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Home My WebLink AboutE2019-0384 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 r* Permit Counter Phone (949)644-3288 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII �� Project is Permit: E2019-0384 Inspection Requests Job Address: 2741 PEBBLE DR Bldg: 1 Floor: Suite: Description of Work: ELEC -DISCONNECT FOR A/C (H2O19-0337) f New Construction Receptacle/Switch/Outlets Inspector Area: 4 Code Edit: 2016 Residential Receptacles/Outlets: 0 $0.00 mese 0 Legal Description: N TR 3660 LOT 42 Temp Underground: 0 $0.00 Multi -Family: 0 $0.00 Fixtures: 0 . eoem e m meeoee Owner: VARNERSTEVEN Contractor: DEPENDABLE GRAHAM AC Worker's Compensation Insurance 1-2 Family: 0 Address: 2741 PEBBLE DR Address: 2952 CENTURY PLACE Carrier: FALLS LAKE FIRE AND CASUALTY ec NEWPORT BEACH CA 6 0 $0.00 COSTA MESA CA 92626 Policy No: FLA000131 m ° m • 6e Phone: Phone: 714-546-1653 Expire : 07/01/2019 of"F ` e e e 0 Con State Lic: 472690 0 $0.00 Service IssuedDate:06/06/2019 Lic Expire: 04/30/2020 Over 100 HP/KW/KVA: 0 Bus Lic: BT01013104 a eexou Processed By: Lic Exp Date: 12/31/2019 0 $0.00 °Pm9f r Plan Check Fee: T3DVCe O ' 0 $0.00 Each Add Circuit: 0 ° m®0000 0 $0.00 Investigation Fee: s o o tees 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. 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 $26.00 1-2 Family: 0 $0.00 Sep Circuits: 0 $0.00 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 20OA: 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 Backrremp 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: $61.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $61.00 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. OWNER -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' State 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). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) 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). ❑ 1, 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 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: By my signature j*IbV 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 spit a structure thata (leve 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 Rrafe"ans Code.tp vailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. STgnatur13 of ProDeRy.Qfuner or Authorized Agent Date LJCFWD CONTRACTOR'S DECLARATION I Hereby affirm underAenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sec ion 7000) of Division 3 of the Business and Prof ns Code, an license ig-jn full force and effect. Licenes bass '"' License No Date An< Contractor Signature WOMERS' C(fl MNSATION DECLARATION VANIN61e: 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 ($100,000), IN ADDITION TO THE 10{ 1 g FCJOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. IlIe19bypffirm u0. paeValty of perjury one Of the following declarations: L lna%a and 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 thl OlIf"ij4hoe of jl*%or? for which this permit is issued. Policy No. +.e. I ave 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' compensatior Nisicrance carrier and policy number are: Tier Policy Number Expiration Date Tie of Agent Phone # certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the worke 'compensation laws of California, and agree I, if I should become subject he workers' comps%1f"ition pros ' ns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. p nature of Applicantl� Datef CLARATION REGA I NS UCTION LENDING AGENCY ereby affirm under p ally 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). ider's Name Lender's Address 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 is correct. I agree to comply with all applicable city and county ord' ances and state laws relating to building construction. I authorize representatives of this city or county to e _ the ab -id t' ed pro rty for inspection purposes. /a� nature of Prooertv Owner or Authorized Aaent .� Print Property Owner's or Authorized Agent's Name i 44`l . /?'7: lTVl`fiL7 Date ACTION DATE BY UtLLAKAIIUN Ur LUWVL1ANLL WJ I H 4UUC Ur r KVftne Une UIVLr FEDERAL REGULATIONS PART 01 OF TIILE40AND AQMDRULE1403. PERMITEXPIRED ❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO.' ❑ EPA ❑ AQMD PERMITCANCELLED PERMITEXTEIVDED El ASBESTOS M017RCA710MIS NOT APPLICABLE TO PROPOSED DEMOLITION PERMIT FINAL 17i IT CERTIFICATE OF SIGNATURE: OCCUPANCYISSUED