HomeMy WebLinkAboutE2019-0495 - PermitsCity of Newport Beach - Building Division I
100 Civic Center Drive, Newport BeaqtrReAMM
9 1 Permit Counter Phone (949)644-328
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Job Address: 881 SANDCASTLE DR Bldg: 1 F
Description of Work: ELEC/NEW A/C UNIT 55dB*
Electrical Permit: E2019-0495
t! n�teegl ests Phone (949)644-3255
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❑ 80% or ❑ 100% relu d
Inspector Area: 4 de Edit: 2016 z^
Legal Description: N TR 6228 LOT 57 EXPIRED V )
Owner: BERGER SUSAN P Contr or: ECONO AIR Worker's Compensation Insurance
Address: 881 SANDCASTLE DR Address: 555 VANGUARD Carrier: ARCH INS COMPANY M
Phone: CORONA DEL MAR, CA 92625 Con e. ic:2Ca9 18 R� QIW387 00)
Issued Date:07/18/2019 Lic Expire: (no work staaarte;id
Bus Lic: BT30064026 1 j
Processed By: Li xp Date: 08/31/2019 I
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New Construction Receptacle/Switch/Outlets Motors/Transformers (HP/KVA)
Residential Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $0.00
Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 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.
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I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) 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,
iness 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: Mtractors' State License Law does not
ly to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contrac a License Law).
J I am exempt from licensure under the Contractors' State License Law for the following reason:
Iy my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one yearGPIMompletion of tqF���.,,,improvements covered by this permit, I cannot legally
ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractor rstand that a co ef,,e applicable law, Section X7044 of the Business and
'rofessions Code, is available upon request when this application is submitted or at the following Web site: . Ieginfo.ca.go,/gala p 1. Ur�O/p (
;ignature of Property Owner or Authorized Agent \\fit i Date
.ICENSED CONTRACTOR'S DECLARATION AA
hereby affirm under penalty of perjury that I am licensed under provisions of C p (commencing with Sec' 0) of Division 3 h§ usiness and Pr essio o ", ad my license is in full force
nd effect.
icense Class License No ate Contractor Simt�
VORKERS' COMPENSATION DECLARATION "� to
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGEPO�kjNLAW D SHALL SUSU T AN 0 CRIMI AL IVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (E100,000j; IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION'37't)7✓IH LA BOR CODE, INTERE DA F -
hereby affirm under penally of perjury one of the following declarations:
I have and will maintain a certificate of consent to sell•.-jn®ih§ wor s' c p i ued by the Directo u ;al tions as provided for by Section 3700 of the Latior Code, for the
erff finance of the work for which this permit is issued. Policy No. x . - `
AI have and will Gain 'n workers' compensation insurance as re ed by Section 3700 o t d e the work for which this permit is Mewed iQ workers', compensatior
isurance carrier a d poli number a ! >
arrier TIJ Po,l�i u � Expiration Date a
SITE of Agent 6 1 '! - P 4 r–
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1I certify that, in the perfor nce of or or which this permit is as , I sh - mploy any person in any manner so to . o bj c thT wgkg.'I?0 pensation laws of California, and agree
Iat, if I should become Uhl to the s' compe Ion 3700 of the Labor Code, I shall forthwith co p asY prr ipyglpOk ' , %%
ignature of Applicant f,. at /Ji/ Zfl
ECLARATION RE G CO ION LENDING AGE Y :�--
hereby affirm under enalty of perjury that there is a construction lendmg ager yAfor an f the work for which this permit is issued (Sect' Civil ode ;,...
ender's Name '"`n = a ddres
y my signature below, I certify to each of the following: '?.,w ltd(- - -
I am the property owner or authorized to act on the property ow s.beti'aif.
I have read this application and the information I have provide is rrect.
I agree to comply with all applicable city and county rdirean d state laws rela g to buildin ruction.
I authorize representatives of this city or county , e er the ve-identifi art •f���^ peclion purposes."""
ignature of Property Owner or Authorized A en / Print Pr wn uthorized A ant's Name
ACT70N DATETI OMPLIANCEWITHCODEOF FOR OFFICE USE ONLY
• •••
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GULAT/ONS PART 61 OF TITLE 40 AND
PERMITEXPIRED fJr 0 RULE 14".
l I "1 • 4 SUBM OEdAiBESTOS NOTIFICATION TO:
PERMtT CANC€LLED • • • ` .'[j 0.0
P€RMIT EXTENDED D AQMD
ASBESTOS NO€7FICARONIS NOT APPLICABLE TO
PERMIT FINAL • o s • • PROPOSEDDEVOLITTON.
CERT7FICATEOF • i • i i ` i
OCCUPANCYISSUED •� :pSANATUNE: