HomeMy WebLinkAboutE2021-0405 - Permits$w City of Newport Beach - Building Division *E2021-0405* Electrical Permit: E2021-0405
100 Civic Center Drive, Newport Beach, CA 92660
- Permit Counter Phone (949)644-3288 Project No
30" WIDE X 36 DEPTH
Inspection Requests Phone (949)6¢9-S26,%
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Job Address: 20 SIDRA COVE Bldg: 1 Floor: Suite:
Description of Work: ELEC A/C DISCONNECT A/c DISQUIX, 7S
Inspector Area: 5 61LZCT Code Edit: 2019
Legal Description:
Owner: BECKS JENNIFER Contractor:
Address: 20 SIDRA COVE Address:
NEWPORT BEACH, CA 92657
Phone: Phone:
Con State Lic:
Issued Date:07/09/2021 Lic Expire:
Bus Lic:
Processed By: (� _X) L 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:
ALISO AIR INC
29736 AVE DE LAS BANDERAS
RSM CA 92688
949-589-2021
526420
03/31/2022
BT30019236
03/31/2022
Receptacle/Switch/Outlets
Receptacles/Outlets: 0 $0.00
Fixtures:
0
$0.00
Sep Circuits:
0
$0.00
Low Voltage
0
$0.00
Signs
$0.00
10 to 50 HP/KW/KVA:
Branch Circuit:
0
$0.00
Each Add Circuit:
0
$0.00
Time Clocks:
0
$0.00
Additional Fee :
$0.00
Plan
Worker's Compensation Insurance
Carrier: LIBERTY MUTUAL
Policy No: WC2Z61036218090
Expire : 07/01/2022
FEES
0
$0.00
Motors/Transformers (HP/KVA)
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 Back/Temp Power: 0 $0.00
Temp Power Pole: 0 $0.00
Temp Underground:
0
$0.00
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1
$29.00
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0
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0 0 0
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Investigation Fee:
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Issuance Fee:
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Temp Underground:
0
$0.00
Sub Panel:
1
$29.00
0
$0.00
0
$0.00
Record Mgmt Fee:
$0.00
Plan Check Fee:
$0.00
Investigation Fee:
$0.00
Issuance Fee:
$38.00
Supplemental Fee:
$0.00
e 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.
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 §jj ped 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 fiveirui*Idred dollars ($500). _
• 0 rl, a3 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 Prrofessions 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
impro 0nents 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
iryproged for tha pelry%e of sale).
6 A owner dfli property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
p9ply4o an ownerrof puperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I a 0101 exemp"Dhn licensure under the Contractors' State License Law for the following reason:
jay rpt 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
ce;l a structure that I JVve 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
Profestions Cdd.%* Lvailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw. html.
Sr§ tVe of Propyerty Owner or Authorized Agent Date
L4100NSED 09NiT4kCTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing t l0 70 0) of Division 3 of the Business aTil
Professions Code, and my license is in full force
and effect.
License Class License No Date 19 Contractor Signatur .
WORKERS' COMPENSATION DECLARATION
WARNING: 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
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I 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 3700 of the Labor Code, for th
----pjjjjerfo��rrmance of the work for which this permit is issued. Policy No.
aiaya 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' compensatiol
ranc
e�e carrier and policy number are:
Policy Number
me of Agent
I certify that, in the pertgqrmance of the work for which
It. if I should becomiksflbiect to the workers' compem
Date
any manner so as to become subject to the
Signature of Applicant �-"Date_
DECLARATION REGA -N - NSTRUCTION LENDTNG AGENCY - v
I hereby affirm under penalty of perjury that th Is a construction lending agency f the perfor nce of the work for which this permit is issue $ec
Lender's Name Lender's Ad tress i
By my signature below, I certify to each of th following:
I am the property owner or authorized to ad"n-the-propert wner'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 an ting to b "on tion.
authorize representatives of this city or cou o enter the ti le ' s o oses
sinnature of Pronertv Owner or Authorized A� Print r v O el'a or Authorized Agent s Name
ACTION I DATE
CANCELLED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCYISSUED
PART 61 OF
I SUBMITTED ASBESTOS NORFICATIOMTO.'
❑ EPA
❑ AOMD
SIGNATURE:
NOT APPLICABLE TO
3097, Civil Code).
laws of California, and
7A/2 l