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HomeMy WebLinkAboutH2019-0312 - PermitsCity of Newport Beach - Building Division o 100 Civic Center Drive, Newport Beach, CA 92660 i Permit Counter Phone (949)644-3288 rn� - Job Address: 239 MILFORD DR Bldg:1 Floor: Suite: Description of Work: MECH/ A/C C/O "TAMPER RESISTANT CAP REQ" Inspector Area:5 Code Edit : 2016 Legal Description: N TR 3357 LOT 170 Owner: SELNA Contractor: Address: 23 LFORD D Address: RONA DEL MA , CA 92625 Phone: 949-683-0551 ' Phone: Ventilation Con State Lic: Issued ate:05/29/2019 Lic Expire: Bus Lic: Processe Lic Exp Date: i to 100K BTU/hr: H2O19-0312 SADDLEBACK PLUMBING INC 23901 REMME RIDGE LAKE FOREST CA 92630 949-829-0910 414946 01/31/2020 BT30032422 07/31/2019 MECHANICAL Permit: H2O19-0312 Project No: Inspection Requests Phone (949)644-3255 F 3 Worker's Comp Insurance- Carrier: EVEREST Policy No: 7600017769171 0 0 0 0 0 Expire :0710112019 ,,1jBjECTT0PIElsbdN :'FCTQW4 AEVILW ANDoAA`1WVA4.' o m.mo oomomo o m o m AC Items s FEES mm••• ,nacesBoilers&Compressors Ventilation Other m°°m •m.•• to 100K BTU/hr: 0 $0.00 Up to 3HP: 1 $19.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 ®©m. $0.00 er 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 dl/Floor Heaters: 0 $0.00 >15 HP to 30 HP: 0 $0.00 Attic Fan: 0 $0.00 Metal Fireplace: 0 $0.00 st Pumps & Package Units >30 HP to 50 HP 0 $0.00 Down -Draft Fan: 0 $0.00 Record Mgt Fee: $0.00 to 100K BTU/hr. 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee: $0.00 Investigation: $0.00 �r 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $16.53 to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: MLI4XCI-060issuance: $35.00 to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: LENNOX :r 1.75M BTU/hr. 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $40.00 TOTAL: $110.53 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $110.53 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. INER-BUILDER DECLARATION 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 item(s) ction 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 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 fessions 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 toA civil penalty of more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, ;iness 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 Irovements 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 (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 )ly 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: - 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 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 fessions Code, 13 available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. -- naturP of PropEft90wner or Authorized Agent Date JeN§ED CQfg1?ACTOR'S DECLARATION Irebyy affirm vndePperealty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 of Division 3 of the Business and Professi d_an my license is in full force I•eRet. 3nt2 Class . _ License No Date ontractor Sign )RRrtRS' CUMPE24SATION DECLARATION HHN& FAILURE T,%SECyRE 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 1► OP COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3TD3 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. Paby affirm under penalty of perjury one of the following declarations: and w9l maiptain 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 ;f mrgn of ft%% t for which this permit is issued. Policy No. have; 4d 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 JUrIb arriefandadlicvnumberare: Policy of Agent certify that, in the performance of , if I should become subjea of provisions Date I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree ction 3700 of the Labor Code, I shall forthwith comply with those provi81 y n_ LLNRNI IVIY MMUA1JU11XU VVlMq I RUV I IVIY LGIYVIIYV IIVGIYa.I ;reby affirm under pe ally of perju that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ider's Name Lender's Address 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. I agree to comply with all applicable city and count _ d-stateio building construction. I authorize representatives of this city or c e above -identified property for inspection purposes. of Property Owner or Print Property Owner's or Authorized ACTION DATE BY DECLARATION OF COMPLIANCEW/TNCODEOF FOR OFFICE USEONLY FEDERAL REGULATIONS PART 67 OF TITLE40AND AQMD RULE 1403. PERMIT EXP/RED ❑ I SUBMITTEDASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD "PERMITCANCEILED PERMITEXTENDED ASBESTOS NORFICARCINIS NOT APPLICABLE TO PROPOSEDDEMOLITION. PERMITFINAL Z j CERTIRCATEOF SIGNATURE: OCCUPANCYISSUED