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Home My WebLink AboutE2019-0620 - Permits(9) City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Electrical Permit: E2019-0620 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 1 9 0 6 2 0 Project No: Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 103 OCEAN VISTA Bldg: 1 Floor: Suite: Description of Work: ELEC -DISCONNECT FOR A/C (H2O19-0470) Inspector Area: 8 Code Edit:2016 Legal Description: TR 9676 LOT 13 UNIT 125 OF PROJECT LOCATED ON AP 442-361-31 TOGETHER = Owner: MORGAN MELINDA Contractor: SIMS COMPANY, A PARTNERSHIP Worker's Compensation Insurance Address: 103 OCEAN VISTA Address: 6943 TRINITY PLACE Carrier: EXEMPT _ NEWPORT BEACH, CA 92660 A 91701 2 Policy No 30a WIDE X 36" DEPTH Phone: Phone: 951) 2 1928 Expire Con State Lie: 1032723 FOR Issued Date:09/11/2019 Lic Expire: 11/3012019 REQUIRED _ Bus Lic: BT30064549 Processed By: Lic Exp Date: 09130/2019 A/C DISCONNECTS 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: 0 $0.00 1-2 Family: 0 $0.00 Sep Circuits: 1 $7.00 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-to20OA: -0 -$0.00 - -Branch-Gircuit. - -0--$0.00 -Plan-cheek-Fee:- - - --$0.00 0-600V over 20DA: 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: $42.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $42.00 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. 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) 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 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 'rofessions 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). 1 I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, �usiness 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). 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 legal 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.loginfo.ca.gov/calaw.html. signature of PropLCy Owner or Authorized Agent ate :C=43ED CON7RA:;TOR'S DECLARATION hereby affirm under p_nalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 70 ) of Division 3 of the Bes=and-Profe and my license is in full force no affect r IoenbeClass__ - License. No Date Contractor Signature ✓URKERS' CUNIF'tNSATION DECLARATION 'ARNING. FAILURE TO SECU }E 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 TH qeT CF COMPENS^IPF, WMAGESAS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hernhy affirm under penalty of perjury one of the following declarations: - 7 I hav- 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, fort] I Wrma,lce of L',L milk for which this permit is issued. Policy No. �iave and will Taint^in 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' compensatior uradue carrier and,oAncy number are: trier Policy Number Expiration Date me of Agent Phone # I certify that, in the the work for which this permit is issue II not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree t, if I should become subject to a worker ' Ion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �I / nature of Applicant Date L l L�h2 CLARATION REG TION LENDING AGENCY areby affirm under i5enalty 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). ider's Name Lenders Address my signature below, I certify to each of the following: I am the property owner or authorized to act on the pro a er's-behalf> I have read this application and the information > orrect. I agree to comply with all applicable city and cou Ina oe� and state laws rate Ijn ilding construction. I authorize representatives of this city or coun a -I entified property for inspection purposes.y[� Date .nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name AC77ON OATE Y DECLARATION OF COMPLIANCE tMTH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART fit OF TITLE40AND AQMD RULE 1401 PERMIT EXPI RED ❑ 1 SUBMITTED ASBESTOS N017FICATION TO: ❑ EPA ❑ AQMD PER7MITCANCELLEO PERMIT EXTENDED ❑ ASBESTOS MOTIHCA770NIS NOT APPLICABLE TO PROPOSED DEMOLITION, PERMITFINAt q/16/ 11� - �'A(Y.S�1 CERTIFICATEOF SIGNATURE: OCCUPANCYISSUED