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Home My WebLink AboutE2020-0095 - Permits� a � City of Newport Beach - Building Division 11111111lllllp1111111p111111lplllp111111111� 11 100 Civic Center Drive, Newport Beach, CA 9266D E 2 0 2 0 0 0 9 5 F'. Permit Counter Phone (949)644-3288 sa Job Address: 2612 CRESTVIEW DR Bldg: 1 Floor: Suite: Description of Work: ELE- DISCONNECTS FOR (2) A/C UNITS Inspector Area: Legal Description: N TR 1102 LOT 60 Owner: OWEN ROBERT Contractor: NEXGEN A/C INC Address: 2612 CRESTVIEW DR Address: 700 N VALLEY ST STE K NEWPORT BEACH CA 92663 ANAHIEM CA 92801 Phone: Phone: 657-208-1987 Con State Lic: 1011173 Issued Date:02/18/2020� Lic Expire: 02/29/2020 Bus Lic: BT30055503 Processed By: Lic Exp Date: 06/30/2020 New Construction Receptacle/Switch/Outlets Residential Receptacles/Outlets: 0 $0.00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1-2 Family: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Service Signs 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Over 600V or 10o0A: 0 $0.00 Time Clocks: 0 $0.00 O/H to U/G 0 $0.00 Additional Fee: $0.00 TOTAL Fee: Electrical Permit: E2020-0095 Project No : Inspection Requests Phone (949)644-3255 Code Edit: 2019 Worker's Compens"aW �ss '�aam� Carrier: OLD 40 , IC GEN INS CO Policy No: A1CWA0001401 Expire : 01/29/2021 FEES Motors/Transformers (HP/KVA) 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 BackfFemp Power: 0 $0.00 Temp Power Pole: 0 $0.00 dI 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 Fee Due at Permit Issuance: PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday -Friday 7.00 a.m. to 6:30 p.mL. and Saturday from 8:00 a.m. to 6:00 p.m. • ° • ° 4B ®6° • G p• B• BBY WER-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) ction 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 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 fessions 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 more than five hundred dollars ($500). J I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of ;usiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of com nproved for the purpose of sale). 1 I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044 pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractc 7 I am exempt from licensure under the Contractors' State License Law for the following reason: ly my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I u 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://w .iegil lignature of Property Owner or Authorized Agent .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 00) I nd effect. .icense Class License No f 0 lc 7 3 Date:.I y` COMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORKERS COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNETS FEES. hereby affirm under penalty of perjury one of the following declarations: 7 I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director edance of the work for which this permit is issued. Policy No. and will maintain workers' co pensation insurance, as required by Section 3700 of the Labor Code, for the carrperilind pof nu er y� Iwo, J r (D�� ex -OIL- Policy Number / I `r i l % certify that, in the performance of the work forrichly ich permit is issued, I shall not employ any person in any manner , if I should become subject to th worke ' DoTpens I n previsirt�rs Bf Section 3700 of the Labor Code, I shall forthwit IatureofApplicantV\ \ ;reby affirm under penalty of perjury tW there is a construction lending agency for the performance of the work for w 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 ordinances and state laws relating to building construction. I authorize representatives of this city or count $ to enter the above -identified property for inspection purposes. (nature of Property Owner or Authorized Agr($y( Print Property Owners or work, and the structure is not intended or offered for sale (Section 7044, ployees' or personal effort, builds or improves the property, provided that the on, the Owner -Builder will have the burden of proving that it was not built or Business and Professions Code: The Contractors' State License Law does not pursuant to the Contractors' State License Law). to completion or cite Improvements coverea Dy tms permit, I cannot that a copy of the applicable law, Section 7044 of the Business and Date Division 3 of the Business and Professions C , aal tb y license is in full force Contractor Signature IES AND CIVIL FINES UP TO ONE HUNDRED THO SAND DOLLARS ($100,000(, IN ADDITION TO THE Industrial Relations as provided for by Section 3700 of the Labor Code, for of the work for which this perm9it is 'ssued. lMy workers' compensatior Expiration Date -- I Phone # o as to become subject to the workers' compensation laws of California, and agree comply with those provisions. Da ? I- this permit is issued (Section 3097, Civil ode). Date ACTION DATE BY DECLARATION OF COMPLIANCEtMTN CODEOF EOROFRCEUSEONtY • ••• ••• • � REE4ULATMSPART61 OF 7ITLE40AND PERMITDIPIRED • • • • �I03. TWTTEDASBESTOS NOTIFICATION TO: •L1 • EPA ❑ AQMD PERMIT CANCELLED • • • • • PERMIT EXTENDED ❑ ASBESTOS NOTIRCATIONIS NOT APPLICABLE TO •PROAQSEDDEMOLITION. • s s s PERMIT FINAL 2 • • • • CERTIFICATEOF • e e e e o °ob'NA°g'UIE: m OCCUPANCYISSUED o o 00 oe