The URL can be used to link to this page

Home My WebLink AboutH2018-0624 - PermitsCity of Newport Beach - Building Division III 1111111111111111111111111111111111111111111111 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 8 0 6 2 4 "Permit Counter Phone (949)644-3288 Job Address: 417 HOLMWOOD DR BIdg:1 Floor: Suite: Description of Work: MECH A/C UNITS (2) *TAMPER PROOF CAP REQ* Inspector Area:2 Code Edit: 2016 Legal Description: N TR 1136 LOT 31 FEES Owner: 417 HOLMWOOD LLC Contractor: SEPULVEDA BUILDERS INC Address: 353 1/2 REXFORD DR Address: 790 NEWTON WY BEVERLY HILLS CA 90212 Ventilation COSTA MESA CA 92627 Phone: Phone: 714-222-1150 Con State Lic: 695401 Issued Date:10/04/2018Lic Expire: 10/37/2018 Up to 3HP: Bus Lic: BT30058100 Processed By: ( Lic Exp Date: 02/28/2019 MECHANICAL Permit: H2O18-0624 Project No : 0757-2018 Inspection Requests Phone (949)644-3255 Worker's Comp Insurance - Carrier : NO EMPLOYEES Policy No: Expire : m ms um me3ep m a Damm c • b o mmmm-+ O C E •m609 ® �mmJL mmm m m E mamm¢m � a mm m """mee mmm0 00 G HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 0 $0.00 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: 2 $70.00 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: $0.00 Investigation: $0.00 Over 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $60.90 Up to 1 M BTU/hr: 0 $0.00 up to 10K CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: 4TTR4060LIssuance: $35.00 Up to 1.75M BTU/hr: 0 $0.00 Over 1 OK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: TRANE Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $40.00 TOTAL: $205.90 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $205.90 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. 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 appfj,Dable 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 dppNcant 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). ❑ 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, providedthatthe 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 ownegof thg 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 owRerroFproperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). 0 1 Im exempj fjgrn licensure under the Contractors' State License Law for the following reason: Lf'y m bsignatare 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 Bella structurelgatl 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 Pto.fp9sions Cock is available upon request when this application is submitted or at the following Web site:http:llwww.leginfo.ca.govlcalaw.html. Signature of PlDper[y Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affimb endar penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busines essions Code, and my license is in full force MIC 81fect. .:e. liemvse Class License No Date �� Contractor Signatu NPRISERS' CAMP.�€yNSATION DECLARATION NARNINCa: FAILURErIi Rq.URE 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 �. M05 COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTOR Y'S FEES. .h.LBby affirm.linder 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 Code, for the )erformance of the work for which this permit is issued. Policy No. :1I 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 nsurance carrier and policy number are: Tier Policy Number Expiration Date ne of Agent Phone # .Eartify that, in the pert mance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subjec//;� a workers' compensation laws of California, and agree t, l -should become bject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prov nature of Applicant Date7y//� CLARATION REG G CTION LENDING AGENCY :reby affirm under of perjury that there is a construction lending agency for the performance of the work for which this permit is issued ( ection 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 coun ordinances and state laws relating to building construction. I authorize representatives of this city or county t above -i tified property for inspection purposes. nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name ACTION DATE BY DECLARATION OF COMPLIANCEMTH CODE OF FOROFFICE USED Y FEDERAL REGULATIONS PART 61 OF TITLE40AND PERMITEXPIRED AQMD RULE 1403. ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: PERMITCANCELLED ❑ EPA PERMITEXTENDED ❑ AQMD PERMIT FINAL PROPOSED OLURCARONIS NOT APPLICABLE TO CERTFfCATE OF OCCUPAN"'ISSUED T SIGNATURE: