HomeMy WebLinkAboutE2019-0525 - Permitswtv, City of Newport Beach - Building Division
`t 100 Civic Center Drive, Newport Beach, CA 92660
k Permit Counter Phone (949)644-3288
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Job Address: 3 PADUA CT Bldg: 1 Floor: Suite:
Description of Work: ELEC/INSTALL NEW A/C UNIT 42dB (CARRIER; 24APB6-36)
Inspector Area:
Legal Description:
Owner: DELANEY KATHRYN Contractor:
Address: 3 PADUA CT Address:
NEWPORT BEACH CA 92657
Phone: Phone:
Con State Lic:
Issued Date:08/01/2019 Lic Expire:
Bus Lic:
Processed By: Lic Exp Date:
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ALISO AIR INC
29736 AVE DE LAS BANDERAS
RSM CA.92688
949-589-2021
526420
03/31/2020
ST30019236
02/28/2020
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
Over600V or1000A:
0
$0.00
Time Clocks:
0
$0.00
O/H to U/G
0
$0.00
Additional Fee:
$0.00
TOTAL
Electrical Permit: E2019-0525
Project No :
Inspection Requests Phone (949)644-3255
cc
Code Edit: 2016
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Worker's Compensation Insurance
W
Carrier: LIBERTY MUTUAL
Policy No: WC2Z61036218098
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Expire: 071011220 0
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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 Backfremp Power: 0 $0.00
Temp Power Pole: 0 $0.00
Temp Underground:'
0 $0.00
Sub Panel:
1 $26.00
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: $61.00
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VAUD 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.
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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
is 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).
7 I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
iusiness 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).
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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:hftp://www.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 Sectio 7 0) Division 3 of the Business and Professions Cod license is in full force
and effect. �� GC
.icense Class License No Dat Contractor Signatu
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 Directors of Industrial Relations as provided for by Section 3700 of the Labor Code, for th
Yrmance of the work for which this permit is issued. Policy No.
have and wI'Iar�fain workers' compensation insurance, as required by Section 3700 of the Labor Code, for theperformance of the work for which this permit is issued. My workers' compensatio
me ai
isurance caA nd Dalicy number are:, f,
Date
ne of Agent r "J IL�4 Phone A
certify that, in the performance of the work for whi ued, I shall not employ any person in any manner so as to become subject to the workers' co pensation laws of California, and agre
1, if I should become su ject mpen ec Ion 3700 of the Labor Code, I shall forthwith comply with those provisions. /'�/
nature of Applicant - at L_/�� �/ 7
CLARATION REGARDIWIZMNSTRUCTION LENDING AGENCY
Ireby 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, Civil Code).
Ider's Name Lenders 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 provided is correct.
I agree to comply with all applicable city and coun �i -relating-t6'bUltdl HE me Ion. %/p
I authorize representatives of this city or coy"' ' ��"eLnDte a ove-identified property for inspection purposes. r�'kc t
nature of Prooertv Owner or Authorized ADent l� Print Property Owner's or Authorized Agent's Na at
ACRON DATE BY ULLtAflR rrvly Ur l VWV.ARry cVVIIn uvu Ur rux urnr-t u3t vrrer
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