HomeMy WebLinkAboutE2016-0360 - Permitsvftp City of Newport Beach - Building Division
r 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
v ,
E �2 016 0 3 6 0
Job Address:431 WESTMINSTER AVE Bldg: 1 Floor: 1 Suite:B
Description of Work: ELEC/INSTALL NEW A/C UNIT 50dB (MAYTAG; CSA4BE-048KA)
Inspector Area: 2
Legal Description: P M 156-47 PAR 2 UNIT 3.OF
TOGETHER
Owner: KERR GENAI `
Address: 431 WESTMINSTERAVE #B
NEWPORT BEACH, CA 92663
Phone:
Issued Date:06/06/2016
Processed
New Construction
Residential
Mult Family:
1-2 Family:
Service
0-600V up to 20OA:
0-600V over20OA:
Over600V orIOOOA:
O/H to U/G
Electrical Permit: E2016-0360
Project No :
Inspection Requests Phone (949)644-3255
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5. y "1Y Wdit:;J2013
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s c %.� - kA1a lZt' WES CA 92653 -
Pho . 9 8 9484 ..Tljl
Cgntal Lie: 968411
Lic Expire a .", Tat
Bus Lic: T30� S
LtDatr" ''�A3�i/20tfi
Receptacle/Switch/Outlel�s]
0 $0.0��} R u �e cles/Qut{ds �00� $�09
0 $0.3 $U Ciredits:' 1-, Ad oo
l Volt�r�i• 0 $0.00
Signs �-
0 $0.00 Branch Circuit: ,0 0
0 $0.00 Each Add Cir�cd— 0 $0.00
0 $0.00 a ,`,TjK6'.GkTckks: o
0 $0.00 Additional Fee :. ;._$Oat10"°�
Worker's Compensation Ir
Carrier: MID-CENTUF
Policy No: A09468247
Expire : 11/30/2016
FEES . � ,,, uy -
Motors/Transforrrr�rs (HP/KVA)
0 to 1 HP/KW/KVA: 0
1 to 10 HP/KW/KVA:
10 to 50 HP/K 0 1
100
gFnp Power: 0 $0.00
Pole: 0 $0.00
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
. . •
0 0� o a ,0 •, ,
� c.. o co 0 ,•
0 0 0 "' o0
Record Mgmt Fee:
Plan Check Fee:
Investigation Fee:
Issuance Fee:
Supplemental Fee:
Fee Due at Permit Issuance :
0 $0.00
0 $0.00
0 $0.00
0 $0.00
$0.00
$0.00
$0.00
$32.00
$0.00
fNER-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) -
ction 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
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
fessions Code) or that he or she is exempt from Iicensure and the basis for the alleged exemption. Any violation of Section 7031.5 a tpplidant fd[ a permit subjects the applicant to a civil penalty of
more than five hundred dollars ($500). _ _ -
I, as owner of the property, or my employees with wages as their sole
iness and Professions Code: The Contractors' State License Law doe
:ovements are not intended or offered for sale. If, however, t�hgArtii
,oved for the purpose of sale). - =,�-u
I, as owner of the pr
rly to an owner of pro
I am exempt fro lir
my signature belo , I
a structure that I h�
fessions Code, is a
nature of Property 0
hereby affirm under
nd effect.
icense Class
FAILURE TO
hereby affirm under per
7 I have and will malr
erformanoe of the work
LII have and will maim,
isuuance carrier and D
ie of Agent
certify that, in the p:
, if I should become
lature of Applicant _
ie„Av;,aareiY aively contracting with licensed
:rty who builds or improves thereon, anf�
�p dsr the C tate License La
:ICDow�Fled�'e tfiat, except for my personal Msic
built as an owner-buildersiCit has, beeh2Eto
nsation, will. do,(_)JLofser1!YVi6rtions of the work, and the structure is
)ply to aTr owner of property who, through, errAloyees' or personal effort,
provement is sold within vne y."f)),fi E3iUap`12''°ion, the Owner -Builder w l
[t u,-, no/
c
)cs.toeonsfruct the projectept_70)B sse�sand'Professians Cc
for the projects with a lice s d QQi9d6r pursuant to the Contractors'
that a copy of the
intended or offered for sale (Section 7044,
iIds or improves the property, provided that the
,e the burden of proving that it was not built or
The Contractors' State License Law does not
License Law).
Tents covered by this permit, I cannot
law, Section 7044 of the Business and
Date
of perlg ff+"t I am licensed under provisions of Ch tebQ (�` e'r�cl w fi ection 7000 of Division 3 of the Business and Pr' evssio s od�an,�d m /I'cens sin fu(I force
4�ns�mN€9• .�� k-,i�_ D 6 I t, Contractor Signature - _
it RA
`,�, sit � &
)RI FRS C SATIO -XOVERA( PgifJ AUL, ANDISA1ALL SU TAN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINE P TO 9 HUNDRE HOUSAND DOLLARS (E'100,000), IN ADDITION TO THE
IS A$PO DE RIN�gIIW?N OF ELABOR CODE, INTEREST, AND ATTORNEY'S FEES. A
of p r on6 the following declarations: "`*
�c�'��' "
a certificate of consent to self -insure for workers' cempensatio iS1d :i ttf !) o r'lndustrial �e atio as provi ed for y Section 3700 of the Labor Code, for thg
rhich this per it is issued. Policy No r ��
orker `er Abdn.ilTl'ls s r iire3 `y ection 3700 of the Labor (rides f�r tide performance of the wo for w ich is rmit is issued. My workers' compensation
Lmb r
of the work for which this permit is issued 1-rrot'employ any person in any mannertsb'- tb becomes or ers' compensation laws of California, ryd agrer
the workers' co ensation o Section 3700 of the Labor Co 4orthzwit� ose provisions.
f a
m' __- = Date e✓
STRUbTIdN LENDING
I herebyaffirm under penalty of u that constructi4 s=- f
p ty ry ___Shereis'S ��endin"'S'g'ency for the Performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Name _ �.z-= Lender's Address
By my signature below, I certify tdeaaYf'bitfie 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 to a er the a v -id ntified ope. y for inspection purposes.
Signature of Property Owner or Authorized Agent � ` 0 _ Ij Print Property Owner's or Authorized Agent's Name Date 6
ACMIV
DA7E
IBY
DECLARATIOQF_ NWOM��1�•iTH CODE
FEDERAL G O iEOF
AQMD RUL%t403y • o
❑ 1 SUBWVED1ASBEST U A$O74FICA M W:;
[3EPA J.
❑ AQMD
❑ ASBESTW AJj)-JI1TCtaTfON1S NOT APPLICABLE TO
PROPOSEPDEMO � KWW • • ° • e ° •� °
s• o e e e° ° °
SIGNATURE:° o e o e u e e•° e o° °
oe•
FDR OFRCEUSE ONLY
-
P€RMITIXPIR€D
P€RMITCANCEIIED
PERMITEKTENDED
PERMIT FINAL
C€R77FICATE OF
OCCUPANCYISSUED
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