HomeMy WebLinkAboutH2019-0081 - Permits1 City of Newport Beach - Building Division
MECHANICAL Permit: H2019 -0081i
100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 9
0 0 8 1.
Project No: 1273-2016
. H q Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Job Address: 187 SHORECLIFF RD Bldg:1 Floor: Suite:
Description of Work: MECH/INSTALL (3) A/C UNITS 51 db*, 55.5dB* & 50cIB (DAIKIN; RX=XTQ36TAVJU, RXTQ48TAVJU) *TIMER REQUIRED ON EQUIPMENT TO
SH TOFF
BETWEEN IOPM & 7AM
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HVAC CONSENT ATTACHED TO PERMIT
-
InspectorArea:5 Code Edit: 2016
Legal Description: N TR 1116 LOT 102
Owner: PERKINS KEN Contractor: BRYCE HEATING & AIC
Worker's Comp Insurance -
Address: 416 POPPY ST Address: 2122 NO QUINCE AVE
Carrier: HARTFORD INS CO.
CORONA DEL MAR CA 92625 RIALTO CA 92377
Phone: Phone: 949-929-1741
Policy No; 72WECABI FHU,
Expire :02/07/2020
Con State Lie: 669545
„ _F
Issued Date:02/13/2019 Lie Expire: 05/31/2019"
Bus Lie: BT30065119
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Processed By:- rl' Lie Exp Date: 11/30/2019
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HVAC Items FEES
FurnacesBoilers& Compressors Ventilation
Other
Up to 1OOK 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 1 OOK 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: ,
$49.59
Up to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add
0 $0.00
Model: Issuance: $35.00
Up to 1.75M BTU/hr. 0 $0.00 '' Over 1OK CFM; 0 $0.00 Supplemental Fee:
$0.00
Manufacturer.
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 : $181.59
PERMITS EXPIRE 1$b„D.4Y1&AFT1f1J:SSUANCE OR LAST VALID INSPECTION _
Construction Hours: Monday - Friday 7c00 a.mKo SNO
p.r8.r11u 2aturday from 8:00 a.m. to 6:00 p.m.
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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)
(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 issuusvXQ ,31,=,o 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 and
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 (_) all of or U 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
improved 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 no'
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).
IJ I am exempt from licensure under the Contractors' State License Law for the following reason:
By, 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
sell 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
Professions Code, is available upon request when this application is submitted or at the following Web site:hltp://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business a4Pres de, a y license is in full force
License
censeffect.Cl ( Contractor Signature
License Class License No Date
WORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAN OLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I 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 thi
pLefmance of the work for which this permit is issued. Policy No.
have andv II aintain 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
nsurance carrie nepolicy numb el, e:
Carrier P Cy umber Expiration Date
Name of Agent Phone #
❑1 certify that, in the performanceVe/work f which t ' ennit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree
khat, if I should become subject to c mpen f n provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those provlsl S. C
Signature of Applicant Date
DECLARATION REGARD—MG ST CTION LE.NING AGENCY
hereby affirm under penalty of perjury that there'onstruction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Name Lender's Address
By'>n�,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 haveWanctato
rect.
I agree to comply with all applicable city and county o la relating to building construction.
I authorize representatives of this city or coun en tif' roperty for inspection purposes. ✓
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name
ACTION DATE BY DECLARATION OF COMPLIANCE MTH CODEOF FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61' OF TTILE40AND
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