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Home My WebLink AboutE2019-0701 - Permits;ty of Newport Beach - Building bivi:Aion Civic Center Drive, Newpo 1 Beach, CA 92660 ..,t Counter Phone (949)644-3208 b '�tJyr1Y� Job Address: 911 KINGS RD Bldg: 1 Floor: Suite: Description of Work: ELEC A/C DISCONNECT Inspector Area: 2 Legal Description: N TR 1219 BLK E LOT 26 Owner: CHASE RYAN AND BROOKE Contractor: Address: 911 KINGS RD Address: NEWPORT BEACH, CA 92660 Phone: 949-623-4344 Phone: Con State Lie: Issued Date:10/18/2019 Lie Expire: Bus Lie: Processed By: Lie 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 iiiiiiiiiiii1ii II SERVICE CHAMPIONS HTG 3150 E BIRCH BREA CA 92821 714-777 4777 799170 10131/2021 BT01080105 07/31/2020 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 Electrical Permit: E2019-0701 Project No : Inspection Requests Phone (949)644-3255 Code Edit: 2016 1 I S P E CTO R Worker's Compensation Insurance ' Carrier, EVEREST NATIONAL INS CO_ , Policy No: RM8WC00044191 Expire : 05/29/2020 ' 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 Check Fee : Temp Underground: 0 $0.00 Sub Panel: 1 $27.00 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 : 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. 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 licensors 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). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do L) 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 ffim 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 exemp, f;cm. 'icensure under the Contractors' State License Law for the following reason: By my;ignature 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 tnat 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 Couc, available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Signature of Prorerty Owner or Authorized Agent Date I-ICENSED CONTPACTOR'S DECLARATION I hereby affirm unoer. oenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with S do 7000) of Division 3 of the Business dea-PH m„ II. CP�6e is in full force and effect. (v ucenFe Class License No Date Contractor Signat e NORKERS' COMPENSATION DECLARATION YARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMP YER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED T DOLLARS ($100,000), IN ADDITION TO THE COST OF COMP,S�LSATI01tl, DAMAGES AS PROVIDED FOR IN SECTION 3766 OF THE LABOR CODE, INTEREST, AND ATTO NEY'S FEES. hereby affirm undei penalty of perjury one of the following declarations: —r I have a,ld 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 IN )erformance of the work for which this permit is issued. Policy No. 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' carrier and policy number are: Policy Number of Agent Date A certify that, in the perform ce of the work forwhich this permit is issued, I shall not employ any person in any manner so as to become subject to theworkers' compensation laws of California, and agre iat, if I should become subj o workers' compensation rovis orthwith comply with those provision e /per ignature of Applicant Date ��/�� ECLARATION REGAR IN ONSTRUCTIO ENDING AGENCY hereby affirm under pe alty of per Ma ere is a construction lending agency for the performance of the work for which this permit is issue (Section 3097, Civil Code). ender's Name Lender's Address y 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 a ounty or (fiances and state law g to building construction. I authorize representatives of this city or coun er th y or Inspection purposes._ Owner or ACTION I DATE /j BY PERMIT FINAL (/•{�''- 7' CERTIFICATEOF OCCUPANCYISSUED I Print FEDERAL REGULATIONS PART 61 OF TITLE 40AND AQMO RULE 1403. ❑ I SUBMITTEDASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD ❑ ASBESTOS N017FICA77ONIS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: