HomeMy WebLinkAboute2022-0348 - Permits0City of Newport Beach - Building Division
.. �'A 100 Civic Center Drive, Newport Beach, CA 92660 II�E 2 0 2 2 0 3 4 s
�, ?.j Permit Counter Phone (949)644-3288
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II Electrical Permit: E2022-0348
Project No
Inspection Requests Phone (949)644-3255
Job Address: 14 SWIFT CT Bldg: 1 Floor: Suite:
Description of Work: ELEC/INSTALL NEW A/C UNIT 51.5dB- (H2O22-0288)
Inspector Area: 2
Code Edit:2019
Legal Description: TR 7817 LOT 3 UNIT 204 OF PROJECT LOCATED ON AP 424-041-01
TOGETHER
CIO
Owner: MORTAJI/BAGHAE-POUR Contractor: GUARANTEED QUALITY HEATING AIR
Worker's Compensation Insurance
Address: 14 SWIFT CT #204 Address: 15560 ROCKFIELD BLVD STE B 100
Carrier: SIRIUS AMERICA INS
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NEWPORT BEACH CA 92663 IRVINE CA 92618
Policy No: CST5020210
Fri
Phone: Phone: 714-389-3925
Expire : 09/25/2022
Con State Lic: 991810
Issued Date:06/07/2022 Lic Expire: 04/30/2024
Bus Lic: BT30073094
Processed By: \J Lic Exp Date: 1013112022
FEES
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:
0
$0.00
1-2 Family:
0
$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
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:
$38.00
O/H to U/G
0
$0.00
Additional Fee :
$0.00
Supplemental Fee:
$0.00
TOTAL
Fee:
$45.00
Plan Check
Fee : $0.00
Fee Due at Permit Issuance:
$45.00
PERk11/TS EXPIRE 1§0 DAYS AFT;R, /SS,IJANCE OR LAST VALID INSPECTION
Construction Hours: jotid�y- I'ri�ay,7:00 a.M. ta6,,30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m.
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OWNER -BUILDER DECLARATION t
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).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) 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-Builderwill have the burden of proving that it was not built or
improved 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
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).
❑ I 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 legally
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 Section 7000) of Division 3 of the Business and Professions Co and my license is in full force
and effect.
License Class License No Date U'�_ Contractor Signature�F'� 6/ L
WORKERS' COMPENSATION DECLARATION —�
NARNING: 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 I$100,0001, IN ADDITION TO THE
COST 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:
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
OF_
ance of the work for which this permit is issued. Policy No.
have and wil,Nintain 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' compensa
Date
of
JI Certify that, in the performance of the work forwhich 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
iat, if I should become su ctt to�ork ' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions
�ignatureof Applicant Date 7�
IECLARATION REGARDING CONSTRUCTION LENDING AGENCY
hereby 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).
Ender's Name Lender's Address
ly 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 correct.
I agree to comply with all applicable city and county ordinances and state laws relating to building construction. / ,t
g I authorize representatives of this city or county to etefthe aboye-iden " d property for inspection purposes. oses. q _ ! 11 . / � � �- T_ zz
;i nature of Property Owner or Authorized Agent �, �� e Print Property Owner's or Authorized Agent's Name ,)( ill (AG(/'ILN r- G Date
AC7tON
BATE
BY
DECLARATION OF COMPLIANCE 147TH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGLVMT18NI PART 61 0J-gTLEJG-JMQ • .
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PERMIT EXPIRED
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PERMIT CANCELLED
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PERMfTEXTENDED
❑ ASBESTOS NOTtFICARON IS NOT APPLICABLE TO
PROPOSEDDEMPIL`FIflAy • • s e • • • e e • s
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PERMIT FINAL
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CERTIFICATEOF
OCCUPANCVSSUED
SIGNATURE. e o •a o eo ec '• e
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