HomeMy WebLinkAboutE2020-0300 - PermitsCity of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Job Address: 6 SIDRA COVE Bldg: 1 Floor: Suite:
Description of Work: ELEC/AIC DISCONNECT (H2O20-0239)
Inspector Area: 6
Legal Description:
Owner: KAUFMAN MARILYN Contractor:
Address: 6 SIDRA COVE Address:
NEWPORT BEACH CA 92657
Phone:
Phone:
Code Edit: 2019
Con State Lic:
Issued Date:06/19/2020
Lic Expire:
Worker's Compensation Insurance
Bus Lic:
Processed By:
Lic Exp Date:
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ALISO AIR INC
29736 AVE DE LAS BANDERAS
RSM CA 92688
949-589-2021
526420
03/31/2022
BT30019236
02/28/2021
New Construction
0
Code Edit: 2019
Receptacle/Switch/Outlets
Residential
M
Worker's Compensation Insurance
Receptacles/Outlets:
0
$0.00
Multi -Family:
0
$0.00
Fixtures:
0
$0.00
1-2 Family:
0
$0.00
Sep Circuits:
0
$0.00
$0.00
Investigation Fee:
Low Voltage
0
$0.00
Service
$35.00
Signs
Supplemental Fee:
0-600V up to 20OA:
0
$0.00
Branch Circuit:
0
$0.00
0-600V over 20OA:
0
$0.00
Each Add Circuit:
0
$0.00
Over 600V or 1000A:
0
$0.00
Time Clocks:
0
$0.00
O/H to U/G
0
$0.00
Additional Fee :
$0.00
Electrical Permit: E2020-0300
Project No :
Inspection Requests Phone (949)644-3255
Expire : 07/01/2020
X
FEES
0
Code Edit: 2019
Motors/Transformers (HP/KVA)
Sub Panel:
M
Worker's Compensation Insurance
$0.00
Carrier: LIBERTY MUTUAL
0
Policy No: WC2Z61036218098
10 to 50 HP/KW/KVA:
Expire : 07/01/2020
X
FEES
0
$0.00
Motors/Transformers (HP/KVA)
Sub Panel:
0 to 1 HP/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:
1
$27.00
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
Fee Due at Permit Issuance:
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday - Fridav 7.00 .m. a o 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m.
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IWNER-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
le 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).
I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of the work, and the structure is not intended proffered for sale (Section 7044,
usiness 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).
I 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 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.html.
ignature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Se Io 7001 of Division 3 of the Business and Professii_�ense is in full force
nd effect.
icense Class License No Date //±±� C 20 Contractor Signature
NORKERS' COMPENSATION DECLARATION
YARNING: 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
:OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
1 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
WI
tormance of the work for which this permit is issued. Policy No.
I 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' compensatioi
nsurance carrier aolicy number are:
T i1
.arrier <Ih• y,lYUrr)Iper Expiration Date
Jame of Agent • Phone #
71 certify that, in the performance G-hich 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
hat, if I should become �subject to t6a work a rovisions of Section 370 e -Labor Code, I shall forthwith comply with those provislo
signature of Applicant V Date A
)reby affirm under pe4alty 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 have provided is correct.
I agree to comply with all applicable city and county nces an to laws relating to building construction.
I authorize representatives of this city or county 1^ enler the =d '=-I^^^' ^-f^r'^e^a^H-.-"m�
nature of Pronedv Owner or Authorized ADent 1 Print Property Owner's or Authorized Agent's Name
ACTLON
PERMIT FINAL
CERTIFtCA TE OF
OCCUPANCYISSUED
DATE I BY
❑ :t iUBhdfTTFD ASSES SOS WOTTnC4TIQN TO:
❑ AQMD
❑ ASBESTOS NODRCANONIS NOT APPLICABLE TO
PROPQSEQ"MQLITION. •••
SIONATUr E. • . i i • • • • i
FOR OFFICE USE ONLY