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Home My WebLink AboutE2022-0182 - PermitsCity of Newport Beach - Building Division *E2022-0182* 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 1140 BAY AVE W Bldg: 1 Floor: Suite: Description of Work: ELEC/INSTALL (2) ROOF MOUNTED A/C UNITS (H2O22-0159) Inspector Area: 1 Legal Description: N TR 626 BLK 4 LOT 1 Owner: WELLS JOHN Address: 3239 COUNTRY CLUB DR GLENDALE, CA 91208 Phone: 818-415-2933 Issued Date:03/2312022 Processed By: (\ New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0-600V up to 20OA: 0 $0.00 0-600V over 20OA: 0 $0.00 Over 600V or 1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: Contractor: D L S HEATING & A/C Address: 8542 LARTHORN DRIVE HUNTINGTON BEACH CA 92646 Phone: 714-231-8002 Con State Lic: 584220 Lic Expire: 01131/2024 Bus Lic: BT98040420 Lic Exp Date: 12/3112022 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 1 $7.00 Low Voltage 0 $0.00 Signs Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee : $0.00 Plan Electrical Permit: E2022-0182 Project No : 0860-2020 Inspection Requests Phone (949)644-3255 L,-t. Code Edit: 2019 0 I - Ci) Worker's Compensation Insurance Carrier: STATE FARM `_, k Policy No: 92GOK7865 FV 4yy-L Expire : 01/06/2023 `) 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 Back[Temp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Temp Underground: 0 $0.00 Sub Panel: 0 $0.00 0 $0.00 0 $0.00 Record Mgmt Fee: $0.00 Plan Check Fee: $0.00 Investigation Fee: $0.00 Issuance Fee: $38.00 Supplemental Fee: $0.00 Fee Due 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 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 ie 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 Iicensure 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). J 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Iusiness 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). 7 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). 7 I am exempt from Iicensure 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.html. 'signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'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 and Professions C e, a my license is in full force nd effect g `Q` !> icense Class License No Dat 3 �� Contractor Si natur �C / VORKERS' COMPENSATION DECLARATION ARNING: 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 J$100,000), IN ADDITION TO THE DST 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 d 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, e TIC of the work forwhich this permit is issued. Policy No. I a a and will . tain workers' c mpensaticn insurance, required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatior Isur nce carrier did J�o1icy numbe_are' if Dale of Agent I certify that, in the performance of the �ork for which 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 lat, if I should become s�u[�{eT ct to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of Applicant /t Dat ECLARATION REGA ING CONSTRUCTION LENDING AGENCY hereby 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). ender's 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-TZ61`116fftl I agree to comply with all applicable city and county ordinances and state law relating to I authorize representatives of this city or county to Pnter the �bove-idenyfi9 property for 'Ni 1 WAI AC77ON DATE BY DECLARATION OFCOMPLIANCE INITHCODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40 AND AQAiD RULE 14P3. PERMfT EXW RED _ _ ❑ I SUDMITTEDASBESTOS NOTIFICATIONTO: ❑ EPA ❑ AQMD PERMITCANCELLED PERMIT EXTENDED ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLIT/ON, PERMIT FINAL CER77FICATEOF OCCUPANCYISSUED 3fCNATURE: