HomeMy WebLinkAboutE2019-0667 - PermitsCity of Newport Beach - Building Division
a s 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
U � $
Job Address: 2245 COAST HWY E Bldg: 1 Floor: Suite:
Description of Work: ELEC -OVERHEAD TO UNDERGROUND. 1 J-BOX ADDED
Inspector Area:
Legal Description:
Owner: MANGOLD MARTIN Contractor:
Address: 2305 E COAST HWY Address:
CDM CA 92625
Phone: Phone:
Con State Lic:
Issued Date:10/01/2019 Lic Expire:
Bus Lic:
Processed By: Lic Exp Date:
Ilii iii 09i 0 6ii6 gi II
J P T CONSTRUCTION INC
409 62NO ST
NEWPORT BEACH CA 92663
714-336-1966
879360
06/30/2020
BT30014788
01/31/2020
New Construction
Receptacle/Switch/Outlets
Residential
Receptacles/Outlets:
0
$0.00
Multi -Family:
0
$0.00
Fixtures:
0
$0.00
1-2 Family:
0
$0.00
Sep Circuits:
1
$7.00
Low Voltage
0
$0.00
Service
Signs
0-600V up to 20OA:
0
$0.00
Branch Circuit:
0
$0.00
0-600V over20OA:
0
$0.00
Each Add Circuit:
0
$0.00
Over 600V or 10oDA:
0
$0.00
Time Clocks:
0
$0.00
O/H to U/G
1
$45.00
Additional Fee:
$0.00
TOT
Electrical Permit: E2019-0667
Project No :
Inspection Requests Phone (949)644-3255
INSPECTOR
Code Edit: 2016
Worker's Compensation Insurance
Carrier: WESCO
Policy No: WWC3408624
Expire : 04/07/2020
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
Check Fee :
Temp Underground
Sub Panel:
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 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m.
.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$35.00
$0.00
)WNER-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
ie 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
of 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 J portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner-Builderwill have the burden of proving that it was not built or
nproved for the purpose of sale).
7 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
pply 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).
7 I am exempt from licensure under the Contractors' State License Law for the following reason:
ly 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 legally
ell 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 It
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sec ion 7 00) of Division 3 of the Business and Professid s Code, nd license is in II force
nd effect.
icense Class License No Date �`s �� Contractor Signatur
PORKERS' COMPENSATION DECLARATION RL// FARMING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EM OYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ON D THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 07DS OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby, affirm under penalty of perjury one of the following declarations:
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
(mance 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 nufnber are:
Policy Number
Agent
Date
I certify that, in the performance of the work r which t ermit I d, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree
that, if I should become subject to the wqr ompen ation 'Ion fi e 3700 of the Labor Code, I shall forthwith comply with those provisions. 11 1 ci
Signature of Applicant Date
DECLARATION REGA ING C0_NA-TiqU9Y1ON LEWDING AGENCY
I hereby. affirm under peiialty of rju at there is a construction lending agency forthe performance of the work for which this permit is issued ( ion 3097, Civil Code).
Lender's Name z 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 behal
I have read this application and the information I have prov' d is c
I agree to comply with all applicable city and county din nc nd stoma. s relating t uilding construction. v
I authorize representatives of this city or county to nter the - -i entified or inspection purposes. '
Signature of Property Owner or Authorized Agent I _ Print Property Owner's or Authorized Agent's Name- ' c=� Date
ACTION
BY
DECLARATION OF COMPLIANCE WITH CODEOF
FOR OFRCE USE ONLY
FEVERPL REGULATIONS PART 61 OF TITL.E40 AND
AWO RULE 7403.
PERMIT EXPIRED
❑ I SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERM IT CANCELLED
___
PERMIT EXTENDED
PUATE
❑ ASBESTOS N017FIC4770MIS NOT APPLICABLE TO
PVOPOSED DEMOLITION.
PERMITFINAL
°� � _ _
CERTI€ICATEOF
OCCUPANCYISSUED
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