HomeMy WebLinkAboutH2019-0488 - Permits>Dr City of Newport Beach -Building Division IIII�IIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIII
100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 9 0 4 8 8
} Permit Counter Phone (949)644-3288
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Job Address: 27 SEA ISLAND DR Bldg:1 Floor: Suite:
Description of Work: MECH NEW A/C UNIT ON THE GROUND *TAMPER PROOF CAP REQ*
Inspector Area:4 Code Edit: 2016
Legal Description: TR 8444 LOT 1 UNIT 27 OF PROJECT LOCATED ON AP 442-251-01
TOGETHER
Owner: FINCHER BENJAMIN
Contractor:
ABC HEATING AND A/C
Address: 27 SEA ISLAND
Address:
306 COLLEN PL
NEWPORT BEACH, CA 92660
COSTA MESA CA 92627
Phone:
Phone:
949-756-0064
°°
Con State Lic:
940181
Issued Date:08/08/2019
Lic Expire:
11/30/2019
Bus Lic:
BT30043258
Processed By: 1
Lic Exp Date:
03/31/2020
MECHANICAL Permit: H2O19-0488
Project No :
Inspection Requests Phone (949)644-3255
HVAC Items
INS
ECeT®..°°
FEES
Worker's Comp Insurance-
°°
o °
Carrier: NORGUARD
°
eo n
Policy No:NAWC961991
Expire :09/24/2019
Up to 100K BTU/hr:
0
°. .
Up to 3HP:
1
$19.00
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
. °
. .
$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
HVAC Items
FEES
FurnacesBoilers & Compressors
Ventilation
Other
Up to 100K BTU/hr:
0
$0.00
Up to 3HP:
1
$19.00
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 :
$0.00
Investigation:
$0.00
Over 500K BTU/hr:
0
$0.00
Air Handling Units
Comm. Hood:
0 $0.00
Plan Check:
$16.53
Up to 1M BTU/hr:
0
$0.00
up to IOK CFM:
0
$0.00
Repair/Alter/Add:
0 $0.00
Model:
RA1442WIssuance:
$35.00
Up to 1.75M BTU/hr:
0
$0.00
Over 10K CFM:
0
$0.00
Supplemental Fee:
$0.00
Manufacturer:
RHEEM
Over 1.75M BTU/hr.
0
$0.00
VAV Box:
0
$0.00
Zoning PC:
$40.00
TOTAL:
$110.53
Plan Check Fee
: $0.00
Fee Due at Permit Issuance :
$110.53
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.
DINNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) 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 :qa 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 U all of or U 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 licensed Contractor pursuant to the Contractors' State License Law).
❑ 1 am exempt f(prp jicensure under the Contractors' State License Law for the following reason:
By my signatur0b ll o w Facknowledge 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 stmcture 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
• {ess.•.•
drolans Code' jSlVilable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signatil of Propert90wner or Authorized Agent Date
CIOi CONRRACTOR'S DECLARATION
I herebyy affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing wit Section 7000) of Division 3 of the Business and f rofes ns Code, and my license is in full force
and.effect. ....�
Cicen%t Class License No Date K Contractor Signature
VdAlkERS' CQ141P,eNSATION DECLARATION
WARNING: FAILURE TQ SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($'100,0001, IN ADDITION TO THE
6(99r-OFCOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
Fherebpaffirm arulei penalty of perjury one of the following declarations:
®1We and 411 mejntain 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 th
pdrMMlance of4h o* 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' compensatiol
(,,have
nce carrier and policy number are:
Carrier Policy Number Expiration Date
ie of Agent _
certify that, in the p(
, if 1 should become
iature of Applicant
Ice of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to he workers' compensation laws of California, and agre
to the workers' co ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prove i ns.
Dafe —�^ f-1
:ONSTRUCTION LENDING AGENCY
hereby affirm under penalty ofy rjury that there is a construction lending agency for the performance of the work for which this permit is issue (Section 3097, Civil Code).
.ender's Name / Lender's Address
ly 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 tb e t t e above -identified property for inspection purposes.
signature of Property Owner or Authorized A ent Print Property Owners or Authorized Agent's Name N SAM A 1 I Date
ACTION DATE / BY DEC ARATIONOFCOMPUA CEWITHCODEOF FOR OFFICEUSEDNLY/
11 FEDERAL REGULATIONS PART k? OF TIJLE40AND
AQMD RULE 1403.
❑ I SUBMITTED ASBESTOS NOTIFICATION TO:.
❑ EPA
El AQMD
❑ ASBESTOS NOTfFICATIONIS NOT APPLICABLE TO
PROPOSED DEMOLITION
OCCUPANCYISSUED I 1 11 SIGNATURE: