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H2019-0567 - Permits
., City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII ' 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 9 0 5 6 7 H 'y Permit Counter Phone(949)644-3288 �Y� Yt54T1'k� Job Address: 37 SOUTHAMPTON CT BIdg:1 Floor. Suite: Description of Work: MECH - RJR (1) A/C CONDENSOR & FAU. TAMPER-RESISTANT CAP & TIMER REQ'D InspectorArea:8 Code Edit: 2016 Legal Description: TR 10987 LOT 2 UNIT 134 OF PROJECT LOCATED ON AP 442-351-08 TOGETHER - Owner: GOODMAN RANDOLPH M Contractor: SERVICE CHAMPIONS HTG Address: 37 SOUTHAMPTON CT Address: 3150 E BIRCH NEWPORT BEACH CA 92660 BREA CA 92821 Phone: Phone: 714-777-7777 Con State Lic: 799170 Issued Date:09/19/2019 Lic Expire: 09/30/2019 Bathroom Fan: Bus Lic: BT01080106 Processed By: Lic Exp Date: 07/31/2020 MECHANICAL Permit: H2O19-0567 Project No: Inspection Requests Phone (949)644-3255 Worker's Comp Insurance - Carrier : PACIFIC COMP Policy No: WA00060705 Expire :03/22/2020 HVAC Items FEES - - FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr. 1 $20.00 Up to 3HP: 1 $20.00 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 Record Mgt Fee: $0.00 Up to 100K BTU/hr: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee : $17.40 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: MC14XCI-048-230 Issuance: $35.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: LENNOX Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $41.50 TOTAL: $133.90 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $133.90 PERMITS EXPIRE 980 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION cConstm°ctior, Nbtfrs: Monday - Friday 7:00 a.m.to 6:30 p.m.and Saturday from 8:00 a.m. to 6:00 p.m. ° ° G G G � o G G GC COG C G •O 4Y• O O OOi GQ � OG OGG OWNER -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 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 Business and 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). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L_) 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 improved 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 legally 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 SCe�}c'{i 700100 of Division 3 of the Business Rs Evde, a my license is in full force and LicenseCl G ` Contractor Signature License Class License No . Date WORKERS' COMPENSATION DECLARATION NARNING: 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 COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 9706 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 Section 3700 of the Labor Cade, for thi or nce of the work for which this permit is issued. Policy No. I ve 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 nce carrier and policy number are: comer Policy Number Expiration Date lame of Agent Phone # 71 certify that, in the performance oLJj4aiqvork f sued, I shall not employ any person in any manner so as to become subject to theES' compensation laws of California, and agree tat, if I should become subj ars' co Ion provisions of Se ZSO-ofAhe Labor Code, I shall forthwith comply with those provisions.//p/'� ignature of Applicant Date � / / `7 'ECLARATION REGARDING CONSTR N LENDING AGENCY. hereby affirm under pen Ity of that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Ender's Name Lender's Address y 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 pnGved is correct. I agree to comply with all applicable city and count laws relating to building construction. /] A / / I authorize representatives of this city or county to ant _ ection purposes. , J�- . - (•/� in _O _ ., /i1 , k ACTION DATE P€RMITEXP/RED PERMIT CANCELLED PERMIT EXTENDED PERMD'R IAL � s CERTIFICAT€OF OCCUPANCYISSOED BY AQMDRULE 9403. ISUBWTIEDASBESTOSNOIIFICATIONTO, ••• 0 EPA © AQMD ASBESTOS M017FICABQNIS NOT APPLICABLE TQ PROPOSEDDEMOLITION. SIGNATURE: