HomeMy WebLinkAboutE2021-0278 - PermitsCity of Newport Beach - Building Division 11�111 111111111111111111111111111111111111111111111 Jill
100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 1 0 2 7 8
Permit Counter Phone (949)644-3288
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Job Address: 1973 PORT CARDIGAN PL Bldg: 1 Floor: Suite:
Description of Work: ELEC/INSTALL (1) NEW A/C UNIT 40dB (H2O21-0277)
Inspector Area:
Legal Description: N TR 7027 LOT 69
Owner: VASQUEZ DAVID
Address: 1007 EMERALD BAY
LAGUNA BEACH CA 92651
Phone:
Issued Date:04/26/202
Processed Bv: d��
New Construction
Residential
Multi -Family:
1-2 Family:
Service
0-600V up to 20OA: 0
0-600V over 20OA: 0
Over 600V or 1000A: 0
O/H to U/G 0
Contractor:
RANCHO VIEJO AIC & HEATING
Address:
22596 COTTONWOOD CIR
LAKE FOREST CA 92630
Phone:
949-212-4870
Con State Lie:
745018
Lie Expire:
1113012021
Bus Lie:
BT30031040
Lie Exp Date:
03/31/2022
Electrical Permit: E2021-0278
Project No : 1394-2020
Inspection Requests Phone (949)644-3255
Code Edit: 2019
Worker's Compensation Insurance �a'1
Carrier: NORGUARD INSURANCE :1, co
Policy No: RAWC223022 0
Expire : 0110112022 rn
J
0
FEES
Receptacle/Switch/Outlets
Motors/Transformers (HP/KVA)
Receptacles/Outlets:
0
$0.00
0 to 1 HP/KW/KVA:
0
$0.00
Temp Underground:
0
$0.00
$0.00
Fixtures:
0
$0.00
1 to 10 HP/KW/KVA:
0
$0.00
Sub Panel:
0
$0.00
$0.00
Sep Circuits:
1
$7.00
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
Signs
Over 100 HP/KW/KVA:
0
$0.00
Record Mgmt Fee:
$0.00
$0.00
Branch Circuit:
0
$0.00
Plan Check Fee:
$0.00
$0.00
Each Add Circuit:
0
$0.00
Piggy Back/Temp Power:
0
$0.00
Investigation Fee:
$0.00
$0.00
Time Clocks:
0
$0.00
Temp Power Pole:
0
$0.00
Issuance Fee:
$37.00
$0.00
Additional Fee :
$0.00
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.
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)WNER-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 7031.6, 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
1e 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 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
n 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
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:
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 (commencing with Section 7000) of Division 3 of the Business and Professions Co my license is in full force
nd effect. LVL Contractor Signature
icense Class License No Date
VORKERS' 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 HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
DST 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:
I 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 the
erffo
o Mance of the work for which this permit is issued. Policy No.
31 have and will ma' aln 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' compensatior
Isurance carrier and p III number are: q ('''� �'
:arrier -�r . 1 PcQs' Lltlbe%: _ _.. Expiration Date
of Agent
certify that, in the performance of the wor fo 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 agree
t, if I should become subject to the worker ' o pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pro isions.
nature of Applicant D:)L !
CLARATION REG G CONSTRUC ION LENDING AGENCY
:reby affirm under enalty 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 owners behalf.
I have read this application and the information I have provided is c rrect.
I agree to comply with all applicable city and county ordinance state laws relating to building construction.
I authorize representatives of this city or count ter the a o eDtified property for inspection purposes. /'
nature of Property Owner or Authorized Agent 7�-� "� Print Property Owner's or Authorized Agent's Name X i 1Av I ��r'A Date
ACTION
DATE
BY
DECLARATION OF COMPLIANCE 41TH CODE OF
FOR OFFICE USE ONLY
••• •
• F{F.(•}*€RAL4dPGULOTIONSPART 670F TITLE40 AND
F16 aD ROU 1401
PERMIT EXPIRED
• • •
• • •
I Sf1BPIITFgASBESTOS M071FICATiON TO:.
• •❑ EPA
❑ AQMD
PERMIT CANCELLED
• •
PERMfTEXTENDED
❑ ASBESTOS M071FICA71ON IS NOT APPLICABLE TO
• PPOP•09•PD Di< UTiON.
SIG41AZU4E:.
PERMIT FINAL
2 2 2
• • • •
CERTIFICATEOF
: . •
OCCUPANCYISSUED