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Home My WebLink AboutE2022-0131 - Permitsa?':�rerk City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 F Permit Counter Phone (949)644-3288 r• � 'dGlvil4'�1 Job Address: 2226 PORT CARLISLE PL Bldg: 1 Floor: Suite: Description of Work: ELELC/INSTALL (2) A/C UNITS (H2O22-0114) Inspector Area: 6 Legal Description: N TR 7845 LOT 60 Owner: JENSEN JACK Contractor: OWNER/BLDR Address: 2226 PORT CARLISLE PL Address: JENSEN JACK NEWPORT BEACH, CA 92660 W/X20214252 Phone: Phone: Con State Lic: O/B Issued Date:03/03/2022 Lic Expire: Bus Lic: Processed By: 7AIIV_�_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 or 1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: Rece pta c I e/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 2 $14.00 Low Voltage 0 $0.00 Signs Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee : $0.00 IIIIIIIIIIIIIIIIIIIIIIIIIIIII II Electrical Permit: E2022-0131 Project No : 0275-2021 Inspection Requests Phone (949)644-3255 Kq Code Edit: 2019 t Worker's Compensation Insurance Carrier: Policy No: Expire FEES 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 Back/Temp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Plan Check Fee: Temp Underground: 0 $0.00 Sub Panel: 0 $0.00 0 $0.00 0 $0.00 Record Mgmt Fee: $0.00 Plan Check Fee: $0.00 Investigation Fee: $0.00 Issuance Fee: $38.00 Supplemental Fee: $0.00 Fee Due at Permit PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday -Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason($) indicated below by the checkmark(s) I have placed next to the applicable item(s) :tion 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 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 `essions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Sectl�n 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions oft a work, and the structure is not intended or offered for sale (Section 7044, mass 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 rovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of comp etion, the Owner -Builder will have the burden of proving that it was not built or rdv�ed for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, usiness and Professions Code: The Contractors' State License Law does not ly to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contrado pursuant to the Contractors' State License Law). LJ I am exempt from licensure under the Contractors' State By my signature below I acknowledge that, except for pei sell a structure that I have built as an owner -builder if as r Professions Code, is available upon request T1,,n Signature of Property Owner or AuthorizedALICENSED CONTRACTOR'S DECLARI hereby affirm under penalty of perjurythat I and effect. License Class License No _ :e Law for the following reason: residence in which I must have resided for at least one y :n constructed in its entirety by licensed contractors. I un g-FAutypitl 9r at the following Web site:http://www.legin :ar prior to completion of the improvements covered by this permit, I cannot legal erstand that a copy of the applicable law, Section 7044 of the Business and 1.ca.gov/calaw.html. of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force Date Contractor Signature VORKERS' COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL IES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 370E 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 o Industrial Relations as provided for by Section 3700 of the Labor Code, for thi erformance of the work for 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' "ance carrier and policy number are: Policy Number Is of Agent _ Date I certify that, in the perfo mance the work for which this permit is issued, 1 shall not employ any person in any manner o as to become subject to the workers' compensation laws of California, and agree 1 if I should be a work rs' o ensation provisions of Section 3700 of the Labor Code, shall for comply with those provisions. 'signature of App11 DaNI IECLARATION RE ARD CONSTRUCTION LENDING AGENCY I hereby affirm 'up p nalt of erj that there is a construction lending agency for the performance of the work for whiclj this permit is issued (Section 3097, Civil Code). Ender's Name Lender's Address II ly my signature below, certify to each of the following: I am the property owner or authorized to act on the property owners behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and coun .erdi sand state laws relating to building construction.Z� I authorize representatives of this city or un r the a ide "ed property for inspection purposes. �� signature of Property Owner or Authorized Agent A� Print Property Owner's or Authorized Agent's Name {�".J�d`�'(�' Da ACTION DECLARATION OF COMPLIANCE NI HCODE OF FOR OFFICE USE ONLY FEDERAL P.FG111 A TIONS:PART 510 TITLE4C AND AQMD RULE f 40:t. PERMIT EXPIRED ❑ I SUEMITTEDAS3ESTOS40TIF ❑ EPA ❑ AQMD -A) ION FO* PERMIT CANCELLED gDAITE PERMITEXTENDEt7 ❑ ASBESTOS NOTIFICA77ONISN PROPOSED9EM9LTIOV. APPLICABLE TO PERMIT FINAL �1� CERTI,RCATEOF SIGNATURE: OCCUPANCYISSUED