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Home My WebLink AboutH2019-0194 - PermitsCity of Newport Beach- Building Division 1111111111111111111111111111111111111111111111111 r- d± 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 9 0 1 9 4 r. s Permit Counter Phone (949)644-3288 Job Address: 20052 CYPRESS ST BIdg:1 Floor: Suite: Description of Work: MECH A/C UNITS (2) ON GROUND *TAMPER PROOF CAP REQ* InspectorArea:8 Code Edit: 2016 Legal Description: TR 706 LOT 180 NELY1/2 Owner: WEBBER MATT Contractor: RL CONSTRUCTION Address: 20052 CYPRESS ST Address: 719 E BUFFALO AV NEWPORT BEACH, CA 92660 Ventilation SANTA ANA CA 92706 Phone: 949-793-1653 Phone: 949-395-4841 Carrier: STATE FUND Con State Lie: 558404 Issued Date:04/05/2019 Lie Expire: 0713112019 Expire :06/01/2019 Bus Lie: BT30062694 Processed By: Lie Exp Date: 03/31/2020 MECHANICAL Permit: H2O19-0194 Project No : 0991-2018 Inspection Requests Phone (949)644-3255 HVAC Items FEES •••• i .m •�em oo FurnacesBoilers & Compressors Ventilation Worker's Comp Insurance - Carrier: STATE FUND •••• Other Policy No: 1696615 .... m Expire :06/01/2019 Up to 3HP: 2 $38.00 o c mm� c eoeoo o Fire Dampers: 0 $0.00 eemco $0.00 ° • omaoco $0.00 moeeom 0 m m e m a $0.00 m om omeeco m Gas Line: 0 o m Doom ommoo HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 0 $0.00 Up to 3HP: 2 $38.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 $0.00 Over 1o0K 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 1OOK 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: $33.06 Up to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: 4AC16L36PIssuance: $35.00 Up to 1.75M BTU/hr. 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: AIC PRO Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $40.00 TOTAL: $146.06 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $146.06 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. /NER-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 applicablePm(s) ction 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 applicantfdr 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 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). 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) 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). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business andProfessionsCode: The Contractors' State License Law does not ,ly to an owAl BPproperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I Sin exempt Trom licensure under the Contractors' State License Law for the following reason: ";;IgnatuTEOQow 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 a structure thst,l•Mave 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 feliions Coda, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. i?Aure of PrgpEay Owner or Authorized Agent Date :EP{SED CQU.TfMCTOR'S DECLARATION :Feby affirmnVer penalty of perjury that I am licensed under provisions of Chapter 9 (commencing wit action 7000) of Division 3 of the Business nd Professions Cod d IV I in full force effect. ,nsg Class • • LS License No .0 P 50110 y Date Li�S" / Contractor Signal re // )Ri6ERS' C0*MPENSATION DECLARATION ININ(i FAILUFIRd4)6FBURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPL ER TO CRIMINAL PENALTIES AND CIVIL FINES UP T ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE �T OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3703 OF THE LABOR CODE, INTEREST, AND ATTOR V'SFEES. *ebyaffirm under penalty of perjury one of the following declarations: I have and 011 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 th( 'ormance of the 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' compensatior hence carrier and policy number are: Policy Number Date ne of Agent Fnone s certify that, in the perfo ante of the work for ich thi per is ' ued, I shall not employ any person in any manner so as to become subject to t e workers' compensation laws of California, and agre( I, if I should become s ject to a workers' a at! sof Section 3700 of the Labor Code, i shall forthwith comply with those provisi s. nature of Applicant Date L CLARATION REGA DIN CONSTRU TION LENDING AGEN :reby affirm under p natty of perjury that there is a construction lending agency for the performance of the work for which this permit is issuedv action 3097, Civil Code). Ider's Name Lender's Address my signature below, I certify to each of the following: I am the property owner or authorized to act on the roperty owner's behalf. I have read this application and the information I h e provided is come t. I agree to comply with all applicable city and cou y ordinances and a s to building construction. I authorize representatives of this city or county a abo - fie r for inspection purposes. // /,,, nature of Prooertv Owner or Authorized ADent Print Property Owner's or Authorized Agent's NameLCl�(/i-�✓V�� ate AC77ON DATE BY tjLLLAl rrvm ur L uiwvuAmur xW l m L.vc ur / FEDERAL REGULATIONS PART 61 OF T17LE40AND AQMORULE1403. PERMITEXPIR€D ❑ 1 SUBMfTrEDASBESTOS NODFfCATION TO. PERMITCANCELLED ❑ EPA ❑ AQMD PERMIT EXTENDED ❑ ASBESTOS NORRICATIONIS NOT APPLICABLE TO PERMITFINAL . PROPOSED DEMOLITION OCCUPANCYISSUED SIGNATURE.