HomeMy WebLinkAboutE2018-0491 - PermitsCity of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counterr'hone (949)644-3288
Job Address: 3 HERMITAGE LN Bldg: 1 Floor: Suite:
Description of Work: ELEC INSTL (2) DISCINNECTS FOR AIC UNITS (H2O18-0448)
Inspector Area:
Legal Description: N TR 7223 LOT 90
II�IIIIIIIIIIIIIIIIIIIIIIIIIINIIIIIIIIIIIIIIIIII II Project Electrical
Permit:
: E2018-0491
Owner: SIBERIO JULIO & KELLI
Contractor:
SEASIDE AIR ENT INC
Address: 3 HERMITAGE LN
Address:
32959 CALLE PERFECTO #C
NEWPORT BEACH CA 92660
SAN JUAN CAP, CA 92675
Phone:
Phone:
949-496-3639
Motors/Transformers(HP/KVA)
Con State Lie:
736214
Issued Date:07/26/2018
Lie Expire:
08/31/2018
0
Bus Lie:
BT30018420
Processed By:
Lie Exp Date:
01/31/2019
New Construction
Residential
Multi -Family:
1-2 Family:
Service
0-600V up to 20OA: 0
0-600V over 20OA: 0
Over 600V or100oA: 0
O/H to U/G 0
TOTAL Fee:
Inspection Requests Phone (949)644-3255
a
Code Edit: 2016 � Wt L
CTOR
Worker's Compensation Insurance
Carrier: STATE COMP
Policy No: 9076609
Expire : 07/21/2019 f•••O•
3011 WIDE X 3&'.1XPTHo•••
REQUIRED FOR
00
A/C DISCOVECTS °•
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.
FEE
-•oo•
Receptacle/Switch/Outlets
Motors/Transformers(HP/KVA)
°o•v
Receptacles/Outlets:
0
$0.00
0 to 1 HP/KW/KVA:
0
$0.00
Temp Underground:
_®
$®.00
$0.00
Fixtures:
0
$0.00
1 to 10 HP/KW/KVA:
0
$0.00
Sub Panel:
•• m
$2640—
$0.00
Sep Circuits:
0
$0.00
10 to 50 HP/KW/KVA:
0
$0.00
•°• • 0
$0130+°
Low Voltage
0
$0.00
50 to 100 HP/KW/KVA:
0
$0.00
0
$0.00
Signs
Over 100 HP/KW/KVA:
0
$0.00
Record Mgmt Fee:
$0.00
$0.00
Branch Circuit:
0
$0.00
Plan Check Fee:
$0.00
$0.00
Each Add Circuit:
0
$0.00
Piggy Back/Temp Power:
0
$0.00
Investigation Fee:
$0.00
$0.00
Time Clocks:
0
$0.00
Temp Power Pole:
0
$0.00
Issuance Fee:
$33.00
$0.00
Additional Fee:
$0.00
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.
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 `) 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
Im roved forthe 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 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 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 legal)
sell 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
Professions Code, is available upon request when this application is submitted or at the following Web site:hftp://www.leginfo.ca.gov/calaw.htmi.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and P o tions Co nd my tic s in full force
and effect. ...�..,, / ,
License Class .... License No �ate----/—/G h � Contract ignature ^ /(/1
WORKERS'. COMRENSATION DECLARATION /
BSIIU144, FAILURE TOBEaURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000), IN ADDITION TO THE
OST ORCOMPEMA?ION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I kereby`affirm under penalty of perjury one of the following declarations:
1'14ave 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 IN
pe rmvnce otRbe9uoCc 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 performance of the work for which this permit is issued. My workers' compensatio
M t°a carri4r a l olicy number are:
arrleP . Policy Number Expiration Date
alameol Agent .
Phone
•.YC
l.gnW that, in the plerformance of the wo or which this p it is issued, I shall not employ any person in any manner so as to becomle subje o the workers' compensation laws of California, and agre
lhgt i Ishould be suubb}/�c •!he wor compensa i owslons of Section 3700 of the Labor Code, I shall forthwith comply with those pro ' eqs.-7
Signature ofA plica t� /� ='?.. to L Z
DECLARATIO CONSTRUCTION LENDING AGEffCCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issue action 3097, Civil Code).
Lender's Name Lenders Address
By 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 cor
I agree to comply with all applicable city and county ordi nces an to lawerng to building construction.
I authorize repr Is city or county to bo d ' 'edor inspection purposes. �.
Signature of Pro a ner or Authorized A ant Print Property Owner's or Authorized Agen s ame t!ie-S Dale CINItf
ACDON DATE BY DECLARATION OF COMPLIANCE FH CODEOF FOR DFRCE USE
FEDERAL REGULATIONS FART 61 DFTITLE 40AND
PERMlTEXP1RED AQMDRULE?4R3.
fSUBIRtTTEDASBESTOSNDIIFICATtDNTO:
PERMdTCANC€LIED ❑ EPA
PERARlT€XTENDED ❑ A4PAD
❑
ASBESTOS NORflCATfONtS NOT APPLICABLE
TO
FROPOSEDDEiifOIlTION.
P€RMCTFINAt • t
CERTt6fCATEOF
SIGNATURE:
OCCUPANCYISSUED