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HomeMy WebLinkAboutE2019-0583 - Permits (2)9t City of Newport Bepdh- Building Division IIIIIilllllllllllllllllllllllllllllllllillllllllll Electrical Permit E2019-0583 '� 100 Civic Center Drive, Newport Beach, CA 92660 - E 2 0 1 9 0 5 8 3 Project No: F `j Permit Counter Phone(949)644-3288 ' a Inspection Requests Phone (949)644-3255 Job Address: 317 ORCHID AVE Bldg: 1 Floor: Suite: Description of Work: ELEC INSTIL CIRCUIT FOR NEW A/C UNIT (H2O19-0510) NO CONSTRUCTION NOWEdit:2016 INSPECTOR Inspector Area: 5 Legal Description: CORONA DEL MAR BLK 241 LOT 17Owner: EVE M E ' THE VMi lt'�EKGcN®Wo rker's Compensation Insurance Address: 3210 SEAV EW VEL Address:Contract P C COOL �'V 0 BOX6868Carrierr: EVEREST NATIONAL .... CORONA DEL MAR CA 92625 ORANGE CA 92863 Policy No: 760007408191 .... Phone: Phone: 714-720-3936 30- WIDE X 36n DEPTH Expire ire : 06/01/2020 Can State Lic: 804056 p' IssuedDate:08/22/ 019 Lic Expire: 01/31/2020 ° Bus Lic: BT30042073 REQUIRED FOR m.° Processed By. Lic Exp Date: 01/31/2020 zC?ki7ECTTOFiELDINSP$CTOR'So° A/C DISCONNECTS REVIEW ANDAPPKOV*AL ° ° 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° ° °O°°4° °" o 0 ° ° New Construction Receptacle/Switch/Outlets Motors/Transformers(HP/KVA) Residential Receptacles/Outlets: 0 $0.00 Oto 1 HP/KW/KVA: 0 $0.00 Temp Underground: 01°0 9QpQo° Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA 0 $0.00 Sub Panel: O°°° 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 Back/Temp 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. )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 ie 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 Cade) 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). ' 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, 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 n^t 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). I am exempt from licensure under the Contractors' State License Law for the following reason: ly 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) 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 Dale .ICENSED C041RACTOR'S DECLARATION hereby affirm umdr:rP� malty of perjury that I am licensed under provisions of Chapter 9 (commencing wit cf n 70 ) 0. Division 3 of he Business and Prof si r s Co fen my Ic a is in kK force ad effect. :EAMClass _ • License No at 7i� �% Contr to Signature VW4 FAQRKE(RS' COMPENSATION DECLARATION I 'RfAILURE TO%ECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER To CRIMINAL PENALTIES AND CI I FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE OST OF COMPENSANON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. INereby�affirm under penalty of perjury one of the following declarations. I,fyaye and %gift ntdlatain 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 grjoruiafiIce of the Norkffor which this permit is issued. Policy No. .���T N�srrue.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 Is ued. My workers' compensatiol I�uta1lcQ carrier,E�yi,ppycy number are: ^s (� DD Od p f G 7 //S aeiec.. Ar[EO Q�f7bd�Policy Number [ % / /� Expiration Date :i/ / 2a ec7eofiagent •�•.�--- Phone# r 31 Ce tatrtify that, hin a 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 workers' compensation laws of California, and ogre , if I should 1 come subject ers' co ,�Jros of Section 3700 of the Labor Code, I shall forthwith comply with those,p[ovisions. ; / / ;reby it under penalty of perjury that there is a construction lending ag cy for the performance of the work for which this permit is issued (Section 3097, Civil 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 cit and co din es and state ws rel"g to building construction. I authorize representatives of this my to er 0 -id f ,prop§rty for inspection purposes. mature of Property Owner or Autho d Agent r �� Print Property Owner's or Au honed Agent's Name AC77ON DATE BY PECLARATIONOFCCIMPLIANCEMJHCCIDEOF FOROFRCEUSEONLY FEDERAL REGULATIONS PART 61 OF TITLE40AND AQMD.RULE 1403. PERMITEXPIRED t SUBMITTED ASBESTOS N077FICATION TO: ❑ EPA PERMIT CANCELLED ❑ AQMO P€RMFTEXTENDED El ASBESTOS NOT APPLfCABL.E TO PERMITFINAL PROPOSED MOUTON.RON/S CERTIFICATEOF SIGNATURE: OCCUPANCYISSUED _