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HomeMy WebLinkAboutH2019-0032 - Permits�wrv� City of Newport Beach - Building Division �IIIIIIIIII�IIII�IIIIIIIIIII�IIIIIIII fl 100 Civic Center Drive, NewportBeach, CA 92660 H 2 0 1 9 0 0 3 2 Permit Counter Phone (949)644-3288 Job Address: 2021 SANTIAGO DR BIdg:1 Floor: Suite: Description of Work: MECH - (3) A/C CONDENSORS ON ROOF. *TAMPER-RESISTANT CAPS REQUIRED Inspector Area:3 Code Edit: 2016 Legal Description: N TR 3801 LOT 23 Owner: SAMORAADOLFO Contractor: Address: 8124 W 3RD ST Address: LOS ANGELES CA 90048 Phone: 818-445-5153 Phone: Con State Lic: Issued Date:01/14/2019 Lic Expire: Ventilation Bus Lic: Processed By: Lic Exp Date: AMPLE CONSTRUCTION 3857 BURCH ST #333 NEWPORT BEACH, CA 92660 714-454-4305 957060 MECHANICAL Permit: H2O19-0032 Project No : 1269-2017 Inspection Requests Phone (949)644-3255 Worker's Comp Insurance - Carrier : BENCHMARK INS CO Policy No: CST5014680 Expire :12115/2019 01/31/2019 BT30067810 S 1113012019. IT r HVAC Items .... FEES Fyfrildc°esBoilero3dam pressors Ventilation Other Up1d `It)(JK BTU/hr:o $0.00 Up to 3HP: 3 $57.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 $0.00 0.0 Otero106K BTUNr': .0 $0.00 > 3 HP to 15 HP: 0 $0.00 Exhaust Fan: 0 $0.00 Gas Line: 0 $0.00 $0.00 Wtitft-16dr Heaters.: 0 $0.00 >15 HP to 30 HP: 0 $0.00 Attic Fan: 0 $0.00 Metal Fireplace: 0 $0.00 HEdt`Pdmps & Paci age Units >30 HP to 50 HP 0 $0.00 Down -Draft Fan: 0 $0.00 Record Mgt Fee: $0.00 Udto`'Yl)OK BTU/hr-: � 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee: $0.00 Investigation: $0.00 O*r65bW( BTUohr: 3 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $49.59 0o Up to I M BTU/hr:, Q $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: YCS60B21SIssuance: $35.00 Ulftobf.%5M BTU/ha: 0 $0.00 Over IOK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: YORK Ovef 1.7`5M 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. 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(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 ie 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 'rofessions 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 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 U portions of the work, and the structure is not intended or offered for sale (Section 7044, Wsiness 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 nprovements 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 nproved 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 pply 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: ly 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) ell 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 'rofessions Code, is 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 .ICENSED CONTRACTOR'S DECLARATION 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 and Professions Code, and my license is in full force effect. !c icense Class License No Date "/ I I� Contractor Signat� VORKERS' COMPENSATION DECLARATION 'pRNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3703 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 7 I 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 the a Nrmance of the work 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 O=d ts' carrier and policy number are: - Policy Number Date , •,sono R1€ of Agent Phone # • ° ° •000 I certify 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 o{California, gr{fl°ygel t, if I should become subject to the work c ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. •; 1 P P PY P I „s, •,eouo nature of ApplicDat I • • o CLARATION R G NGC RUCTION LENDING AGENCY I I , , • ° areby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 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 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 or county to enter the\ abov .identified property for inspection purposes. 1 nature of Prooertv Owner or Authorized ADent I �w Print Prooertv Owner's or Authorized Agent's Name N sc,I I�;�f-'0—��'ld�1L.AWDate ACTION DATE BY UCULPIal I IVR Vr wAOrurlvs crrr rn wuc VV fUn urrnc vat uivr.r FEDERAL REGULATIONS PART 61 OF TITLE 40AND AOMDRULE 1403. PERMITECPIRED f SUBWTTEDASBESTOS NOIIFICATION TO © EPA ❑ AQND PERMITCANCELLED PERMITEXTENDED P©ASBESTOS ROPOSEDDENOLIT RON15 NOT APPLICABLE TO PERMITFINAL ry. ( CERTIRMEOf SIGNATURE: OCCUPANCYISSUED