The URL can be used to link to this page

Home My WebLink AboutE2018-0402 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 2900 QUEDADA Bldg: 1 Floor: Suite: Description of Work: ELEC AIC DISCONNECT Inspector Area: Legal Description: N TR 7167 LOT 1 Owner: COOMBEJOHN M Contractor: Address: 2900 QUEDADA Address: NEWPORT BEACH, CA 92660 Phone: Phone: Con State Lic: Issued Date:06/11/2018 Lic Expire: Bus Lic: Processed By: Lic Exp Date: *E2018-0402* Electrical Permit: E2018-0402 AIRWEST A/C & HEATING INC 1886 SO SANTA CRUZ ST ANAHEIM CA 92805 714-978-7877 733715 03/31/2019 BT30057337 05/31/2019 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: 0 $0.00 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 Over600V or1000A: 0 $0.00 Time Clocks: 0 $0.00 O/H to U/G 0 $0.00 Additional Fee: $0.00 TOTAL Fee: Project No: Inspection Requests Phone (949)644-3255 Code Edit: 2016 Worker's Compensation Insurance Carrier: NORGUARD INS Policy No: AIWc857477 Expire : 11/14/2018 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 Plan Check Fee: Temp Underground: 0 $0.00 Sub Panel: 1 $25.00 0 $0.00 0 $0.00 Record Mgmt Fee: $0.00 Plan Check Fee: $0.00 Investigation Fee: $0.00 Issuance Fee: $33.00 Supplemental Fee: $0.00 ie at Permit Issuance : $58.00 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 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 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 improved for the purpose of sale). ❑ 1, as owner of file afoperty, 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 cf p-operty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). L i a,n exempt wom licensure under the Contractors' State License Law for the following reason: By my signature belcv' 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) veil 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 Cods, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmt. Signature of Prcp sty Caner or Authorized Agent Date LICEf:SED CONTRACTOR'S DECLARATION I F=•ety affirm I rd=r penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with ction 7000) of Division 3 of the Business and Pro Sion C;od� and my license is in full force and Pffect. License Class License No Date 1,16 Contractor Signature 1,il6RKFRS' CGMPENSATION DECLARATION WARNINGS FAILURE TO SECJRE 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 THE r'OST OF^OMPENSPTION DAMAGES AS PROVIDED FOR IN SECTION 37000F THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm upde, nenalty of perjury one of the following declarations: I 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 performance of the work for which this permit is issued. Policy No. 41 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' compensatio in ante carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # I certify that, in the pe Orman a the rk for which this permit is issued, I shall not employ any person in any manner so as to become subject to t workers' compensation laws of California, and agre that, if I should become ubject o th wok ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisi0 S. Signature of Applicant Date DECLARATION REG RDIN CONSTRUCTION LENDING AGENCY I hereby affirm under enalty 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). Lender's Name Lender's Address By my signature below, I certify to each of the following: I am the property owner or authorized to act on the propertyA 'half. I have read this application and the information I have 'ct. I agree to comply with all applicable city and co ty or inante laws relating to building construction. I authorize representatives of this city or county o e the'led property for Inspection purposes. Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name /te 41 ACTION DATE BY DECLARATION OF COMPLASBESTOS I ANCE 4YITNCODEOF FOR OFFICE USED LY FEDERAL REGULATIONS PART 61 OFT17LE4IIAND AQMQ RULE 1403. PERMIT EXPIRED ❑ 1SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMIT EXTENDED A❑ROPDSEDDEMQU ON.DONISNOTAPPLICA8LE70 PERMITFINAL m�c—PJA CERTLFLCATEOF �wS OCCUFANCYlSSQED SIGNATURE: