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Home My WebLink AboutE2020-0291 - Permits0 ,. City of Newport Beach - Building Division 1I1ill11111p1p1111111p11p111ps111pp111111JillElectrical Permit: E2020-0291 4 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 0 0 2 9 t Project No: Permit Counter Phone (949)644-3288 . �R„-,.'� Inspection Requests Phone (949)644-3255 Job Address: 119 25TH ST Bldg: 1 Floor: Suite: Description of Work: ELEC/INSTALL (1) NEW A/C 44.5dB @ DECK (GREE; LIVS12HPI15VI8) Inspector Area: 1 Code Edit: 2019 cc Legal Description: NEWPORT BEACH CITY BILK 25 LOT 26 Owner: BENDER GEORGE Contractor: KLONDIKE AIR INC Worker's Compensation Insurance 0 Address: PO BOX 5248 Address: 1308 LOGAN STE E Carrier: FALLS LAKE FIRE & CASUAL NEWPORT BEACH CA 92662 COSTA MESA CA 92626 Policy No: FLA00809502 Phone: Phone: 714-979-2070 Expire : 01/01/2021 ' A ' Con State Lic: 754456 � P � Issued Date:06/16/2020 Lic Expire: 09/30/2020 Bus Lic: BT30060482 p caq L 9 J Processed By: !J'ryllr� Lic Exp Date: 1013112020 New Construction Residential Multi -Family: 1-2 Family: Service 0-600V up to 20OA: 0 0-600V over20OA: 0 Over600V or1000A: 0 O/H to U/G 0 FEES Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $0.00 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 1 $27.00 $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 Signs Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: $0.00 $0.00 Branch Circuit: 0 $0.00 Plan Check Fee: $0.00 $0.00 Each Add Circuit: 0 $0.00 Piggy Backrremp Power: 0 $0.00 Investigation Fee: $0.00 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $35.00 $0.00 Additional Fee: $0.00 Supplemental Fee: $0.00 Plan Check Fee: PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday- Friday 7P.O a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m O i B J0 B B 6 OV GG(i • OGi of Q O O 4 U tl•�1 LpC 6 B tltl ti0J �r4• 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 items) (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). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) 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 legal[, 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:/lwww.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 Pro ssiol s Code, m c(se is n full force and effect. License Class License No Date / Z(� Contractor Signature WORKERS' 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: 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 th )erfprmance 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' compensatioi trance carie an,policy numb r are: Tier �arl Number Expiration Date me of ADen %f T` Phone # i certify that, in the perfornanc f the work for wh�Section d, 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 shouldbecomesubjec o th workers' mp3700 of the Labor Code, I shall forthwith comply with those provisions. nature ofApplicant Date`JC/ le / CLARATION REGA G CONSTRUCTION LENDING AGENCY Ireby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issue 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 prov Is correct. I agree to comply with all applicable city and county ordi 1c and state s I ti t to building Construction. 'j ff/j, I authorize representatives of this city or county to me he a ove-identi r or inspection purposes. }ate�.C� / I b I nature of Property Owner or Authorized Agent Print Property Owner's or Authorized ADent's Name \ %` ACTION DATE BY DECLARATION OF COMPLIANCE MTH CODEOF FORUFFILEUSE40NLY FEDERAL RESULAPIONS P 614OF ITTLC- 40AND AQMDRULE;44 3,: : : : : •. : : PERMITEXPIRED I SUBM ITI:D 1SBESTQI ICQTIQN7'O`. ❑ EPA' •• • +• ❑ AQMD PERMITCANCELLED PERMIT EXTENDED ❑ ASBESTOS M017RC4170MIS NOT APPLICABLE TO PROPOSED DEAD, dTIQN.• e • e s • e e • • s • s a o 0 0 0 o e PERMIT FINAL CERTIFICATE OF SIGNATURE. OCCUPANCY(SSUED goo