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HomeMy WebLinkAboutE2019-0294 - Permits (2)9City of Newport Beach 'Building Division *E2019-0294* Electrical Permit: E2019-0294 o `. 100 Civic Center Drive, Newport Beach, CA 92660 Project No r, Permit Counter Phone (949)644-3288 "e'�tGrixa"+h'u Inspection Requests Phone (949)644-3255 Job Address: 560 HARBOR ISLAND DR Bldg: 1 Floor: Suite: Description of Work: ELEC/DISCONNECT TO AIC �Y I Inspector Area: 2 Legal Description: N TR 3867 LOT 31 Owner: EGGLESTON DAVID W & LARAINE Contractor: Address: 560 RBOR ISLAND DR Address: XWPCRT BEACH, CA 92660 Phone: New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0 $0.00 0-600V up to 20OA: 0 $0.00 0-600V over20OA: 0 $0.00 Over 600V or1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: $42.00 Phone: Con State Lic: Lic Expire: Bus Lic: Lic Exp Date: BEST AIR COND & HEATING INC 959-A N ELM ST ORANGE CA 92867 714-771-2330 419737 03/31/2020 BT30065307 12/31/2019 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 1 $7.00 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 eoe• • • mii • a • 4C a Worker's Compensation Insurance • • • o • m Carrier: STATE COMP INS FUND • m Policy No:92GBX0541 •ima• 9 • • m i • r••eeo a m Motors/Transformers (HP/KVA) Expire : 06/28/2019 30t, V ° . o, �, omm•c �•ii4m L C A/C a m m oaoi ooao 0to1HP/KW/KVA: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 Over 100 HP/KW/KVA: 0 $0.00 Piggy Back/Temp Power: 0 $0.00 Temp Power Pole: 0 $0.00 Plan Check Fee : Temp Underground: 0 $0.00 Sub Panel: 0 $0.00 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. /NER-BUILDER DECLARATION I hereby affirm under penally 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) ction 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 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 fessions 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 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, liness 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 ,rovements 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 ,roved 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 ily 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 ff" licensure under the Contractors' State License Law for the following reason: my signaturelv"%racknowledge 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 lega% , 13btrocture that, 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 fessidns Col, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. nature of Property owner or Authorized Agent Date :QED CONYRACTOR'S DECLARATION :rebr.affirm ups®,pBilalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my lice as is in full force I%fpdt. -ns:Class ++•• License No Dat ^lel Contractor Signatur )MLIRS' COMPIP NSATION DECLARATION TV: ILLJJ FAILURE TO -SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EM LOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE I b 4OMPENSATION, QAMAGES AS PROVIDED FOR IN SECTION 3TOS OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. TV vebyliffirm AtOrmffeiialty of perjury one of the following declarations: IDim and wNl•maiigtain 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 rWance of Ilivi"IZ 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 policy number are: Policy Number Expiration Date me of Agent -vnone s 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 workers' compensation laws of California, and agre t, if I should become subject the wort rg' sa 'oa-provl f3L�Gdn 3700 of the Labor Code, I shall forthwith comply with those provlsio )��yy nature of Applica��-^'yyyyyyY ,•�� ' Dat 7�/©�/'7 CLARATION REC RDING CO UCTION LEND AGENCY :reby affirm under enalty of perjury that there is a onstruction lending agency for the performance of the work for which this permit is issue (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 ordinances and state laws I ting to building construction. I authorize representatives of this city or county to _e°tey�t)�above-i1 i' t nsDa�tg c purposes. nature of PrOUertv Owner or Authorized AGent� /�7 ��` 1 operty Owner's or Authorized Agent's Name Jllil/� ACTION I DATE (I BY I PERMITEXPIRED I I / l // 1 I PERMITCANCELLED I /I l.i /1 1 PERMIT FINAL CERTIFICATEOF OCCUPANCYISSUED PART 61 OF TITLE40AND AQMD RULE 1403. I SUBMITTED ASBESTOS N077FICATION TO.' ❑ EPA ❑ AQMD ❑ ASBESTOS U017RCAIJONIS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: