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Home My WebLink AboutE2019-0537 - Permits0sCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 ``g Permit Counter Phone (949)644-3288 A Job Address: 1402 Description of Work: ILIA BLVD E tlldg: 1 FIOOC Suite: INSTIL DISCONNECT FOR NEW A/C UNIT (H2O19-0473) Inspector Area: 1 Receptacle/Switch/Outlets Legal Description: BALBOA TR EAST SIDE ADD BILK 23 LOT 12 Owner: SIMMONS JOHN & KRISTINE Contractor: Address: PO BOX 4320 Address: NEWPORT BEACH CA 92661 $0.00 Phone: Phone: 0 - Con State Lie: IssuedDate:08/05/2019 Lie Expire: yr, Bus Lie. Processed B"0400"� Lic Exp Date: New Construction Residential Multi -Family: 0 1-2 Family: 0 Service 0-600V up to 20OA: 0 0-600V over 20OA: 0 Over 600V or1000A: 0 O/H to U/G 0 11111111111111111p11111Jill p1JI11111 Electrical Permit: E2019-0537 E. 2 0 1 9 0 5 3 7 Project No Inspection Requests Phone (949)644-3255 NO CONSTRUCTIQWQkSE DYNAMIC AIR SERVICESO mpensation Insurance 21088 BAKE PKWY #1044✓ THE WEA OAK RIVER INS n`°° LAKE FOREST CA 92630 Policy No: DYWCIOWDE X 36 "Dt'PTHm o 949-340-3917 Expire: 03/01/2020 R��SES ®e 753286 V 02/28/2021 e o 0 0 BT30064634 X� E)JSGONNIECTS 10/31/2019 C P. [ice O m m OmmOm so m o omomm TOTAL Fee: $61.00 Motors/Transformers (HP/KVA) 0 to 1 HP/KW/KVA: Receptacle/Switch/Outlets $0.00 Receptacles/Outlets: 0 $0.00 $0.00 Fixtures: 0 $0.00 $0.00 Sep Circuits: 0 $0.00 $0.00 Low Voltage 0 $0.00 Temp Power Pole: Signs $0.00 $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 TOTAL Fee: $61.00 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 Backrremp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Plan Check Temp Underground: Sub Panel: Record Mgmt Fee: Plan Check Fee: Investigation Fee: Issuance Fee: Supplemental 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. Issuance: bmssmm ° o C4G0 Q� ommmm $0.6®OD 1 $26.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 $35.00 $0.00 WNER-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) ;action 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 IS 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 withiSection 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 any applicant for a permit subjects the applicant to a civil penalty of of 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, usiness 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 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 nproved 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 alicensed Contractor pursuant to the Contractors' State License Law). _ I am exempt from licensure under the Contractors' State License Law for the following reason: y 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.ca.gov/calaw.html. signature of Property Owner or Authorized Agent Date .ICENSED CONTP.ACTOR'S DECLARATION hereby affirms uasler eenalty'of pejury that I.am licensed nde noVto.,rys gS.,C ter 9 (commencing with Secti n'S0� of Division 3 of the me d Professions de, and r ieefise is in full force adeYact. .. i)'�U( Contra nature icensEClass • • • License No tQRlfERS' COMPENSATION DECLARATION IARARG: FAILUREJQ•SgCURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SMALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAN S (5100,0001, IN ADDITION TO THE OST OF COMPENSATION,AAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm u`naer penalty of perjury one of the following declarations: ... . 3'1'ITz;ve and.wll"dintain 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 t vrmance of the work for which this permit is issued. Policy No. Funiaw and will maietain 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' compensatio rante carri2l'2rlti't431icv number are: Policy Number Date ne of 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 agrer :, if I should become sub' Ct to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature o t Date 0 CLARA REG_0NSTRUCT4DN LENDING AGENCY !reby affirm tinder penalty of perjury ere is a construction lending agency for the performance of the work for which this permit is issued (e tion 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 owner's behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city ounty nances and state laws relating to building construction. 1 authorize representatives of this city or coun me = d ntified property for inspection purposes. \�r� nature of Prooertv Owner or Autypr� Agent �d Ag Print Property Owner's or Autqent's Name LJ r ACTION -OATS --- FEDERAL REGULATIONS PART Gf OF TITLE40AND AQMO RULE -1403. I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD ❑ ASBESTOS NOIiFICATIONIS NOT APPLICABLE TO PROPOSED DEMOLITION SIGNATURE. EXPIRED CANCELLED E:ffENDEO FINAL •\ ,ATEOF CiCCUPANCYISSUEO