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Home My WebLink AboutE2021-0057 - PermitsW :. City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 a Permit Counter Phone (949)644-3288 Job Address: 518 BEGONIA AVE Bldg: 1 Floor: - Suite: Description of Work: ELEC INSTALL DISCONNECT FOR NEW A/C UNIT (H2O21-0056) Inspector Area: 5 Legal Description: CORONA DEL MAR BLK 530 LOT 20 Owner. HEARD SHARON Contractor: Address: PO BOX 9215 Address: NEWPORT BEACH CA 92658 Phone: Phone: Con State Lic: Issued Date:02/03/2021 Lic Expire: Bus Lic: Processed By: W"- V 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 over 20OA: 0 $0.00 Over 600V or 1000A: 0 $0.00 O/Hto UIG 0 $0.00 TOTAL Fee: $65.00 *E2021 -0057* Electrical Permit: E2021-0057 Project No : Inspection Requests Phone (949)644-3255 Code Edit: 2019 Uri °°Qi° ° ° ° ° ° C ANDREW COOPER CO Worker's Compensation insurance 543 E CENTRAL PARK AVE --Carder: NORGUARD INS CO ANAHEIM CA 92802 Policy No: WCO27118414CA 714-991-4700 30" WIDE X 36" D jrp[L07/0112021 ��/�j�, 220551 NO COl�ISTRUCTIOMN ,�6- ° ° 03/31/2021 REQUIRED FOR ° BT30074103 01/31/2022 A/C DISCONNECTS ON S&TURDA.Y.S. ReceptacielSwitch/O utiets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 0 $0.00 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 FEES Motors]Transformers (HP/KVA) 0 to 1 HP/KW/KVA: 0 $0.00 1 to 10 HP/KWIKVA: 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: 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 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. 74ER-BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 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) lion 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 permitto 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 Fessions Cods) or that he or she is exempt from Hcensure and the basis for the alleged exemption. Arry violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of more t!?an fiuie Hundred dollars ($500). 1, as owner ofjthe property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, iness 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 completion, the Owner -Builder will have the burden of proving that it was not built or roved for ihl,i0 pose of sale). U 1, as owner, 14 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,owneir of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ 1 y exempt from iicensure under the Contractors' State License Law for the following reason: ByrrrsLon atu� re below 1 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 legaih, seA sftuctrrre tii t ,l have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. 1 understand that a copy of the applicable law, Section 7044 of the Business and Pl fessiors Code, is available upon request when this application is submitted or at the following Web site:httpJfwww.leginfo.ca.govlcalaw.html. Sig R i t { of. Property Owner or Authorized Agent Date LrGENSIrD CONTRACTOR'S DECLARATION I hereby ifirm under of perjury that i am licensed under provisions of Chapter 9 (commencing with S ;'7 0) of Division 3 of the Business an P fessions and m license., 11 force and pffecL} ,obiLic�ensee Classl License No 1 17� i�' f Contrar/or Signature VW6M rPcR8 C6MPENSATION DECLARATION NARNiNG: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THO S D OO 90A,000), IN ADDITION TO THE COST OrrCOMPENsA-n6 i, DAMAGES AS PROVIDED FOR IN SECTION 37UU OF THE LABOR CODE, INTEREST, AND ATTORNErS FEES. r-m-hu aftfrrrr ul der penalty of perjury one of the following declarations-, -) 14 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 qft"@nce of the work for which this permit is issued. Policy No. -,thave and willmaintain workers' compensation insurance, as required try Section 3700 of the Labor Code, for the performance of the work for which this germil is issued. My workers' compensatioi suranr carner,and;pol number a j,��+ 0 �j ^''� 1 I,� p a i~'j: Policy Number (RJ� - 4 6L+ c Expiration Date fame of Agenf Phone # �l certify Yhat, in I,the pe nce of the o for w ' this permit is issued, i shall not employ any person in any manner so as to become subje9tto the worke ' co ensation laws of California, and agre rat, if I should I su je to the r ' c➢ a saticn visions of Section 3700 of the Labor Code, I shall forthwith comply with thos .4visions. ignature of Ap r, ntl IECLARATIOtl R ('sARDIN ON5 t3 T N 1.E DI G AGENCY hereby affirm under penalty of perju at t e is construction lending agency for the performance of the work for which this permit is issued (Section 347 Ch l Code) Ider's Ngme Lender's Address my signature below, I certify to each of the following: I am the property owner or authorized to act on the Droperty owner's behalf. i have read this application and the information I ha rovided is come S agree to,corriply with all applicable city and un o roan stat la s relating to bolding construction. i I authorize representatives of this city,o co to nt r h a e nature nature of Property Owner or Authorize nt erty for inspection purposes - /j Print Property Owner's or Authorized Agent's tdarae Date AC RON' BATE DE-CLARA770M OF COMPLIANCE MTM CODE OF FOR DFACE USE 0171Y FEDERAL REGULATIONS PART Of OF777LE40AND AG?WD RULE 1403. PE4 ITENPIRED ❑ I SUBAII TTED ASBESTOS N077FICA170M TO. ® EPA L AQMD PEfimrrcAivCELLED PERA'fit7EX -SWED OS N07IRC 77ON IS NOT APPLICABLE TO PERMi7 F7iYAL / - - PROPOSASBED OCCUPANCYiSSUED SIGNATURE.