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HomeMy WebLinkAboutE2019-0470 - Permits9City of Newport Beach - Building Division 111111111111111111111111111111111111111111111111111111 JillElectrical Permit: E2019-0470 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 1 9 0 4 7 0 Project No: [+ Permit Counter Phone (949)644-3268 c�W�e , Inspection Requests Phone (949)644-3255 Job Address: 21 IMA LOA CT Bldg: 1 Floor: Suite: TIMER REWIRED ON EQUIPMENT Description of Work: ELEC A/C DISCONNECT TO SHUT OFF BETWEEN 10 P.M. AND 7 A.M. Inspector Area: 3 Code Edit: 2016 Ii� V`w ,^PEC-Ir"®R Legal Description: TR 7817 LOT 3 UNIT 150 OF PROJECT LOCATED ON AP 424-041-01 FEES TOGETHER p 000e p®ep New Construction Owner: SUGDEN ROMAN Contractor: GUARANTEED AIR Worker's Compensation insurance a®® a., eeel Address: 21 IMA LOA CT Address: 1250 VALEVIEW AVE Carrier: MID-CENTURY INS NEWPORT BEACH, CA 92663 0 ANAHEIM CA 92807 Policy No: A09484276 Phone: Phone: 714-777-6600 Expire :05/05/2020 $0.00 Con State Lic: 997377 $0.00 Issued Date:07/12/2019 Lic Expire: 10/31/2020 % 0 Bus Lic: BT30053897 p too. Processed By: ��Lic Exp Date: 02/28/2020 m Sep Circuits: 0 $0.00 oopeco 0 $0.00 C&©000 CO p 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. FEES p p m p®ep 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 $0.00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 1 $26.00 1-2 Family: 0 $0.00 Sep Circuits: 0 $0.00 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 BackfFemp 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: $61.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $61.00 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) 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 ($500). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law doesnot apply to an owner of property who, through; employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or ��im roved for the purpose of sale). - I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally sell a structure that Ihave built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, isavailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Properly Owner or Authorized Agent Date J-ICEN$ED C(NITRACTOR'S DECLARATION I Nr2152 affirm ynrjAr ptnalty of perjury that I am licensed under provisions of Chapter 9 (commencing with S Ction 7000) of Division 3 of the Busine/anof)ro ron�e my license is in full force and effect.Lcense.Class • License No Date �� Contractor Signat WORKERS' CQMPP•NSATION DECLARATION WARNINOR FAILURE TO SEWRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOY RTO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (E100,0001, IN ADDITION TO THE tOST•AF COMPENSeTION QAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEPS FEES. t'P &O%affirm %V pQnaity, of perjury one of the following declarations: ®•I•Ave and wiN 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 thi &grtolftnce of the work for which this permit is issued. Policy No. • •.•••. 14%vg and will mairffiain 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 s nee carrieraad policy number are: !*aarne'r 0..:.* Policy Number Expiration Date Name of Agent Phone # ❑I certify that, in the perform D th work for which t emit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agrer that, if I should become subj t o tl rkers' compaation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions Signature of Applicant Date ` c �` 19 DECLARATION REGARD G ST UCTION LENDING AGENCY I hereby affirm under pe Ity of perjury that there is a construction lending agency for the performance of the work for which this per is issued (S ction 3097, Civil Code). Lender'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 pr vided is correct. I agree to comply with all applicable city and county ord'(I ces and state I ws-[elating to building construction. I authorize representatives of this city or county to el a I%%�,�e-identifi d property for inspection purposes. nature of Property Owner or Authorized Agent JG(J7� Print Property Owner's .7_izo ACTION DATE BY DECLARATION OF COMPLIANCE KgTHCODEOF ' FOR OFFICE USE tY FEDERAL REGULATIONS PART 61 OF TIILE40AND AQMD RULE 1403. PERMIT EXPIRED ❑ f SUBMITTDASBESTOS NOITFICAT@N TO: ❑ EPA ❑ AQMD PERMIT CANCELLED P€RMITEXTENDED ASBESTOS PROPOSED DEMOUT NRON/S NOT APPLICABLE TO PERMITFINAL �`1 C€RTIFICATEOF OCCUPANCYfSSUED SIGNATURE: