HomeMy WebLinkAboutE2019-0744 - Permits,0-wlr City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Job Address: 526 VISTA GRANDE Bldg: 1 Floor: Suite:
Description of Work: ELEC PANEL UPGRADE 200 AMPS
Inspector Area: 8
Legal Description: TR 6230 (L.L.84-214033) PAR 32
Owner: AMBERLEAF INVESTMENS LLC Contractor:
Address: 2616 SAN MIGUEL DR, STE 485 Address:
NEWPORT BEACH, CA 92660
Phone: 949-945-8118 Phone:
Con State Lic:
Issued Date:11/05/2019 Lic Expire:
Bus Lic:
Processed By: Lic Exp Date:
New Construction
Residential
Multi -Family:
0
$0.00
1-2 Family:
0
$0.00
Service
0-600V up to 20OA:
1
$45.00
0-600V over 20OA:
0
$0.00
Over 600V or 1000A:
0
$0.00
O/H to U/G
0
$0.00
TOTAL Fee:
L G ELECTRIC
146 N QUAIL LN
ORANGE CA 92869
714-493-9127
1020048
10131/2020
BT30069641
11/30/2020
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 :
$0.00
11111111111111111111111111J111111111111111Electrical
is!Permit:
it : E2019-074411111�111Project 38
Inspection Requests Phone (949)644-3255
Code Edit: 2016
Worker's Compensation Insurance
Carrier: EVEREST
Policy No: 14901381
Expire : 11/01/2020
FEES
Motors/Transformers (HP/KVA)
0 to 1 HP/KW/KVA:
0
$0.00
Temp Underground:
0
$0.00
1 to 10 HP/KW/KVA:
0
$0.00
Sub Panel:
0
$0.00
10 to 50 HP/KW/KVA:
0
$0.00
0
$0.00
50 to 100 HP/KW/KVA:
0
$0.00
0
$0.00
Over 100 HP/KW/KVA:
0
$0.00
Record Mgmt Fee:
$0.00
Plan Check Fee:
$0.00
Piggy Back/Temp Power:
0
$0.00
Investigation Fee:
$0.00
Temp Power Pole:
0
$0.00
Issuance Fee:
$35.00
Supplemental Fee:
$0.00
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.
OWNER -BUILDER DECLARATION
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 items)
(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 t;ie Busirisss 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).
111, 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
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.f.om IiLensure 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)
s+li q 9tr- cture 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
F;ofessluns Coda, ;S areilable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
SignatU a of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereb,, affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with S ction 7000) of Division 3 of the BusiAONEHUNIPROD
fes ions Code, my license is in full force
a. id effeci. '
License Class License No Date l-O.5 Contractor Sign -
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLO ER TO CRIMINAL PENALTIES AND CIVIL FINES UP T THOUSAND DOLLARS IE100,000), IN ADDITION TO THE
GIST OF COMPENSATION, DP MAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORN Y'S FEES.
I hereby affirm uncer peralty of perjury one of the following declarations:
❑ I hay., and wi;; ;nair.tain 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
pertprmance of the ^iir'I for which this permit is issued. Policy No.
have 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' compensatioi
sahknce carrier and policy number are:
arrier - Policy Number Expiration Date
ame of Agent Phone #
]I certify that, in the perfoance of the w . f r which this permit is issued, I shall not employ any person in any manner so as to become subject to t }@ workers' compensation laws of California, and agre
lat, if I should become subject t the wo rs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisi s.
ignature of Applicant Date
DECLARATION REMiRobteCGlorStRUCTION LENDING AGENCY
hereby affirm under pe�alty 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).
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 owners behalf.
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and county dinances and ate laws relating to building construction.
I authorize representatives of this city or county to nterlthe abov tified property for inspection purposes. /
ignature of Property Owner or Authorized Agent �i� Print Property Owner's or Authorized Agent's Name 7 r3 Date /�-0 'V
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOROFFTCEU5EONLYI/
FEDERAL REGULATIONS PART 61 OF TITLE 40AND
AQMD RULE 1403.
PERMIT EXPIRED
❑ 1 SUBMITTEDASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERMITCANCELLED
PERMITEXTENDED
❑ ASBESTOS NOHHCATIONIS NOTAPPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE:
PERMIT FINAL
CERTIFICATEOF
OCCUPANCYISSUED
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