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Home My WebLink AboutE2021-0763 - PermitsCity of Newport Beach, Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II .� 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 1 0 7 6 3 •..; Permit Counter Phone (949)644-3288 4 t4k14n Job Address: 824 HARBOR ISLAND DR Bldg: 1 Floor: Suite: Description of Work: ELEC/INSTALL (2) NEW A/C UNITS (H2O21-0638) Inspector Area: 2 Legal Description: N TR 3867 LOT 4 Owner: KENNEY WILLIAM J Contractor: DEPENDABLE GRAHAM AC Address: 824 HARBOR ISLAND DR Address: 2952 CENTURY PLACE NEWPORT BEACH, CA 92660 COSTA MESA CA 92626 Phone: Phone: 714-546-1653 Con State Lic: 472690 Issued Date:11/08/2021 Lic Expire: 04/30/2022 Bus Lic: BT01013104 Processed By: ow-w: Lic Exp Date: 12/31/2021 New Construction Residential Multi -Family: 1-2 Family: Service 0-600V up to 20OA: 0 0-600V over20OA: 0 Over600V or1o00A: 0 O/H to U/G 0 Electrical Permit: E2021-0763 Project No: 1248-2021 Inspection Requests Phone (949)644-3255 Code Edit: 209 171 Worker's Compensation Insurance Carrier: SERVICE AMERICAN Policy No: SAMTWC0072800 Expire : 07/01/2022 X FEES Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $0.00 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 0 $0.00 $0.00 Sep Circuits: 2 $14.00 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 Signs Over 100 HP/KW/KVA: 0 $0.00 ` - Record .Mgmt,Fee: $0.00 $0.00 Branch Circuit: 0 $0.00 Plan Check Fee: $0.00 $0.00 Each Add Circuit: 0 $0.00 Piggy Back[Temp Power: 0 $0.00 Investigation Fee: $0.00 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $38.00 $0.00 Additional Fee : $0.00 Supplemental Fee: $0.00 Plan Check Fee: PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday- Friday7.00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m 4 P • Ye4 P � e • 4e e P 4J 4y iP• �.P •6 P P 46P �3-J OWNER -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 checkma&(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). ❑ 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, 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.html. 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 Pr ssions Cod , and my 'cerise Is in full force and effect. License Class License No Dat _ �� ' Z Contractor SignatlJtra WORKERS' COMPENSATION DECLARATION WARNING: 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$100,000j, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I 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 rmance of the work forwhich this permit is issued. Policy No. i ave 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 compensa ance carvg—ra'ft policy nuD*er are: 1�1 f I of Number.; Expiration Date Phone # L I certify that, in the performance bf 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 that, if I should become subject tQ4e workersee�n�s,atioo�qprovisions of Section 3700 of the Labor Code, I shall forthwith comply with those pro , Islons. Signature of Applicant r, ,i1Vl d''� 'f/lLE7 ate 1/_ d _ :Z—/ DECLARATION REG*DfNGrCON9TRIJCTION LENDING AGENCY I hereby affirm under ftnalty 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). Lender's Name Lender's Address By 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. I authorize representatives of this city or county to nt he abo a-ide Tied pr erty for inspection purposes. �A Signature of Property Owner or Authorized Agent _ Print Property Owner's or Authorized Agent's Nam /�C t ACDON DATE BY DECLARATION OF COMPUANCE IrYITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 51 OF TITLE40 AND AQMDRULE1403. •• ••s s•• ••• •a• •-•• PERMIT EXPdRED ❑ 15UBMITT€DASUESjOS NQ77F�fL°AFION f0: s . • • • s m • i PERMIT CANCELLED [IEPA • • • s AQMD PERMITEXTENDEO ❑ ASBESTOS MOTIRCA77ON IS NOT APPLICABLE TO PROPOSED D€MOUT{OV • • • c s PERMIT FINAL 'qj CERTIFICATEOF SIGNATURE.,OCCUPANCYISSUED o c a• a m 0 0 o c Vo o ao