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Home My WebLink AboutE2016-0367 - PermitsCity of Newport Beach - Building Division (10 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 46 HILLSDALEDR Bldg:1 Floor: Suite: Description of Work: ELEC- 200 AMP SERVICE UPGRADE Inspector Area: II IIE IIII IIII 0I�I� IIII 0�II IIIII IIIII III II Legal Description: TR 11785 LOT 4 UNIT 27 OF PROJECT LOCATED ON AP 442-301-69 TOGETHER Owner: BERNATZ ROBERT L Contractor: Address: 46 HILLSDALE DR Address: NEWPORT BEACH, CA 926660 Phone: Phone: Con State Lic: Issued Date:06/08/2016 Lic Expire: Bus Lic: Processed By: Lic Exp Date: New Construction Residential 1-2 Family: Service 0-600V up to 20OA: 0-600V over20OA: Over600V or1000A O/H to U/G POWELL ELECTRIC 5625 W WASHINGTON BLVD LOS ANGELES CA 90016 800-660-8076 631836 11/30/2017 BT30024341 07/31/2016 Electrical Permit: E2016-0367 Project No: Inspection Requests Phone (949)644-3255 Code Edit: 2013 I N S P Koff% T 0" Rik Worker's Compensation Insurance Carrier: TRAVELRS PROPERTY INS Policy No: DTJUB1 G47215 Expire : 07/01/2016 FEES Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Receptacles/Outlets: 0 $0.00 0 to 1 H P/KW/KVA: 0 $0.00 —0--$0.00 Fixtures: $0.00 1 to 10 HP/KW/KVA: 0 $0.00 0 $0.00 Sep Circuits: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 Low Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 Signs Over 100 HP/KW/KVA: 0 $0.00 1 $40.00 Branch Circuit: 0 $0.00 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 TOTAL Fee: Plan Check Fee: PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Temp Underground: 0 $-0.00 Sub Panel: 0 $C.30 0 $C.33 0 $C.33 Record Mgmt Fee: :G.30 Plan Check Fee: 0.00 Investigation Fee: M00 Issuance Fee: $32.OG Supplemental Fee: $0.00 Fee Due at Permit Issuance : $72.00 )VIINCK-OUILUCK idm�iwn I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) 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 .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 iot 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 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 mproved 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 fallowing 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 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.govlcalaw.htmi. Date Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of e B siness and rofe ions Code nd�my-licgnse is in full force and effect. / G 3 �6 /PLOYER �� — ` Contractor ignature J License Class C License No WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT ATO CRIMINAL PENALTIES AND CIVIL FIN S UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 370G OF THE LABOR CODE, INTEREST, ANDS FEES. I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will mairtain 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 ormaice of the work for which this permit is issued. Policy No. and wid maioterin 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' compensatiol sarance carrier and policy number are: .Carrier Policy Number Expiration Date --- Phone ,e of Agent - - - certify that, in ti rma ce oft work for h this permit is issued, I shall not employ any person in any manner so as to become sL it I rbould be^'ome s blect o theWorkers' compqrlsation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those LLA"TI�N F:EGARDING CONSTRtgDON LENDING AGENCY V` hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued snder'F 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 appli ble city and cou ty Inances relating to building construction. I authorize representative his city or county en rthe ove-identified property for inspection purposes. Print Pi Owner's or AuthorizedVVsme ACTION I DATE PERMITEXPIRED PERMIT CANCELLED PERMIT EXTENDED PERMIT HNAL CERTIFICATE OF OCCUPANCYISSUED BY II FEDERAL OFTITLE40AND ❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD ❑ ASBESTOS NOTIRCATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. 11 SIGNATURE: to the workers' compensation laws of California, and 6—F-/C 3097, Civil Code). _ � ✓L .r( G VL r