HomeMy WebLinkAboutH2019-0146 - Permits1 - City of Newport Beach - Building Division IIIIuIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII MECHANICAL Permit: H2O19-0146
.100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 9 0 1 4 6 Project No:
rte, Permit Counter Phone (949)644-3288
v� Gr
Inspection Requests Phone (949)644-3255
L}PYYLk�
Jab Address: 1717 MIRAMAR DR BIdg:1 Floor:
Suite:
Description of Work: MECH INSTL (3) A/C UNITS @ THE SIDE YARD "TAMPER RESISTANT CAP REQ"FUJITSU AOU36RLXFZ1, AOU9RL2XF4
_ . , 7-,s
SUB-CONTR AGREEMENT ATTACHED
FurnacesBoilers & Compressors
Inspector Area:1 Code Edit: 2016
Fa
Legal Description: N TR 518BLK H LOT 28
Other
Up to 100K BTU/hr:
,
$0.00
Owner: SANJEET NIJJAR
Contractor:
URBAN -CA INC
Worker's Comp Insurance -
0 $0.00
•
0 $0.00
$0.00
Over 100K BTU/hr:
0
$0.00
Address: ' 4900 SANTA ANITA AVE
Address:
PO BOX 10818
Carrier: STATE FUND
0 $0.00
' °
EL MONTE CA 91734
NEWPORT BEACH CA 92658
Policy No: 9203854
0
$0.00
Phone:
Phone:
6§37-900-2150
Expire :01/2812020
0 $0.00
Metal Fireplace:
0 $0.00
Con State Lic:
1 7845•"
Heat Pumps & Package
°
>30 HP to 50 HP
0
$0.00
Down -Draft Fan:
0 $0.00
Record Mgt Fee:
$0.00
Issued Date:03itS 2
Lic Expire:
09/30/2020
0
$0.00='
0
Bus Lic:
BT30066196
0 $0.00
Additional Fee:
e..em
.... ® °
Processed
Exp Date:
02/29/2020°
0
omeeme
°
mmom
o °
memdm°
HVAC Items
FEES
FurnacesBoilers & Compressors
Ventilation
Other
Up to 100K BTU/hr:
0
$0.00
Up to 3HP:
3
$57.00
Bathroom Fan:
0 $0.00
Fire Dampers:
0 $0.00
$0.00
Over 100K BTU/hr:
0
$0.00
> 3 HP to 15 HP:
0
$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 100K BTU/hr:
0
$0.00='
>j60'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:
$49.59
Up to 1M BTU/hr:
0
$0.00
up to 10K CFM:
0
$0.00
Repair/Alter/Add:
0 $0.00
Model:
AOU24RLXFZlssuance:
$35.00
Up to 1.75M BTU/hr:
0
$0.00
Over 1 O CFM:
0
$0.00
Supplemental Fee:
$0.00
Manufacturer:
FUJITSU
Over 1.75M BTU/hr:
0
$0.00
VAV Box:
0
$0.00
Zoning PC:
$40.00 '
TOTAL: $181.59
Plan Check Fee:
$0.00
Fee Due at
Permit Issuance :
$181.59
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.
OWNER -BUILDER DECLARATION
1 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)
(Section 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
the 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 a'nd
Professions 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
not more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business 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
improvements 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
im 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 ^st
apply 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).
.
11I am exempt from••. licensure under the Contractors' State License Law for the following reason:
By my Signature oelow 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 legall,
tdlPErSt(uctufe Dia( 11`14ve 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
PI;ofes:ions Coda, i9 available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
Signature of Property Owner or Authorized Agent Date
LIC12ASED CONTRACTOR'S DECLARATION
66e7edy affirm ISMdef Hrialty of perjury that I am licensed under provisions of Chapter 9 (commencing wi Secti�sion 3 of the Business d P. ofessions bde, and my license is in full force
Ind Offect.
kitenseC lass • • License No Date Contractor Sign at e
�RKERS' COpIIPENSATION DECLARATION
I1AlFAILURE TO SECf�RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SD&IECT AN EMPL YER TO CRIMINAL PENALTIES AND CIVIL FINES UP T ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
`OST OFyOMPENSNTJQN• IjAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
J"(%114affirm under pdnalty of perjury one of the following declarations:
1 treve and wil.y m� Mtain 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
Derttheormance of work for which this permit is issued. Policy No.
have 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
nsurance carrier and policy number are:
-arrier Policy Number Expiration Date
Vame of Agent Phone #
:1I certify that, in the perf rmance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to a workers' compensation laws of California, and agre
:hat, if I should become s bj t the worke ' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provis' ns.
Signature of Applicant Date TM -s -s t4i
DECLARATION REGAiRDINGC NSTRUC N LENMG AGENCY
hereby affirm undernalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued 4ection 3097, Civil Code).
-ender's Name t Lender's Address
3y my signature belo4v, 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 ordinances and state laws relating to building construction.
I authorize representatives of this city or cou y en th/n�bove-identified property for inspection purposes. /1 • ' �n
signature of Property Owner or Authorized Age I'Y! i �/ Print Property Owner's or Authorized Agent's Name `r�
ACT70N DATE t RY
DECLARATION OF COMPLIANCEIMTN CODE OF
FOR OFFfIQE USED Y
FEDERAL REGULATIONS PART 61 OFTITLE40AND
AQMDRULE7403.
'PERA4ITEXPIRD
❑ I SUSMITFEDASBESTOS N077FICATION T0:
❑ EPA
❑ AQMD
[3 ASBESTOS
P OPOSEDDEMOLITION.RONIS NOTAPPLICABLE TO
PERMITCANCELLED
'.PERA41TEXTENDED
'.PERMITFINAL �J—r-i—(� /�-/4�
CERTIFICATE OF
SIGNATURE:
'..00CUPANCYISSUED
Z
O
Q
N
Cc
O
2
Q
W
O
cc
I
r
co
cm
N
Q
U
L
N
00
0
CL
N
z
CISE
C
T
,T^
VJ
W
CE
Q
U
W
O
cc
a
L
�ui
o �
U 00
L T
O
T
U 4t
i N
V1
E i
CL U
c �
o
.0
d U
�Q
�U
0
o m
ami .o
N
O O
co U
N co
. CD
O 0
E 3
ro m
= Z
C O
c
QU
r�
:•E
U
•i
0
O
0
U
a
C
Cli
ao
U
0-5
R
=O G
�U
t '�
a)r
w O
Ja'
'6 y
' N
�3
O.L..
co
o- v
c
O c
n
lV
w L
a
a °a
� Y U
r 3a
Im
wo
n
N r- O
O O U
N — N
O a)
EJ�
a3
0CoCo
n
U) m
0
.0 d O
���
� c
O E
DoE
LL o .
oL=a
uj
IL ca Ei
0
� a7
fn CL
I
I
!I
I
I
I
C L
I, rn
0
I
I
�
�1
r
c
Y
�
0
I
7
oO
IL
R
N
W
I
z
a¢II
aI
$tea
it
I
i
V
a
t
I
�
o
I
dpl
C � cc
^Lr
II
I
a3 ca
1A
N L
O
C6
E
N
a�
I
d
of
Eco
F w
L L I
Y =�
x
O
E
F G
F
Z
O V N
L N
LU
7 Q
OU'
MW
W m "t
W
C
FM
Azo°
W
.G
`o
(
N
Z on
'
N
Q
N
aa5�m
�
a
m
A
OC7�0
O
vo
V LU
cwo
�am�
�W
W
F-1
a
0
N
Z
7
c
17'I O
> _
0
U 7
zU)
Z
m
a) a)
cn
w o
0
2Om
U
U
o >
=
cL:E
U G
o
Ea)0
w T
H
C�
E2 C
0�
a
m a
'fit
M
�m
o
E
L
3
O
ILI
O ;0 N U
a
0
0-5
R
=O G
�U
t '�
a)r
w O
Ja'
'6 y
' N
�3
O.L..
co
o- v
c
O c
n
lV
w L
a
a °a
� Y U
r 3a
Im
wo
n
N r- O
O O U
N — N
O a)
EJ�
a3
0CoCo
n
U) m
0
.0 d O
���
� c
O E
DoE
LL o .
oL=a
uj
IL ca Ei
0
� a7
fn CL
I
I
!I
I
I
I
I, rn
0
I
I
�
�1
r
c
Y
�
0
I
7
LL
0
o
IL
R
N
W
I
z
a¢II
aI
d
i
it
I
i
V
t
I
�
o
I
dpl
7
^Lr
II
I
IWn
4
C6
E
N
a�
I
d
of
NI
n�i
0-5
R
=O G
�U
t '�
a)r
w O
Ja'
'6 y
' N
�3
O.L..
co
o- v
c
O c
n
lV
w L
a
a °a
� Y U
r 3a
Im
wo
n
N r- O
O O U
N — N
O a)
EJ�
a3
0CoCo
n
U) m
0
.0 d O
���
� c
O E
DoE
LL o .
oL=a
uj
IL ca Ei
0
� a7
fn CL
I
I
!I
I
I
I
I
Y
�
0
I
I
LL
0
o
IL
R
N
W
I
I
�
I
i
I
I
^Lr
II