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Home My WebLink AboutH2019-0183 - PermitsCity of Newport Beach - Building Division IIII�IIIIIIIIIIIII�IIIIIIIIIIIII�IIIIIIIIIIIIII o" 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 9 0 1 8 3 Permit Counter Phone (949)644-3288 MECHANICAL Permit: H2O19-0183 Project No: 1347-2017 Inspection Requests Phone (949)644-3255 '... Job Address: 311 ANADE AVE BIdg:1 Floor: Suite: Description of Work: MECH/LINE FOR FUTURE CONDENSER Up to 3HP: Inspector Area:1 Code Edit: 2016 $19.00 Legal Description: EAST NEWPORT BLK A LOT 57 0 Owner: OLS VIN C Contractor: OWNER/BLDR Worker's Comp Insurance - Address: 3 ANADEAV Address: Carrier: EWPORT BEA FI CA 92661 Policy No: Phone: Phone: Expire Con State Lie: 0/B Exhaust Fan: Issued ate:03/29/2019 Lie Expire: $0.00 Bus Lie: 0 $0.00 Processe By: Lie Exp Date: 0 rnacesBoilers & Cohipressors Ventilation to 100K BTU/hr: $0.00 Up to 3HP: 1 $19.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $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 ill/Floor Heaters: 0 $0.00 >15 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: $0.00 ar 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 to 1M BTU/hr: 0 $0.00 up to 10K CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: Issuance: to 1.75M BTU/hr: 0 $0.00 Over 1OK CFM: 0 $0.00 Supplemental Fee: $10.00 Manufacturer: ar 1.75M BTU/hr. 0 $0.00 VAV Box: 0 $0.00 ° ° 04 O O Other ° Investigailob $0.00 Plan Check: $0.00 $0.00 Zoning PC: $0.00 TOTAL: $29.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $29.00 PERMITS EXPIRE 480 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7:00 a.m.to 6:30 p.m.and Saturday from 8:00 a.m. to 6:00 p.m. . I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031 .5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Bu$lness af�d 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). ❑ 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, 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 not 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). ❑ 1 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 legal) 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:http://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 tion 7000) of Division 3 of the Business and P fessions Code, and my license is in full force and effect.D License Class . License No Date '.2 �l Contractor Signatu WORKERS. WAPENSATION DECLARATION WARRING: FAIL .URE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPL VER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUS ARS ($100X00), IN ADDITION TO THE COStOF COMPENsA116N, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I h(Veby affir'm under penalty of perjury one of the following declarations: ® 4 -have and wD 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 parformanceb( th% Zork for which this permit is issued. Policy No. ❑I -have and will'm4intain 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 insurance cartiprand policy number are: Policy Number Date rte*+ that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and ould babgrn subject I the work ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pro ' I s. 4 of Applicant/ v ! i_� to '° I hereby affirm under Fenalty of perjury that is a c struction 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 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 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 oro enter the bo -identified property for inspection purposes. Signature of PropertyOwner or Authorized A u taPrint Property Owner's or Authorized Agent's Name._ > e€u! AJ LS Iv IS, BATE By DECLARATION OF COMPUA CEiMTNCODEOF FOROFFICEUSEONLY ACTION FEDERAL REGULATIONSPART01 OFTITLE40AND AQMORULE 1403. I SUBMITTEDASBESTOS W17FICATION TOr ❑ EPA ❑ AQMD PERMfTFXPfRFB PERMiTCANCELLED PERMITEXTENDED ❑ ASBESTOS NOURCATIONIS NOT APPLICABLE TO PROPOSED DEMOLITION SIGNATURE: PFRMIT FINAL — CERTtFICATE OF OCCUPANCYISSUED