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Home My WebLink AboutE2021-0156 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIII�IIIIIIIIIIII�IIIIIIIIIIIIIIIIII 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 1 0 1 5 6 Permit Counter Phone (949)644-3288 ca ^� rr\\ t V 1 �UI1$ Y'UVk IIElectrical Permit: E2021-0156 Project NO :1123-2018 Inspection Requests Phone (949)644-3255 Job Address: 2018 PORT PROVENCE PL Bldg: 1 Floor: Suite: Description of Work: ELEC/DISCONNECT @ A/C UNIT New Construction Inspector Area: 4 Code Edit: 2019 66��x�,� Cn Legal Description: N TR 6624 LOT 16 Residential Receptacles/Outlets: rn Owner: KALESNIK VITALI. Contractor: IST CHOICE HEATING & A/C Worker's Compensation Insurance $0.00 Address: 2018 PORT PROVENCE PL Address: 20371 LAKEFORESTDR STE A-5 Carrier: OHIO SECURITY INS CO. Multi -Family: NEWPORT BEACH, CA 92660 LAKE FOREST, CA 92630 Policy No: XWS2262377720 0 Phone: 310-465-4586 Phone: (949) 305-5754 Expire : 02/15/2022 $0.00 Sub Panel: Con State Lie: 1006824 $28.00 1-2 Family: Issued Date:02/24/2021 Lie Expire: 08/31/2021 Sep Circuits: 0 $0.00 Bus Lie: BT30064046 0 $0.00 Processed By:- /r r ' d Lie Exp Date: 08/31/2021 $0.00 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 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: 1 $28.00 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 Back/Temp 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: $37.00 O/H to U/G 0 $0.00 Additional Fee: $0.00 Supplemental. Fee: $0.00 TOTAL Fee: $65.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $65.00 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 IWNER-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) lection 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). 7 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, lusiness 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 n 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 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: y 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 legall7 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:http://www.leginfo.ca.gov/calaw.htmi. 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 7000) of Division 3 of the Business an Profess' ns Code, a ense is in full force nd effect. icense Class License No Date X172 / 2 N/21 Contractor Signa r YORKERS' COMPENSATION DECLARATION eow IARNING: 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 ($700,000), IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 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 3700 of the Labor Code, for th errformance of the work for which this permit is issued. Policy No. have and'll maintain workers' compensation ins ance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatioi rance Barr r nd policy nure are 'ler I' yNumber Expiration Date is of Age # certify that, in the performance of th w or which this per is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and ogre , if I should become suubb''�ct o ers' compen visions of Section 3700 of the Labor Code, I shall forthwith comply with those prows ns. latureofApplicant /fir Dat(Z2 y)Z hereby affirm under penally 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). Ender's Name Lender's Address ly 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 ordinanc state toting to building construction. I authorize representatives of this city or countyv(o�Etd r Vi property for inspection purposes. t f C �icnature of Prooertv Owner or Authorized Agent X / Print Property Owner's or Authorized Agent's Nam Jd c ACTION BATE r BYr-r_suw�r�n ur r.vinruwrr.c. rrr •.r:...r...�.., FEDERAL RW44L VJ(jNSP417T 61 OF TITLE 49AND AQMDRULE110❑ 3 • • "' ••• PERMfTFXPIRFD I SUBMITREDASBESTWOOVF1C,%TfON i'O; ❑ EPA. - ' • - ❑ AQMD PERMIT CANCELLED PERMIT EXTENDED ASBESTOS NORRCARONIS NOT APPLICABLE TO PROPOSEDDEdWUUQN. e i i `• PERMIT FINAL CERTIFICATEOF SIGNATURE.'OCCUPANCYfSSUED • • •• • • •• �_