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Home My WebLink AboutH2018-0731 - PermitsCity of Newport Beach - Building Division 11111111111111111111 IN 1111111111111 P 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 8 0 7 3 1 Permit Counter Phone (949)644-3288 4X �ytirn#fie. Job Address: 20141 BAY VIEW AVE BIdg:1 Floor: Suite: Description of Work: MECH -A/C CONDENSOR *TAMPER-RESISTANT CAP REQUIRED* Inspector Area:8 Code Edit : 2016 $0.00 Legal Description: N TR 1507 LOT 7 FEES $0.00 Owner: CROCKETT GARY W & SYLVIE Contractor: N I V CONSTRUCTION Address: 20141 BAY VIEW AVE Address: 150 N AVENIDA SEGOVIA NEWPORT BEACH, CA 92660 );toj.%)�, BTU/Wr: ° ° 0 ANAHEIM CA 92808 Phone: Phone: 949-606-6895 0 $0.00 Con State Lic: 929624 Issued Date: 11/19/2018 Lic Expire: 03/31/2019 Exhaust Fan: Bus Lic: BT30044187 Processed By: Lic Exp Date: 07/31/2019 MECHANICAL Permit: H2O18-0731 Project No: 0964-2018 Inspection Requests Phone (949)644-3255 Worker's Comp Insurance - Carrier : STATE FUND Policy No: 9227217 Expire : /A(; Items $0.00 0 $0.00 FEES $0.00 0 $0.00 ireacasBoilersBs CbMiloressors Ventilation $0.00 $0.00 );toj.%)�, BTU/Wr: ° ° 0 $0.00 Up to 3HP: 1 $19.00 Bathroom Fan: 0 $0.00 Fire Dampers: ter 1 OOK BTU/bE,:°, °9 $0.00 > 3 HP to 15 HP: 0 $0.00 Exhaust Fan: 0 $0.00 Gas Line: dIUP,1ooE Heater%: tl $0.00 >15 HP to 30 HP: 0 $0.00 Attic Fan: 0 $0.00 Metal Fireplace: :at,Ptlmps & PaBkage Units >30 HP to 50 HP 0 $0.00 Down -Draft Fan: 0 $0.00 Record Mgt Fee: IAoA0.0W BTU%h'r: ° 9 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee: for 5QOK BTU/hf:° U $0.00 Air Handling Units Comm. Hood: 0 $0.00 $0.00 up to I OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: ido 1-.75M BTUfnr. 1) $0.00 Over 1 O CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: FeE9.75M BTU/hf 0 $0.00 VAV Box: 0 $0.00 <I °, �°°l Other 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 $0.00 Investigation: $0.00 Plan Check: $16.53 CSA1BFIssuance: $35.00 MAYTAG Zoning PC: $40.00 TOTAL : $110.53 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $110.53 ° PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction flours: Monday - Friday 7:00 a.m.to 6:30 p.m.and Saturday from 8:00 a.m. to 6:00 p.m. DWNER-BUILDER DECLARATION 1 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 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 im roved 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). IJ I 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 Iegalll 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 Sectio 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No Date Contractor Signatures WORKERS' COMPENSATION DECLARATION WARNING: 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 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: 111 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 th ormance of the work for which this permit is issued. Policy No. 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. M1 workers' compensatioi insuyhnce carrier and policy number are: •,�••• •••"O° Policy Number Date ne of Agent 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 o4 California aPlO gore I, if I should become subject �tto he workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. • • • • • .0000 PP tr'�/ !4 D I • • • •000° nature ofA titan !�/ - — • '• CLARATION REGA�1)"Gi CONSTRUCTION LENDING AGENCY • • ° ° " :reby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Se tion 3097, Civil Code). • • • • • • • ° Ider's Name Lender's Address • ° v my signature below, I certify to each of the following: • ' ° 1 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 tp ante the property for inspection purposes. _• •• .,...,,.e ,.a o.....ew„ n,.,..e.... A„lh—i—A An•nr / N. 61,r Print Pronertv Owner's or Authorized AGent's Name. ,40/1t' nate AC77ON DATE RY DECLARATIONOFCOMPLIANCEMTHCODEOF I N FOR OF17CE USE ONLY 11 FEDERAL REGULATIONS PART 61 OF ITL.E40AND rtnevN I rAvintu ❑ / SUBMITTEDASI3ESTOS NODFlCARON TO: ❑ EPA ❑ AQMD PERA41TCAIVCELLED PERMITEXTENDED ❑ ASBESTOS N01IRCA170NIS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: PERMIT FINAL CERTIFICATEOF OCCOPANCYISSOED