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HomeMy WebLinkAboutE2019-0167 - Permits0 City of Newport Beach - Building Division II IIIIIIIIIIIIIIIIIIIJill III1IIIIIIIIIIIIIIIIIII 11Electrical Permit: E2019-0167 P 100 Civic Center Drive, Nevo-pore Beach, CA 92660 II�E 2 0 1 9 0 1 16 7 Project No - Permit Counter Phone (949)644-3288 ,�� ,A�` Inspection Requests Phone (949)644-3255 Job Address: 404 OCEAN FRONT E Bldg: 1 Floor: Suite: Description of Work: ELEC INSTL DISCONNECTS FOR (2) NEW A/C UNITS (H2O19-0161) r1� Inspector Area: 1 Legal Description: BALBOA TR BLK 4 LOT 13 Owner: JOHN THOMAS SHERMAN Contractor: Address: 9149 LINDANTE DR Address: WHITTIER CA 90603 Phone: Phone: Con State Lie: Issued Date:03/20/2019 Lie Expire: / Bus Lie: Processed B� O �9— `� / Lic Exp Date: 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 or 1000A: 0 $0.00 O/H to U/G 0 $0.00 Code Edit: 2016 `- A C COOL INC Worker's Compensation Insurance P O BOX 7316 Carrier: EVEREST NATIONAL FULLERT714-532-206 CA 92834 Policy No: Expire: 06 06020007�,4Q§161.IDE X 36° DEPTH 804056 U VV 01/31/2020 REQUIRED FOR BT30042073 •°°o 01131/2020 A/C DISCONNR CTSom,° Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 0 $0.00 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 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 Backrremp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Fee Due at Permit Issuance: $87.00 I 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. Temp Underground: ° .. Sub Panel: .... ®. 2 $52.®0° ° °°©0<0 10.00 Record Mgmt Fee: 0.00 -- Plan Check Fee: m ° ° 0.00-C Investigation Fee: ° ° ° $0.00 Issuance Fee: $35.00 Supplemental Fee: $0.00 Fee Due at Permit Issuance: $87.00 I 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. INER-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) shave placed next to the applicable item(s) ction 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 fessions 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 more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, ;iness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the rovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or roved for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed Contractors to constructtheproject (Section 7044, Business and Professions Code: The Contractors' State License Law does not ly to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' Slate License Law). .1 1 am exempt from licensure under the Contractors' State License Law for the following reason: Iy my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of Ill ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. ',ignature of Property Owner or Authorized Agent -ICENSED CONTRACTOR'S DECLARATION 9 hereby,aiFrm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700) of Division 3 of the B siness and Prof dons Co ra 'Ce 1 n '011 orF Ind effect. .icense Class License No a .Q Conlracto ignature YORKERS' COMPENSATION DECLARATION 1ARNING: FAILURE TQ$gGURE 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 :OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 7706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby>:ffirm um1e� 'penalty of perjury one of the following declarations: YI havg* and jip IgZrTtain 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 grform•bVice of the work for which this permit is issued. Policy No. Zwave and will maiatain 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' compensatior lAwri 4grriel'WW'po�cy number are: ,arrie�* PA.EQ4tA4"--W 4 e Policy Number 7/s67Ono '7Nd 7// $% Expiration Date /0, tame oiAgent * Phone # lgoe"9 04 that, in life performance of work for which thi rmit is is ue , I shall not employ any person in any manner so as to become subject to a workers' co pensation laws of California, and agree ?at, -If I should be s o m e aubjec e w ' co ns on rovis' n of ection 3700 of the Labor Code, I shall forthwith comply with those pr s s. 49M o plica : - Da e IY(J.AJK& G CO STRUCTIONLENDING AGENCY hereby affirm und&-pBnalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, ivil Code). Ender's Name Lender's Address ly 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 is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this%� Or county to enter the above -identified property for inspection purposes. li❑nature of Pro❑ertv Owner ❑r Aut#'h>Fized Anent Print Prooertv Owner's or Autho(ied aerents Name • /f.lL/ Oc`L L Dat4101 Tents covered by this permit, I cannot law, Section 7044 of the Business and Date ACTION DATE BY IttLI-rraw IJun ur UIKVU Rn vrr I Uvue air run urrl. use VIVLT FEDERAL REGI/LATIONSPART Of OFTITLE40AND AQMDRULE1403. PERMITEXPIRED ❑ 1SUBMfTTEDASBESTOS N071FICATIONTO. ❑ EPA ❑ AQMD PERMITCANCELL€D P€RMIT€XTENDED [3 ASBESTOS PROPOSEDDEMOLITON RONiS NOT APPLICABLE TO PEBMITFINAL -1 I't. C€RTIFICATEOF SIGNATURE: OCCUPANCYISSUED