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Home My WebLink AboutE2018-0604 - Permitst a City of Newporkl3gash .espi[dincg Division IIII IIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIII III II d 100 Civic Center Drive, t ewpo%Bea@h, 6A 626Ct0 E 2 0 1 8 0 6 0 4 ww Permit Counter Phone 41V)94.4132(i8: ® o o a SF y�,y � , ° e e e e • Ce �k g 0 Job Address: 18 HARBOR ISLAND••Bldg:11Fdoor:• �;pltei•a Description of Work: ELEC -DISCONNECT FOR A/C CONDENSOR Inspector Area: 2 Legal Description: P BK 182 PG 43 PAR 1 Owner: TELLURIDE Address: PO BOX 842 NEWPORT BEACH, CA Phone: 0 Issued Date:09/11/2018 Processed New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0 $0.00 0-600V up to 20OA: 0 $0.00 0-600V over20OA: 0 $0.00 Over 600V orI000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: Contractor: Address: Phone: Con State Lic: Lic Expire: Bus Lic: Lic Exp Date: INEGRITY AIR 39996 MILOS CT MURRIETTA CA 92563 951-306-9061 1039609 05/31/2020 BT30064436 09/30/2019 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 1 $7.00 Low Voltage 0 $0.00 Signs $0.00 10 to 50 HP/KW/KVA: Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee: $0.00 Electrical Permit: E2018-0604 Project No : Inspection Requests Phone (949)644-3255 Code Edit: 2016 Worker's Compensation Insurance Carrier: MARKEL INS CO Policy No: MWC0133113 Expire : 08/03/2019 FEES 0 $0.00 Motors/Transformers (HP/KVA) 0 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 Fee : Temp Underground: 0 $0.00 Sub Panel 0 $0.00 0 $0.00 0 $0.00 Record MgmtFee: $0.00 Plan Check Fee: $0.00 Investigation Fee: $0.00 Issuance Fee: $35.00 Supplemental Fee: $0.00 Fee Due at Permit Issuance: PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated -below 6$the ckeokrrart(s�l haul 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 lepkV:inJ sl1ructure, prior tdif's 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 sulyects the applicant to a civil penalty of not more than five hundred dollars ($500). • , ; , . . o ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do `) all of orL) portions of the wml�!and$6e atruofure isnot Tnta°ndeV r tffered for sale (Section 7044, d Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' of personal effor4 builds or' proves 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*Oe Owner-BLIM wllfhave 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). n I 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 1 must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legal) 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 Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and P e BIG Code, and my license is in full force and effect. . el/ License Class License No Contractor Signatu NORKERS' COMPEL SATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO UNDREO THOUSAND DOLLARS ($700,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 the �efform nce 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' compensation nsu ante carrier and Dolicv number are: of Agent Policy Number M . PUL ZZ Expiration Date Z=9 a Phone # certify that, in the performance of a work 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 I. if I should become subj workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant : Date CLARATION REGA CONSTRUCTION LENDING AGENCY Ireby affirm under ty of perjury that 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 be ow, 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 county o InanC s and state laws relating to building construction. I authorize representatives of this city, or count t r ab 'dentified property for inspection purposes. nature of Property Owner or Authorized Agent Print Property Owner ,9-11-4 ACT70N DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFRCE USE ONLY y FEDERAL REGULATIONS PART 61OFTITLE40AND AQMDRULE1403. PERMITEXPIRED ❑ I SUBMITTED ASBESTOS M077FICATIONTO: 0 EPA ❑ AQMD PERMITCANCELLED PERMITEXTENDED [3 ASBESTOS PPROPOSEDDEMOLIODONISNOTAPPLtCABL.ETO PERMITFINAL (,� /7 / CERTIFtCATE OF SIGNATURE: OCCUPANCYtSSUED