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Home My WebLink AboutE2022-0176 - Permitsw�tv City of Newport Beach- Building Division d 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 G �'r rYn4� Job Address: 114 EMERALD AVE Bldg: 1 Floor: Suite: Description of Work: ELEC - DISCONNECT FOR HEAT PUMP INSTALLATION Inspector Area: Legal Description: BALBOA ISLAND RESUB SEC 1 BLK 3 LOT 19 (111111111111111111111111111111111p111111111p1111111 Electrical Permit: E2022-0176 E 2 0 2 2 0 1 7 6 Project No: 0256-2022 Owner: GUARDIA PHIL Contractor: SIRIUS MECHANICAL INC Address: 114 EMERALD AVE Address: 16692 MARIPOSA NEWPORT BEACH, CA 92662 RIVERSIDE CA 92504 Phone: Phone: 951-640-5097 Con State Lie: 851512 Issued Date:03/21/2022 Lie Expire: 11/30/2023 Bus Lie: BT30078031 Processed By: Lie Exp Date: 02/28/2023 New Construction Receptacle/Switch/Outlets Residential Receptacles/Outlets: 0 $0.00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1-2 Family: 0 $0.00 Sep Circuits: 1 $7.00 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 Inspection Requests Phone (949)644-3255 Code Edit: 2019 Worker's Compensation Insurance Carrier: STATE COMP. INS Policy No: 9055133 Expire : 05/0112022 VN A FEES 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 Back/Temp, Power: 0 $0.00 Temp Power Pole: 0 $0.00 Check Fee : 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: $38.00 Supplemental Fee: $0.00 Due at Permit Issuance: PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION construction Hou rs.Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. ° IWNER-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 ie 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 I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or L) 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). 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). 1 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.html. 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 P ssions Code d my li use is 111 f 5rce iseffect. 3� Contractor icense Class License No Date Signalu VORKERS' COMPENSATION DECLARATION IARNING: 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 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY's FEES. hereby affirm under penalty of perjury one of the following declarations: 7 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 exformance of the work for which this permit is issued. Policy No. 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' carrier and policy number are: ie of Agent certify that, in the performance , if I should become subject to 1 of Applicant Policy Number forwhich this permit is issued, I comoensation DrovisiA of Sec Date any person in any manner so as to become subject to the workers' compensation laws of California, and Labor Code, I shall forthwith comply with those provisions. { Date / 3-21'Z2-- 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 .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 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 ordin es and state laws latin ullding construction. I authorize representatives of this city or county to entg ie 9bove KgRtifie rop or inspection purposes. of Property Owner or Authorized Owner's or Authorized Agent's Name Civil Code). �C&0 t PI V— Date 3 ,Z 1 ACTION DATE 8Y DECLARATION OF COMPLIANCE KITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 Qf*QT4P$0 ANIZ • • • • • • • . AQMDRULE1403 PERMfTFXPi,4ED ❑ I SUBMITTED ASBESTOS NO774CATIOP-TO? ••: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMIT.EXTENDED PROPOSEDDEMOLITONASBESTOS 7IONI5NOT APPLICABLE .0 • ••• •• PERMITRNAL 9 (Z. Z, J F SIGNATURE. e e• s e s• s OCCUANCYI OCCUPAfiICY755UED ... .. • s ses e•