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Home My WebLink AboutE2021-0310 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 4 i'7 Job Address: 401 15TH ST Bldg: 1 Floor: Suite: Description of Work: ELEC/INSTALL (2) A/C UNITS (H2O21-0307) Inspector Area: 3 Legal Description: N TR 1218 LOT 31 Owner: FLORIANI DAN Contractor: Address: 1130 DOLPHIN TER Address: NEWPORT BEACH, CA 92625 Phone: Phone: Con State Lic: Issued Date:05113/2021 Lic Expire: Bus Lic: Processed By: Lic Exp Date: 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 over 20OA: 0 $0.00 Over 600V or 1000A: 0 $0.00 O/H to U/G 0 $0.00 TOTAL Fee: IIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIII II Electrical Permit: E2021-0310 Project No : 1232-2020 SOLSTICE HEATING & A/C 310 W AVENIDA GAVIOTA SAN CLEMENTE, CA 92672 949-573-3607 938888 10/31/2021 BT30041721 02/28/2022 Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 Fixtures: 0 $0.00 Sep Circuits: 0 $0.00 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 Inspection Requests Phone (949)644-3255 Code Edit: 2019 Worker's Compensation Insurance Carrier: SECURITY NATIONAL INS CO Policy No: SWC1328473 Expire : 03/19/2022 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 Temp Underground Sub Panel: Record Mgmt Fee: Plan Check Fee: Investigation Fee: Issuance Fee: Supplemental Fee: Fee Due at Permit Issuance : 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 2 0 0 $37 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 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 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 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 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). ❑ 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 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 Busine4HUN ssi ode, and my license is in full force and effect. License Class License No Dat 3 Contractor Signet 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 THOUSAND DOLLARS($100,000), 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: 111 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. and will matin 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' carrier an poet number are: ilo)r'1Poli�uTnrber / i, ? Expiration Date of Agent certify that, in the performance of the work for which this permit llss issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree t, if I should become sub o orkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant'y DateK � 3 /� i CLARATION REGARDI CONSTRUCTION LENDING AGENCY f rreby affirm under pena4rt y1of 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 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 ordina es and state laws relating to building construction. I authorize representatives of this city or county t9 ,�('jrto/,//j' bove-identified property for inspection purposes. I / nature of Property Owner or Authorized Agent V ' 1 X Print Property Owners or Authorized Agent's Name o4w� Cc_,) .2 ¢,�- D - ! t S 2 ACTION DATE BY DECLARATION OF COMPLIANCE VATH CODE OF FOR OFFfCE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40AND AQMD RJ,_E PERMIT EXPIRED ❑ ISUEMITTEDAS&-Si OS;IORRCAT'OM'rO: ❑ EPA ❑ AQM0 PERMIT CANCELLED PERMIT EXTENDED ❑ ASBESTOS NOTIF1CAnON IS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL Z,��—'Z _ i CERTIFICATEOF SIGNATUFE: OCCUPANCYISSUED IR7,01,t-030 :7-