HomeMy WebLinkAboutE2020-0255 - Permits0��ma City of Newport Beach - Building' Division IIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIII II Electrical Permit: E2020-0255
o d 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 0 0 2 5 5 P(OJBCt NO
M ', Permit Counter Phone (949)644-3288
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f'sSvru�"' Inspection Requests Phone (949)644-3255
Job Address: 128 TOPAZ AVE Bldg: 1 Floor: Suite:
Description of Work: ELEC AIC DISCONNECTS (2)
Inspector Area: 2
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Code Edit: 2019
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Legal Description: BALBOA ISLAND RESUB
SEC 1 BLK 13 LOT 29
Owner: MAXSON ROD
Contractor:
SKY HEATING
AND COOLING
as a
Worker's Compensation Insurance
Address: 128 TOPAZ AVE
Address:
769 N GLASSELL ST
Carrier: NORGUARD INSURANCE
NEWPORT BEACH, CA 92662
ORANGE CA 92867
Policy No: SKWC149863
Phone:
Phone:
714-883-0623
Expire : 0210112021
Con State Lie:
1045281
Issued Date:05/27/2020
Lie Expire:
12/31/2021
t�'
NO CONSTRUC
�7 �
Bus Lie:
BT30066983
t i �.I¢
Processed By: C1VY: 1 V �
Lie Exp Date:
02/28/2021
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FEES
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: 2
$54.00
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 Backrremp 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: $89.00
Plan Check Fee: $0.00
Fee Due at Permit Issuance - SIM An
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday- Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m.
- -- ------•••• ��•=rw =k mm�unBwim semen ruen)of Dti$an.3 of dte.Business and
� mm censure and the basis fcrthe alleged exempdan: Any Wolatton of 9ecYon7031.5 by any applicant for a permRsubjects the applicant: to a civil penalty of
am with w gees w thawdaes t eole compensation,
e nation, will do:( ) all of or U portiws of the work; and the structure is not intended or offered for sale (Section 7094,
pply to an owner of Properlywho, through employees' or personal effort, builds or Improves the. property, provided that the
sale. If, however, the building or Improvement Is sold within one year of completion, the Owner-Bullderwill have the burden of proving. that It was not built or
I contracting with licensed Contractore to conshuctths project (Section 7044, Business and Professions Code: The -Contractors' State License Law does: not
'Proves thereon, and who cant acts forthe projects with a licensedContractor pursuant to the Contractors' State License Law).
1haMn�e .CvI—I:......-r.-...-_..._.-._....
affirm under penaltymperjury that I
t am licensed under provisions of Chapter 9 (commencing a" SAIOn 7980) 0; Division 3 of the Business I
License
COMPENSATION DECLARATION.
�ntracmr Signature
is in full force
OUT OF .1LAnw aneLL SYBJECTAN EMPLOyCRTIaMNINAL PENALTIES MO eMLFINES UP M aNLTNu�i�R"ODUNe DOLL-ofte 10o,onpl, IN AUDMON To
PENS/1d a penalty of p,g,,yp,, Ffthe SEaNOng dS OFT tions: 8 CODE INTEREST, AND AVDJ NWS FEES. VV
hereby effirtn antler penalty of perjury one of the following declarations:
7 t have and WHI maintain a certificate of consent to self -insure for workers' compensation, issued b
e¢annance of the wade for which this pemlitis issued. Policy No. Y'tire Director of Industrial Relations as Provided for by Section 3700 of the Labor Code, for
UI have'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' cempemal
�s nce center and policy number are:
ariar_MON–GUARD I I-kr*2"_L1,49-D POIIcy Number_ S r -W C l'{�Lo°63 ° I
arae. of Agent lana — Expiration Date. to ZO-2%p®/ZI
In
I am the property owner or authortwd to act an the property owners behalf.
I have mad this application and the inter undon I have Provided Is correct.
1 agree to comply with all applicable city and
,wupWohlinancas an'Stat�lal
I authorize representatives.af tris city orwu e e 16ad
DATE /I Y / By
SIGNATURE.
mnerso es'to become subject tod a worker ' Wrlpensallan laws of California, and agre
tdwiih comply wdh those pro i s��tIC /
Data
UiS 'Zd
which this permit is issued (e n 3097, Civil Code).