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Home My WebLink AboutE2021-0423 - Permits� City of Newport Beach - Building Division 1111111111111p11111111 111111p1111111111111 Qs 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 1 0 4 2 3 Permit Counter Phone (949)644-3288 Job Address: 1816 NEWPORT HILLS DR E Bldg: 1 Floor: Suite: Description of Work: ELEC -DISCONNECT FOR MINI -SPLIT (H2O21-0423) Inspector Area: Legal Description: N TR 7031 LOT 71 Electrical Permit: E2021-0423 Project No: 1492-2018 Inspection Requests Phone (949)644-3255 Code Edit: 2019 Owner: CHU CLEMENT Y Contractor: ALPS A/C & HEATING INC Worker's Compensation Insurance Address: 1816 NEWPORT HILLS DR E Address: 1895 S SANTA CRUZ ST Carrier: PREFERRED PROFESSIONAL NEWPORT BEACH, CA 92660 ANAHEIM, CA 92805 Policy No: ON0915602 Phone: 949-720-0918 Phone: 714-633-8892 Expire:10/1912021 Con State Lic: 667953 Issued Date:07/15/2021 Lic Expire: 04/30/2023 Bus Lic: BT30047511 Processed By: Lic Exp Date: 07/30/2022 OR INSF FEES New Construction Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Residential Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 1-2 Family: 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 Service Signs Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: 0-600V up to 200A: 0 $0,00 Branch Circuit: 0 $0.00 Plan Check Fee: 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Piggy Backrremp Power: 0 $0.00 Investigation Fee: Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: O/H to U/G 0 $0.00 Additional Fee : $0.00 Supplemental Fee: Plan Check Fee : 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 DWNER-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 Iicensure 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 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 Iicensure 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 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.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sec' n 70 ) of Division 3 of the Business and Professions Code, and y.diseHse-is in full force and effect. CC License Class License No Date./ �D Contractor Signat e WORKERS' COMPENSATION DECLARATION J WARNING: 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 COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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 pv&rmance 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 Date Name of Agent vnone iF I certify that, in the performance of th for is permit is issu all not employ any person in any manner so as to become subject to the workers' co pensation laws of California, and ogre that, if should become subject t compensation 1, . ' of Section 3700 of the Labor Code, shall forthwith comply with those provisions. _ Signature of Applicant Date DECLARATION RLGARDRtG 92NS41RFLICTIONj,DING AGENCY I hereby affirm under penaltyo perjury that tIbefe is a construction lending agency for the performance of the work for which this permit is issued (Section 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 ordinances and state laws reI building construction. I authorize representatives of this city or county o enter the above-ide property for inspection purposes. Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name _ L'ft'c'i Date ACTION DATE y DECLARATION OF COMPLIANCE IMTH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403. PERMIT EXPV RED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMIT EXTENDED ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO DEMOLITION. PERMIT FINAL 747fiPROPOSED CERTIFICATEOF SIGNATURE: OCCUPANCYISSUED