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Home My WebLink AboutE2021-0396 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 2012 VISTA CAJON Bldg: 1 Floor: Suite: Description of Work: ELEC -DISCONNECT FOR A/C CONDENSER Inspector Area: 4 Legal Description: TR 5480 (L.L.84-214026) PAR 23 AND PAR 23G Owner: ENGLEBRECHT ROY Contractor: Address: 2012 VISTA CAJON Address: NEWPORT BEACH, CA 92660 $0.00 Phone: Phone: $0.00 Con State Lic: Issued Date:07/0112021 Lic Expire: 0-600V over20OA: Bus Lic: Processed By: Lic Exp Date: New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0 $0.00 0-600V up to 20OA: 0 $0.00 0-600V over20OA: 0 $0.00 Over 600V or1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: $67.00 11111111111111p11111p11111Illill111p1111111111Jill 11Electrical Permit: E2021-0396 E 2 0 2 1 0 3 9 6 Project No : BREATHE EASY HVAC 277 CALIFORNIA ST MISSION VIEJO CA 92692 714-713-0566 1047628 12/31/2021 BT30073500 11/3012021 Receptac I e/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Signs 0 to 1 HP/KW/KVA: Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee : $29.00 $0.00 Inspection Requests Phone (949)644-3255 Code Edit: 2019 Policy h Expire Insurance V- FEES A Motors/Transformers (HPIKVA) 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 $29.00 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 BackfTemp Power: 0 $0.00 Investigation Fee: $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $38.00 Supplemental Fee: $0.00 Plan Check Fee : Fee Due at Permit Issuance: $67.00 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. opo 0 �o goo o 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 (_) all of or U 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 does not 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 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 iT•jt,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.html. 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 and Professions Code, and my license is in full force and effect./� License Class License No Date / 2 ( Contractor Signature WORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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 cfperjury one of the following declarations: 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 oe OV ance 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 of Agent Date certify that, in the performance 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 agre t, if I should become subject to the workers' compensation provjs.io�s o Section 3700 of the Labor Code, I shall forthwith comply with those provisions. — ... Date o &/2 nature of Applicant �-- - CLARATION RE DING CO�,S.1RU(,-IE)N"CEND1NG AGENCY sreby affirm under penalty pegury that there is a construction lending agency for the performance of the work for which this permit is issued ( ection 3097, Civil Code). ider'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 provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or coun�J'to enter the above -identified �°t�erty for inspection purposes. ..1r,,.o ^f or.,. 11 rn.,^or ^r A1 fh^rlvaH Ano -"� _r...m = -eY"— Print Pronertv Owner's or Authorized Aaent's Name //!/(-f//G vC. �fP�>~ Date ACTION DATE BY vii i+tnx,rvir yr k.v FEDERAL REGULATIONSPART69 OF TITLE40ffip At7MDRULE1403. ... •'• °s PERMIT EXPIRED ❑ isuBmiurEDUISBESTa NUI:FIGATrCWTO:. ❑ EPA. •• : : • ••• •: PERMITCA1VCELLED . • ❑ At MI • • ° PERA&TEYTEN:D€D ❑ ASBESfASNOACATIONISNOTAPPLICAMETO PROPOSED. DEMOLITION, PERMIT FINAL tiw9s • .. CERTIFICATEOF . ° :° SIGNATURE ••• OCCUPANCYISSUEO .•. . •• , . � .�