HomeMy WebLinkAboutH2019-0286 - Permits. City of Newport Beach - Building Division IIII�IIIIIIIIIIIIIIIIIIIIIII�III�IIIIIIIIIIIIII
't 100 Civic Center Drive, Newport Beach, CA 92660 H 2. 0. 1 9 0 2 8 6
Permit Counter Phone (949)644-3288
Job Address: 3126 CORTE MARIN BIdg:1 Floor: Suite:
Description of Work: MECH A/C UNIT (1) *TAMPER PROOF CAP REQ* *revised 7116/19* TIMER REQUIRED
*REVISED 06/20/2019
InspectorArea:8 Code Edit: 2016
Legal Description: N TR 12271 LOT 94
Owner; WESTERVELT DEREK
Address: 3126 CORTE MARIN
NEWPORT BEACH, CA 92660
Phone:
Issued Date:05/20/2019
Processed By:
Contractor:
WHITE MECHANICAL INC
Address:
23601 RIDGE ROUTE DR #B
LAGUNA HILLS CA 92653
Phone:
949-456-5328
Con State Lic:
822474
Lic Expire:
0 8131 /2 01 9
Bus Lic:
BT30056814
Lic Exp Date:
02/28/2020
MECHANICAL Permit: H2O19-0286
Project No:
Inspection Requests Phone (949)644-3255
Worker's Comp Insurance -
Carrier: INS CO OF THE WEST
Policy No: WVE5024604
Expire :10/01/2019
HVAC Items
•
FEES
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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Furnaces Boilers & Compressors
Ventilation
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°
• •
Other
c
Up to 100K BTU/hr:
0
$19.00
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:
1 $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 1OOK BTU/hr:
0
$0.00
>50 HP:
0 $0.00
Residential Hood:
0 $0.00
Additional Fee:CID
$0.00 Investigation:
$0.00
Over 500K BTU/hr:
0
$0.00
Air Handling Units
Comm. Hood:
0 $0.00
Xw
pfe p. �>,"O Check:
$16.53
Up to 1 M BTU/hr:
0
$0.00
up to 1 OK CFM:
0 $0.00
Repair/Alter/Add:
0 $0.00
Model:
.6678)
G4.06*ssuance:
$35.00
Up to 1.75M BTU/hr:
0
$0.00
Over 10K CFM:
0 $0.00
Supplemental Fee:
$0.00
Manufacturer:
LENNOX
Over 1.75M BTU/hr.
0
$0.00
VAV Box:
0 $0.00
Zoning PC:
$40.00
TOTAL: $110.53
Plan Check Fee
: $110.53
Fee Due at Permit Issuance : $0.00
•
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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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.
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IWNER-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)
lection 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
ie 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).
I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or L_) 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
nproved 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).
I am exempt from licensure under the Contractors' State License Law for the following reason:
y 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 legal
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.html.
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 S C' 700 ) of Div' n 3 of the Business an f ssions Cod and y B ense is in full force
nd effect. /
icense Class License No Date Contractor Signal
YORKERS' COMPENSATION DECLARATION
lARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUN HOUSAND DOLLARS 100,00" ADDITION TO THE
:OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
1 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
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' compensation
t Ura carrier and policy number are:
rrr Policy Number Expiration Date
lame of Agent Phone #
�I certify that, in the petteamitrice of the work for which this per it is issued, I shall not employ any person in any manner so as to become subject to th orkers' compensation laws of California, and agree
Pat, if I should become su ' o orkers' com anon prov 'ons of Section 3700 of the Labor Code, I shall forthwith comply with those provisio s. 1(,f
lignature of Applicant De
IECLARATION REGAO&ING CCY
hereby affirm under penalty of 'ury that there is a con uction IN\g gency 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, I certify to each of the following:
I am the property owner or authorized to act on the property owners beh .
I have read this application and the information I have provided is correct.
I agree to comply with all applicable cit t ordinances and state laws relating to wilding construction.
I authorize representatives of this oily or county toe bove-id 'ed p for' spectiori purposes. //�,.,I
li nature of Prgd %wner or Authorized Agent wner's or Authorized Agent's Name WI I CIEDate '
.... AOTtON•• D BY ECL.. N OF COMPLtAN(EL MTN CODEOF OFFICE USE ONLY
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SUDMfTTEDASBESTOS NOTIFICATION TO:
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Al:fiTEXiFNDED ❑ AOMD
PETtRRITFfNAt • • "+ ❑ ASBESTOS N07IRflC4770NIS NOTAPPLICABL.E TO
PROPOSED DEMOLITION.
ENRTIFICATE OF
SIGNATURE: