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Home My WebLink AboutE2021-0439 - Permitsw vrd, City of Newport Beach - Building Division IIIIIIII�IIIIIIIIIIIIIIIIIIIII II Electrical Permit: E2021-0439 T� 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 1 0 4 3 9 p Project No H,, Permit Counter Phone (949)644-3288 0fi;l�ry ups Inspection Requests Phone (949)644-3255 Job Address: 4827 DORCHESTER RD Bldg: 1 Floor: Suite Description of Work: ELEC/CHANGE OUT (E) A/C UNIT 59.4dB Cn 00 Inspector Area: 5 Code Edit: 2019 M Legal Description: N TR 3519 LOT 38 0 - Owner: Owner: WYLE DAVID/CARMEN Contractor: WHITE MECHANICAL INC Worker's Compensation Insurance Address: 4827 DORCHESTER RD Address: 27221 BURBANK Carrier: TRAVELERS CASUALTY 0 CORONA DEL MAR, CA 92625 FOOTHILL RANCH CA 92610 Policy No: 83R5812182026G ry� Phone: Phone: 949-716-8379 Expire : 10/01/2021 dij Con State Lie: 822474 Issued Date:07122/2021 Lie Expire: 0813112021 Bus Lie: BT30055645 Processed By: Lie Exp Date: 06/3012022 New Construction Residential Multi -Family: 1-2 Family: Service 0-600V up to 20OA: 0 0-600V over20OA: 0 Over 600V or 1000A: 0 O/H to U/G 0 Receptacle/Switch/Outlets Plan Check Fee: Temp Underground: Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 1 0 Low Voltage 0 1 to 10 HP/KW/KVA: Signs $0.00 $0.00 Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee : $0.00 Plan Check Fee: Temp Underground: FEES $0.00 Sub Panel Motors/Transformers (HP/KVA) $0.00 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 $7.00 10 to 50 HP/KW/KVA: 0 $0.00 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 Over 100 HP/KW/KVA: 0 $0.00 $0.00 Issuance Fee: $38.00 $0.00 Piggy Backlfemp Power: 0 $0.00 $0.00 Temp Power Pole: 0 $0.00 $0.00 Plan Check Fee: Temp Underground: 0 $0.00 Sub Panel 0 $0.00 0 $0.00 D $0.00 Record Mgmt Fee: $0.00 Plan Check Fee: $0.00 Investigation Fee: $0.00 Issuance Fee: $38.00 Supplemental Fee: $0.00 Fee Due at Permit Issuance : 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. o ° o00 °°o °oo Oc0 u o ° v ccs °o °0 0 0 OpU O O U t(.t GU ° � C U OU4 Uf �'L �U VUpU 4 ODU UV UUO ° LDER 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 items) 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 ie 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 '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). 1, as owner of the property, or my employees with wages as their sale compensation, will do (_) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness and Professions Cade: 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 nprovdments 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). 7 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 ppJy 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: ly 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 Iega11, 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 Irofesbions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.govlcalaw.html. signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, -m3 Ott ic ff'�x� /'�j nd effect. afect. Class License No Date Contractor Signatur VORKERS' COMPENSATION DECLARATION IARNING: FAILURE To SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUN GRED THOUSAND DOLLARS 1$100,0001, IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th erfgrmance of the work for which this permit is issued. Policy No, and will m tain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' carrier a'_ p d cy number a( 1 I�r . , 5,19v N41ber Expiration Date is of Agent � V—e✓" a yr L.aw-r" certify that, in the performance of the work for which this permit is issued, I shall if I should become subject to the workers' compensat1oiQ9gMpna-o.$ectLon : nature of Applicant CLARATION REGenl CONSTRUCTION LEWNG AGENCY :reby affirm under alty of perjury that telt; �a construction lending agency Ider's Name my signature below, I certify to each fi 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 IawE I authorize representatives of this city or countylto enter the abo�i en I person in any manner so as to become subject to the workers' compensation laws of California, and agre, 3- ode, I shall forthwith comply with those provisions. /j Date 1 this permit is issued (Section 3097, Civil Code). ACTION DATE SY DI : ARATIONOF COMPLIANCE MTH CODE OF FOR OFFICE USE ONLY fE@&RAL ••• ••• EG#J1TVNSPAR.87OfTfRE40AND.. ,�Y' ggj,�Iypgi„7�(ED,°149 ,ES TOS j7ihARON TO: ° •' ° F.PA t �' • AQIV ° • • : • • � • • L] A BESTOSNOIIFICATJONISMOT APPLICABLE TO • PROPOSAVJDFIVOLITIOM • ° =a ° PERMLTFXPfRED • •• • PERMIT CANCELLED ° • ° PERwrEXTENDED PERMIT FINAL • • •. • CERTIFICATEOF • • • OCCUPANCYISSUED : : ' : • 31�.R;fl f'LFt1F" : o , ° , � • . �e � • •fir•,.