HomeMy WebLinkAboutE2020-0254 - PermitsCity of Newport Beach - Building Division
J' 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Job Address: 77 BRADBURY Bldg: 1 Floor: Suite:
Description of Work: ELEC -DISCONNECT FOR A/C INSTALLATION
11111111111111111111ill111�111111111111111JillElectrical Permit: E2020-02541111J1111Project
Inspector Area: 8
Legal Description: TR 12164 LOT 3 UNIT 39 OF PROJECT LOCATED ON AP 442-291-39
TOGETHER
Owner: ROCKEFELLER KIRWAN
Contractor:
HOME COMFORT USA
Address: 77 BRADBURY
Address:
1120 N TUSTIN AVE
NEWPORT BEACH CA 92660
ANAHEIM CA 92807
Phone:
Phone:
888-769-3009
Motors/Transformers (HP/KVA)
Con State Lic:
974908
Issued Date:
Lic Expire:
07/31/2020
0
Bus Lic:
BT30056727
Processed By:
Lic Exp Date:
10/31/2020
New Construction
Residential
Multi -Family:
1-2 Family:
Service
0-600V up to 20OA: 0
0-600V over20OA: 0
Over 600V or 1000A: 0
O/H to U/G 0
TOTAL Fee:
Inspection Requests Phone (949)644-3255
Code Edit: 2019
Worker's Compensation Insurance
Carrier: TRAVELERS PROPERTY
Policy No: UB2L764577
Expire: 11/01/2020
Fee :
Fee Due at Permit Issuance :
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
Receptacle/Switch/Outlets
Motors/Transformers (HP/KVA)
Receptacles/Outlets:
0
$0.00
0 to 1 HP/KW/KVA:
0
$0.00
Temp Underground:
0
$0.00
$0.00
Fixtures:
0
$0.00
1 to 10 HP/KW/KVA:
0
$0.00
Sub Panel:
1
$27.00
$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
Signs
Over 100 HP/KW/KVA:
0
$0.00
Record Mgmt Fee:
$0.00
$0.00
Branch Circuit:
0
$0.00
Plan Check Fee:
$0.00
$0.00
Each Add Circuit:
0
$0.00
Piggy Back/Temp Power:
0
$0.00
Investigation Fee:
$0.00
$0.00
Time Clocks:
0
$0.00
Temp Power Pole:
0
$0.00
Issuance Fee:
$35.00
$0.00
Additional Fee :
$0.00
Supplemental Fee:
$0.00
Fee :
Fee Due at Permit Issuance :
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.
)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
ie 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 U portions of the work, and the structure is not intended or offered for sale (Section 7044,
Usiness 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:
ly 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: hltp://www. leginfo.ca.gov/calaw.html.
signature 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 000) of Division 3 of the Business= " e and my license is in full force
effect.
is 5 2�
icense Class License No Date Contractor Signat
VORKERS' COMPENSATION DECLARATION
'ARNING: 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
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
I 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 370Q of the Labor Code, for th
erfprmance 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:
ne of Agent
certify that, in the performance
, if I should become subject to
of
Policy Number
Date
work for which this permit is issued, I shall not employ any person in any manner so as to become subjec to the workers' compensation laws of California, and agre
rkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pr Isions.
Date S/Z -7/7-0
DECLARATION REGARD COA TRUCTION LENDING AGENCY
I hereby affirm under penalty 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).
Lender's Name Lender's Address
By 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 nd state laws relating to building construction.
I authorize representatives of this city or county toe - `'- Hfied-aroparty for inspection purposes.
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name
ACDON DATE
DECtARATtONOFCOMPLIANCEWITNCODEOF
FOR OFFICE DSEONtY
FEDERAL REGULATIONS PART 61 OF TITLE40AND
AQMORULE 1403.
P€RA41T EXPIRED
I SUBMITTEDASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERMITCANCELLED
PERMITEXTENDED
❑ ASBESTOS M077FICA710NIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
CERTIFICATE OF'
SIGNATURE:
OCCOPANCYISSDED