HomeMy WebLinkAboutE2022-0014 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIII�IIIIIIIIIIII Electrical Permit: E2022-0014
(9)
100 Civic Center Drive, New ort Beach, CA 92660 E 2 0 2 2 0 0 1 4p Project No : 0687-2020
Permit Counter Phane (949)644-3288
Inspection Requests Phone (949)644-3255
Job Address: 340 VISTA TRUCHA Bldg:
1 Floor: Suite:
Description of Work: ELEC FOR HEAT PUMP & AIR HANDLER AND INSTALL LIGHT SWITCH IN ATTIC
Inspector Area: 4
Code Edit: 2019
Legal Description: N TR 6885 LOT 14
Owner: STONE IRENE
Contractor:
QUALITY HEATING A/C
Worker's Compensation
Insurance
Address: 340 VISTA TRUCHA
Address:
305 EAST RIVERSIDE AVE
Carrier:
NORGUARD
NEWPORT BEACH, CA 92660
ORANGE CA 92865
Policy No: JOWC229723
Phone:
Phone:
714.448-5406
Expire :
0611712022
Con State Lie:
960363
Issued Date:02/03/2022
Lie Expire:
0413012023
Bus Lie:
BT30077675
! N I ^_
Processed By:
Lie Exp Date:
01/30/2023
FEES
New Construction
Receptacle/Switch/outlets Motors/Transformers (HP/KVA)
Residential
Receptacles/Outlets:
2 $3.50 0 to 1 HP/KW/KVA:
0
$0.00
Temp Underground: 0 $0.0
Multi -Family: 0 $0.00
Fixtures:
0 $0.00 1 to 10 HP/KW/KVA:
0
$0.00
Sub Panel:
1 $29.0
1-2 Family: 0 $0.00
Sep Circuits:
0 $0.00 10 to 50 HP/KW/KVA:
0
$0.00
0 $0.0
Low Voltage
0 $0.00 50 to 100 HP/KW/KVA:
0
$0.00
0 $0.0
Service
Signs
Over 100 HP/KW/KVA:
0
$0.00
Record Mgmt Fee:
$0.0
0-600V up to 20OA: 0 $0,00
Branch Circuit:
0 $0.00
Plan Check Fee:
$0.0
0-600V over 20OA: 0 $0.00
Each Add Circuit:
0 $0.00 Piggy Back/Temp Power:
0
$0.00
Investigation Fee:
$0.0
Over 600V or 1000A: 0 $0.00
Time Clocks:
0 $0.00 Temp Power Pole:
0
$0.00
Issuance Fee:
$38.0
O/H to U/G 0 $0.00
Additional Fee :
$0.00
Supplemental Fee:
$0.0
TOTAL Fee: $70.50
Plan Check Fee : $0.00
Fee Due at Permit Issuance : $70.50
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.
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 rile 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
lot more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) 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 -Builder will have the burden of proving that it was not built or
'mproved 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, I cannot legal
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.htmi.
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 70 0) of Division 3 of the Business and rofe sions Co a d y license is in full force
and effect.
License Class License No Date 2? ' Contractor Signature
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 ($100,000), IN ADDITION TO TH
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 6706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 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 t
ormance of the work for which this permit is issued. Policy No.
ve 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' compensati�
I sur nce carrier and policy number are:
Policy Number
Date
ne of Agent """
certify that, in the performs If the work y r whl h 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 agree
if I should become_ spbje toe workers'bom a s�tion provisions of Section 3700 of the Labor Code, shall forthwith comply with those provisions.
nature of Applicant /X` Date, Z,
CLARATION RE RDING CONSTRUCTION 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 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 is behalf.
I have read this application and the information I have pr Id Lei
I agree to comply with all applicable city and county or nonce law re ti to building construction.
I authorize representatives of this city or county to nt r the afied o r inspection purposes.
nature of Prooertv Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nam Date 42,
ACTION
DATE
BY
DECLARATIONOF COMPLIANCE WITH CODE OF
' FOR OFFICE
FEDERAL REGULATIONS PART 51 OF TIRE 40 AND
--
AQMD RULE 1403.
❑ I SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERMIT EXPIRED
_ _
PERMIT CANCELLED
PERMITEXTENDED
❑ ASBESTOS N07IRCA77ON IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE:
PERMITFINAL
CERT[RCATEOFOCCUPANCYI
��JJ
SUED
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