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Home My WebLink AboutE2016-0603 - Permits�wwro� City of Newport Beach - Building Division 04 G 100 Civic Center Drive, Newport Beach, CA 92660 ram. Permit Counter Phone (949)644-3288 G fp n r Job Address: 2815 CASSIA ST Bldg: 1 Floor: Suite: Description of Work: ELEC/INSTALL A/C UNIT 48.5dB (GOODMAN; GSX14) Inspector Area: 8 Legal Description: N TR 5018 LOT 94 Owner: TOVTIN BRIAN P & KRISTIN Contractor: Address: 2815 CASSIA ST Address: NEWPORT BEACH, CA 92660 Phone: Phone: Con State Lie: Issued Date:09/27/2016 Lie Expire: Bus Lie: Processed By: Lie 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 over20DA: 0 $0.00 Over 600V or 10oDA: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: $38.00 Ilii iii 06 0 6 hill II MEYERS CONSTRUCTION CO 7020 EAST EL CEDRAL ST LONG BEACH CA 90815 562-841-8405 988356 11/30/2017 ST30052492 09/30/2016 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 1 $6.00 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 Electrical Permit: E2016-0603 Project No : Inspection Requests Phone (949)644-3255 Code Edit: 2013 Worker's Compensation Insurance Carrier: STATE COMP INS FUND - -'• Policy No: 9158630 Expire : 05/10/2017 6 E3 d 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 Check Fee PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION csa a° 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: $32.00 Supplemental Fee: $0.00 Fee Due at Permit Issuance : DWNER-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 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 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 penalty of not more than five hundred dollars ($500). ❑ 1, 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' State 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 legally sell 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 Professions Code, is available upon request when this application is submitted or at the following Web site:http://www. leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent to LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 700) of Division 3 of the Business and te o nd y Ii is in full force and effect. License Class License No �� V Cat Contractor Signa re WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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, perfo-imance of the ork or which this permit is issued. Policy No. have and will me tam 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' Prance carrier and icy number are: (� / e. dl / Exoiration Date Tie of Agent certify that, in the performance of t e, ork for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree t, if I should become sub' ct to s' ns n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /n /'� nature of Applican Dat tX/�(Zll CLARATION REG DING CO ST C ON LENDIN AGENCY :reby affirm under penalty of perj hat there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Ider's Name Lender's Address 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' orrect. I agree to comply with all applicable city and county ordinanc d state laws relating to building construction. 1 authorize representatives of this city or county t e r the e r y purposes. nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Na D Z Ely, DECLARATION OF COMPLIANCE WITH CODE OF OR OFFICE USE ONLY AC77ON DATE FEDERAL. RECULATIONS PAR* 61 OF 1117 E 10 AND AQMD 7U�E 1403. ❑ I SUSNITrEDASDESTCS f10TiF.CATIONTO: ❑ EPA ❑ AQMD PERMITEXPIRED P P€RMITCANCELLED PERMIT EXTENDED ❑ ASBESTOS N077FICAT70N IS NOT APPLICABLE TO _ -D€M71-1710N. SIGNATURE; PERMIT FINAL /� Z� N CERTIFICATEOF OCCUPANCY/SSUED