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Home My WebLink AboutE2019-0657 - PermitswtD4 City of Newport Beach - Building Divisruri 100 Civic Center Drive, Newport Beach, CA 92660 '.; Permit Counter Phone (949)644-3288 c+y�xYx�R4�5a Job Address: 12 HARBOR ISLAND Bldg: 1 Floor: Suite: $0.00 Description of Work: ELEC/DISCONNECT TO A/C 0 H2O19-0587 0-600V over20OA: 0 Inspector Area: 2 Over 600V or1000A: 0 Legal Description: TR 802 LOT 12 ALL -INC BET SAME & HIGH TIDE LINE - Owner: LO Contractor: A C COOL INC Address: KARM N AVE Address: P O BOX6868 ORT BEAC CA 92660 0 ORANGE CA 92863 Phone: 0-0801 Phone: 714-720-3938 (43VON Con State Lic:. 804066 Issued Date2019 Lic Expire: 01/31/2020 0 Bus Lic BT30042073 Processed B Lic Exp Date: 01/31/2020 0 $0.00 Record Mgmt Fee: New Construction 1 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 or1000A: 0 $0.00 O/H to U/G 0 $0.00 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 2 $14.00 Low Voltage 0 $0.00 Signs 0 to 1 HP/KW/KVA: Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee : $0.00 $0.00 Electrical Permit: E2019-0657 Project No : Inspection Requests Phone (949)644-3255 INSPECTOR Code Edit: 2016 Worker's Compensation Insurance Carrier: EVEREST NATIONAL •••° Policy No: 760007408191 Expire : 06/01/2020 c ° 04®® • IY'D • ° C�. •04 ° oo°oa m OOGUU FEES Motors/Transformers (HP/KVA) 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: ° z 16 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 0 $0.00 50 to 100 HP/KW/KVA 0 $0.00 0 $0.00 Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: $0.00 Plan Check Fee: $0.00 Piggy Back/Temp Power: 0 $0.00 Investigation Fee: $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $35.00 Supplemental Fee: $0.00 $0.00 Fee Due at Permit Issuance : $49.00 3nil WIDE X 36 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. SEQUIRED FOR A/ ECTs NO CONS ImpNOISE ON THE WEEKEND 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 by the checkmark(s) I have 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 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). ❑ I, as owner of the 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, 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-Builderwill have the burden of proving that it was not built or im roved for the purpose of sale). _ 1. as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Cade: 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). ❑ 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 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 Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under panalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 7000) f Division 3 of the Business and Professio a%,ce is in full force $Id effect ° • " hicense Class •• • License No Date Contractor Signature kYORKERS' COMPENSATION DECLARATION NARMNII°. FAILURE Td SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001, IN ADDITION TO THE CAST OF COMPENSATION DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. h8rg�y affirm under pi}nalty of perjury one of the following declarations: I•kave and'wW"If'intain 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 ?crjdance ofttie work for which this permit is issued. Policy No. ee 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' compensatioi J carrjel aqq;olicy number are: ` Policy Number Expiration Date ele of Agent"" Phone # certify that, in the performance thew or which th' permit is ' sued, shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and ogre I, if I should become subject the r mp ns ov' n of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant CLARATION REG DI CONSTRUCTION LENDING AGENT-��—�� !reby affirm under enalty of perjury that there is a construction lurnding 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 is correct. I agree to comply with all applicable city and county ordii ces to aWpfor Iding construction. /,f I authorize representatives of this city or county to tl o -Jde iedection purposes.. //nature of PfoDertV Owner orAuthorized ADent Clint Prooertv Owner's or Authorized ADenl's Nam .,, (�i/r'4 ii,) Datee ACTION DATE BY UCt.LIitUirIU1Y Vr'l.UlVlYGr/ilY4C rrtirl l.ULC OF tUH flttIU Uit UIVLY' FEDERAL REGULATIONS PART 61 OFTI7LE40AND AQMO RULE 1403. PERMIT IXPIRED — 0 I SUBMUTTEDASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMtD _ PERMITCANCELLED PERMITEXTENDED PROPOSED DEMOLITION.RONLS NOT APPLICABLE TO PERMITFINAL F y- �� CERTrFICAT€OF OCCUPANCYISSUED SIGNATURE: