HomeMy WebLinkAboutE2020-0187 - Permits00,
Mye�r.1,k, City of Newport Beach - Building Division ���111111111p11111111Jill pp11p11111p111111111 Electrical Permit: E2020-0187
oe 'Cl_ 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 0 0 1 8 7 Project No : 2691-2019
Permit Counter Phone (949)644-3288
3 @
A a Inspection Requests Phone (949)644-3255
Job Address: 1011 GRANVILLE DR Bldg: 1 Floor: Suite:
Description of Work: ELEC- RECESSED LIGHTING THROUGHOUT DWELLING, INSTALL SUB -PANEL, REPLACE SWITCHES
REV20-0450, DELTA 1 I IN
S P lE ^T0
Inspector Area: 8 Code Edit: 2019 j �!
Legal Description: TRACT 14839 LOT 2 OF PROJECT 939-63 LOCATED ON AP 442-421-13
Owner: MBS TRUST Contractor: MASTERWORKS CONSTRUCTION SERVICES INC
Compensation Insurance
Address: 1011 GRANVILLE DR
Address:
1376-B CORONADO AVE
NEWPORT BEACH, CA 92660
LONG BEACH CA 90804
Phone:
Phone:
562-961-0607
Con State Lic:
653222
Issued Date:03! /2020
Lic Expire:
05/31/2021
BT30070624
Processed By:
Lic Exp Date:
01/31/2021
Carrier: BENCHMARK INS CO
Policy No: CST5015682
Expire : 04/01/2020
Worker's
FEES
New Construction
Receptacle/Switch/Outlets
Motors/Transformers (HP/KVA)
Residential
Receptacles/Outlets:
10
$10.00
0 to 1 HP/KW/KVA:
0
$0.00
Temp Underground:
9
$C.00
Multi -Family:
0
$0.00
Fixtures:
73
$73.00
1 to 10 HP/KW/KVA:
0
$0.00
Sub Panel:
1
$27.00
1-2 Family:
0
$0.00
Sep Circuits:
0
$0.00
10 to 50 HP/KW/KVA:
0
$0.00
0
$0.00
Low Voltage
0
$0.00
50 to 100 HP/KW/KVA:
0
$0.00
0
$0.00
Service
Signs
Over lUU HFJ/KVV/KVA:
0
$0.00
Record MgmtFee:
0-600V-up-to-200A:-
0
$0.00
Branch-Circuit:
-0___$0.00
Plan _Check -Fee:-
_$D.00
0-600V over 20OA:
0
$0.00
Each Add Circuit:
0
$0.00
Piggy Back/Temp Power:
0
$0.00
Investigation Fee:
$0.00
Over 600V or 100DA:
0
$0.00
Time Clocks:
0
$0.00
Temp Power Pole:
0
$0.00
Issuance Fee:
$35.00
O/H to U/G
0
$0.00
Additional Fee :
$0.00
Supplemental Fee:
$0.00
TOTAL
Fee:
$145.00
Plan Check
Fee : $0.00
Fee Due at Permit Issuance :
$145.00
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.
r
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 theapplicantfor
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).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or J 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.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm unJLr penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the usiness an Profess n ode, and y license is in full force
and effect. �y Imp '
L'CegSP,;lassLicense No [" to 3'—u—ZE'� Contra�rovVignature
WORKERS' C*2MPENSATION DECLARATION
W9R"ING: 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
CJST uF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I h reb� affirm u.iJLr p3:lalty of perjury one of the following declarations:
I have and '-till mpintain 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
uur�ance of Lie work for which this permit is issued. Policy No.
Kave and will rlaintain 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
"su•anc= carrier and Policy number are:
Carrier Policy Number Expiration Date
Name of Agent Phone #
❑I certify that, in (lie performance Atha work for which this 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
that, if I sIX115ecome subject to orkers' co pennp sation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Sig nat a of Applicant 117.E A / IV-1.�, l4 Datt
DECLARATION REGARD C NSTRUCTION LENDI AGENCY
I 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 ( ection 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 ordinanc d state laws relating to building construction. _
I authorize representatives of this city - ounty to enter the e-identifie property for inspection purposes.
Signature of PropertyOwner orAut ed Agent Print Property Owners or Authorized Agent's LLB AA L,015 J to
ACTION DATE BY DECLARATION OF COMPLASBESTOS NOTIFICA
IANCE IMTHCDDE OF FOR OFflCE USE ONLY
FEDERAL REGULATIONSPART 61 OFTtTLE40AND
AOMD RULE 1403.
PERMITEYP)RED
❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AOMD
PERMIT CANCELLED
PERMIT EXTENDED
PROPOSED DEMOLITON.UONIS NOT APPLICABLE TO
_
PERMlTFtNAC
aCGa iM.
CER7fHCATEOF
OCCUPANCY}5SUED
SIGNATURE: