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HomeMy WebLinkAboutE2019-0347 - PermitsCity of Newport Beach -Building Division 100 Civic Center Drive, Newport Beach, CA 92660 ' Permit Counter Phone (949)644-3288 Job Address: 637 VISTA BONITA Bldg: 1 Floor: Suite: Description of Work: ELEC/DINSCONNECT TO MINI SPLIT H2O19-0313 Inspector Area: Legal Description: Owner: LEST] 8 TR 5877 (L.L.84-214030) PAR 22 JANET A BONITA CA 92660 Date:05/29/2019 New Construction{/ Residential r Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 949-885-0102 Con State Lic: 0-600V up to 20OA: 0 $0.00 0-600V over20OA: 0 $0.00 Over 600V orIOOOA: 0 $0.00 0/H to U/G 0 $0.00 *E2019-0347* Contractor: GREENSTAR HOME SERVICES Address: 1951 N MAIN ST 1 ORANGE CA 92865 Phone: 949-885-0102 Con State Lic: 795556 Lic Expire: 02/29/2020 Bus Lic: BT30056111 Lic Exp Date: 08/31/2019 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 1 $7.00 Low Voltage 0 $0.00 Signs 10 to 50 HP/KW/KVA: 0 Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee: $0.00 Electrical Permit: E2019-0347 Project No: Inspection Requests Phone (949)844-3255 Code Edit: 2016 Worker's Compensation Insurance Carrier: LIBERTY INS ... 0 Policy No: WA763D508631018 Expire : 10/01/2019 a ©a.o 0000cn " v o os o 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 o e 30" WIDE X 315)''m DEPTH D o e n REQUIREQ7 PGR Temp Underground: Sub Panel: Record Mgmt Fee: Plan Check Fee: Investigation Fee: Issuance Fee: Supplemental Fee: Fee Due at 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 6:00 a.m. to 6:00 p.m. 0 0 $0.00 $0.00 $0.00 $0.00 $0.00 $35.00 $0.00 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 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 (_) all of or (_) 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 1t was not built or ffIm roved for the purpose of sale). 1, 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 ap ly 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: 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.govtcaiaw.htmi. Date Signature of Property Owner or Authorized Agent LICENSED CQDURACTOR'S DECLARATION se is in full force I hereby affirm'4"i;ir.0enalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 00) of ivislon 3 of the Business and P ,and effect. �tcbh94 Class' License No Dat -121 Contractor Signature WORKERS' 609PENSATION DECLARATION INAAWNG: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000(, IN ADDITION TO THE COST OF COMPENS AT191d, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. L Pierreb affrm under penalty of perjury one of the following declarations: ,I jlpve and.wiQ 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 ojrPBnce of trid?Ork for which this permit is issued. Policy No. and will mainjain. 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 Osdran carriereee Q@licy number are: ray _ _ Policy Number Expiration Date certify that, in the performance of the 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 agree if I should become subject to the wor 0 of the Labor Code, I shall forthwith comply with those provisions / nature of Applicant Dat CLARATION REG DI ION L G AGENCY :reby affirm under enalty of perjury that there' -construction lending agency for the performance of the work for which this permit is !as' us d (Section 3097, Civil Code). ider's Name Lender's Address 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. �Z�/ I agree to comply with all applicable city and count ws re Sting to building construction. I authorize representatives of this city or c°�my then eabove-identified property for inspection purposes. ` ^ l�j , , „ Duk nature of Procertv Owner or Authorized Againl�L/ Print Property Owners or Authorized Agent s NaniE�-� 444///����1 / ✓yuLc ACTION I DATE I BY AQMQRULE4403. © 1 SUBMITTEDASBESTOS NO7IFICATION TO: © EPA AQMD ❑ ASBESTOS M017RCAJIONIS NOT APPGCABLE TO PROPOSED DEMOLITION. SIGNATURE. OCCUPANCYISSUED