HomeMy WebLinkAboutE2019-0188 - PermitsCity of Newport Beach - Building Division pII'�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 11 Electrical Permit: E2019-0188
100 Civic Center Drive, Newport Beach, CA 92660 ('I E 2 0 1 9 0 1 8 8 Project No:
g Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Job Address: 2130 PORT DURNESS PL
Bldg: 1 Floor: Suite:
Description of Work: ELEC INSTIL DISCONNECT FOR NEW A/C UNIT (H2O19-0180)
Inspector Area: 4
Receptacle/Switch/Outlets
Motors/Transformers (HP/KVA)
Code Edit: 2016 j meg'LC I A
Legal Description: N TR 7845 LOT 10
Receptacles/Outlets:
Owner: BURCHETT R DEAN
Contractor:
WEST COAST ENERGY
Worker's Compensation Insurance
Address: 2130 PORT DURNESS PL
Address:
1180 NORTH FOUNTAIN WAY #F
Carrier: NORGUARD INSURANCE CO
NEWPORT BEACH, CA 92660
Fixtures:
ANAHEIM CA 92806
Policy No: HOWC902727
`OGCV°
Phone:
Phone:
714/630-6330
Expire :04/Il1(�019,IDEX36°
',0
°o
Con State Lic:
685478
U VV D€1�IF2
Issued Date:03/ /2 19
Lic Expire:
03/31/2020
a• °®
a
$0.00
Bus Lic:
BT30063308
REQUIRED FOR,
Processed By:
Lic Exp Date:
05/31/2019
a
50 to 100 HP/KW/KVA
0
$0.00
A/C DISCONNEItTk
0
$0.00
a000 °
New Construction
Residential
Multi -Family:
1-2 Family:
Service
0-600V up to 20OA: 0
0-600V over 20OA: 0
Over 600V or1000A: 0
O/H to U/G 0
Fee
.00
Check Fee: $0.00 Fee
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
Receptacle/Switch/Outlets
Motors/Transformers (HP/KVA)
Receptacles/Outlets:
0
$0.00
0 to 1 HP/KW/KVA:
0
$0.00
Temp Underground:
$01.00°
$0.00
Fixtures:
0
$0.00
1 to 10 HP/KW/KVA:
0
$0.00
Sub Panel:
',0
°o
skee°
$0.00
Sep Circuits:
0
$0.00
10 to 50 HP/KW/KVA:
0
$0.00
..4
0
$0.00
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 Backrremp Power:
0
$0.00
Investigation Fee:
$0.00
$0.00
Time Clocks:
0
$0.00
Temp Power Pole:
0
$0.00
Issuance Fee:
$35.00
$0.00
Additional Fee :
$0.00
Supplemental Fee:
$0.00
.00
Check Fee: $0.00 Fee
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.
)WNER-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
is 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, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U 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).
7 1 am exempt from licensure under the Contractors' State License Law for the following reason:
�y 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)
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:http://www.leginfo.ca.gov/calaw.htmi.
signature of Property Owner or Authorized Agent J Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm uadreFpenalty, of perjury that I am licensed under provisions of Chapter 9 (co me ting with Section 7000) of Division of the Business and rofessions Cade, and my license is in full force
nd effect. '.•.•
�s��Glass .--+ - License No \EM
��pntLracrSignature
YORKERS'CQWNSATION DECLARATION
ING�FAILURE TQ SECURE WORKERS'COMPENSATION COVERAGE le UNLAWFUL, ANO SHALL SUBJECT qER TO CRIMINAL PENALTIES S UP TO ONE H OREO THOUSAND DOLLARS (E100,000), IN ADDITION TO THE
OS F)6 OMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, ANDY'S FEES.
here affirm ung erpanalty of perjury one of the following declarations:
nd wl:rnaptain 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 the
e of the vUR for which this permit is issued. Policy No.
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'
carrier and pglicy number are:
Policy Number Expiration Date
certify that, in 14i6erfo nce 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 workers' compensation laws of California, and
if I shout a /n�th�e/w�orkers I c� sation provisions of Section 3700 of the Labor Code, I shall forthwith comply with/thoss_A.[Jovis ions.
lature of Apolican /t u�Jk^—v er - Hate
hereby affirm under penalty 4f perjury that 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 ILender's Address
�y my signature below, I certito each of the following:
I am the property owner cr authorized to act on the roperty owner's behalf..
I have read this application and the information I h provided is correct.
1 agree to comply with all applicable city and cou y o dinancas and state laws relating to building construction.
I authorize representatives of this c(ty or county t e r the abAve-KgpAfied property for inspection purposes.„-
AC17ON DATE
BY
DECLARATION OF COMPLIANCEWITU CODED
FOR OFFICE USED
FEDERAL REGULATIONS PART 61 OFTITLE40AND
AQMDRULE1403.
PERMITEXPIR€D
--
❑ 1 SUBAFTTED ASBESTOS M071FICATION TO:
❑ EPA
❑ AQMD
P€RMITCANCELLED
PERMiTEXTEND€D
❑ ASBESTOS NOIIRCA770NIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMITFINAL
CERTIRCATEOF
OCCUPANCYISSUED
SIGNATURE.