HomeMy WebLinkAboutH2019-0378 - PermitsCity of Newport Beach - Building Division IIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
100 Civic center Drive, Newport Beach, CA 92660u
Permit Counter Phone (949)644-3288 H 2 0 1 9 0 3 7 8
MECHANICAL Permit: H2O19-0378
Project No :
Inspection Requests Phone (949)644-3255
Job Address: 1412 SERENADE TER Bldg -1 Floor: Suite:
Description of Work: MECH/CHANGE OUT F.A.0 & A/C UNIT 43.5dB
0 $0.00
Ventilation
(LENNOX; EL16XC1-060)
W/DUCT W
Inspector Area:2 Code Edit: 2016
Legal
Metal Fireplace:
I to 100K BTU/hr:
,er 100K BTU/hr:
Description: TRACT 1700 LOT 34 & FOR OF LOT 45
$19.00
$0.00
Up to 3HP:
Owner: GEOFFROY DAVID PAULContractor:
Address: 1412 SERENADE TER
ECONO AIR
M
Address:555
CORONA DEL MAR, CA 92625
VANGUARD
Workers Comp Ir sura
Carrier:
Phone:
BREA, CA 92821
INS COMPs�yyy�
Phone:
714-695-6667
Policy No: ZAWCI-25387-00 �i O
Expire
Con State Lic:
Issued Date;06/25/2019
445220
:10/0112019 mr
Lic Expire:
02/28/2020
0 $0.00
Processed By: Bus Lic:
BT30064026
$0.00
Lic Exp Date:
08/31/2019
irnacesBoilers & Compressors
0 $0.00
Ventilation
Gas Line:
0 $0.00
FEES
Metal Fireplace:
I to 100K BTU/hr:
,er 100K BTU/hr:
1
0
$19.00
$0.00
Up to 3HP:
1
$19-00
Bathroom
$0.00
all/Floor Heaters:
0
$0.00
> 3 HP to 15 HP:
>15 HP to 30 HP:
0
$0.00
Exhaust Fan:n
0 $0.00
at Pumps & Package Units
>30 HP to 50 HP
0
0
$0,00
$0.00
Attic Fan:
0 $0.00
to 1OOK BTU/hr:
0
$0.00
>50 HP:
0
Down -Draft Fan:
b $0.00
er 500K BTU/hr.
0
$0.00
Air Handling Units
$0.00
Residential Hood:
0 $0.00
to 1M BTU/hr:
0
$0.00
up to IOK CFM:
0
$0.00
Comm. Hood:
0 0.00
to 1.75M BTU/hr:
0
$0.00
Over 1 O CFM:
0
$0:00
Repair/Alter/Add:
1 $$9.00
ar 1.75M BTU/hr;
0
$0.00
VAV Box:
Supplemental Feer
$0.00
0
$0.00
Fire Dampers:
0 $0.00
Other
Gas Line:
0 $0.00
Metal Fireplace:
0 $0.00
Record Mgt Fee:
$0.00
Additional Fee:
$16.53
Investigation:
Model•Plan
Issuance:
Check:
$35.00
Manufacturer.
Zoning PC:
TOTAL: $148.53 Plan Check Fee: $0.00
Fee Due at Permit Issuance: $148.53
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR
Construction Hours: Monday - Frida}l:O�a.m.t2 eb pLAST i(AL1D INSPECTION
30m.and Satyvdey from 8:00 a.m. to 6:00 p.m.
.° °
$0.00
$0.00
$0.00
$0.00
$40.00
VNER-BUILDER DECLARATION
indicated below by the checkmark(s) I have placed next to the applicable item(s)
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the imprearove,
d
;coon 7031 .5, Business and Professions. Code: Any city or county that requires a permit to constmct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant or
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 t the Business and
, e permit
t 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
I more than five hundred dollars ($500). all of or Portions of the work, and the structure is not intended or offered for sale (Section 7044,
1, as owner of the property, or my employees with wages as their sole compensation, will do (_) U P
provemenisiness d Professions are not mended or offered for sale. State
License
the building oot imappprovement to a no snsoldfwithen one year of complet oln, the Owner Builder wi I havle the burden of proving ds or improves thet that itpwas not built orovided that r
proved for the purpose of sale).
Business and III
'ply to an owner as owner of the
property who builds exclusive
overs thereon. licensed Contractors to construct the project (Section 7044, and who contracts for the projects with a licensed contractor pursuant to he Cfontractors' State L censeessions Code: The rLaw)s' State License Law does not
not
s covere
I am exempt from licensure under the Contractors' State License Law for the following reason:
VII astructuresignature
below
l have built le an owner
-builder except
ldefor
f has not belen sidence in co strutted which tsl entirety by licensed must have �_eaid_ed oontractors� I understand that a copy of thelefion of happl cable aw,t5ection 7044tof the Businesshis permit, I nandlega
rofessions Cade, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm .
Date
ignature of Property Owner or Authorized Agent
ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 72000) of Division 3 of the Business and r fess Co and my license is in u force
is effect. Date
icense Class License No
VORKERS' COMPENSATION DECLARATION -UL AND SHALL SUBJECT AN
IOST OF COMPENSATION,FAILURE
TSE DAMAGES AS PROVIDED FOR iO SECTION
G IS THE W'A R CODE, INTEREST, AND ATTrORNEY'S FEES.
'MINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED TRODSAND,OOLLARS ($700,000), IN ADDITION TO T
CURE
hereby affirm under penalty of perjury one of the following declarations:
th
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
serf rmance of the work for which this permit is issued. Policy No.
have and will intain 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
surance carrier nd licy number Expiration Date
Carrier " hq a urpj�' Phone #
Name of Agent
gre
ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pro i11 cions.
❑I certify that, in the performanc of the wo ich this permit is issued, I shall not employ any person in any manner so as to become subject to She workers' compensation laws of California, an a
that, if I should becom s ject to he wo rs' P Daf€�
f A licant d (Section 3097 Civil Code).
nature o pp NDING AGENCY of the work for which this perms is issue
CLARATION REGA DING C the
lending agency forLender's
:reby affirm under penalty of perjury that re is a construction
Address
ider's Name
my signature below, I certify to each of the following:
the property owner's behalf.
ig�^
I am the property owner or authorized to act on
this application and the information I have provid d is correct.
► (vv_
1" 1
to buding construction
I have read
I agree to comply with all applicable city and county ordinan s and s laws elating
' i ropert for inspection
I authorize representatives of this city or county ter the ove
rint Property Owner's or Authorized Agent's Nam
nature of Pro a Owner or Authorized A ant
FOR OFFICE OS
DECLAPo4TLONOFCOMPUANCE T CODEOF E
DATE
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PERMIT CELL
❑ AQMD TO
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SIGNAJU1SE: •. •.
OCCUPANCYISSUED