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Home My WebLink AboutE2020-0454 - PermitsI City of Newport Beach - Building Division o� 100 Civic Center Drive, Newport -Beach, CA 92660 F , Permit Counter Phone (949)644-3288 �xirrrPd'�- Job Address: 1416 DOLPHIN TER Bldg: 1 Floor: Suite: Description of Work: ELEC INSTALL DISCONNECT FOR NEW A/C UNIT (H2O20-0491) Inspector Area: 2 Legal Description: N TR 1700 LOT 24 Owner: DANCY JACQUELINE ALICE Contractor: Address: 1416 DOLPHIN TER Address: CORONA DEL MAR CA 92625 0 to 1 HP/KW/KVA: Phone: Phone: 0 Con State Lic: Issued Date:09/01/ 02 Lic Expire: $0.00 Bus Lic: Processed By: Lic Exp Date: *E2020-0454* JAMISON HEATING & COOLING SVCS 2481 SANTA YSABEL AV FULLERTON CA 92831 714-397-4132 1015392 06/30/2022 BT30065676 01/31/2021 New Construction 0 $0.00 Receptacle/Switch/Outlets Residential, 0 to 1 HP/KW/KVA: 0 Receptacles/Outlets: 0 $0.00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1-2 Family: 0 $0.00 Sep Circuits: 0 $0.00 $37.00 Supplemental Fee: Low Voltage 0 $0.00 Service Signs 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 O/H to U/G 0 $0.00 Additional Fee: $0.00 TOTAL Fee: Electrical Permit: E2020-0454 Project No : Inspection Requests Phone (949)844-3255 6 �r�CT onCode Edit: 2019 ° . Worker's Compensation Insurance Carrier: NORGUARD INSURNACE Policy No: JAWC137132 Expire : 05/29/20sorr WIDE X 36'"DEPTR ° ° REQUIRED FOR FEES 0 $0.00 Motors/Transformers (HP/KVA) 1 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 BackfFemp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Plan Check Fee: KC DISCONOONIQTS ...° e o °ocoo 4400 Temp Underground: 0 $0.00 Sub Panel: 1 $28.00 0 $0.00 0 $0.00 Record Mgmt Fee: $0.00 Plan Check Fee: $0.00 Investigation Fee: $0.00 Issuance Fee: $37.00 Supplemental Fee: $0.00 e at Permit Issuance; $65.00 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. OWNER -BUILDER DECLARATION F 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 checkmarli(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 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 im 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 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). D I am exempt frggi j�censure under the Contractors' State License Law for the following reason: By my signature Belo: 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, sell a structure than MAE 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 Pd)te%%ib6s Code,'IS avEllable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Siggatul;e of Prop" -Owner or Authorized Agent Dale L'CONySED CONTRACTOR'S DECLARATION I hereby affirm unc a par alty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of he Business and Professions Code, and my license is in full force aff Sri LiCens2'Class License No a Co ctor Signature JINIKK RS' CONR$'IQSATION DECLARATION N.SFIFJ M. FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYE TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,0001, IN ADDITION TO THE :GSR -COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. Hereby affirm uaerperialty of perjury one'of the following declarations: .• ain a certifica .• 1'h'a8$ and wig gWtte 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 )�er�fd/hltlence of tM work -for {or which this permit is issued. Policy No. (have 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' compensatiol ns ante carrier and policy number are: Policy Number of Agent ertify 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 if I shouldKecgibe subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with tho Of Date to the workers' compensation laws of California, and r l.�o CLARATION'REGARDING CONSTRUCTION LENDING AGENCY V \ Ireby affirm under penalty 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 citycounty to enter the ove-identified property for inspection purposes. nature of Property Owner or Authorj Agent Print Property Owner's or AuthorizO-7MsO ' ame ACTION DATE BY DECLARATION OF COMPLIANCEWTH CODE OF FOR Off TOE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40AND AQMDRULE1403. PERMiTEXPfRED ❑ I SUBMfTTEDASBESTOS N071FICATION TO.. ❑ EPA E3 AQMD PERMITCANCELLED P€RMI7EXTEND€D ❑ ASBESTOS NOITFICA DONIS NOT APPLICABLE TO PERMITFRVAL PROPOSED DEMOLITION. CERTIRCAT€OF OCCUPANCYGSUED SIGNATURE: el. - Lf) a j $ �-�/ dmr =« � 4)Y !a p C \ =cam 3 v 15 E U co W Z N Q N C o_ al LU 0� J Q � W J j 2 z Z = ° 00 z N LU E co E E nj� I r 0 a- w 'o,� o� u- 5 v ZWWC_1 jD ='�0cn W a 8d 0e N— 0. 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