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Home My WebLink AboutE2020-0030 - Permits7rN1vk City of Newport Beach - Building Division r 100 Civic Center Drive, Newport Beach, CA 92660 H !% Permit Counter Phone (949)644-3288 x< Job Address: 17 GLENEAGLES DR Bldg: 1 Floor: Suite: Description of Work: ELECI(2) A/C UNITS DISCONNECTS Inspector Area: 8 Legal Description: N TR 15388 LOT 56 Owner: ERIKSSON JAN Contractor: Address: 17 GLENEAGLES DR Address: NEWPORT BEACH, CA 92660 Phone: Phone: Can State Lic: Issued Date:01/15/2020 Lic Expire: Bus Lic: Processed By: Lic Exp Date: ALISO AIR INC 29736 AVE DE LAS BANDERAS RSM CA 92688 949-589-2021 526420 03/31/2020 BT30019236 0212812020 Electrical Permit: E2020-0030 Project No : Inspection Requests Phone (949)644-3255 Code Edit: 2019 e P Cf) Worker's Compensation Insurance Carrier: LIBERTY MUTUAL rt 1 Policy No: WC2Z61036218098 Expire : 07/01/2020 0 _0 DJ New Construction Residential Receptacle/Switch/Outlets Receptacles/Outlets: 0 $0.00 FEES Motors/Transformers (HP/KVA) 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $0.00 - ul i- armly: $0-00-- i ures 0 0-00 1 to 10 1 0.00 Su anel: 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 TOTAL Fee: $89.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $89.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION - Construction Hours: Monday - Friday 7.00 a.m. to 6 a30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. o V • Jp IWNER-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) iection 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 IS 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 of more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 nprovements 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 nproved for the purpose of sale). 1 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 pply 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). I am exempt from licensure under the Contractors' State License Law for the following reason: ly 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 Iegalll ell 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 'rofessions 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 .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 00) o Division 3 of the Business and ro esslert ode, and my license ism full force nd effect. _ icense Class License No Date CS `'G Contractor Signature ,o VORKERS' COMPENSATION DECLARATION IARNING: 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 ($100,000), IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNETS FEES. hereby affirm under penalty 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 elformance of the work for which this permit is issued. Policy No. 61 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' compensatiol Isurance carin policy numb re: :arrier P y Number Expiration Date lame of Agent - Phone # 31 certify that, in the p�aj man of the work Is permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and ogre tat, if I should become s of Section 3700 of the Labor Code, I shall forthwith comply with those _provisions. Iignature of Applicant e� i— IECLARATION REVIR-13MG CON&IRUGTtON LENDING AGENCY hereby affirm unde 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). enders Name Lender's Address ly 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 prove ct. I agree to comply with all applicable city and coo r inap sand state laws n purposes. I authorize representatives of this city or county to nt r [n eaffrepe�rannlospe-' coon purposes. �- ( j js �1 lignature of Property Owner or Authorized Agent Print Property Owners or Authorized Agent's Name L Z ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF L FOR OFRCE USE ONLY FEDERAL REGULATIONS PART fit OF TIILE40AND 4QMD ROLE V03. PERMIT EXPIRED C1 I SU[3,WTIEOASBECTGS PI071FICATION TO: ❑ ZPA- ❑ AQMD ❑ ASBESTOS N071FIC41TIONIS NOT APPLICABLE TO ` PnOPC.SED DFM0i1TIGN. Y SIGNAIIJFE: PERMITCANCELLED PERMIT EXTENDED PERMITFLNAt • m i CERTIFICATEOF OCCUPANCYISSUEO