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Home My WebLink AboutH2018-0557 - PermitsCity of Newport Beach - Building Division MECHANICAL Permit: H2O18-0557 a 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 6 0 5 5 7 Project No Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 35 CAPE ANDOVER BIdg:1 Floor: Suite: Description of Work: MECH/DUCTING (2 ZONES) InspectorArea:3 Code Edit: 2016 CTOR Legal Description: N TR 15012 LOT 24 Owner: KISTNER LOUISE Contractor: SERVICE CHAMPIONS HTG Worker's Comp Insurance - Address:VER Address: 3150 E BIRCH Carrier: PACIFIC COMP NEWPORTPE BE H, CA 92660 BREA CA 92821 Policy No: WA000607 Phone: Phone: 714-777-7777 Expire :03/22/2019 Con State Lie: 799170 Issu Date:09/061201 2018 Lie Expire: 09/30/2019 Bus Lie: BT01080105 ..... ° Proses ed By: Lie Exp Date: 07/31/2019 s m ® Tooeoo emeo ° m c o ° m o HVAC Items FEES ...... FurnacesBoilers & mpressors Ventilation Other ° ° m m Up to 10OK BTU/hr: 0 $0.00 Up to 3HP: 0 $0.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 .° ° e $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 10OK BTU/hr: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee: $0.00 Investiggib%. °° $0.00°' °° Over 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Cheep m $0.0(r'" Up to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 2 $36.00 Model: Issuance: $33.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $0.00 TOTAL: $69.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $69.00 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 penally 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) - lection 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 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 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 of 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 (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, �usiness 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 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 nproved for the purpose of sale). v. �_-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 exemgt from licensure under th4Contractors' State License Law for the following reason: �y 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 Irofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw,htmi. ignature 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 700) f Division 3 of the Business and ProfeaionsCDHe and my license is in full force is effect. J/, J ". icense Class License No Date ontractor Signatur I/ORKERS',13011MENSATION DECLARATION —�� ARNING: FAILUREI'O 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 (IST.* COMPEN64TIONr DAMAGES AS PROVIDED FOR IN SECTION 7706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. herelty affirrrf ur6%6 penalty of perjury one of the following declarations: 3 j,hove and WIII 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 e o ance of $hemork for which this permit is issued. Policy No. �! and wAlimaintain 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' compensatioi Furan carne? jild'policy number are: ark _ • ' ' • Policy Number Expiration Date p.e.of Agent ' rnone F certify that.- flTs'ge¢ornr3nce9f a work for .which this permitrued-l-strallnot employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre l,.!,I,should b`c R subjec td the workerscompensation-prSvfsions of Section 3700 of the Labor Code, I shall forthwith comply with those 2tUp�oyv�'a�i a. hre of APbGc'ani Da{e CLARATION REG R ING CO. 5T' UCTION LENDING AGENCY Heby affirm under enal,y�oF erjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ider s Name Lender's Address my signature w, 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 ordinarfces ands _'e, WE relating to building construction. 1 authorize representatives of this city or conn v' enter he, ati identified property for inspection purposes. ',D mf im of PrnnuHv (Tuner nr Anthn07M A nn�''` Print Prooertv Owner's or Authorized ADent's Name ed" Date ACTION DATE BY UtL.LAIr Irvly yr UVWVLJAUV .r rrr rn a VUE yr rvn FEDERAL REGULATIONS PART 61 OF T17LE40AND PERAMTEXPIRED AQMDRULE 1403. f SUBMITTED ASBESTOS NORFICATION TO..* PERMITCANCELLED ❑ EPA PERMITEXTENDED ❑ AQMD ❑ ASBESTOS M077HCA1701V IS NOT APPLICABLE TO PERMIT FINAL 1 10 PROPOSED DEMOLITION. CERTIFICATEOF OCCUPANCYISSUESIGNATURE. D ƒ; _ 3 ` \ ~ (D J jD (` ;20>� m 3 N z 3 n 3 \( \ \ ;{> o 7 0) w g z \ M .. .. ¢ � § 2 m §� E� 9 � m kk tAk M 0 D m 1 x 2 '0 m mILN11%71 I'M71 \ z \( \ \ ;{> o 7 0) w g z \ M § 2 m §� E� 9 � m kk tAk M 0 D m 1 x 2 '0 m mILN11%71 I'M71