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Home My WebLink AboutE2020-0282 - Permitsu,.� City of Newport Beach - Building Division *E2020-0282* -'` �.,rt�. 100 Civic Center Drive, Newport Beach, CA 92660 ,„ r;p ::"" Permit Counter Phone (949)644-3288 w�- 3 c_ f"�4, k Electrical Permit: E2020-0282 Project No Inspection Requests Phone (949)644-3255 Job Address: 206 HARBOR WOODS PL Bldg: 1 Floor: Suite: Description of Work: ELEC INSTALL CIRCUIT FOR A/C UNIT @ THE PORCH (H2O20-0307) F I U Inspector Area: 8 Code Edit: 2019 Legal Description: TR 12164 LOT 4 UNIT 51 OF PROJECT LOCATED ON AP 442-291-39 TOGETHER Owner: JOFFREY LONG Contractor: DEPENDABLE GRAHAM AC Worker's Compensation Insurance Address: 17045 CHATSWORTH ST Address: 2952 CENTURY PLACE Carrier : FALLS LAKE FIRE AND CASUALI'r GRANADA HILLS CA 91344 COSTA MESA CA 92626 Policy No: FLA000131 Phone: Phone: 714-546-1653 Expire : 0710112020 ' Con State Lic: 472690 - Issued Date:06/11/2020 Lic Expire: 04/30/2022 ,�>> /� Bus Lic: BT01013104 ".TFCTTO FIELD Processed By:` `Di J ",j!!-�Lic Exp Date: 12/31/2020 REVIEW AND APPROVAL ' FEES 1 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 $0.0n 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: 1 $7.00 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 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 BackfTemp Power: 0 $0.00 Investigation Fee: $0.00 Over 600V or 1000A: 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 : $42.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $42.00 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. IWNER-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 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 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). 1 I, 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, 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 legall, 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:hftp://w .leginfo.ca.gov/calaw.html. lignature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirr aub@r penalty of perjury that I am licensed under provisions of Chapter 9 (commen n Ith S cti n 7000) of Division 3 of the Business to a e-a� my license is in full force nd effect. ,�/ icel'se Class License No a 20 Contracto nature _ VOHKERE' COMIDENSATION DECLARATION �� 11 -^s— IARN'NG: FAILUR' 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 CST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affix, n Ladal- penalty of perjury one of the following declarations: I S I have and will, rnelntain 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 a,formance'oi the work for which this permit is issued. Policy No. r.- /have and wall 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' compensatioi surence carre:r and policy number are: :arrier I Policy Number Expiration Date lame of Agent Phone # A certify that; in the performance of the workpr which this permit is issued, I shall not employ any person in any manner so as to become subje to the workers' co ensation laws of California, and agm iat, if I should become subject i of Section 3700 of the Labor Code, I shall forthwith comply with those r Isions. �/P P Y P /// / r� 'signature of Ap nt D e ((C��/-�j[�/ IECLARATION R GARDI LENDING AGENCY hereby affirm under penal y ry at 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 Iy 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 provided is c react. I agree to comply with all applicable city -��+ manc ds aws rre_l_atinn Hding construction. I authorize representatives of this y or unty to e�a a = eMi ' property for inspection purposes. J,. Iignature of Property Owner or Auth Agent c:�.. Print Property Owner's or Authorized ggMIS(g Name154�d e ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TLTLE40AND AQMD RULE?403. PERMIT EXPIR€D ❑ 1 SUBMITTED ASBESTOS N077FICATION TO: ❑ EPA ❑ AQMD PERMITCA.NCELLED PERMITEXTENDED ❑ ASBESTOS NORRCATIONIS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL CERTIFICATEOF OCCUPANCYISSUED SIGNATURE: