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Home My WebLink AboutE2017-0452 - PermitsCity of Newport Beach - Building Division II�IIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIII II UG--,0-,9 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 424 COLTON ST Bldg: 1 Hoor: Suite: Description of Work: ELEC/DISCONNECT FOR CONDENSER Electrical Permit: E2017-0462 Project No : Inspection Requests Phone (949)644-3255 Inspector Area: 3 Code Edit: 2016 Legal Description: TR 772 LOT 15 BILK 24 ALL (EX NELY 11 FT) THEREOF AND NELY 15 FT LOT Owner: TAUBER ANNETTE Contractor: BASIC AIR INC Worker's Compensation Insurance Address: 424 COLTON ST Address: 1157 SALINAS AVENUE Carrier: STATE FUND NEWPORT 663 COSTA MESA CA92626 Policy No: 9086207 ° `° ° ° ° Phone: 949-887 74 Phone: 714-469-4542 Expire:10/22/2017 Con State Lic: 909834 Issued Date:08/ /2017 Lic Expire: 01/31/2018 Bus Lic: BT30045172 ° Processed By: Lic Exp Date: 1013112017 ° m m m m me em 0 0 0 eeom FEES ` New Construction Rece acle/Switch/Outlets Motors/Transformers(HP/KVA) .omcm Residential Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 1-2 Family: 0 $0.00 Sep Circuits: 1 $6.00 10 to 50 HP/KW/KVA: 0 $0.00 m Low Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 0 Service Signs Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 Plan Check Fee: 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Piggy Backrremp Power: 0 $0.00 Investigation Fee: Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: O/H to U/G 0 $0.00 Additional Fee : $0.00 Supplemental Fee: TOTAL Fee: $39.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $39 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7:00 a.m. to &30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. mo •eo cmmmo $�,,pIDzaa . ING%o $0.00 $0.00 $0.00 $0.00 $0.00 $33.00 $0.00 IWNER-BUILDER DECLARATION 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) 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 is 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). 1 1, 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, 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). 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 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 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.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 Code nd my license is in full force nd effect. •... icense Class .,-,-0 License No DatA, nD 1°i ( Contractor SignatureJ�� / Vo:RKtcRS' COMPENSATION DECLARATION IARNING FAILURE a(T r.ECtRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (61a0,000), IN ADDITION TO THE OST Of COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNETS FEES. hereby affirm under penalty of perjury one of the following declarations: � I Ave and 416Nhain 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 ramr�,,..,• Hance ofor which this permit is issued. Policy No. 71�ha and wllFmeinfain 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 IE a cam`ef apld polic um er are: ¢ �f / IO i2-L �l✓'� Policy Number 0 i] 2( % ^I0 Expiration Date / .•••.• dame D?ADent . - Phone # Fgrjliy that, :I tDO jSQrformance 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 agre I, if I should become subject tqJ4wo rs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. r} nature of Applican CLARATION REG RDING NST LENDING AGENCY :reby affirm under nalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097 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 ordinances and state laws relating to building construction. I authorize representatives of this city or county t�oteyr/a/bo/identified property for inspection purposes. nature of Property Owner or Authorized Age Print Print Property Owner's or Authorized Agent's Nam& Civil Code). ACTION DATE BY DECLARATION OF COMPLIANCE VYLTH CODE OF FOR OFFICE O&EONLY FEDERAL REGULATJONSPART61 OFTITLE40AND AQMDRULE 1403. , PERMITEXPIRED ❑ ISUBMITFEDASBESTOSN07IFICATIONTO: ❑ EPA ❑ AQMD PERMITCANCELLED PERMIT EXTENDED ❑ ASBESTOS NORFICATIONIS NOT APPLICABLE TO PROPOSED DEMOLITION. PERH4ITFINAL I,l '!i �� CERTIFICATE OF OCCUPANCYISSUED SIGNATURE: