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HomeMy WebLinkAboutE2019-0627 - PermitsCity of Newport Beach - Building Division �' Gv 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288. a' v a[enl�v� Job Address: 1959 PORT LAURENT PL Bldg: 1 Floor: Suite: Description of Work: ELEC/@ A/C UNIT Inspector Area: 4 Legal Description: N TR 7031 LOT 44 Owner: HILLIARD ANNAIDONALD Address: 108 N KROEGER ST ANAHEIM CA 92805 Phone: Issued Date:09/1312019 Processed By: New Construction Residential J Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 784141 Lic Expire: 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 11iiiiii11111piip1111111111plIJ1iii11iiiiii ii Contractor: ANAHEIM HEATING & A/C L P Address: 1416 S CENTRAL PARK AVE $0.00 ANAHEIM CA 92802 Phone: 714-772-9899 Con State Lic: 784141 Lic Expire: 09/30/2020 Bus Lic: BT30051575 Lic Exp Date: 06/30/2020 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Signs Policy No: A0127857004 M Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee : $0.00 $0.00 Electrical Permit: E2019-0627 Project No : Inspection Requests Phone (949)644-3255 Code Edit: 2016 0 $0.00 Motors/Transformers (HPIKVA) Sub Panel: prz� VJ Worker's Compensation Insurance 0 Carrier: EVERST NATIONAL INS 1 to 10 HP/KW/KVA: Policy No: A0127857004 M Expire : 07/01/2020 0 $0.00 —1 0 X FEES 0 $0.00 Motors/Transformers (HPIKVA) Sub Panel: 1 0 to 1 HP/KW/KVA: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 Over 100 HP/KW/KVA: 0 $0.00 Piggy BackfTemp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Temp Underground: _ 0 $0.00 Sub Panel: 1 $27.00 0 $0.00 0 $0.00 Record Mgmt Fee: $0.00 Plan Check Fee: $0.00 Investigation Fee: $0.00 Issuance Fee: $35.00 Supplemental Fee: $0.00 Due at Permit PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Foday j.,00 adpo to g:30 p& aaraJ Saturday from 8:00 a.m. to 6:00 p.m a o o o ao O C 00 O 4 G O O a a u o 00 0 oe a o o a c coo u c ( O LOO IOU 00 O L I 11O OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' Stale 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). 11 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, 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 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). ❑ I 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 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 Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca,govlcalaw.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 S ti n 70 0) of Division 3 of the Business :afesS1 an 0 ..ode -a ILII e I In u force and effect. - License Class License No Dat Contractor Signet WORKERS' COMPENSATION DECLARATION JJARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDi ED THOUSAND DOLLARS ($.700,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 9706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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 IN peVormance of the work for which this permit is issued. Policy No. 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' compensatior ¢ante carrier an tsy number are: rier _ Policy m e 'l I it Expiration Date ae of Agent ) Phone # certify that, in the performance thei5rk for ' this-pemnit-is ssved-1 toy -any person in any manner so as to become subject to the workers' compensation laws of California, and egret if I should become su jeet tot a wo'eerss covisi o Section 3700 of the Labor Code, I shall forthwith comply with those p ons �d J iature of Applicant ate reby 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). 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 o n state I Iia pe Ing to building construction. I authorize representatives of this city or coun a er th above-' ICff ed propert f 'nspet�tF�oses. nature of Property Owner or Authorized Agent � Print Property Owner's or Authorized Agent's Name�L" ACTION DATE BY DECLARATION OF COMPLIANCEWITH CODEOF FOROFFIC€USEONIY FEd1ERAt42EGU6.K l0g9'PARZ6?O f(TLE4fJ.ANt} Ai7MiYRPJ1E?$ffl2• • •. s . PERMITEXPJRED G°.( jSI [1`FEQAS1r.V S..dOPJF4A'(IONTO. • •EPA •'• © AQMD PERMITCANCELL€D P€RMIT:EKTENDED AYS� O�cS�FNMt1OTTFIICATIONIS NOT APPLICABLE TO Y i' s iV..'• PERMITFINAE 1 C C€RTTfCATEOF OCCUPANCYISSU€D