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HomeMy WebLinkAboutE2020-0677 - Permits (3)I>fi, City of Newport Beach - Building Division Y• Gp 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 ��t �YiitiN`t. Job Address: 86 VICTORIA Bldg: 1 Floor: Suite: Description of Work: ELEC -DISCONNECT FOR AIC REPLACEMENT (2) Inspector Area: Legal Description: N TR 15409 LOT 49 111111111111111111111111Jill1111111111111111111111111 Electrical Permit: E2020-0677 Project No : Owner: GAITLEY JANE L Contractor: ALISO AIR INC Address: 86 VICTORIA Address: 29736 AVE DE LAS BANDERAS NEWPORT BEACH CA 92660 RSM CA 92688 Phone: Phone: 949-589-2021 Con State Lic: 526420 Issued Date:11123I2020 Lic Expire: 03/31/2022 Bus Lic: BT30019236 Processed By: Izy Lic Exp Date: 0212812021 New Construction Residential Multi -Family: 1-2 Family: Service 0-600V up to 20OA: 0-600V over 20OA: Over 600V or 1000A: O/H to U/G TOTAL Fee: Receptacle/Switch/Outlet Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 0 Low Voltage 0 Signs $0.00 Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee : Inspection Requests Phone (949)644-3255 Code Edit: 2019 Worker's Compensation Insurance Carrier : LIBERTY MUTUAL Policy No: WC2Z61036218090 Expire : 07/01/2021 FEES s Motors/Transformers (HP/KVA) $0.00 0 to 1 HP/KW/KVA: 0 $0.00 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 Over 100 HP/KW/KVA: 0 $0.00 $0.00 $0.00 Piggy BackfTemp Power: 0 $0.00 $0.00 Temp Power Pole: 0 $0.00 $0.00 Plan Check Fee : Temp Underground: 0 $0.00 Sub Panel: 2 $56.00 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 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) indi( (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, deml the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License L Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Sectk not 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 tf Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through e improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of compl ri-m-roved for the purpose of sale). LJ 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, 1 apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one yr sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I unc Professions Code, is available upon request when this application is submitted or at the following Web site:http://w .leginfi Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sec 700 ) of and effect. on License Class License No /Date/ ad below by the checkmark(s) I have placed next to the applicable item(s) >h, or repair any structure, prior to its issuance, also requires the applicant for ' (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of work, and the structure is not intended or offered for sale (Section 7044, ployees' or personal effort, builds or improves the property, provided that the ion, the Owner -Builder will have the burden of proving that it was not built or and Professions Code: The Contractors' State License Law does not to the Contractors' State License Law). to completion of the improvements covered by this permit, I cannot legs that a copy of the applicable law, Section 7044 of the Business and (calaw.html. Date 3 of the Business and ProfessiDRS Code, "cense is in full force Contractor WORKERS' COMPENSATION DECLARATION �J NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALT -SAND CIVIL FINE$ UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: 111 have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of ndustrial Relations as provided for by Section 3700 of the Labor Code, forth kivrmance of the work for which this permit is issued. Policy No. ' h and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the Pei sura a carrier and policy number are: Carrie Policy Number e of Agent certify that, in the performance of the wo for which this per e I shall not employ any person in any manner! if I should become subject to the wor rs' comp n provisions of Section 3700 of the Labor Code, I shall forthwith ignature of Applicant DECLARATION REGARVITRLICTIPAILIENDING AGENCY hereby affirm under penalty of p ere is a. construction lending agency for the performance of the work for which 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 1 have provided is correct. I agree to comply with all applicable city and county ordinances a d sla s relating to building construction I authorize representatives of this city or county to enjer the ' entified property for inspection purposes. of the work for which this permit is issued. My workers' Date as to become subject to the workers' comation laws of California, and agree )mply with those provisions. D e Z� is permit is issued (S ction 3097, Civil Code). Date 4 ACTION DATE DECLARATION OF COMPLIANCEMTh CODE OF FOR OFFICE USE ONLY ' FEDERAL REGULATIONSPART61OF AQMD RULE 1403, 7TLE40AND PERMITEXPIRED ❑ I SUBMITTEO ASBESTOS NOTIFIC ❑ EPA ❑ AQMO tTKM TO: PERMIT CANCELLED PERMfTEXTENDED ❑ ASBESTOS NORFICARONIS NOT PROPOSED DEMOLITION, APPLICABLE TO PERMIT FINAL / — Y • 22 CERTIFICATEOF OCCUPANCYISSUED SIGNATURE: