HomeMy WebLinkAboutH2020-0291 - PermitsCity of Newport Beach - Building Division III 111111111111111111111111111111111111111111111
100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 0 0 2 9 1
Permit Counter Phone (949)644-3288
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Job Address: 853 VIA LIDO SOUD BIdg:1 Floor: Suite:
Description of Work: MECH CHANGE OUT (3) PACKAGE UNITS *TAMPER PROOF CAP REQ*
Inspector Area:1 Code Edit:
2019
Legal Description: TR 907 LOT 312(AND ELY1/2 LOT 311
Owner: THOMPSON JOHN
Contractor:
TRI - PACIFIC HEATING & A/C
Address: 853 VIA LIDO SOUD
Address:
2116 E WALNUT AVENUE
NEWPORT BEACH, CA 92663
Furnaces Boilers & Compressors
FULLERTON CA 92831
Phone:
Phone:
714-888-6820
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Con State Lic:
894392
Issued Date:06/04/2020
Lic Expire:
04/30/2021
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Bus Lic:
BT30044853
Processed By:
Lic Exp Date:
09/30/2020
MECHANICAL Permit: H2O20-0291
Project No:
Worker's Comp Insurance -
Carrier : OLD REPUBLIC
Policy No: MWC312170
Expire :03/01/2021
Phone (949)644-3255
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HVAC Items
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Furnaces Boilers & Compressors
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Other
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Up to 100K BTU/hr:
0
$0.00
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Bathroom Fan:
0 $0.00
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0 $0.00
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0
$0.00
> 3 HP to 15 HP:
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$0.00
HVAC Items
FEES
Furnaces Boilers & Compressors
Ventilation
Other
Up to 100K BTU/hr:
0
$0.00
Up to 3HP:
3
$60.00
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:
$52.20
Up to 1M BTU/hr:
0
$0.00
up to 1 O CFM:
0
$0.00
Repair/Alter/Add:
0 $0.00
Model:
48VLNC42-3lssuance:
$35.00
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:
$41.50
TOTAL:
$188.70
Plan Check Fee:
$0.00
Fee Due at Permit Issuance :
$188.70
PERMITS EXPIRE 980 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
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 applicabl&-irm(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 (_) 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).
❑ 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
apply to an owner -of pmPerty, who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
QI am exempt ffdhT Ilcensure under the Contractors' State License Law for the following reason:
By"? signature beliDwol 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 tiat1 hale 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
Pfdfesspns Code, Ih available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signatlfre of Property Owner or Authorized Agent Date
I,ICENgED CONTRACTOR'S DECLARATION
thereby affirm under ltf perjury that I am licensed under provisions of Chapter 9 (commencing with Secti n 7 00) of Division 3 of the Business and roess E,'BR my license is in full force
andowect. ...;
UGP.PSe Class • • • • License No Date Contractor Signature ole
WORKERS' COMPENSATION DECLARATION
4ARAINGyFAILURF.fO qFCQRE 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 COMPENSMION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
•••u•
lilerebYeffirm underperi ally of perjury one of the following declarations:
I have and vAI*ftintain 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.
^�71 ave 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
s ante carrier and policy number are:
rier Policy Number Expiration Date
me of Agent mune *
certify that, in the performanc 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 of California, and agree
I, if I should be ome sub's sa ion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant A1W Date rLl�J /GC:J
CLARATION REGAG CO ENDING AGENCY �—
lreby affirm under pen Jury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
lder'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 county ordinances and state laws relating to building construction. / I
I authorize representatives of this city o n e pe y or mspec Ion purposes. s n . % n1 . . �n/ t /!7 r
Signature of Property Owner or Authoriz`edA en Print Property Owner's or Authorized Agent's Nam
ua[e v
ACTION DATE BY
DECLARATION OF COMPLIANCE IMITH CODE OF
FEDERAL REGULATIONS PART 61 OF71TLE40AND
AQMO RULE 1403.
I SUB60TTEDASBESTOS NOIIFICATION TO:
❑ EPA
❑ AQMD
❑ ASBESTOS NOTIFTCAIIONIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE:
FOR DFRCE USE ONLY
PERMITEXP/RED
PERMITCANCELLED
PERMITEXTENDED
PERMIT FINAL —Z. —?b
CERTIFICATE OF
OCCUPANCYISSUED
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