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Home My WebLink AboutH2016-0769 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIII II 100 Civic Center Drive, Newport Beach, CA 92660 - H 2 0 1 6 0 7 6 9 Permit Counter Phone (949)644-3288 o, e tr Job Address: 18 HARBOR ISLAND Bldg:1 Floor: Suite: Description of Work: MECHANICAL - R/R (1) EXISTING CHILLER TAMPER RESISTANT CAP REQUIRED InspectorArea:2 Code Edit: 2013 Legal Description: P BK 182 PG 43 PAR 1 FEES Owner: WILSON GWENDOLYN Contractor: WELLS PLUMBING HEATING & AIR INC Address: 18 HARBOR ISLAND Address: 30951 SAWGRASS COURT NEWPORT BEACH, CA 92660 TEMECULA, CA 92592 Phone: 949-413-9532 Phone: (951)676-7971 Other Con State Lie: 950590 Issued Date:11/ 16 Lie Expire: 04/30/2018 0 $0.00 Bus Lie: BT30057062 Processed By: / -Lie Exp Date: 11/30/2017 MECHANICAL Permit: H2O16-0769 Project No : e , •eeem• Inspection Requests Phone (949)604-3255 , e o • mee000 meeaoe m o , CTURomeoe � • ommmee mmmemo ° m e , • o Worker's Comp Insurance- „Oe ••••em Carrier: EVERTEST NATIONAL INS CO a m••.m° Policy No: Expire :07/27/2017 HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 0 $0.00 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: 2 $66.00 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 : $37.50 Investigation: $0.00 Over 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $57.42 Up to 1 M BTU/hr: 0 $0.00 up to 10K CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: CGAM020A2 Issuance: $33.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: TRANE Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 TOTAL: $193.92 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $193.92 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION '1Vn0�td,1e Qty n\7[nazt LE.CTRICAL METALLIC TUBING (EMS IS NOTALLOWED FoMERS VERIFICATION REQ EXTERIOR APPLICATIONS )WNER-BUILDER DECLARATION I hereby af(jrm uVer penalty 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 & Boaipss 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 he pegnit 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 ilo(eslions Cg(W Ai 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 lot more than five hurfdred dollars ($500). a I as owner oMhe 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, 3uslness and PIofESSiyns 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 fipro6P,ments ararKA 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 mproCed for thepurpose of sale). :0161' %owner of ilie property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not Ipply to an owner pf property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). 'IP' ;' m exempt4rom licensure under the Contractors' State License Law for the following reason: ily my stgnaturd 6AIbdG1 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. iallastnucture thptll 4ave 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 °rpWji5ns 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 Prdperty 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 andProf Ion , and my license is in full force Ind effect. _ .icense Class License No DatJ6/_ Contractor Signatur 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 0 DRED 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 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 rmance of the work for which this permit is issued. Policy No. Fave 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' compensatioi surance carrier and policy number are: Policy Number of Agent Date 71 certify that, in theperformance f the 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 agre tat, if I should become subject h -ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.;ignatureofApplican Date IECLARATION REGARDI NSTRUCTION LENDING AGENCY hereby affirm under penal; perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ender's Name Lender's Address ly my signature below, rcertify 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. I agree to comply with all applicable city and county ordi nc and state laws relating to building construction. I authorize representatives of this city or cotoe above -identified property for inspection purposes. innature of Pronertv Owner or Authorized Ace Print Property Owner's or Authorized Agent's DECLARATION OF COMPLIANCE WITH CODE OF ,�!/ FOR OFFICE USE ONLY ACTION DATE - FEDERAL REGULA TIONS PART 61 OF TITLE40AND (X .I D .ISUBMITTED,4SBESTOSNORFICATION TO: NOT APPLICABLE TO PERMIT FINAL C€RTIFICATEOF OCCUPANCYISSUEU