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Home My WebLink AboutE2021-0482 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Electrical Permit: E2021-0482 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 2 1 0 4 8 2(9) Permit Counter Phone (949)644-3288Project No Inspection Requests Phone (949)644-3255 Job Address: 3 ANONDALE Bldg:1 Floor: Suite: Description of Work: ELEC/DISCONNECT (H2O21-0469) ��-----�� Inspector Area: 4 Code Edit: 2019 Legal Description: N TR 15409 LOT 101 Owner: SMITH RONALD Contractor: ALISO AIR INC Worker's Compensation Insurance Address: 3 ANONDALE Address: 29736 AVE DE LAS BANDERAS Carrier: LIBERTY MUTUAL co NEWPORT BEACH, CA 92660 RSM CA 92688 Policy No: WC2Z61036218091 Phone: Phone: 949-589-2021 Expire : 07/01/2022 Can State Lic: 526420 Issued Date:08/1112021 Lic Expire: 03/31/2022 Bus Lic: BT30019236 Processed By: Lic Exp Date: 03/31/2022 New Construction Receptacle/Switch/Outlets Residential Receptacles/Outlets: 0 $0.00 Multi -Family: 0 $0.00 Fixtures: 0 $0.00 1-2 Family: 0 $0.00 Sep Circuits: 1 $7.00 Low Voltage 0 $0.00 Service Signs 0-600V up to 20OA: 0 $0.00 Branch Circuit: 0 $0.00 0-600V over 20OA: 0 $0.00 Each Add Circuit: 0 $0.00 Over 600V or 1 o00A: 0 $0.00 Time Clocks: 0 $0.00 C/H to U/G 0 $0.00 Additional Fee: $0.00 TOTAL Fee: 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 $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. $45.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $38.00 $0.00 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, priorto 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). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do U 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 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 legall) 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 Sect7 0%)Pf Division 3 of the Business and Professions Code, and my lics in full for and effect.%z License Class License No Dat Contractor Signatur 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 THOUSAN OLLARS 3100,0001, IN AD O 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: V1hrave ave 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 mance of the work forwhich this permit is issued. Policy No. and will mai tain orkers' comp tion insurance, as reclKired by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatioi insurance carrier and p [icy ember are: Carrier Ili mb Expiration Date Name of Agent Phone # ❑I certify that, in the performance of the work forwhich this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' 9orrrcrryyyQQpensajlon laws of California, and agre that, if I should become subje to the workers' compensa s of Section 3700 D_ f the Labor Code, I shall forthwith comply with those provi o / I I �\ Signature of Applicant I I+ ^`- ARATION REGARD-1413 CONSTRUCTIO DING AGENCY :reby affirm under penalty of perjury that ere is a construction lending agency the Ider's Name Len( my signature below, I certify to each of the-%ItQ f 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 relatir I authorize representatives of this city or county r +a 1H of Property of the work f?lrvhich this permit is issued (Section 3097, Civil Code). CD W r`l;, C/-//) AC770N GATE BY CLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY C FECEF,ALREGUL:.:ION5PART 61 OFTI-LE40AND AQM,)RULE 1403, PERMIT EXPIRED ❑ J SUL MITTEDA.iRES1-OS o4OTiFICaRUN TOr ❑ EPA ❑ AQMD PERMITCANCELLED PERMJTEXTENDED ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPO�;EDOZMGLITIOIJ. PERMIT FINAL CERTIFICATEOF SIGNA TUaE: OCCUPANCYISSUEO