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H2019-0337 - Permits
City of Newport Beach - Building DivisionII��II�I�I�IIpNIIIII�I�l�ly� 100 Civic Center Drive, Newport Beach, CA 92660 o H e 0 b ° Dn 03 3m 70 Permit Counter Phone (949)644-3286 a oc � Job Address: 2741 PEBBLE DR Bldg:1 Floor: Suite: Description of Work: MECH -ADD (1) NEW A/C UNIT "TAMPER RES CAP REQ" Inspector Area:4 Code Edit: 2016 Legal Description: N TR 3660 LOT 42 Owner: VARNER STEVEN Address: 2741 PEBBLE DR NEWPORT BEACH CA 9266A Phone: / Issued Date:06/06/2019 Processed Contractor: DEPENDABLE GRAHAM AC Address: 2952 CENTURY PLACE oomm COSTA MESA CA 92626 Phone: 714-546-1653 Con State Lie: 472690 Lie Expire: 04/30/2020 Bus Lie: BT01013104 Lie Exp Date: 12/31/2019 MECHANICAL Permit: H2O19-.0337 Project No: Inspection Requests HVAC Items eeee m Worker's Comp Insurance -° oomm FEES Carrier: FALLS LAKE FIRE AND omoe CASUALT%. e moeamo • ° Policy No: FLA000131 • o ° e ° o Expire :07/01/2019 °• ° ° m ° Other cow° o e c mm �. 0 emeo Up to 3HP: 0 $0.00 O O O bmOOC Fire Dampers: mm o 0 $0.00 Over 1o0K BTU/hr: om000 $0.00 • omobcc m r Exhaust Fan: 0 o c000mo e c c 0 $0.00 • 000000 HVAC Items FEES morn 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 1o0K BTU/hr: 0 $0.00 > 3 HP to 15 HP: 1 $35.00 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: $30.45 Up to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: 4TrL6048A11ssuance: $35.00 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 Zoning PC: $40.00 TOTAL: $140.45 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $140.45 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. WE DECLARATION R NER-BUILD I hereby affirm under penalty of perjury that I am exempt from the Contractors' Shie License L v;for the re asonfp1 ipdicated below by the checkmark(s) I have placed next to the applicable items) Section 7031.5, Business and Professions Code: Any city or county that requires a pe%itto oonstruct, altbr, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for he 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 gf•Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of lot more than five hundred dollars ($500). • . ". .. • •; I, as owner of the property, or my employees with wages as their sole compensatip'n, will do �j a15{.or)ortiots if firework, and the structure is not intended or offered for sale (Section 7044, 3usiness and Professions Code: The Contractors' State License Law does not apply t1:2n owner of pPopgrt3i WFio, throegh efiployees' or personal effort, builds or improves the property, provided that the mprovements are not intended or offered for sale. If, however, the building or improvenfAt A Id within one year of completion, the Owner -Builder will have the burden of proving that it was not built or m roved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not ipply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' Slate License Law). 7 1 am exempt from licensure under the Contractors' State License Law for the following reason: 3y my signature beby✓eI acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally yell a structure t11i t Ih afe built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and '�ofessions Code, Is available upon request when this application is submitted or at the following Web site:hftp://www.leginfo.ca.gov/calaw.html. Jer ai'ur4 of Propl$jyOymer or Authorized Agent Date -ICENSED CONTRACTOR'S DECLARATION Qefepy tlffirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profe o s Code, and ��J(icce�ense 1 full force Ind effect • .... / / i<��.o s!�i`D icease Blass .... License No Date v / Contractor Signature a /iv YgfZAERS' COMPENSATION DECLARATION JARNING:-FAILURE.rO SEBURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE .b%?CPCOMPENSATIRN, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. frEI$Dy affirm unrger pepalty of perjury one of the following declarations: I have and Mllm*Ntain 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, . .... � arrce of th@yuorlGfor which this permit is issued. Policy No. ... . . . 1 ave and will•rnaintain 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' compensatiol ranee carrier and policy number are: rier Policy Number Expiration Date ne of Agent Phone # certify that, in the Performa of the work for whic this permit is issued, I shall not employ any person in any manner so as to become subject to the orkers' compensation laws of California, and agree if I should become sub' a he workers' co sation pro ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisi /g latureofApplicant -,� I �'//i1 Dat 455-- IECLARATION REGARDING CONSTRUCTION LENDING AGENCY hereby affirm under penalty 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). ender's Name Lender's Address iy my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owners 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 nces and state laws relating to building construction. I authorize representatives of this city or county to a the abg/ye-iden{if' pro pee y for inspection purposes. Nnnature of Pmnertv Owner or Authorized ADent 9'7 AT, I//„%lA Print ProDertv Owner's or Authorized ADent's Name%Jii3OV1 AL ACTION DATE BY ucc.Lsulxttvm yr uwmrunrvic vrlrnlvuc yr tvnvttJLkWevrvr.r FEDERAL REGULATIONS PART 61 OF TITLE40AND PERMIT EXPIRED AQMO RULE 1403. ❑ I SUBMFTFEDASBESTOS N077F)CATION TO. PERMITCANCELLED © EPA PERMITEXTENDED ❑ AQMD PERMIT FINAL ('jam I9 RE P�ROPOSEDDEMOUTIOpL ASBESTOS UON75 NOTAPPLICABLE TO CERTIFICATE OF OCCUPANCYISSUEO SIGNATURE'