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HomeMy WebLinkAboutE2020-0059 - Permits-.'.1gSY lY}4, City of Newport Beach - Building Division 11111111111 lilI IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Jill 11 - Electrical Permit: E2020-0059 '', 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 0 0 0 5 9 Project No : 0111-2020 E, Permit Counter Phone (949)644-3288 �:<rraa Inspection Requests Phone (949)644-3255 Job Address: 424 MARIGOLD AVE Bldg: 1 Floor: Suite: Description of Work: ELEC/DISCONNECT TO A/C H2O20-0080 INSPcL; Inspector Area: 5 Code Edit: 2019 Legal Description: CORONA DEL MAR BLK 440 LOT 16 Owner: COSS EDWARD Contractor: OCEAN A/C & HEATING CO Worker's Compensation Insurance Address: 301 POPP AVE Address: 28052 CAMINO CAPISTRANO #101 Carrier: EVEREST DEL MAR CA 92625 LAGUNA NIGUEL CA 92677 Policy No: 7600020119191 Phone: 949-394-9 2 Phone: 949-582-0700 Expire :03/01/2020 Con State Lic: 278618 Issued D te:01/29/2020 Lic Expire: 02/29/2020 p� �v q gs�ww °.°p.� ®�/4-d�e Bus Lic: BT00003631 O��y � ��tg�e '�6JIV NOV,7 Processed By. Lic Exp Date: 03/31/2020 ... ° m ° E ° ° o FEES o° New Constructi n Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) G m O 09foO Residential Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: eoo.0 4.00« Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 0 ©.00- 1-2 Family: 0 $0.00 Sep Circuits: 1 $7.00 10 to 50 HP/KW/KVA: 0 $0.00 ° ° `10 $0.00 Low Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 ° ° ° 0 6.09, 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: $0.00 Fee Due at Permit Issuance: $42.00 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 6:00 a.m, to 6:00 p.m. 30" WIDE X 36" DEPTH REQUIRED FOR A10 D6SOONa4ECTS )WNER-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 is 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 'rofessions 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 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, lusiness 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 nprovements 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 nproved 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 pply 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). 7 I 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 the improvements covered by this permit, I cannot legall 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 applicable law, Section 7044 of the Business and 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Iignature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 p9) of Division 3 of the Business and Professions Code, and my license is in full force is effect. icG Z� ZAp4O ense Class License No � G6 19 Date ontractor Signatur IIORKERS' COMRE'NNSATION DECLARATION DARNING: FAILURE*FP.SI_AE 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 OOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. gereby affirm umJ fe4alty of perjury one of the following declarations: �%hAv 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 the oTAnce of thii work. or which this permit is issued. Policy No. and witomaintain 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' compensation I&Ura a carrier and pgcy number are: Policy Number Expiration Date -o7 Agent • • I Certify that, ijj the„pe�iormance ofre work fo ich this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' Compensation Taws or uallrornla, ana agree t, if I should beeame subject tot works pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pro ..... rmkX; of Applican * a CLARATION fi6'G D M N N LENDING AGENCY =.reby affirm under y 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). lder's Name Lender's Address my signature biroll I certify to each of the following: I am the property owner or authorized to act on the property ow is behalf. I have read this application and the information I have provid s correct. I agree to comply with all applicable city and county ordinan s and sta s relating to building construction. I authorize representatives of this city or count to e b v = Ified arty for inspection purposes.. //���/�� nature of Property Owner or Authorized Agent Property Owners or Authorized Agent's Names./ D AC77ON DATE '- Ey DECLARATION OF COMPLIANCE WITH CODEOF FOR OFFICE USEONLy _ FEDERAL REGULATIONS PART 61 OFT17LE40AND AQMD RULE 1403. PERMT€XP/RED - ❑ 1 SUBMITTEDASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMITCANC€LLED PERMITEXTENDED E3 ASBESTOS NOTIFICA NOT APPLICABLE TO PERMITFINAL PROPOSED DEMOLITON.DONIS CERTIFICATEOF SIGNATURE: OCCUPANCYISSUED-