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Home My WebLink AboutH2018-0566 - PermitsCity of Newport Beach - Building Division o't. t "' 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 nw�n 1 0Wt:PMarNIEAL Permit: H2O18-0566 H 2 1 8 0 5 6 6 Project No: ° e e eo ee e ° ° e n Ins pegtion Frequests6bhonee(949)644-3255 e o ° o c o0 0° ece c ° °o Job Address: 18 HARBOR ISLAND BIdg:1 Floor: Suite: Description of Work: MECH - RIR A/C UNIT ON ROOFTOP *TAMPER-RESISTANT CAP REQUIRED* InspectorArea:2 Code Edit: 2016 Legal Description: P SK 182 PG 43 PAR 1 Owner: TELLURIDE Contractor: Address: PO BOX 842 Address: NEWPORT BEACH, CA 92661 Phone: Issued Date:09/11/2018 Processed rnacesBoilers & Comp"son to 100K BTU/hr: 0 $0.00 sr 100K BTU/hr: 0 $0.00 ill/Floor Heaters: 0 $0.00 at Pumps & Package Units to 10oK BTU/hr: 1 $18.00 er 500K BTU/hr: 0 $0.00 to 1M BTU/hr: 0 $0.00 $33.00 0 $0.00 Down -Draft Fan: to 1.75M BTU/hr: 0 $0.00 :r 1.75M BTU/hr: 0 $0.00 Phone: Con State Lie: Lie Expire: Bus Lie: Lie Exp Date: INEGRITY AIR 39996 MILOS CT MURRIETTA CA 92563 951-306-9061 1039609 05131 /2020 BT30064436 09/30/2019 Over 1 OK CFM: 0 VAV Box: 0 TOTAL: $122.16 Worker's Comp Insurance - Carrier : MARKEL INS CO Policy No: MWC0133113 Expire :08/03/2019 x FEES Fire Dampers: Ventilation $0.00 Gas Line: 0 $0.00 Up to 3HP: 1 $18.00 Bathroom Fan: 0 $0.00 > 3 HP to 15 HP: 0 $0.00 Exhaust Fan: 0 $0.00 >15 HP to 30 HP: 0 $0.00 Attic Fan: 0 $0.00 >30 HP to 50 HP 0 $0.00 Down -Draft Fan: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 up to 1 O CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Over 1 OK CFM: 0 VAV Box: 0 TOTAL: $122.16 Worker's Comp Insurance - Carrier : MARKEL INS CO Policy No: MWC0133113 Expire :08/03/2019 x $0.00 Supplemental Fee: $0.00 Manufacturer: MAYTAG $0.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance 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. Zoning PC: $122.16 $37.50 Other Fire Dampers: 0 $0.00 $0.00 Gas Line: 0 $0.00 $0.00 Metal Fireplace: 0 $0.00 Record Mgt Fee: $0.00 Additional Fee: $15.66 Investigation: $0.00 Plan Check: $0.00 Model: CSH1BE4M1S936K Issuance: $0.00 Supplemental Fee: $0.00 Manufacturer: MAYTAG $0.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance 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. Zoning PC: $122.16 $37.50 e )INNER -BUILDER DECLARATION . -. I hereby affirm under pendlty of ps rjury that I am exempt fror1 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 Pzofejlbns Coge: 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 ie permit to file a signed staf%TfOnt (fiat he orsfie 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 sh21s exemp0rom Wceneurp am d Ina 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). '0- •; . : • : . 1, as owner of the property, or my employees with wageEI tfigii sole compensation, will do (_) all of or U 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 n roved 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 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. .ignature 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 7000) of Division 3 of the Business and Prof a ons ode, and my license is in full force nd effect. icense Class C (,c � G J TJ License No 1019 60°% DateContractor Signal e IIORKERS' COMPENSATION DECLARATION V` 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP T UNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE OST OF. COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penally 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 air @rmance of the work for which this permit is issued. Policy No. �ve 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' compensatior lar nce roar and policy number are: �^ y (�� p arrier ��iL� I n51m1n �o (.folic Number �"1 W � 1 Expiration Date SITE of Agent SEE( Phone # 11 certify that, in the performance o he rk for which this 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 agree at, if I should become subject m ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of Applicant Dat a�i DECLARATION REG DI STRUCTION LENDING AGENCY IV hereby affirm under pe y perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). antler's Name Lender's Address y my signature bw certify to each of the following: I am the prop y owner or authorized to act on the property owner's 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 es a tate laws ting to building construction. I authorize representatives of this city or county to ant a e -Id d property for inspection purposes. / i ignature of Property Owner or Authorized Agent ^� Print Property Owner's or Authorized Agent's Name ) &L6d pkv) Shin Date ACTION DATE BY DECLARATION OF COMPLIANCEWITN CODEOF FOROFRCEUSEONLY FEDERAL REGULATIONSPART H1 OFT17LE40AND AQMD RULE 1403. PERMITEXPIRED I SUBWT7EDASSESTOS N071FICATION TO: ❑ EPA ❑ AQMD PERMITCANCELLED PERMIT EXTENDED ❑ ASBESTOS NORRCARONIS NOT APPLICABLE TO PROPOSED DEMOLITION, PERMITFINA.L CERTfFfCATE OF SIGNATURE. OCCUPANCYISSUED