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Home My WebLink AboutE2019-0246 - Permits/ City of Newport Beagh- Building Vi1>Tiiert IIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIII Electrical Permit: E2019-0246 off. 100 Civic Center Drive, Newport Beach, CA 91660 a<° m o m E 2 0 1 9 0 2 4 6 Project No E ^S Permit Counter Phone (949)644-3$88 • ° ° , n° ° . ° • • ° ° ••• Inspection Requests Phone (949)644-3255 m m _. °°.o m ° m mm • o moo Job Address: 5 ADRIANA Bldg: 1 Floor:;.* Swte: ;-8 ° Description of Work: ELEC -DISCONNECT FOR A/C REPLACEMENT Inspector Area: 6 Legal Description: Owner: PAVONY BILL Contractor: Address: 5 ADRIANA Address: NEWPORT COAST CA 92657 $0.00 Phone: Phone: 0 Con State Lie: Issued Date:04/25/2019 Lie Expire: 0 Bus Lie: Processed By: -Lie Exp Date: New Construction Residential Multi -Family: 1-2 Family: Service 0-600V up to 20OA: 0 0-600V over 20OA: 0 Over 600V or1000A: 0 O/H to U/G 0 TOTAL Fee BOARDWALK HEATING AND AIR 27271 PRINCIPE ST MISSION VIEJO CA 92692 562-841-7089 1029478 07/31/2019 BT30067062 04/30/2020 Code Edit: 2016 Worker's Compensation Insurance Carrier: EXEMPT Policy No: 1 - Expire t� FEES Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 $0.00 Fixtures: 0 $0.00 $0.00 Sep Circuits: 0 $0.00 0 Low Voltage 0 $0.00 $0.00 Signs 1 $26.00 $0.00 Branch Circuit: 0 $0.00 $0.00 Each Add Circuit: 0 $0.00 $0.00 Time Clocks: 0 $0.00 $0.00 Additional Fee : $0.00 $0.00 61.00 $0.00 Plan Code Edit: 2016 Worker's Compensation Insurance Carrier: EXEMPT Policy No: 1 - Expire t� FEES Motors/Transformers (HP/KVA) 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel 1 $26.00 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/remp Power: 0 $0.00 Investigation Fee: $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $35.00 Supplemental Fee: $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. OWNER -BUILDER DECLARATION : •• . I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s )*wdicatgd b®IoW 4 t7e aheckmirk(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 tiny staidchirf 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 of8ectign 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars ($500). : ; ; • • • •; ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portion's of tV work -and tM% strBctureis dot jntended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, thrEdgh ernployeke$'•or p nonalAlfErtbuilds 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-Buildbr will hove 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 legall, 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.htmi. 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 d:ssonsiC license is in full force and effect. / — �/ License Class License No D e / Contractor Signatu NORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE Is UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE H JTHOUSAND LARS ($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. 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 i"Monnance of the work for which this permit is issued. Policy No. 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' carrier and policy number are: Policy Number Agent Date ce Ify that, in the perform 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 agref I, if should become subject to 0 kers' pens tin ovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisi nns. ature of Appo lic to �l /iJ' 1 "I CLARATION REGARDIN ONSTRUCTIO ND AGENCY :reby affirm under penalty of p that there is a n ruction 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 ing: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the info 'on I have provided is correct. I agree to comply with all applicable city and co ordinance state la lating to uilding construction. I authorize representatives of this city or county tp en abo tl ion purposes. ,�_/-Z, _# ACTION DATE BY D E TNCODEQF FOR OFFICE USE 'ONLY ARL FED RAL REGULATIONSPART&1 OF IfTLE40AND QJMORULE 1403. PERMITEXPIRED I SUBMITTED ASBESTOS NO77FICATION TO: ❑ EPA ❑ AQMD PERMITCANCELLED PERMITEXTENDED ❑ ASBESTOS M07IRC4770NIS NOT APPLICABLE TO PROPOSEDDEMOLI-TION. PERMITFINAL CERTIFICATE OF OCCUPANCYISSUED SIGNATURE: