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Home My WebLink AboutE2017-0269 - Permitsgwaxo� City of Newport Beach - Building Division u 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 [ E2017--0269 ]* Electrical Permit: E2017-0269 0��I�H�� 111 M�IMIJIVProject No: e a a e• e• a s BBa a a p aBa 90 Inspection Requests Phone (949)644-3255 a JobAddress: 4 PADUACT BIdg:1 Floor: Suite: • ��. • •a` •a' a• •'• Description of Work: ELEC - REPLC DISCONNECT FOR A/C CONDENSOR (H2O17-0265) ' • G °' 6B ° • a a a Inspector Area: 6 Code Edit: 2016 Legal Description: Owner: RAY GARY Address: 4 PADUA CT Contractor: Address: ALISO AIR INC Worker's Compensation Insurance NEWPORT COAST CA 92657 29736 AVE DE LAS BANDERAS Carrier: LIBERTY MUTUAL Phone: Phone: RSM CA 92688 949-589-2021 Policy No: WC2Z61036218096 Issued Date:05/22/2017 Con State Lie: 526420 �T a Expire: 07/01/2017 , t SI Processed Lie Expire: Bus Lie: 03/31/2018 BT30019236 x , y By: Exp -Lie Date: 02/28/2018 8 New Construction Residential Receptacle/Switch/Outlets FEES Motors/Transformers (HP/KVA) Multi -Family: 0 $0.00 Receptacles/Outlets: Fixtures: 0 $0.00 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $0.00 1-2 Family: 0 $0.00 Se Circuits: P 1 $6.00 1 to 10 HP/KW/KVA: 10 to 50 HP/KW/KVA: 0 $0.00 Sub Panel: 0 $0.00 Service Low Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 0 $0.00 0 $0.00 $0.00 0-600V up to 200A: 0 $0.00 Signs Branch Circuit: 0 $0.00 Over 100 HP/KW/KVA: - 0 0 $0.00 Record Mgmt Fee: $0.00 $0.00 0-600V over 200A: Over 600V or 1O 0 0 $0.00 $0.00 Each Add Circuit: 0 $0.00 Piggy Back/Temp Power: 0 Plan Check Fee: $0.00 Investigation Fee: $0.00 Oto U/G 0 $0.00 Time Clocks: Additional Fee: 0 $0.00 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $0.00 $0.00 Supplemental Fee: $10.00 TOTAL Fee: $16.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $16.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. NER-BUILDER DECLARATION •.. ••• • 0 " " "• . ., . Sl. I hereby affirm under penalty of perjury that I am exempt from therCBntrae;ors ate license Lavtfor the reason(s) indicated below by the checkmark(s) I have placed next to the applicable items ction 7031.5, Business and Professions Code: Any city or county t$atE�requiiisa '(-r¢litfo sorwtru& 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 pursuannO tPfe°IooviSions df the ConRators' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and cessions 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 more than five hundred dollars ($500). , , ,,, I, as owner of the property, or my employees with wages as theia sole compensation, will -do (_) aloofor�) portions of the work, and the structure is not intended or offered for sale (Section 7044, iness and Professions Code: The Contractors' State License Law dyes not appl'yho an owner of propPrtgwho, throughlemployees' or personal effort, builds or improves the property, provided that the rovements are not intended or offered for sale. If, however, the building% imprgvAnvJ G sold%'Mir?grte year of completion, the Owner -Builder will have the burden of proving that it was not built or roved 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 ily 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: 3y my signature below I acknowledge that, except for my personal residence in which I must have resided for at least on Sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.le Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700C and effect. t License Class License No to completion of the improvements covered by this permit, I cannot that a copy of the applicable law, Section 7044 of the Business and Division 3 of the Business and Contractor Date Code, and my license is in full force WORKERS' 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 ATTORNEYS 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 performance of the work for which this permit is issued. Policy No. the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation 71 have and will maintain workers' compensation insurance, as required by Section 3700 of lsurance carrier and policy number are: Expiration Date <---� --;,_ Policy Number of Agent me s .. c rtity that, in the performance of thawork 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 should becom subject to the work ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applica Da�� r CLA R G CONS t- LENDING AGENCY areby affirm undd er en erjury that theree is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). affirm Ider's Name Lender's Address 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 p'Povided is correct. I agree to comply with all applicable city and county inances ands ate laws relating to building construction. �Date�� I authorize representatives of this city or countyto to a above-ide lifted pro y for inspection purposes.�� ennt Prnnarty Owner's or Authorized Agent's Name 1 F'�"" `- ` AC170AI 1 DATE T BY PERMIT ❑ 1 SUBMITTED ASBESTOS U071FICATIOIV TO: ❑ EPA ❑ AQMD ❑ ASBESTOS NOURCARONISNOT APPLICABLE TO PROPOSED DEMOLITION. CERTIFICATEOF OCarQANCYISSUED SIGNATURE: