HomeMy WebLinkAboutE2019-0319 - PermitsCity of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
`€ Permit Counter Phone (949)644-3288.
Job Address: 128 45TH ST Bldg: 1 Floor: Suite:
Description of Work: ELEC A/C DISCONNECT (STOP WORK) C2019-0088
Inspector Area: 1
Legal Description: RIVER SECTION BILK 44 LOT 13
Owner: BOWMAN BRADFORD S Contractor:
Address: 128 45TH ST Address:
NEWPORT BEACH, CA 92663
Phone: Phone:
Con State Lic:
Issued Date:05/17/2019 Lic Expire:
Bus Lic:
Processed By: �x/"� Lic Exp Date:
New Construction
Residential
Multi -Family: 0 $0.00
1-2 Family: 0 $0.00
Service
0-600V up to 20OA:
0
$0.00
0-600V over20OA:
0
$0.00
Over 600V or1000A:
0
$0.00
O/H to U/G
0
$0.00
TOTAL Fee: $87.00
GOETTL AIR CONDITIONING
532 MALLOY CT
CORONA CA 92880
714-336-6159
1047781
1213112020
BT30062269
02/28/2020
Receptacle/Switch/Outlets
Receptacles/Outlets: 0 $0.00
Fixtures:
0
$0.00
Sep Circuits:
E
2 0 1
9������� 3 1
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GOETTL AIR CONDITIONING
532 MALLOY CT
CORONA CA 92880
714-336-6159
1047781
1213112020
BT30062269
02/28/2020
Receptacle/Switch/Outlets
Receptacles/Outlets: 0 $0.00
Fixtures:
0
$0.00
Sep Circuits:
0
$0.00
Low Voltage
0
$0.00
Signs
0
$0.00
Branch Circuit:
0
$0.00
Each Add Circuit:
0
$0.00
Time Clocks:
0
$0.00
Additional Fee:
• • • • °
$0.00
• •
Plan
Electrical Permit: E2019-0319
Project No :
Inspection Requests Phone (949)544-3255
0
$0.00
"A
0
$0.00
i
0
.Code Edit: 2016
50 to 100 HP/KW/KVA:
0
$0.00
Over 100 HP/KW/KVA:
0
$0.00
Piggy Backfremp Power:
0
$0.00
o e
e °
Worker's Compensation Insurance
• • •
• • • • °
Carrier: GEMINI INS CO
• •
Policy No: VGGP003726
•
°
• °
e e
Expire : 12/01/2019
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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 Backfremp Power:
0
$0.00
Temp Power Pole:
0
$0.00
Temp Underground:
0
$0.00
Sub Panel:
1
$26.00
0
$0.00
0
$0.00
Record Mgmt Fee:
$0.00
Plan Check Fee:
$0.00
Investigation Fee:
$26.00
Issuance Fee:
$35.00
Supplemental Fee:
$0.00
iue at Permit Issuance:
$87.00
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
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 penally 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
improved 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' Slate 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 legall,
sell a structure thabl•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 Coh,,A. available upon request when this application is submitted or at the following Web site:hftp://www.leginfo.ca.gov/calaw.htmi.
$iggatylp of PrgWitypwner or Authorized Agent Date
LICENSED CQN`rRAtCTOR'S DECLARATION
I *herelby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencingTER
Section 7000) of Division 3 of the Business d Professions Code nd my licen;n is in full force
and'affect.
Ligense Class .: License No Dat'"\�-t�`V Contractor Signa/1E
AfdRKERS' COMP]=NSATION DECLARATION
NAM...
COST OF OMPENSPMON, DAM WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOO CRIMINAL PENALTIES AND CIVIL FINES UP TO HUNDRED THOUSAND DOLLARS ($700,000), IN ADDITION TO THE
COST OF aOMPEN3RfION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
• reb
sh{e� y� ffirm under penalty of perjury one of the following declarations:
;.1 T hate and yu�h walitain a certificate ol�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
e,(fyvp!nce of the work for which this permit Is?issued. Policy No.
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slave 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' compensatioi
nsu nce carrier3l'id lolicy number are:
Policy Number
of Agent
Date
JI certify that, in the pe7b'Jm,
ance of the work for which this pe K issued all not employ any person in any manner so as to become subject tot workers' compensation laws of California, and agre
tat, if I should becomect to the workers' compensati si action 3700 of the Labor Code, I shall forthwith comply with those provisio s.
ignature of Applicant Date •'l�-t.t�
DECLARATION REGA DING CONSTRUCT] LENDING AGE CY
hereby affirm under p nalty of perjury that there is a constr on lending agency for the performance of the work for which this permit is issued ( ction 3097, Civil Code).
ender's Name Lender's Address
y 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 countyrdinances and st�dy
to building construction.
I authorize representatives of this city or county toe ter the ab or inspection purposes. / //
iqnature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name% - ��£ { �1u1G'.4�1 (late C, -i
ACTION DATE / BY ULCLAKA I IUN UI- CUMYUANCL WiI H COUL OF ( FOR OFRCE USE ON&Y
FEDERAL REGULATIONS PART 61 OF TITLE 40 AND
PERMITEXPIRED AQMD RULE 1403.
I SUBMITTEDASSESTOS NOTIFICATION TOr
PERMITCANCELLED ❑ EPA
PERMITEXT€NDED ❑ AQMD -
❑ ASBESTOS NORFTC4AONIS NOT APPLICABLE TO
PFRMfTFINAL 1. PROPOSED DEMOLITION
CERT0CAT€ OF
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