HomeMy WebLinkAboute2022-0009 - Permitsgwrfxq City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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*E2022-0009*
30" WIDE X 36" DEPTH
Electrical Permit: E2022-0009
Project No :
Inspection Requests Phone (949)644-3255
Job Address:1950 PORT CARDIFF PL Bldg:
1Floor: Suite:
°
°•°°"°
Description of Work: ELEC A/C DISCONNECT
REQUIRED FOR
°
A/C DISCONNECTS
:•°...
°
Inspector Area: 4
Code Edit:2019
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Legal Description: NTR6623LOT 9
•.••••
•••�°°
Owner: WESTJUSTIN
Contractor:
DEPENDABLE GRAHAM AC
Worker's Compensation Insurance
Address: 1966 PORT CHELSEA PL
Address:
2952 CENTURY PLACE
Carrier: SERVICE AMERICAN
. ••°
NEWPORT BEACH, CA 92660
COSTA MESA CA 92626
Policy No: SAMTWC0072800
• •
....
Phone:
Phone:
714-546-1653
Expire : 07/01/2022
• • •
®• °
Con State Lic:
472690
Issued Date:01/10/2022
Lic Expire:
04/30/2022
Bus Lic:
ST01013104
Processed By:
_
Lic Exp Date:
12/31/2022
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FEES
New Construction
Receptacle/Switch/Outlets
Motors/Transformers(HP/KVA)
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:
- '
°^o°�o
$29s0'0 = a
1-2 Family:
0
$0.00
Sep Circuits:
0
$0.00
10 to 50 HP/KW/KVA:
0
$0.00
°=°°0°
$0=.00 °
I
Low Voltage
0
$0.00
50 to 100 HP/KW/KVA:
0
$0.00
° ° 0
$Oa00 ° `
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 20DA:
0
$0.00
Each Add Circuit:
0
$0.00
Piggy Back/Temp Power:
0
$0.00
Investigation Fee:
$0.00
Over 600V or 100oA:
0
$0.00
Time Clocks:
0
$0.00
Temp Power Pole:
0
$0.00
Issuance Fee:
$38.00
O/H to U/G
0
$0.00
Additional Fee:
$0.00
Supplemental Fee:
$0.00
TOTAL Fee: $67.00
Plan Check Fee : $67.00
Fee Due at Permit Issuance
: $0.00
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.
t hereby affirm under penalty of.Pe)ury
lion 703t.5, Business and Professions
iermit to file a signed statement that he
morethan five hundred dollars ($500)...�• ,���
1, as owner of the property, or my employees v
mesa ana.{tmfessiOns Code: The Conbactore'
roverndh WO?lotintendedorofferedforsate:
the
am eEmpt from the Contractors`State LCEIISe.Law forthe
licensure
of
I have
next to
e also
for
of the work and the structure es not intended or offered forsale (Section 7044,
mIII lotion ees' or personal effort, builds or Improves the property, Provided thatthe
L1•I, as owlxs'a98ra: property,. - - ---mpletion, the owner -Builder whl havethe burden of proving that it was not built or
h licensed
lapply to an wmerofpropedyho builds orrIimPmves tcontra�reon, and who�ac�rs to construct the Project (Section 7044, Business and Professions Code: The Contractors' Stale License Law does not
•lam exempt from hcerrsure urrderthe Contra Contract;forthe projects theh a licensed.Contrad r pursuant to the Contractors. he Contr clOr
BY r"am Exemp b0OWrom censuackntors' State License Law for the follovAngTeason:
seNa ltFledge that except t h personal resonance tewhich I must have residedfor at least one year pdor to compietfon of;the bn tovem
structure the! 1 have built as an owner -builder when rf H has not been constructed in its erdirely by licensed contractors.1 understand that a,
Pfofialure f P(OP,:is avwneroupon orbmd when appiicetioo issubmittad or at the follswin Web site:h P e"tSeczerl 7044ois peBusin Business
aotiegali
nature Of Pmpet(y Owner or Authorized Agent 9 fpJlwww.legiMo.ca.gov/tataw.htmi.af the applfpbte law, Sscfon,70g4 of the Business and
ENSED 66WRACTOR'S DECLARATION
i bWOby alfmri under penalty of Date
gm effect Perjury that i am fieensed under provisions of Chapter 9 (commencingKEofDivision 3 of the Business P
nse Claas. • :ions Code,: myleense is in full force • License No Date
MANILA ftg COMPENSATION DECLARATION ComractorSignatuns
;OST OPCgIWM TO.SECNRE wa'poMriNsATbr}CDyERAGE 6ONU.wFu4-Arrf)••snAllsu
TION, DAYAGF4As PROVIDED FOR IN 3?WOF THE LABOR CODE r"TEAL�.ANO T ORNErS FES ND CMI FINES Lip ROM 'nrGuspND
hereby affirm under Penalty Of Perjury one of the MOINIng declarations: DOUARs Istso owl, IN ADDITION To THE
I have and wilt maintain a certificate a of. consent . Self --insure for workers'. compensation, issued by the . Director . of Industrial : Relations :as. Provided for S
E,hr
nanceoftheworkfarwhlchthisPeonit)sissued. Pogcy.No.
P by Section 3700 of the Labor Code, for thr
ave antl er and
Polk numworkber compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this pertnit is issued. My workers' compensation
nce carver and policy number are:
artier
of
i shall not employ any person -in
�c"On 3700 of the tabor Code, is
=—y amen underpe Of Peryury that there is a consinrction lending iders Name agency Performance of the
MY Signature below, I Certify to.each .of the-follow'Rlg: Lenders Address
I am the Property owner or authod ed. to act on the property owners behalf,
1 have read this application and the information I have provided is correct:
I agree to complyoraan a fi l nflicable olty'en cour�v OITMSreft andstase laws-relatin to bulklino constnrersee.
i authorize reoresenrartvx nrrn� x....._ f.._j . _ 9
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PROPOSED DEMOUTION,
SIGNATURE.