The URL can be used to link to this page

Home My WebLink AboutE2020-0257 - Permitst1p': City of Newport Beach - Building Division 't 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 1015 BALBOA BLVD W Bldg: 1 Floor: Suite: Description of Work: ELEC -DISCONNECT FOR A/C INSTALLATION Inspector Area: 1 Legal Description: N TR 234 BLK 10 LOT 20 Owner: DOOLITTLE KEITH Contractor: CALIF A A C CONSTRUCTION Address: 15476 ROJAS ST Address: 41200 ANZA ROAD HACIENDA HEIGHTS CA 91745 Receptacles/Outlets: TEMECULA CA Phone: 626-695-1968 Phone: 0 $0.00 Con State Lie: 595631 Issued Date:05/29/2020 Lie Expire: 06/30/2020 $0.00 Bus Lie: BT30071887 Processed By: Lie Exp Date: 05/3112021 New Construction 0 $0.00 Sub Panel: Receptacle/Switch/Outlets Residential 0 to 1 HP/KW/KVA: 0 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 Low Voltage 0 $0.00 Service Signs 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 TOTAL Fee: Electrical Permit: E2020-0257 Project No : Inspection Requests Phone (949)644-3255 Code Edit: 2019 Worker's Compensation Insurance Carrier: EXEMPT Policy No: NO EMPLOYEES Expire : FEES 0 $0.00 Sub Panel: Motors/Transformers (HP/KVA) 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 Backrremp Power: 0 $0.00 Temp Power Pole: 0 $0.00 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 Due at Permit Issuance : 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. N®IS'IE -rot ICTION ON spju"Wr,YS 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' Slate 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 L) all of or U 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 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). 7 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 legally 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 Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 J (commencing with Section 7 00) of Division 3 of the Business and Professions Code, and my license is in full force nd effect. n / 7 !cense Class 3 -/ License No ✓ J �Jz 1 D t ��- Contractor Signature - .�'------..-_. IIORKERS' COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDg THOy AND DOLLARS ($100,000), IN ADDITION TO THE OST 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: 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 thi erformance 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' rance carrier and policy number are: Policy Number of Agent Date i rtify 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 ogre if I should become subject to Aworke com n ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. mature of Applicant I/ id Date 1 CLARATION REGhRDpenalty�N�C.0 NSTRUCTIO'4VI.EN6fAG AGENCY F� :reby affirm under o equry that th;pte is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, 6vil Code ider's Name Lender's Address my signature below, I o rtify 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 relating to building construction. I authorize representatives of this city or count! to�enter bove-i nti ' r party for inspection purposes. mature of Pronertv Owner or Authorized ADent V �� Print Prooertv Owner's or Authorized Agent's Name AC77ON DATE BY / uctLAr Iftviv yr wlrruttrvaC vvitrr wuc yr / Mn urnLr V�LurvLr / FEDERAL REGULATIONS PART 61'OFTt1LE40AND PERMIT EXPIRED AQMD RULE 1403. ❑ ISUBMITTEDASBESTOSNOTIFICAT(ONTO: PERMITCANCELLED ❑ EPA PERMIT EXTENDED ❑ AQMD ❑ ASBESTOS NOTIRCAIIONIS NOT APPLICABLE TO PERMITFINAL i-?-Z�zo PROPOSED DEMOLITION. CERTIFICATEOF OCCUPANCYISSUED SIGNATURE: