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Home My WebLink AboutE2019-0848 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 {�{/Y41Yb4` Job Address: 1128 CORELLA Bldg: 1 Floor: Suite: Description of Work: ELEC *BLDG 15* REPLACE DISCONNECTS (H2O19-0804) UNITS 1128-1138 Inspector Area: 8 Legal Description: N TR 12309 LOT 4 Owner: IAC AT JAMBOREE LLC Contractor: Address: PO BOX 2450 Address: NEWPORT BEACH CA 92658 Phone: Phone: Con State Lic: Issued Date:12/ / 19 Lic Expire: Bus Lic: Processed By: Lic Exp Date: New Construction Residential Multi -Family: o $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 Fee: $251.01 E 2 0 1 9 0 8 4 8�� II U M AIR INC 12211 WOODRUFF AVE DOWNEY CA 90241 562-413-1235 1050013 02128/2021 BT30061455 12/3112019 Receptacle/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 : $0.0c Electrical Permit: E2019-0848 Project No : Inspection Requests Phone (949)644-3255 A,tc "- A h I'\" Code Edit: 2016 �B Worker's Compensation Insurance Carrier: NATIONAL LIABILITY Policy No: A9WC045079 - - Expire :109/j3i2020 ` 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 Plan Check Piggy Back/Temp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Temp Underground: 0 Sub Panel: 1 8 $2iC.33 0 $0.00 0 $0.00 Record Mgmt Fee: $0.00 Plan Check Fee: $0.00 Investigation Fee: $0.00 Issuance Fee: $35.00 Supplemental Fee: $0.00 Due at Permit Issuance : $251.00 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. OINNEK-tiUILUhK 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 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 Busirie9s 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 (_) 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 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.Jeginfo.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 usmass and Pr ssions Code, and my license is in full force and effect. Va Class License No d /49 �/ 9 Contra IOR us PA CbMPEF!SATION DECLARATION W,RF NG:-AILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUWECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($10 ,000), IN ADDITION TO THE �.ST CF ZOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. �hereby affirm uc.�e: por.alty of perjury one of the following declarations: 0 I 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 thi )enonnl nice of ti,e'work For which this permit is issued. Policy No. and will rT.aintain 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 , - nluue certify that, in the performance of the work forwhich this permit is issued, I shall not employ any person in any manner so as to become s if I rould b!�qrne sl�tto the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those I U=GLAKATIUN EGARDING CONSTRUCTION LENDING AGENCY hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit ender's Name Lender's Address y 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 representatiAsArl city or county to a above-identif -for inspection purposes. ignature of Property Ow o Authorized Agent Print Property Owner's or Au or d Agent's Na - - ,,�' Dat 4,12 / b, Date bject to the workers' compensation laws of California, and agre provisions. ✓J Date��-! 3097, Civil Code). ACTION DATE BY DECLARATION OFCOMPLJANCE WITH DEQF FEDERAL REGULATIONS PARTfit OF 7 TLE640 AND AQMD RULE 1403. ❑ I SUBMITTEDASBESTOS NOTIFICATION T0: ❑ EPA ❑ AQMD ❑ ASBESTOS NOTlACARONIS NOT APPLICABLE TO PROPOSED DEMOLITION, SIGNATURE: FOR OFFICE USE ONLY PERMIT EXPIRED PERPv1IT CANCELLED PERMIT EXTENDED PERMIT RNAL 5 Z/Z/ZI CERTfFfCATEOF OCCUPANCY? SSUED Ab "