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Home My WebLink AboutE2020-0123 - Permits"Pr,V City of Newport Beach - Building Division IIIIIIIII�IIIIII IIIIIIIII IIIIIIIIIIIIIII II Electrical Permit: E2020-0123 0 F o� 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 0 0 1 2 3 Project No Permit Counter Phone (949)644-3288 V $ u `'"Llr o*p.T Inspection Requests Phone (949)644-3255 Job Address: 1613 ARCH BAY DR Bldg: 1 Floor: Suite: Description of Work: ELEC -DISCONNECT FOR A/C REPLACEMENT Inspector Area: S Code Edit:2019 Legal Description: N TR 15222 LOT 22 Owner: MALOY DENNIS Contractor: KALKA KEVIN J HEATING & A/C Worker's Compensation Insurance Address: 1613 ARCH BAY OR Address: 15550 ROCKFIELD BLVD #A-100 Carrier: EMPLOYEE SERVC GRP NEWPORT BEACH, CA 92660 IRVINE CA 92618 Policy No: WCO290817 Phone: Phone: 949-458-6600 Expire: 07/01/2020 Con State Lic: 677889 Issued Date:02/26/2020 Lic Expire: 10/31/2020 Bus Lic: BT30054832 Processed By: Lic Exp Date: 06/30/2020 t�El FEES New Construction Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Residential Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $0.00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 1 $27.00 1-2 Family: 0 $0.00 Sep Circuits: 0 $0.00 10 to 50 HP/KW/KVA: 0 $0.00 0 $0.00 Low Voltage 0 $0.00 50 to 100 HP/KW/KVA: 0 $0.00 0 $0.00 Service - Signs Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: $0.00 0-600V up to 20OA: 0 $0,00 Branch Circuit: 0 $0,00 Plan Check Fee: $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Piggy Back/Temp Power: 0 $0.00 Investigation Fee: $0.00 Over 600V or 1000A: 0 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $35.00 O/H to U/G 0 $0.00 Additional Fee : $0.00 Supplemental Fee: $0.00 Plan Check Fee : $0.00 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 F:vO p.rr1. NV 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 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 Iicensure 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 legallt 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:/Aww.ieginfo.ca.gov/calaw.htmi. - Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION .�i _ 7,eran a of the or f which'.I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencinywisions.'Division 3 of the Businct the wor err b' a sjcense is in full force and effect. License Class License No Date ' Z: Z" Contractor Sign 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 ($100,001)), IN ADDITION TO THE COST 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: ❑ 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 th rformance 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 Expiration Date ame of Agent I•none P ]I certify that, in the pert (7 man a of the o which this permit is issued, I shall not employ any person in any manner so as to become subject to the workee,,rs' gggompensation laws of California, and agree iat, if I should become sf�bject the wor r c e sation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those provisions. / / ignatu re of Applicantt I h Datev 2'/Zil 2' DECLARATION REGMbING CONSTRUCTION LENDING AGENCY th hereby 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). ender's Name Lenders Address y my signature below, I certify to each of the following: I am the property owner or authorized to act on the prope owner's behalf. I have read this application and the information he provided is correct. I agree to comply with all applicable city and co orlf fiances an a laws relating tc building construction. I authorize representatives of this city or county ent r �thae .ab�ove-id nti is roperty for inspection purposes. ionature of Prooertv Owner or Authorized ADent tr.liv" Print Property Owner's or Authorized Agent's Name Date AC77ON I DATE., BY PERMITEXPIRED — — — — PERMIT FINAL 1 1211 / 7,— CERPRCATE OF � OCCUPAPICYISSUED ! FEDERAL REGULATIONS PART fit OF TITLE40AND AQMD RULE 1403. ❑ I SUBM[ TIED ASBESTOS N077FICATION TO: ❑ EPA ❑ AQMD ❑ ASBESTOS NOTIRRCATiON'IS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: