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Home My WebLink AboutE2020-0267 - Permitsw ,, City of Newport Beach - Building Division 11111111111111p11111111p11111111p11111111111111p ;` ' 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 0 H .1,�.'- `. Permit Counter Phone (949)644-3288 v n'"�:" �, 11Electrical Permit: E2020-0267 0 2 6 7 Project No Inspection Requests Phone (949)644-3255 Job Address: 509 HARBOR WOODS PL Bldg: 1 Floor: Suite: Description of Work: ELEC - DISCONNECT FOR A/C INSTALLATION,,, s � Inspector Area: 4 Code Edit: 2019 Legal Description: TR 11935 LOT 2 UNIT 509 OF PROJECT LOCATED ON AP 458-311-08 TOGETHER Owner: POPEJOY WILLIAM J Contractor: NEXGEN A/C INC Worker's Compensation Insurance Address: 29 CHATHAM CT Address: 700 N VALLEY ST STE K Carrier: OLD REPUBLIC GEN INS CO NEWPORT BEACH, CA 92660 ANAHIEM CA 92801 Policy No: AlCWA0001401 Phone: Phone: 657-208-1987 Expire : 01/2912021 Con State Lic: 1011173 Issued Date:06/04/2020 Lic Expire: 02/28/2022 Bus Lic: BT30055503 Processed By: Lic Exp Date: 06/30/2020 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: 1 $27.00 1-2 Family: 0 $0.00 Sep Circuits: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 0 $0.00 Law 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 200A: 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 100 A: 0 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $35.00 O/H to U/G 0 $0.00 Additional Fee : $0.00 Supplemental Fee: $0.00 TOTAL Fee : $62.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $62.00 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. ER -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 the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' Slate 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). ❑ 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, 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 o: yloperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). 0 I am exempt If o,n i,censure under the Contractors' State License Law for the following reason: B / c.y � i4nature b3lo.v 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 sell a structure that I h,ve 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://www.leginfo.ca.gov/calaw.htmi. S;gna:u.e of Property Owner or Authorized Agent Date LICENSED CCNTRA--TOR'S DECLARATION I Serer affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing wit ec ion 00 of Division 3 of the Business d Profe use is in full force a0 effect. License Class License No Date Contractor Signatu WnRKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SELURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOY R TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENS.A-InN, D'1MAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. tiereby affirm under penalty of perjury one of the following declarations: 1 have and wH 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 tha eerformance of the work for which this permit is issued. Policy No. kve 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' compensation ce carrier and policy number are: arrier Policy Number Expiration Date lame of Agent Phone # ]I certify that, in the performance of a work f which this permit is issued, I shall not employ any person in any manner so as to become subject to the Kjorkers' cc npensation laws of California, and agre( Iat, if I should become ftbject to the workewfornpereation l2rovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions ignatureof Applicant Data uHfi/ IECLARATION REG DI NST TION LENDING AGENCY hereby affirm under enalty o at there is a construction lending agency for the performance of the work for which this permit is issued (S3097, Civil Code). Ender's Name Lender's Address 'y my signature below, I certify to each of the fallowing: 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 prpv' Is correct. I agree to comply with all applicable city and county rdinances nd state laws relating to building construction. I authorize representatives of this city or county to 4a s - fiei9re�Inspection purposes. z r z // / A d , r A L'f ACTION DATE BY DECLARATION OF COMPLIANCE MTR COBEOF FOR OFFICE USE ONLY FEDERAL REGULATIONSPART 01 OF TITL.E40AND AQMD RULE 1403. PERMIT EXPIRED f SUBMLTFEDASL3ESTOS NOTIFICATION TOr ❑ EPA ❑ AQMD PERMIT CANCELLED P€RMl€EXTENDED ❑ ASBESTOS NOnrICATLONIS NOT APPLICABLE TO PROPOSEOOEMOLITION. PERMITFINAL -11- at ,w./L r: A_ - CERTfFICATE OF OCCUPANCYISSUED SIGNATURE: