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Home My WebLink AboutH2019-0237 - Permits� pQ City of Newport Beach - Buiddipg Qlvikianm°�III�IiIINIIiIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII MECHANICAL Permit: H2O19-0237 s 100 Civic Center Drive, Newport Beach, CA H266C e o < W200 e0 1 9 0 2 3 7 Permit Counter Phone (949)644-3288 ° • • • ° • • • • o Project ey a oee o Inspection Requests Phone (949)644-3255 KtaF'aY. o e ° e m m o a e %.•o • c ° `� o a oeb o e e ec • • e o • Job Address: 5 ADRIANA BIdg:1 Floor: Suite: Description of Work: MECH -A/C CONDENSOR & FAU *TAMPER-RESISTANT CAP REQUIRED* Inspector Area:6 Code Edit: 2016 Legal Description: Owner: PAVONY BILL Contractor: Address: 5 ADRIANA Address: NEWPORT COAST CA 92657 FEES Phone: Phone: Con State Lie: Issued Date:04/25/2019 Lie Expire: Ventilation Bus Lie: Processed By: Lie Exp Date: BOARDWALK HEATING AND AIR 27271 PRINCIPE ST MISSION VIEJO CA 92692 562-841-7089 1029478 07/31/2019 BT30067062 04/30/2020 Worker's Comp Insurance - Carrier: EXEMPT Policy No: Expire HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 1 $19.00 Up to 3HP: 0 $0.00 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 Re rd Mgt Fee: $0.00 Up to 100K BTU/hr: 1 $19.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 - =ditional Fee < $16.53 Investigation: $0.00 - Over 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $0.00 Up to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model 4A7A606AB1Issuance: $35.00 Up to 1.75M BTU/hr: 0 $0.00 Over 1 O CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: AM STANDARD Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $40.00 TOTAL: $129.53 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $129.53 PERMITS EXPIRE 980 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Cgp�tKurt(pgga and - F-r_ifJay 7:00 a.m.to 6:30 p.m.and Saturday from 8:00 a.m, to 6:00 p.m: REQUIRED E0F1 A/C DISCC7NNE-C-TO )WNER-BUILDER DECLARATION • •� ." .' I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for theI indicateal belc$M by thl 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, dentolish,•or reptair ab7structure, prior to its issuance, also requires the applicant for is 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 vigiation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of of more than five hundred dollars ($500). • • • • • . 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or:(, porilons of the work, anal & Itr*utre is not intended or offered for sale (Section 7044, lusiness and Professions Code: The Contractors' State License Law does not apply to an owner of propertylnho� Eough'ep$igy@Js' 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 n roved 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 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). 7 I 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 legally 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.ht 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 Pr Sions Code nd my is nse is in full force nd effect. cense Class License No Date `^ _' Contractor Signatu rV IIORKERS' COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMP OYER TO CRIMINAL PENALTIES AND CIVIL FINES UTO ONP� E HUNDRED THOUSAND OOLLA (57 ,OODI, IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 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 3700 oftDb Labor Code, for th performance of the work for which this permit is issued. Policy No. I 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' compensatio insurance carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # I rti that, in the pe ich thi rmit a I not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agreat, �thework ' should become subjec s of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. -' Signature of Applicant Date DECLARATION RE ONSTRUCT ON LE G AGENCY I hereby affirm under pen k of perjury that there is a cons tion lending agency for the performance of the work for which this permit is issued (Se ion 3097, Civil Code). Lender's Name Lender's Address By my signature below, I certify to each_o wing: I am the property owner or authorized to act on the prope y owner's behalf. I have read this application and the infauggLation I have provided is correct. I agree to comply with all applicable city an�ordinanceate s relati g tobuilding construction. I authorize representatives of this city or cou'e o y for inspection purposes.L/7 Signature of Propert Owner or Authorized APrint Property Owner's or Authorized Agent's N Date !!�J L ACTION DATE BY 'OLULARATION OF COMPLIANCEiMTR CODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40AND AQMDRULE 1403. P€RMITEXPIRED ❑ I SU6MITFEDAS13ESTOS NOTIFICATION TO. PERMITCANCELL€D ❑ EPA ❑ AQMD P€RMIT€XT€NDED ❑ ASBESTOS M07IFTCA170MIS NOT APPLICABLE TO PERNUTFINAL PROPOSEDDEMOLITION. CERTFiCAT€OF - OCCDPANCYISSOED SIGNATURE: