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HomeMy WebLinkAboutE2019-0710 - Permits., City of Newport Beach - Building Division IIIlilllllllllllllllllllllllllllllllllllllllllllll �) Electrical Permit: E2019-0710 ' 100 Civic Center Drive, Newport Beech, CA 92660 Permit Counter Phone - E 2 0 1 9 -.: 0 7 1 0 Project No (949)644-3288 Inspections Requests Phone (949)644-3255 Job Address: 316 ANADE AVE Bldg. 1 Floor: Suite: Description of Work: ELEC/DISCONNECT TO AIC H2O19-0653 nspectorArea: 1 Code Edit 2016 INSPECTOR Legal Description: EAST NEWPORT BILK A LOT 43 Owner: LAGSAM BOB & PATRICIA Contractor: BASIC AIR INC Worker's Compensation Insurance Address: 316 Address: 1157 SALINAS AVENUE Carrier`. OAK RIVER INS ° a PORT BEA H, CA 92661 COSTA MESA CA92626 Policy No: BAWC917646 ° ..... Phone 949-375-0345 Phone: 714-469-4542 Expire: 10/22/2019 p°a°m ®mmc o Con State Lie: 909834 Issued ate:10/23/2019 Lie Expire: 01/31/2020 30" WIDE X 36" DEP`fH Bus Lie:- BT30045172 q : ^m ° Processe Lie Exio Date: 10/31/2019 REQUIRED t-bl A/C DISCONNF`f - FEES c.. o 'Oo ecou New Construction Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) .... Residential Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA; 0 $0.00 Temp Underground: °0 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1to10HP/KW/KVA: 0 $0.00 Sub Panel: 0o0o4 $@f/0'° 1=2 Family: 0 $0.00 Sep Circuits:- 1 $7.00 - 10 to 50 HP/KW/KVA: 0 $0.00 - 0 $0.00 Low Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 : ` 0 $0.00 Service Signs Over 100 HP/KW/KVA 0 $0.00 Record Mgmt Fee: $0.00, 0-600V up to 20OA: - 0 $0.00 Branch Circuit: 0 $0.00 Plan Check Fee: $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Piggy Back/Temp Power: 0 $0.00 Investigation Fee: $0.00 Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 Temp power Pole: 0 $0.00 Issuance Fee: $35.00 O/H to U/G 0 $0.00 Additional Fee: $0.00 Supplemental Fee: $0.00 TOTAL Fee: $42.00 Plan Check Fee : $42.00 Fee Due at Permit Issuance : $0.00 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 NNER-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 applicafto item(s) action 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 I 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 Jfessions 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 t 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, siness 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 provements 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 proved 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 ply 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: _ 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 legall! II 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 )fessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.govlcalaw.htmi. (nature of Property Owner or Authorized Agent Date 'ENSED CONTRACTOR'S DECLARATION ereby affirm.0gleb11enalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions de, asd my license is in full force d effect. 0 L I Contractor Signature arcs Class .... License No Data DRKERS' COMPENSATION DECLARATION RNIN& 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 S PdF COMPENSkTIOIV,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR COOS, INTEREST, AND ATTORNEY'S FEES. ireb4 affirm bg4er penalty of perjury one of the following declarations: I%ve 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 Ch nce of3We We for which this permit is issued. Policy No. ... Yha a 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 • se carrierand policy number are: trier • • Policy Number Expiration Date me of Agent • • • Phone # I certify that, in tale performance of the 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 agre t, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. (n > 1 mature of Applicant on Dat yfl/�/ CLARATION REG RDING O S CTION L =reby affirm under enalty 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 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 representativesof this city or county to enter the above -identified property for inspection purposes. �,I_ / 7 mature of Property Owner or Authorized Agen0�0f � fi Print Property Owner's or Authorized Agent's Name /1 (^ 1U1��i0.dMt GL1+1+ Datq� %012317 ACTION DATE BY DECLARATION OF COMPLIANCE L41TH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40AND AQMDRULE1403. '.,PERMITEXPIRED - 1 SUBMITTEDASBESTOS N071FICATION TO: ❑ EPA ❑ AQMD 'PERMITCANCELLED PERMITEXTENDED ASBESTOS M077RCA170NIS NOTAPPLICA13LE TO PROPOSED.DEMOfITION. PERMITFINAL CERTfFICATEOF SIGNATURE: OCCUPANCYISSUED