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Home My WebLink AboutH2018-0424 - PermitsCity of Newport Beach - Building Division H2O18-0424 100 Civic Center Drive, Newport Beach, CA 92660 F .r_ Permit Counter Phone (949)644-3288 Job Address: 4148 SHORECREST LN BIdg:1 Floor: Suite: Description of Work: MFR FURNACE C/O SAME LOCATION • o Inspector Area:5 Code Edit: 2016 e Legal Description: Owner: DOMINIC LUCILLE MARY Contractor: CHOICE AIR Address: 4148 SHORECREST LN Address: 3633 WOODPECKER STREET NEWPORT BEACH, CA 92625 BREA CA 92823 Phone: Phone: 714-388-7986 $18.00 Con State Lic: 855665 Issued Date:07/18/2018 Lic Expire: 0 3/3112 01 9 e• a Bus Lic: BT3007826 Processed By: Lic Exp Date: 01/31/2019 MECHANICAL Permit: H2O18-0424 Project No: Inspection Requests Phone (949)644-3255 Worker's Comp Insurance - Carrier: SEQUOIA Policy No: QWCA5216706 Expire :03/01/2019 eeee • o FEES e e e o Ventilation •• e m •o• m e Up to 100K BTU/hr: o • e $18.00 •o • 0 $0.00 Bathroom Fan: • • oe•ee e• a $0.00 ...e• ``',',�.�-� $0.00 e • o a •eo 0 n �F,pe �'%� $0.00 ee•Jeo o �� • o000 $0.00 >15 HP to 30 HP: p Attic Fan: ,rte Metal Fireplace: 0 HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 1 $18.00 Up to 3HP: 0 $0.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 $0.00 Over 100K BTU/hr: 0 $0.00 > 3 HP to 15 HP: 0 $0.00 Exhaust Fan: 0 $0.00 Gas Line: 0 $0.00 $0.00 Wall/Floor Heaters: 0 $0.00 >15 HP to 30 HP: 0 $0.00 Attic Fan: 0 $0.00 Metal Fireplace: 0 $0.00 Heat Pumps & Package Units >30 HP to 50 HP 0 $0.00 Down -Draft Fan: 0 $0.00 Record Mgt Fee: $0.00 Up to 100K BTU/hr: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee: $0.00 Investigation: $0.00 Over 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $0.00 Up to 1 M BTU/hr: 0 $0.00 up to 1 O CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: Issuance: $33.00 Up to 1.75M BTU/hr: 0 $0.00 Over 1 O CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $0.00 TOTAL: $51.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $51.00 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 penally of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) 1 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). ❑ I, as owner Qf& 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 Bro essions 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 'mprovaments aVildl 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 T IbVld for tit poodte of sale). I, as ownee& 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 p lY Jo an ownerbf 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 exempCfigpl Dcensure under the Contractors' State License Law for the following reason: ymmy�signature belocvI 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) sell a structure MEN 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 df✓ss`gjons Cft* ip ptailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. grrefure of Propgrty Owner or Authorized Agent Date 49ENGED CONTRACTOR'S DECLARATION // hereby` affirm un6lenpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with ction 7000) of Division 3 of the Business and Fofessions Code, and my license is in full force o vifect. �/ IA' ,i, to jcgQ%erClass _�-••_ License No Date `�� Contractor Signature U_Vjq?Kc (U WORKERS' CbMI9ENSATION 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 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: 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. ave 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 insurance carrier and policy number are: Carrier S®lAC Policy Number Expiration Date Name of Agent Phone # I certify that, in the pert rmance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to Ye workers' compensation laws of California, and agre that, if I should become s bject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provis' ns. n Signature of ApplicantVA)Date DECLARATION REG DING CO STRUCTION 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 property owner's behalf. I have read this application and the information I have provided is correct. r� 1 agree to comply with all applicable city and couno ordinances and state laws relating to building construction. 1 authorize representatives of this city or county Yt Ver the above =de ffied roperty for inspection purposes. Si nature of Property Owner or Authorized A ent V7 Print Pro ertOwner's or Authorized A ent's Na OLD WclAiai �(/1. Date ACTION DATE BY DECLARATtON IIFCOMPLIANCEWTTHCODEIIF FOR OFFICE EDNLY FEDERAL REGULATIONS PART 8t OFTITLE40AND PERMiTfXPtRED AOMO RULE 9403. ❑ 1 SUBISPfTf€DASS€5TOS NOTTFICATiON TO: PERMtTCANCfLLEQ ❑ EPA PERMITEXTEfVDEQ ❑ AbihtD PERMITFINAL ❑ ASBESTOS NIIitfTCATTON/S NOT APPLtCA81E TO j PROPOSED DEMOLITION. CERTIHCATE OF SIGNATURE: OCCUPANCyt55QEQ