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Home My WebLink AboutE2017-0309 - PermitsR�waro;,T City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIII II 100 Civic Center Drive, Newport Beach, CA 92660 E 2 0 1 7 0 3 0 9 > ; Permit Counter Phone (949)644-3288 M.< a" �atirnwPF Job Address: 407 VISTA SUERTE Bldg: 1 Floor: Suite: Description of Work: ELECTRICAL DISCONNECT FOR A/C (H2O17-0310) Inspector Area: 8 Legal Description: N TR 7148 LOT 18 Owner: SELIM ALAA/HOSNI MAHA Contractor: A C COOL INC Address: 407 VISTA SUERTE Address: P O BOX 7316 NEWPORT BEACH, CA 92660 FULLERTON CA 92834 Phone: Phone: 714-532-2467 Con State Lic: 804056 Issued Date:06/1 120 Lic Expire: 01131/2018 Bus Lic: BT30042073 Processed B Lic Exp Date: 01/31/2018 New Construction Residential Multi -Family: 1-2 Family: Service 0-600V up to 20OA: 0 0-600V over20OA: 0 Over600V or1000A: 0 O/H to U/G 0 TOTAL Fee: Electrical Permit: E2017-0309 Project No: Inspection Requests Phone (949)644-3�55 7 CT 00 Code Edit: 2016 14A Worker's Compensation Insurance Carrier: EVEREST NATIONAL Policy No: 7600007408 Expire : 06/01/2018 FEES Receptacle/Switch/Outlets Motors/Transformers (HP/KVA) Receptacles/Outlets: 0 $0.00 0 to 1 HP/KW/KVA: 0 $0.00 Temp Underground: 0 $0.00 $0.00 Fixtures: 0 $0.00 1 to 10 HP/KW/KVA: 0 $0.00 Sub Panel: 0 $0.00 $0.00 Sep Circuits: 1 $6.00 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 Signs Over 100 HP/KW/KVA: 0 $0.00 Record Mgmt Fee: $0.00 $0.00 Branch Circuit: 0 $0.00 Plan Check Fee: $0.00 $0.00 Each Add Circuit: 0 $0.00 Piggy BackfTemp Power: 0 $0.00 Investigation Fee: $0.00 $0.00 Time Clocks: 0 $0.00 Temp Power Pole: 0 $0.00 Issuance Fee: $33.00 $0.00 Additional Fee: $0.00 Supplemental Fee: $0.00 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. 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 itern(s) (Section-7031.5- t3,isiness 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 siyiied 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 r'ro-'assions 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 U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and ProfPsslons 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 unt.iiltended 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 i,np;c.v ad for the purpose of sale). C -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 Lpply to,an owri of-amperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). C 1 a,n exempt from licensure under the Contractors' State License Law for the following reason: B; 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 const ed in ij ntirety b tensed contractors. I understand that a copy of the applicable law, Section 7044 of the Busine s and Professions Code, is available upon request whin this applica 1 s fitted r at(th@ fgllo g W site:http://w�wv.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent 1 I ( Date 7 LICENSED CONTRACTOR'S DECLARAT N I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No Date Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO 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: 111 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, forth 1p�o�aId,[�oormance of the work for which this permit is issued. Policy No. 1j-.1l�gave 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: Policy Number Date lame of Agent Phone # 71 certify that, in the performance of the work for which this permit i ss ed, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre rat, if I should beco ubje5jeq wo r; 7prtion ions f Section 3700 of the Labor Code, I shall forthwith comply with those provi 'ons. :ignature of Applican /1 I//� Date — / IECLARATION RE ARDI CON TR C N LPNDtAG AG Y hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 309 Civil Code). ender's 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 provided is correct. I agree to comply with all applicable city and county ordina sands e s lating to building construction. I authorize representatives of this city or co to en he v Ident fi d o y for inspection purposes. / ' �Is 'igna ture of Property Owner or Authorized Age Print Property Owner's or Authorized Agent's Name A!".//U� Ly%1 6CrJ Dat ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40AND AQMO RULE 1403. PERMIT EXPI RED ❑ iSUBM17TEDASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMITCANCELLED PERMIT EXTENDED ❑ ASBESTOS N077FICA170HIS NOTAPPLICABLETO PROPOSED DEMOLITION. SIGNATURE: PERMITFINAL — M L-oc teQ CERTIFICATE OF (a." OCCUPANCYISSUED