HomeMy WebLinkAboutE2021-0797 - PermitsCity of Newport Beach - Building Division Electrical Permit : E2O21-0797
100 Civic Center Drive, Newport Beach, CA 92660 -
Project No
Permit Counter Phone (949)644-3288
v m
e•r x�,� Inspection Requests Phone (93255
Job Address: 1705 BAY AVE E Bldg: 1 Floor: Suite:
Description of Work: SFR ELEC (2) DISCONNECTS (H2021-0661)
Inspector Area: 1 Code Edit: 2019 ex-
Inspector
Description: BALBOA TR EAST SIDE ADD BLK 26 LOT 3 ALL-INC ABAND ST ADJ ON
N-(AND
Owner: COLLINS PAULINE Contractor: OASIS AIR CONDITIONING Worker's Compensation Insurance
Address: 1705 E BAY AVE Address: P O BOX 937 Carrier: INSURANCE CO OF THE WEST
NEWPORT BEACH, CA 92661 SAN JUAN CAP CA 92693 Policy No: WSD5045393
Phone: 949-572-3321 Phone: 949.420-1321 Expire : 1213112021
Con State Lic: 767272 "
Issued Date:11118/2021 Lic Expire: 08131/2023
Bus Lic: BT97027460
Processed By: Lic Exp Date: 11/30/2021
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:
0
$0.00
1-2 Family:
0
$0.00
Sep Circuits:
2
$14.00
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 IOOOA:
0
$0.00
Time Clocks:
0
$0.00
Temp Power Pole:
0
$0.00
Issuance Fee:
$38.00
O/H to U/G
0
$0.00
Additional Fee :
$0.00
Supplemental Fee:
$0.00
TOTAL Fee:
$52.00
Plan Check Fee : $0.00
Fee Due at Permit Issuance :
$52.00
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.
1WNER-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)
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
is 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).
I, as owner of the property, or my employees with wages as their sole compensation, will do U 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
nproved 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).
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 year prior to completion of the improvements covered by this permit, I cannot legally
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 COPITRASTOR'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 arce
nil =ffert
,tense Class License No Date 11 U Contractor Signature /
WORKERS' COMPENSATION DECLARATION
ARNINU: 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
O-,T OF COMPENE �TI'1N, 04MAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
lereh;' affirm under penalty of perjury one of the following declarations:
klave and will maii,tain 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 the
T.ance of the work for which this permit is issued. Policy No.
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'
carries• and'policy number are:
arner Policy Number
ame of Agent
Date
]I certify that, in th @ fl erk7 r w ich this perms Is d, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agi
at, if I should bec e u rkers' compensation provisions of ction 3700 of the Labor Code, I shall forthwith comply with those provisions. f
Ignature of Applicant , , — _ Data 11--,
ECLARATION REGARDI G CONSTRUCTION LENDING AGENCY 11
iereby affirm under penalty 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).
3ndeis Name Lender's Address
y 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.
1 agree to comply with all applicable city and f t rAiaa�cles and state laws relating to building construction.
I authorize representatives of this city or nt h bov -�fl le erty for inspection purposes.
ignature of Property Owner or Authorized Agent—��rrroperty Owner's or Authorized Agent's Name '�Date
ACTION
DATE
BY
DECLARATION OF COMPLIANCE KITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TITLE40 AND
AQMD RULE 1403.
PERMIT EXPIRED
❑ /SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERMIT CANCELLED
PERA-11T EXTEPIDED
CAT70N IS NOT APPLICABLE TO
El ASBEDTOS DEMOLITION.
PERMIT FINAL
Z-ZZ
R
CERTIFICATEOF
SIGNATURE:
OCCUPANCYISSUED