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Home My WebLink AboutE2020-0728 - PermitsCity of Newpo 7ivision 100 Civic Center Drive, N_ Permit Counter Phone (949)o M IIP�E 2 0 2 0 0 7 2 8�� II Electrical Permit: E2020-0728 Project No: Inspection Requests Phone (949)644-3255 Job Address: 121 VIA FIRENZE Bldg: 1 Floor: Suite: Description of Work: ELEC/CHANGE OUT (E) A/ DISCONNECT ,® z Inspector Area: 2 Code Edit: 2019---ttt Legal Description: TR 907 LOT 970 POR OF LOT '� Owner: PALLEY ROGER & M Contractor: ALISO AIR INC Worker's Compensation Insurance Address: 121 VIA FIRENZE Address: 29736 AVE DE LAS BANDERAS Carrier: LIBERTY MUTUAL NEWPORT BECH CA 92663 RSM CA 92688 Policy No: WC2Z61036218090 Phone: Phone: 949-589-2021 Expire: 07/01/2021 r� ✓l Con State Lie: 526420 Issued Date:12/18/2020 11 Lie Expire: 0313112022 0 Bus Lie: BT30019236 Processed By: Lic Exp Date: 02/28/2021 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: 2 $56.00 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 1 OOOA: 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: $93.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $93.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION - Construction Hours; MQryrday - Fpday,7Q00 adgr, to, 6;30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m ° . o DINNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated'oelow by the checkm r. _.-.as s 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 iskuagce, alao 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 t',.e 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). 111, 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 mproved for the purpose of sale). 111, 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 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://w .leginfo.ca.gov/calaw.htmi. 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) Division 3 of the Business and PlrefeS&ien&-Ciode, and my license is in full force and effect. License Class License No Date Contractor Signaturg. NORKERS' COMPENSATION DECLARATION NARNING: 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 ATTORNEYS 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 ' r ance of the work for which this permit is issued. Policy No. ve 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' compensal franc er add policy number are:, i� - !1 Policy ie of Agent _,] Date I certity that, in the performance of the work fo hich 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 that, if I should become subject to the w rs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those p Islons. Signature of Applicant DECLARATION REGAR NG 9OVSTRYC ING AGENCY I hereby affirm under penalty o at 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 owners behalf. 1 have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinancelsand state laws relating to building construction. I authorize representatives of this city or county to Inter ove identified prove ' spection purposes.A4NSignature of Property Owner or Authorized Agent Print Property Owners or Authorized Agent's Nam_ V l to t ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFREUSE ONLY FEDERAL REGUIIVIrl OSPARP Of Of T&TLE4f ANLL • e AQMD RULE 14" • • • •• ❑ I SUBM TELCASBE-*O'SA017Ft: MiCtN ;fOr ❑ EPA ❑ AQMD PERMITEXPIRED PERMIT CANCELLED PERAOTEXTENDED A.❑ ASBESTOS NOTIFICATION IS NOT APPOCABL€ TO PROPOSED IIEMOLAM. e • • e • e .0. i • • i • s e• e e s s% PERMIT FINAL CER77FICATEOF SIGNATURE., e ee ee eo OCCUPANCYISSU€D o o c e o o o o e %