HomeMy WebLinkAboutH2019-0469 - PermitsI City of Newport Beach - Building Division III IIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIII
100 Civic Center Drive, Newpo,:, Beach --,-CA 92660 H 2 0 1 9 0 4 6 9
;x Permit Counter Phone (949)644-3288
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Job Address: 11 CAPE DANBURY BldgAFloor: Suite:
Description of Work: MECH/FAU (2) & A/C C/O (2) "TAMPER RESISTANT CAP REQ"
InspectorArea:3 Code Edit 2016
Legal Description: N TR 15012 LOT 89
Owner: MCKAY KENNETH L KEN Contractor:
Address: 11 CAPE DANBURY Address:
NEWPOK BEACH, CA 92660
Phone:
Issued
Phone:
Con State Lic:
Lic Expire:
Bus Lic:
Lic Exp Date:
ALISO AIR INC
29736 AVE DE LAS BANDERAS
RSM CA 92688
949-589-2021
526420
03/31/2020
BT30019236
02/28/2020
MECHANICAL Permit: H2O19-0469
Project No :
Inspection Requests Phone (949)644-3255
moms
Worker's Comp Insurance - ° m
Carrier: LIBERTY MUTUAL
Policy No: WC2Z61036218096 ° ° °
Expire :07/01/2020 SUBJECT TO FIELDINW(;TOR'SS'
REVIEW AND APPROVAL
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'AC Items V
FEES
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rnacesBoilers & Compressors
Ventilation
Other
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to 100K BTU/hr:
2 $38.00
Up to 3HP:
2 $38.00
Bathroom Fan:
0 $0.00
Fire Dampers:
0
$0.00
$0.00
er 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
ill/Floor Heaters:
0 $0.00
>16 HP to 30 HP:
0 $0.00
Attic Fan:
0 $0.00
Metal Fireplace:
0
$0.00
at Pumps & Package
Units
>30 HP to 50 HP
0 $0.00
Down -Draft Fan:
0 $0.00
Record Mgt Fee:
$0.00
to 100K BTU/hr:
0 $0.00
>50 HP:
0 $0.00
Residential Hood:
0 $0.00
Additional Fee:
$33.06
Investigation:
$0.00
or 500K BTU/hr:
0 $0.00
Air Handling Units
Comm. Hood:
0 $0.00
Plan Check:
$0.00
to 1M BTU/hr:
0 $0.00
up to 1 O CFM:
0 $0.00
Repair/Alter/Add:
0 $0.00
Model:
24APB6-048/042
Issuance:
$35.00
to 1.75M BTU/hr:
0 $0.00
Over 1OK CFM:
0 $0.00
Supplemental Fee:
$0.00
Manufacturer:
CARRIER
or 1.75M BTU/hr:
0 $0.00
VAV Box:
0 $0.00
Zoning PC:
$40.00
TOTAL: $184.06 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $184.06
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.
i1NER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(a) I have placed next to the applicable item(s)
action 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
permit to file 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
,fessions 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
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,
iiness 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
)rovements 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
(roved for the purpose of sale).
1, as owner of the property, ann exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
)ly to an owner of propertywho 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:
my signature below Iacknowledge 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
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
�fessions Ctftlu available upon request when this application is submitted or at the following Web site:http://wm.leginfo.ca.gov/calaw.html.
nature of Rrepefty Owner or Authorized Agent Date
;nNSED GONTf ACTOR'S DECLARATION
Irdby affirLunder penalty of perjury that I am licensed under provisions of Chapter 9 (comm ting with Secti 000) of Division 3 of the Busine s and Professions „a license is in full force
leffect.
;psre Class License No ate" Contractor ig ure
)RKERS'-QQM�ENSATION DECLARATION
WG: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ON RED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
IT OF COMPE 1SAT60NPDAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
reby affirm under penalty of perjury one of the following declarations:
(gave and yill 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 IN
"nce ohtlne 1NUge for which this permit is issued. Policy No.
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'
cerria ppd policy number are:
to of Agent
certify that, in the p
. if I should become
for
Policy Number
Date
any person in any manner so as to become sulilect to the workers' compensation laws of California, and
Labor Code, I shall forthwith comply with th rovisions.
n re �'/ /2 If 41
CLARATION`KEGAIDING CTION LENDING AGENCY
rreby affirm under pen Ity of perjury that there is a construction lending agency for the performance of the work for which this permit is
Ider's Name Lender's Address
my signature below, I certify to each of the following:
I am the property owner or authorized to acj. on the property owner's behalf.
I have read this application and the inf ation f have provided is correct.
I agree to comply with all applicable and count IR a aws relating to building construction.
I authorize representatives of thi Ity or the above -identified property for inspection purposes. (\��
nature of Property Owner or Aut rized Ager Print Property Owner's or Authorized P.geflt
ACTION I DATE I BY 11 DECLARATION OF COMPLIANCE WITH CODE OF
PERMITEXPIRED
0 I SUSMITFEDASDESTOS NOTIFICATION TO:
0 EPA
0 AOMD
PERMITTCAIYCELLED
PERMITEXTENDED
0 ASUESTOSM017FICAIJONIS NOTAPPLICABLETO
PROPOSEDDEMOLIT/ON.
PERMITFINAL . a(
CERTIFiCAT€O€
SIGNATURE:
OCCUPANCYISSUED
(Section 3097, Civil Code).