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Home My WebLink AboutE2020-0024 - Permits,�#, City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIII II Electrical Permit: E2020-0024 3' _ 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 0 0 0 2 4 Project No „l., Permit Counter Phone (949)644-3288 yy C °, `..4' Inspection Requests Phone (949)644-3255 zta�xti Job Address: 37 SOUTHAMPTON CT Bldg: 1 Floor: Suite: Receptacle/Switch/Outlets Residential $0.00 Description of Work: ELEC -DISCONNECT FOR A/C (H2O19-0567) Receptacles/Outlets: 1 P� Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1-2 Family: Inspector Area: 8 $0.00 Sep Circuits: Code Edit: 2019 $0.00 Legal Description: TR 10987 LOT 2 UNIT 134 OF PROJECT LOCATED ON AP 442-351-08� Issuance Fee: Low Voltage 0 TOGETHER Service $0.00 Signs Owner: GOODMAN RANDOLPH M Contractor: SERVICE CHAMPIONS HTG Worker's Compensation Insurance °°•°°° 0 Address: 37 SOUTHAMPTON CT Address: 3150 E BIRCH Carrier: EVEREST NATIONAL INS 00 ° ° ° NEWPORT BEACH CA 92660 Over 600V or 100oA: BREA CA 92821 Polley No: RM8WC00044191 Time Clocks: 0 Phone: Phone: 714-777-7777 Expire : 05/29/2020 Additional Fee : $0.00 Con State Lic: 799170 ° IssuedDate:01/10/2020 Lic Expire: 10/31/2021 Bus Lic: BT01080105 Processed By: Lic Exp Date: 07/31/2020 ° ° 6 O OGOCO / V ®p®P 9 041J rJC GO 1000 New Construction Receptacle/Switch/Outlets Residential $0.00 Oto 1 HP/KW/KVA: Receptacles/Outlets: 1 $1.00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1-2 Family: 0 $0.00 Sep Circuits: 0 $0.00 $0.00 Issuance Fee: Low Voltage 0 $0.00 Service $0.00 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 100oA: 0 $0.00 Time Clocks: 0 $0.00 O/H to U/G 0 $0.00 Additional Fee : $0.00 TOTAL Fee: FEES Motors/Transformers (HP/KVA) ° " 0 $0.00 Oto 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 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. 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. OWNER -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 the 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 Professions 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 not 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 U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business 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 improvements 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 improved for the purpose of sale). ❑ 1, 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 apply 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). ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By 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 sell 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 Professions 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 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Secti 700 ) of Division 3 of the Business anrkProf ®and my license is in full force ar?ri efjepi��.. Libense 131ass ...... License No Date U Contractor Signature W05tK!ERS' COMPENSATION DECLARATION WARNIM. FAILURE T9 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 CO6T OFCOMPENSATJGi* CAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I liereb)yaffirm under penalty of perjury one of the following declarations: 13vhIla% and will malrftain 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 the parkinmance of the work for which this permit is issued. Policy No. and will vairgiiin 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' carrierOVO-policy number are: Policy Number Agent Date certify that, in the performance of thew ichthi Issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree I, if I should become subje sation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisigns. /�D /Z� nature of Applicant Date / CLARATION REGARDIN6CQNaJRIJGT1aN LENDING AGENCY :reby affirm under penalty 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 c aws relating to building construction. I authorize representatives of this c or co r the above -identified property for inspection purposes. lature of Property Owner or Authorized Agent Print Property Owner's or Authorized ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART df OFTITLE40AND AQMORULE1493. PERMITEXPIRED ❑ f SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMITEXTENDED ❑ ASBESTOS N017RCA7I0NIS NOTAPPLICABL.ETO PROPOSED DEMOLITION. PERMITFINAL CERTIFICATE OF OCCUPANCYISSUED SIGNATURE: