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Home My WebLink AboutH2019-0012 - PermitsAwa $ City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 9 0 0 1 2 .. Permit Counter Phone (949)644-3288 Job Address: 2101 SANTIAGO DR BIdg:1 Floor: Suite: Description of Work: MECH/CHANGE OUT F.A.0 & A/C UNIT 50c1B (LENNOX; XC16-060-230) Inspector Area:3 Code Edit: 2016 Legal Description: N TR 3801 LOT 27 Owner: CESARIO Address: 2101 SANTIAGO DR NEWPORT BEACH, CA 92660 Phone: Issued Date:01/04/2019 ` , Processed By: �yw-a--- Contractor: SERVICE CHAMPIONS HTG Address: 3150 E BIRCH BREA CA 92821 Phone: 714-777-7777 Con State Lic: 799170 Lic Expire: 09/30/2019 Bus Lic: BT01080105 Lic Exp Date: 07/31/2019 MECHANICAL Permit: H2O19-0012 Project No : Inspection Requests Phone (949)644-3255 HVAC Items FEES Worker's Comp Insurance - Carrier: PACIFIC COMP Policy No: WA000607 FurnacesBoilers & Compressors Expire :03/2212019 HERS VERIFICATION RECD Other i" HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 1 $19.00 Up to 3HP: 1 $19.00 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: $16.53 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 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model Issuance: $35.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: Over 1.75M BTU/hr. 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $40.00 TOTAL: $129.53 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $129.53 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7:00°a.g1°fo 6:30 p.m.and Saturday from 8:00 a.m. to 6:00 p.m. ° • ° . ° • ° ° ° • )WNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 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). 3 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, 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 Troved for the purpose of sale). 1, 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). 1 am exempt from licensure under the Contractors' State License Law for the following reason: iy 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 legally 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.htmi. signature of Property Owner or Authorized Agent - net. .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 000 of Division 3 of the Business and Profess s-Go2ie, and my license is in full force nd effect. y/ icense Class License No Date Contractor Signature/ 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 OST OF COMPENSATION, DAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS 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 the armance of the work for which this permit is issued. Policy No. +1 have and will intain 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' compensation Isurance car rie and p icy number grin n _ ier Expiration Date to of Agent r Phone # certify that, in a performance of the work for which this permit is issued, I shall not emplo an rson ' manner so as to become subject to the workers' compensation laws of California, and agree if I should become subj t to the wor sation provisio o e, shall forthwith comply with those prov1 s. 1 �! iature of Applicant Date !% :LARATION REGARD NG :ONSTRUCTIO ING AG hereby affirm under penalty of perjuVA4aMere is a con tion lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code) ender's Name Lender's Address y 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. (�%,p ,,r 1/I �� ,r,,,,, .�.4��/-/ I I agree to comply with all applicable city and county ordinance a i laws relating to building construction. rt�o----�J�✓ ` / vYr/'�""vl t \ �l �� I authorize representatives of this city or coun bove-identified property for inspection purposes. ionnture of Prnnerty Owner or Authnrized AGent Print Prooertv Owner's or Authorized ADent's Na Da e ACTION DAA Zy DECLARATION OF COMPLIANCEYYIfNCOUIL OF FORGERCEUSEONLY FEDERAL REGULA77ONS PART61' OFTITLE40AND AQMDRULE'1403. •• ... ❑ I SUBIWTTEDA MESTa NOTIFIC4TV4 TO:... P€RMLT€XP/R€D P€RMITCANCELLED ❑ EPA : • • .�• ❑ AQMD • ASBESTOS •• : • • • :. NfliAPT�LtCABL£T(i,• PERMLTEXTENDED PERMITFlNAL �/S (� )A -YL- P❑ROPOSEDDEMOfJTION.DONIS ••� CERTfFLCATEOF OCCUPANCYISSUED SIGNATURE. �•� ••• •• • •., • . ,� • • . • • .