HomeMy WebLinkAboutE2020-0184 - Permits� , City of Newport Beach - Building Division 11111111111111111111111111111111111111p1111111111
a 100 Civic Center Drive, Newport Beach, CA 92660
F7; a Permit Counter Phone (949)644-3288
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Electrical Permit: E2020-0184
Project No
Inspection Requests Phone (949)644-3255
Job Address: 464 62ND ST Bldg: 1 Floor: Suite:
Description of Work: ELEC/INSTALL NEW A/C UNIT 59.5dB" (H2O20-0178)
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Inspector Area: 3
Code Edit: 2019
Legal Description: TR 772 LOT 7 BLK 22 AND NLY 2 FT LOT 6 AND SLY 2 FT LOT 8
ALL IN BLK
Owner: MCMAINS MICHAEL Contractor:
SKY HEATING AND COOLING
Worker's Compensation Insurance
LU
Address: 460 62ND Address:
769 N GLASSELL ST
Carrier: NORGUARD INSURANCE
NEWPORT BEACH, CA 92663
ORANGE CA 92867
Policy No: SKWC149863
Phone: Phone:
714-883-0623
Expire : 02/0112021
Con State Lic:
1045281
Issued Date:03/13/2020 Lic Expire:
12131/2021
Bus Lic:
BT30065983
Processed By: Lic Exp Date:
02/28/2021
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:
0
$0.00
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
TOTAL Fee:
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
Plan Check Fee :
Temp Underground:
0
$0.00
Sub Panel:
1
$27.00
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
Fee Due at Permit Issuance :
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday - Friday 7:00 a.m.fooe�0 p.M 2nj?4atur yak from 8:00 a.m. to 6:00 p.m
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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
he 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
iot more than five hundred dollars ($500).
1 I, as owner of the property, or my employees with wages as their sole compensation, will do L) 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
nproved for the purpose of sale).
7 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
Irofessions Code, is available upon request when this application is submitted or at the following Web site:hftp://ww .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 rofessd my license is in full force
nd effect. ., �,,//``
icense Class License No Data 03 / 13 C a Contractor Signatur
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 ONII(; RED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
OST 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:
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 thi
ppfolrmance of the work for which this permit is issued. Policy No.
have an V 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'
rance ca ier a d policy number g7g: _ 11` R
Expiration Date
of
certify that,irttKe performance of the w rk 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 ogre
I, if I should become sub' pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provi(si/ops. Sri 9 h,
nature of Applicant D. OyI506
CLARATION REGA CONSTRUCTION LENDING AGENCY
weby affirm under pen ty f perjury that there is a construction lending agency for the performance of the work for which this permit is issue (Section 3097, Civil Code).
Ider's Name Lender's Address
my signature below, I certify to each of the following:
1 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 ordinance to laws relating to building construction. r
I authorize representatives of this city or count to ej'� ve ' d' d property for inspection purposes.
nature of Property Owner or Authorized Agent V Print Property Owner's or Authorized Agent's NarJL� ��12�J�L ( dl✓!�/ (( D
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
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