HomeMy WebLinkAboutE2020-0226 - Permits (3)aYnhp4;i^ City of Newport Beach - Building Division *E2020-0226*
�v 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
INSPECTOR
uoD Haaress: 1ovs 13RUIN13ARK LN Bldg: I Floor: Suite:
Description of Work: ELEC A/C DISCONNECT
Inspector Area: 8
Legal Description:
Owner: WHITE RACHEL
Contractor:
BASIC AIR INC
Address: 1516 BRUINBARK
Address:
1157 SALINAS AVENUE
NEWPORT BEACH, CA 92661
COSTA MESA CA92626
Phone: 818-645-8316
Phone:
714-469-4542
Con State Lic:
909834
Issued Date:04/29/2020
Lic Expire:
01/31/2022
Bus Lic:
BT30045172
Processed By:
Lic Exp Date:
10/3112020
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 over20OA:
0
$0.00
Over 600V or 1000A:
0
$0.00
O/H to U/G
0
$0.00
TOTAL
Fee:
$62.00
Receptacle/Switch/Outlets
Receptacles/Outlets: 0 $0.00
Fixtures:
0
$0.00
Sep Circuits:
0
$0.00
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
Electrical Permit: E2020-0226
Project No :
Inspection Requests Phone (949)644-3255
Code Edit: 2019
Worker's Compensation Insurance
"
Carrier: OAK RIVER INS
-''-
Policy No: BAWCO21077
Expire : 10/22/2020
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
Plan Check Fee :
Temp Underground:
0
$0.00
Sub Panel:
1
$27.00
0
$0.00
0
$0.00
Record Mgmt Fee:
$0.00
Plan Check Fee:
$0.00
Investigation Fee:
$0.00
Issuance Fee:
$35.00
Supplemental Fee:
$0.00
e at Permit Issuance :
$62.00
PERMITS EXPIRE 160 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.
I hereby affirm under penalty of perjury that 1 am exempt from the Contractors' State License Law for the reasons) indicate
Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolisl
he permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law
'mlessions Code) or that he or she Is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7
lot more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do (-) all of or U portions of the B
Business and Professions Code; The Contractors' State License Law does not apply to an owner of property who, through empl
mprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completie
m roved for the purpose of sale).
1, as owner of the property, am exclusively Wnbecting with licensed Contractors to construct the project (Section 7044, Bus
rally to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pur
Ll I am exempi from acansure under the Contractors' State License Law for the following reason:
By my signa.u, s below I acknowledge that, except for my personal residence In which I must have resided for at least one year
sell a stru:hue that I have built as an owner -bulkier If it has not been constructed in its entirety by licensed contractors. I under:
F.ofessions Cade. is available upon request when this application is submitted or at the following Web slte:hgp:f/www.laglnfo.e
Signature of Property Owner or Authorized Agent
LICENSED' CONTRACTOR'S DECLARATION
I hereby afforn under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencingO h ecti 7000) of Ph
ar,d effect.
:ioense Class _ License No Date
XORKER-911,OMPENSATION DECLARATION
.JARNI NG: FAILURE TO SECURE WOWfER3' COMPENSATION MVERA aE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTES
COSTOFMMP6NSAmm,DAMAGESASPROVIDEDFORINSECTIONna4OFTHEL MCOOF INTEREST.ANDATTORNEY'SFEES.
I hareby affiim ul,oer penalty of perjury one of the following declarations:
a 1 have and will maintain a certificate of consent to self -insure for workers' compensation. issued by the Director of Inc
Wlie annanc cf 6.e work 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 perfol
Insurance caller and policy number are:
Carrier Policy Number
is of Agent
certify that, in thkile*rnance of the work for which this permit is issued, I shall not employ any person in any manner so
if I should becorrilt spbject to thjr*drkers',Compensation prcnd i ns of Section 3700 of the Labor CO* I shall forthwith c
Nature of Applicant
hereby affirm under penalty\f perjury that there is a construction lending agency for the performance of the work for which
tinder's Name Lender's Address
ly my signature below, I certify to each of the following:
I am the property owner art authorized to act an 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 okunty rdinances and state laws relating to buridi construction.
I authorize representatives of this cityor coun o rdert a vex nt'died � ron u oses.
tignature of Property Owner orAuthcrixed Agent G 'M party Olmer's or Aut
below by the checkmark(s) I have placed next to the applicable hem(s)
or repair any structure, prior to its issuance, also requires the applicant for
hapter 9 (commencing with Section 7000) of Division 3 of the Business and
31.5 by any applicant for a permit subjects the applicant to a civil penalty of
k, and the structure is not intended or offered for sale (Section 7044,
Oils' or personal effort, builds or improves the property, provided that the
the Owner -Bulkier will have the burden of proving that It was not built or
and Professions Code: The Canhactors' State License Law does not
to the Contractors' State License Law)_
id that a copy of the c
wlcalaw.html.
rn 3 of the Business i
Contractor Signature
I CIVIL MES UP To ONE
ments covered by this permit, I cannot
law, Section 7044 of the Business and
Date
in full force
art ADDITION TO THE
Relations as provided for by Section 3700 of Ole Labor Code, for
of the work for which this permit is issued. My workers'
Date
to become subject th rkers' compensation laws of California, and agm
iply with those prowls
Date ZC7:.
permit Is issued (Se A3097, Civil Code).
ACTION
GATE
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