HomeMy WebLinkAboutE2019-0066 - PermitsCity of Newport Beach - Building Division II�IIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIII
' 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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Job Address: 1533 MIRAMAR DR Bldg: 1 Floor:
Description of Work: ELEC/DISCONNECT TO A/C UNITS
H2O19-0070
Inspector Area: 1
Legal Description: N TR 518 BILK I LOT 38
Owner: PENCE GY
Contractor:
TERRA BELLA DEVELOP INC
Address: 1 MIRAMA DR
Address:
27001 LA PAZ RD #354
EWPORT BEA H, CA 92661
Residential
MISSION VIEJO CA 92691
Phone: 805 405-1567
Phone:
949-916-6747
0 to 1 HP/KW/KVA: 0 $0.00
Con State Lic:
807405
Issued ate:02/06/2019
Lic Expire:
04/30/2020
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Bus Lic:
BT30061388
Proces ed By:
Lic Exp Date:
11/30/2019
Electrical Permit: E2019-0066
Project No: 1234-2017
Inspection Requests Phone (949)644-3255
Code Edit: 2016
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Worker's Compensation Insurance °
Carrier: NO EMPLOYEES
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Policy No:
Expire :
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New Construction
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FEES
Motors/Transformers (HP/KVA)
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Residential
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0 to 1 HP/KW/KVA: 0 $0.00
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Multi -Family:
0
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New Construction
Receptacle/Switch/Outlets
FEES
Motors/Transformers (HP/KVA)
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Residential
Receptacles/Outlets:
0 $0.00
0 to 1 HP/KW/KVA: 0 $0.00
Temp Underground: 0
$0.00'
Multi -Family:
0
$0.00
Fixtures:
0 $0.00
1 to 10 HP/KW/KVA: 0 $0.00
Sub Panel 0
$0.00'
1-2 Family:
0
$0.00
Sep Circuits:
2 $14.00
10 to 50 HP/KW/KVA: 0 $0.00
0
$0.00,
Low Voltage
0 $0.00
50 to 100 HP/KW/KVA: 0 $0.00
0
$0.00
Service
Signs
Over 100 HP/KW/KVA: 0 $0.00
Record Mgmt Fee:
$0.00
0-600V up to 20OA:
0
$0.00
Branch Circuit:
0 $0.00
Plan Check Fee:
$0.00'
0-600V over 20OA:
0
$0.00
Each Add Circuit:
0 $0.00
Piggy Back/Temp Power: 0 $0.00
Investigation Fee:
$0.00,
Over 600V or 1000A:
0
$0.00
Time Clocks:
0 $0.00
Temp Power Pole: 0 $0.00
Issuance Fee:
$0.00'.
O/H to U/G
0
$0.00
Additional Fee:
$0.00
Supplemental Fee:
$10.00'
TOTAL Fee: $24.00
Plan Check Fee: $0.00
Fee Due at Permit Issuance: $24.00
PERMITS EXPIRE 980 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.
30" WIDE X 36" DEPTH
REQUIRED FOR
A/C DISCONNECTS
JWNtZK-[IUILUGR uo1.L Nr IwN
I hereby affirm under penalty of perjury that I am exempt from the Contractors' Stale 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
:he 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
3rofessions 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
iot 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 U 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
i�m 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
apply t0 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 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 structurettlaNl•heve 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 CIA i%available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Dale
Sigaahlre of Propprty Pprier or Authorized Agent
LICENSED CON,TRgCTOR'S DECLARATION
611ereb affirm u.cp. penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with action 7000) of Division 3 of the Business and Professions Code,. and my license is in full force
And dRect.
License Class License No Date G Contractor SignatureX�
I have
2S' CO�W**ENSATION DECLARATION
AILURE 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
1MPENSATI8If, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
ffirm under penalty of perjury one of the following declarations:
and.lWeinintain 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
ce of the wotk 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' compensatio
carne; Ind policy number are:
_ Policy Number Expiration Date
Agent
y 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 agre
hould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Dao—-�/�Ql
of Applicant
CLARAI JUN KLUAKFI INV UU NO Ku� nVN
3reby affirm under penally of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (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 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 relating to building construction.
I authorize representatives of this city or county t nter abo -identified property for inspection purposes.
mature of Property Owner or Authorized A en Print Property Owner's or Authorized Agent's Name
ACTION DATE RY DECLARATION OF COMPLfANCEkVITN CODEOF FDR OI
11 FEDERAL REGULATIONS PART 61 OFTITLE40AND
AQMD RULE 1403.
PERMITEXPIRED _ ❑ tSUBMITTEDASSESTOSNOTIFICATIONTO:
PERMITCANCELLEO ❑ EPA
❑ AQMD
P€RMITEXTENDED - -, ❑ ASBESTOS NORRCARONIS NOTAPPLICABLE TO
PERMITFINAL -Z-Zo PROPOSEDDEMOLITION.
CERTIRCAT�OF SIGNATURE:
OCCUPANCyfSSDED "
Date