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HomeMy WebLinkAboutE2020-0245 - Permits001!T City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 0 0 2 4 5 Permit Counter Phone (949)644-3288 IJ fi Job Address: 507 AVENIDA CAMPO Bldg: 1 Floor: Suite: Description of Work: ELEC (507 & 509 AVENIDA CAMPO) ELEC CONDUIT Inspector Area: Ali) Legal Description: TR 5435 (L.L.84-214024) PAR 83 AND PAR 83G Owner: THE BLUFFS Contractor: BALLARD ELECTRICAL CONTR Address: 2414 VISTA DEL ORO Address: 415 SANTA ANA AVENUE NEWPORT BEACH, CA 92660 NEWPORT BEACH CA 92693 Phone: Phone: 949-642-3670 Con State Lic: 780450 Issued Date:05/21/2020 Lic Expire: 06/3012020 Bus Lic: BT00004347 Processed By: a Lic Exp Date: 12/31/2020 New Construction Residential Multi -Family: 1-2 Family: Service 0-600V up to 20OA: 0 0-600V over20OA: 0 Over 600V or 1000A: 0 O/H to U/G 0 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 $0.00 Fixtures: 0 $0.00 $0.00 Sep Circuits: 2 $14.00 Low Voltage 0 $0.00 Signs $0.00 Branch Circuit: 0 $0.00 $0.00 Each Add Circuit: 0 $0.00 $0.00 Time Clocks: 0 $0.00 $0.00 Additional Fee: $0.00 Electrical Permit: E2020-0245 Project No : 0918-2020 Inspection Requests Phone (949)644-3255 ftp Code Edit: 2019 L • ®F? Worker's Compensation Insurance Carrier: STATE COMP Policy No: 9246335 Expire : 03/01/2021 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 Plan Check Fee : Temp Underground: 0 $0.00 Sub Panel: 0 $0.00 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 Fee Due at Permit Issuance : 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. 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 L all of or L) 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 im roved 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 sign,IN1 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,leginfo.ca.gov/calaw.htmi. Signature of 1Drop^rty Owner or Authorized Agent Date L ICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with action 7000) of Division 3 of the Business a ,Profs ionenyicense is in full force and effect. A Llc,)nse Clacc License No Date Contractor Signature / COMPENSATION DECLARATION NAr.NING: FAILURE TJ SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYW TO CRIMINAL PENALTIES AND CIVIL FINES UP TO OJYE HUNDRED THOUSAND DOLLARS I$100,0001, IN ADDITION TO THE . OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 370E OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 111 have avid wil: 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 IN uegormance of the work for which this permit is issued. Policy No. have and mil, 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' Vnce carrier and policy number are: Policy Number Date me of Agent Phone # certify that, in the pe rmance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to/thworkers' compensation laws of California, and agree t, if I should become ubjectto th yors' c ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisi nature of Applicant ./F/%i`i% Date CLARATION REG RDIN6'CONS'rRUCT�N'LENDING AGENCY ' / areby affirm under enalty of perjury that t ere is a construction lending agency for the performance of the work for which this permit is issued (ection 3097, Civil Code) Ider's Name Lenders 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 havyrprovided is correct. I agree to comply with all applicable city and countyrdinances and states relating to building construction. I authorize representatives of this city or county to me the ah y.@`le% r6eerty for inspection purposes. Signature of Property Owner or Authorized Agent n �/' <'' Print Property Owner's or Authorized Agent's Name d✓' 7j !/ V �✓ ,1 21 Dat '" ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE US ON[Y FEDERAL REGULATIONS PART 61 OF TI TLE40AND AOMO RULE 1403. PERMIT EXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMITCANCELLED PERMITEXTENDED ASBESTOS NOTIFICA PROPOSED DEMOLITION. HON IS NOT APPLICABLE TO PERMIT FINAL _ L • Z C€RTWICATEOF OCCUPANCY[SSU€D SIGNATURE: \ _ u > ® K/ 3 e ) / \ \/ \ a\ t 0 / () 0 §\p0 f o \ Cd ad � k ` © m l �\ )k/ \ b '% 2a ° \ § §] /\\ \ e ƒo kg©/ / ) ka (ƒ \\\ y/ / )§ m} '§/ 2 cn /U / \§ - cd op, _ )\�C.) § ui �kƒ\ u %u% a §)m\m j& o CD5)\ ®� \ \;a j \ / \ ƒ\\ a } x// (� 2 eX J 4.Hf �\ 40