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HomeMy WebLinkAboutE2019-0564 - Permitserr City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 206 ADAMS Description of Work: ELEC - Inspector Area: 1 1 Floor: 1 Suite: B ECT FOR A/C INSTALLATION Legal Description: BALBOA TR ]BILK 5 LOT 9 Owner: TALEBI TONY Contractor: Address: 206 ADAMS AV UNIT B Address: NEWPORT BEACH CA 92661 $0.00 Phone: Phone: $0.00 Con State Lic: Issued Date:08/13/2019 Lic Expire: Branch Circuit: Bus Lic: Processed By: Lic Exp Date: 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: $61.00 'Ij ^°" '"Zh ?t9c-al°Permit: E2019-0564 E 2 0 1 9. 0.5 6 40 °oPr'pject'+10:° m ° 0 0 Inspection Requests Phone (949)644-3255 e o °o a OC O O KLONDIKE AIR INC 1308 LOGAN STE E COSTA MESA CA 92626 714-979-2070 754456 09/30/2020 BT30060482 10/31/2019 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 0 $0.00 Low Voltage 0 $0.00 Signs 0 $0.00 Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee : $0.00 Code Edit: 2016 Worker's Compensation Insurance Carrier: FALLS LAKE FIRE & CASUAL Policy No: FLA008095- Expire : 01/01/2020 FEES 0 $0.00 Motors/Transformers (HP/KVA) 1 $26.00 0 to 1 HP/KW/KVA: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 10 to 50 HP/KW/KVA: 6 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 Over 100 HP/KW/KVA: 0 $0.00 Piggy Backfremp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Plan Check Fee : INS txj nj Temp Underground: 0 $0.00 Sub Panel: 1 $26.00 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 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. NO CONSTRUCTION NOISE ON THE WEEKEND DWNER-BUILDER DECLARATION.", "; - : --. I hereby affirm under penalty of perjory:hatl, rr6exempt 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 VolJg:".dtybi cou°niy that-mquires 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 ($500), , ... ❑ I, as owner of the property, or my e1Tpoye4 with wages at; their VTe cc2n*nsation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Ceiltractdjs' Statf License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sal&. If, ho$vev&ofhe bulling or imprgvement 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). 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). ❑ 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 year prior to completion of the improvements covered by this permit, I cannot legall) 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:http://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 Se tion 000q) of Division 3 of the Businesand r fession d y icense is in full force and effect. ` ' 1. I Contractor Si License Class License No D gnat NORKERS' COMPENSATION DECLARATION NARNING: 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 COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: :11 have 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 th, 3-3-88�1���..((��ormance of the 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 performance of the work for which this permit is issued. My workers' compensatior s rance carrier and policy number are: - Policy Number Expiration Date Te of Agent Phone # certify that, in the pertorma e o the work w t '�.p it is is ued,I shall not employ any person in any manner so as to become subject to the workers' ompensation laws of California, and agre, t, if I should become subje to th workers' co l!51h a d isio of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant Date CLARATION REGARDING CONSTRUCTION LENDING AGENCY or— reby affirm under penalty 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 hav vided is c rre I agree to comply with all applicable, and cou ,ordin nces and tate ting building construction. .yt �1 r 1 I authorize representatives of this city or county o enter . above -i pro �r'sspection purposes. —/, t nature of Property Owner or Authorized Agen �+-- �2[jC.Properly Owner's or Authorized Agent's Name, p�j P" Y D_a`te ACTION DATE BY DECLARATION OF COMPLIANCEMTH CODEOF FOR OFFICE USE ONLY FEDERAL_ REGULATIONS PART 61 OFTf7LE40AND AQMD.RULE 1403. PERMITEXPIR€D ❑ ISUBIWITEDASBESTOSN071FICATIONTO. ❑ EPA ❑ AQMD PERMITCANCELLED P€RMITEXTENDED ❑ ASBESTOS NOTIFICA77ONIS NOT APPLICABLE TO PROPOSEDDEMOLITION, PERMITFINAI ,1 L4-19 EERTIFICATEOF OCCUPANCYISSUED SIGNATURE: