30056111 Processed By: Lic Exp Date: 08/31/2018 „ FEES New Construction Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Residential Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $0 I.t. Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 2 $32.00 Sub Panel: 0 $0,110 1-2 Family: 0 $0.00 Sep Circuits: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 0 $O no Low Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 9 $o nn Service Signs Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: $0.00 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 Plan Check Fee: $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Piggy BackfFemp Power: 0 $0.00 Investigation Fee: $0.00 Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $33.00 O/H to U/G 0 $0.00 Additional Fee : $0.00 Supplemental Fee: $0.00 TOTAL Fee : $65.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $65.00 PERMITS EXPIRE 130 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. 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, 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 (_) 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 legal) 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 Pr fes ' s Code, and my license is in full force and ee Lise Ulass---- License No Vdate� Contracla r9 re WORK EPS' ( OPRFIENSATION DECLARATION �/ QJPPN-N 1 FAILURE -0 SEC')RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($10(1,000), IN ADDITION TO THE rOST C9 :OMPENCAT.C.V, LAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I h?•eby affirm under penalty of perjury one of the following declarations: , nave 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 W.Imnianca of .he worn for which this permit is issued. Policy No. _P` `ve and wil! 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' compensatio Isurance carrier and policy number are: Career Policy Number Expiration Date t('ame of Agent Phone # I �er.ifv tl iat, 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 Iothe workers' compensation laws of California, and agre that, if I should be-otao su the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prove ns. Signature of pplicant� DECLA TI AR G CONSTRUCTION LENDING AGENCY I hereby affi 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). Lender's Name Lender's Address By 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 ordinances and state laws relating to building construction. I authorize representativas ofth. I or county ente a above-i ntified property for inspection purposes. Signature of Property Owner dr Authorized Agent Print Property Owner's or Authorized n s e Date ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGDLAT/ONSPART 61' OFTITLE40AND AQMD RULE 1403. PERMIT EXPIRED ❑ 15UBMlTTED ASBESTOS NOTIFICATION TO: ❑ EPA [I AQMD PERMIT CANCELLED � PERMIT EXTENDED ❑ ASBESTOS NOTIflCARONIS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: PERMITFINAL CERTIFICATEOF OLCUPANLYISSUED