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HomeMy WebLinkAboutE2020-0583 - PermitsoofTIM,%, City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II U 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 0 0 5 8 3 Permit Counter Phone (949)644-326830" WIDE X 36" DEPTH REQUIRED FOR Job Address: 2452 VISTA HOGAR Bldg: 1 Floor: Suite: A/C DibuONNEffS Description of Work: ELEC A/C DISCONNECT Electrical Permit : E2020-0583 Project No : Inspection Requests Phone (949)644-3255 Inspector Area: 4 I N P ECD1 ®R Code Edit: 2019 Legal Description: TR 5798 (L.L.84-245722) PAR 78 Owner: DUFFIELD BRIANNA Contractor: ABSOLUTE AIRFLOW INC Worker's Compensation Insurance Address: 2452 VISTA HOGAR Address: 14122 WILLOW LN Carrier: WEST AMERICAN NEWPORT BEACH, CA 92660 WESTMINSTER CA- 92683 Policy No: XWW2060310239 Phone: Phone: 833-482-2626 Expire : 10/2512020 Con State Lic: 1049023 Issued Date:10/20/2020 Lic Expire: 01/3112021 Bus Lic: BT30067300 Processed By: Lic Exp Date: 05131/2021 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 200A: 0 $0.00 Branch Circuit: 0 $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 O/H to JIG 0 $0.00 Additional Fee : $0.00 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 BackrTemp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Temp Underground: 0 $0.00 Sub Panel: 1 $28.00 0 $0.00 0 $0.00 Record Mgmt Fee: $0.00 Plan Check Fee: $0.00 Investigation Fee: $0.00 Issuance Fee: $37.00 Supplemental Fee: $0.00 Fee Due at Permit Issuance : PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Constriction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. OWNER -BUILDER DECLARATION 1 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 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 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 yearof completion, the Owner -Builder will have the burden of proving that it was not built or proved for the purpose of sale). LJ 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 `ram licensure under the Contractors' State License Law for the following reason: Fly 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 Iegall ,Ell a at, ucture tha. ; 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 Codc, is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.html. Sig-catwe of Property Owner or Authorized Agent Date LICENSED CONTPACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing ' h action 000) of Division 3 of the Business and ro €� ss�i Code a d my license is in full force and ef.ect. Li=Es Class License No Date 10 Contractor Signature 4CCR:(ERS' COMPENSATION DECLARATION V. d.K:AS. 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 ,:OSr OF COMPENS..TION, uAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm uuoar 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 performance of the wurk 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' compensatio I ur a carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # I certify that, in the performance of t rk for which I 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 hat, if I should becomes fact to th orkers' nsation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provis Signature of Applicant Date DECLARATION REGA TRUC LENDING AGENCY I hereby affirm under pe alty o at there is a construction lending agency for the performance of the work for which this permit is issued (S ction 097, Civil Code). Lender's Name Lenders Address By 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 cou ty ordinanc state laws re1pt 'fdtng construction. I authorize representatives of this city or coun t enter a above-i property for inspection purposes. Signature of Property Owner or Authorized Agent Print Property Owners or Authorized Agent's Name . Da OASBESTOS M017R ACTION DATE BY DECLARATION OFCOMPLIANCE WITH CODE OF FOR OFFlCE USf ONLY FEDERAL REGULATIONS PART 51 QF7fTLE40AND AQMD RULE I403. PERMITEXPoRED ❑ I SUBMfTTEO ASBESTOS NORFICATION TO: ❑ EPA ❑ AQMD PERMlTCANCELLED PERA4lTfXFENDED PROPOSED DEMOLITION NONIS NOT APPLICABLE TO PERM(TFJNAL CERTfFICATE OF SIGNATURE: OCCUPANCYISSUED