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Home My WebLink AboutE2018-0783 - Permits1 City of K&p8ft.Bb;9cb 00ulkling Division m . e o ® co e ' 100 Civic Cen$rr DrivC Np4oi,j Bp aah, C692.660 Permit CounB=.f Phode (949)64428$.. m. III'�� II Proicjectloons it: E2018-0783 qi fl��1 •o o°m e e m a _ ¢ m• o m o m Job Address: 608 BAY FRONT S Bldg: 1Floor: ... Sdite: Description of Work: ELEC -DISCONNECTS (2) FOR A/C CONDENSOR INSTALLATIONS Inspector Area: Legal Description: BALBOA ISLAND SEC 2 LOT 5 BLK 1(AND LOT 6 BLK 1 Owner: HANSEN ROBERT Address: 841 APOLLO ST #450 EL SEGUNDO, CA 90245 Phone: Issued Date:12/10/2018 Processed New Construction Residential Multi -Family: 1-2 Family: Service 0-600V up to 20OA: 0 0-600V over 20OA: 0 Over 600V or1000A: 0 O/H to U/G 0 TOTAL Contractor: CLIMATE AIR MASTERS INC Address: 1139 N ANAHEIM BLVD Time Clocks: ANAHEIM CA 92801 Phone: 951-2$8-6822 Con State Lic: 695854 Lic Expire: 08/31/2019 Bus Lia BT30059886 Lic Exp Date: 12/31/2019 Receptacle/Switch/O utle Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 0 Low Voltage 0 Signs $0.00 $0.00 $0.00 $0.00 .00 Inspection Requests Phone (949)644-3255 Code Edit: 2016 Worker's Compensation Insurance Carrier: SECURITY NATIONAL Policy No: SWC1157439 Expire : 06/25/2019 rm lr �,114 is FEES Each Add Circuit: 0 $0.00 Time Clocks: Motors/Transformers (HP/KVA) Additional Fee: $0.00 0 to 1 HP/KW/KVA: 0 $0.00 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 Over 100 HP/KW/KVA: 0 $0.00 Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee: $0.00 Piggy Backfremp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Temp Underground: Sub Panel: Record Mgmt Fee: Plan Check Fee: Investigation Fee: Issuance Fee: Supplemental 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. .00 $0.00 $52.00 $0.00 $0.00 $0.00 $0.00 $0.00 $35.00 $0.00 )WNER-BUILDER DECLARATION I hereby affirm under penalty of a 'u that I am exempt from the Contractors' State License Law for the reasons indicated below b Fhe.checkmark t ave 2ce .xt to the applicable item (s) Y P Y P 0 ry P () Y ,,, i) h •Pl def' PP (s) Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct; alter, improve, demolish, or repair arty stru5ture, prior to its issuance, also requires the applicant for ie 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 'rofessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by anj applicant for V perrgit subjects the applicant to a civil penalty of of more than five hundred dollars ($500). . .. e 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 it venped or offered iar sale (Section 7044, lusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or MonaCaffort, uildsor improv09•th8 o fterty, provided that the nprovements 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 n 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 pply 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: ly 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, ell 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ce.gov/calaw.html. lignature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 O�f Division 3 of the Business and Professions Code, and my license is in full force nd effect. icense Class License No Dal % d), Contractor Signa re VORKERS' COMPENSATION DECLARATION 'ARNING: 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 OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: I have 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 th erf mance of the work for which this permit is issued. Policy No. 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' carrier and policy number are: Policy Number Expiration Date lame of Agent Phone # JI certify that, in the performance o rk fo Is permit is issue not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre iat, if I should become subje a rs' compensation prov' ' of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Q� lignature of Applicant Dates IECLARATION REGARDING CONST L DWS'AGENCY �. hereby affirm under penal qury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ender's Name Lender's Address ly 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 torr I agree to comply with all applicable city and county orad' ate la o wilding construction. I authorize representatives of this city or count nt bey - entified property for inspection purposes. kmature of Property Owner or Authorized Au L_�� Print Property Owner's or Authorized ADent's Name t Date ACTION DATE G BY OtLLAHA IIUN UI- LUMPLIANtt WIIH LUOL UI- I `, FOR OFFICE - FEDERAL REGULATIONS PART 61 OFTITLE40AND AQMDRULE 1403. PERMITEXPIR€D ❑ I SUDMfTTEDASBESTOS NOTIFICATION T0: ❑ EPA ❑ AQMD PERMITCANCELLED PERMITEXTENDED ❑ ASBESTOS NOTfFfCARONIS NOT APPLICABLE TO PROPOSED DEMOLITION SIGNATURE: PERMITFINAL CERTIFICATEOF OCCUPANCYISSUEDIli II IG /