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Home My WebLink AboutE2022-0269 - Permitsrwwrrry; City of Newport Beach - Building Division 'E2022-0269* o'r= 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 n �y ,ins' � � r L_T'tt Job Address: 211 EVENING CANYON RD Bldg: 1 Floor: Suite: Description of Work: ELEC FOR REPLACEMENT OF A/C UNIT (H2O22-0221) Inspector Area: 4 Legal Description: N TR 6565 LOT 85 Owner: NARUSE ROBERT Contractor: WHITE MECHANICAL INC Address: 1700 PORT STIRLING PL Address: 27221 BURBANK NEWPORT BEACH, CA 92660 FOOTHILL RANCH CA 92610 Phone: Phone: 949.716-8379 Con State Lic: 822474 Issued Date:04/27/2022 Lic Expire: 08/31/2023 Bus Lic: BT30055645 Processed By: Lic Exp Date: 06/30/2022 New Construction Residential Multi -Family: 0 $0.00 1-2 Family: 0 $0.00 Service 0-600V up to 20OA: 0 $0.00 0-600V over20OA: 0 $0.00 Over600V orIOOOA: 0 $0.00 O/H to U/G 0 $0.00 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 1 $7.00 Low Voltage 0 $0.00 Signs Branch Circuit: 0 $0.00 Each Add Circuit: 0 $0.00 Time Clocks: 0 $0.00 Additional Fee : $0.00 Electrical Permit: E2022-0269 Project No : Inspection Requests Phone (949)644-3255 Code Edit: 2019 Worker's Compensation Insurance Carrier: TRAVELERS CASUALTY Policy No: B3R5812182026G Expire : 10/01/2022 a" ' as aeaaae a .a as 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 Fee Temp Underground: Sub Panel: Record Mgmt Fee: Plan Check Fee: Investigation Fee: Issuance Fee: Supplemental Fee: 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. 0 0 0 0 DWNER-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 :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 Drofessions 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 lot 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 U 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 -Builder will have the burden of proving that it was not built or i�m 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 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). ❑ 1 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, 1 cannot legally sa;, a structure t316t I 'nave 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, 's Ev3ilable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. $igratur= of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm ugdeP penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force end q-fuC. Y ^I— Z7-ZZ. L'cen^e Class � License No Date /` Contractor Signature VIORKERS' COMPENSATION DECLARATION AA2:11:lC: 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 ($100,000), IN ADDITION TO THE COS, OF GOMPENSAi ION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'$ FEES. herebv affirm under penalty of perjury one of the following declarations: Q ! bcve 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 th performance of the work for which this permit is issued. Policy No. have 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' rance carrier and policy number are: Policy Number Date ne of Agent rnone s certify that, in the performance of 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 t, if I should become subject to the mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant X 7 . V. Date / �yq — L 7 - Z Z' CLARATION REGARDING CONSTRUCTION LENDING AGENCY !reby 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 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 provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. X I authorize representatives of this city or county to enter the Ified property for inspection purposes. y_ Z nature of Property Owner or Authorized Agent ��1.�.�. Print Property Owner's or Authorized Agent's Name , \(6.0 �ol%!"'S""✓O'"t'� Date 7 Z AC77ON DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403. PERMITEXPVRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMIT EXTENDED ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL CERTIR CA TE O'F SIGNATURE: OCCUP4 NCYISSUED