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H2019-0143 - Permits
:1&Vr1 City of Newport Beach - Building Division 11111111p1111111111111111IN11111/1/11111 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 9 0 1 4 3 p " Permit Counter Phone (949)644-3288 MECHANICAL Permit: H2O19-0143' Project No: 0156-2018 Inspection Requests Phone (949)644-3255 Job Address: 660 HARBOR ISLAND DR BIdg:1 Floor: Suite: Description of Work: MECH/INSTALL (2) ROOF ACCESS A/C'S UNITS 40.5dB & 45.5dB (YORK; YHE36B21H & AC PRO; 4AC16L60P) InspectorArea:2 Code Edit: 2016 Legal Description: N TR 3867 LOT 20 HVAC Items Owner: HALCOVICH/HERTZ-POLAKOV Contractor: TURNER AND SONS AC & HEATING Worker's Comp Insurance - Address: 81161 INDIO BLVD Address: 6017 ARBOR RD Carrier: NORGUARD INS FurnacesBoilers & Compressors INDIO CA 92201 LAKEWOOED CA 90713 Policy No: TSWC921645 Phone: 760-343-2704 Phone: 562-425-6495 Expire :05/08/2019 Up to 100K BTU/hr: 0 Con State Lie: 1011169 1 $19.00 Issued Date:03/12/2019 ( 1 Luc Expire: Fire Dampers: 0 $0.00 � ,�_j+at�y Bus Lie: BT300212912020 BT30066399 663 $0.00 > 3 HP to 15 HP: Processed By: -Lie Exp Date: 03/31/2020 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: PERMITS EXPIRE 180 DAYS AF•7ER 4SSUANQA OR.L,AST V411 JELINSPECTION Construction Hours: Monday - Friday 7:09a.2n.to *6:301tm.aijd Satutday febm 8:00 a.m. to 6:00 p.m. • O O •• ♦ • OJ M 4 O BGC' • D • O' •i• • 00• (O C OVO O OV G C G 6 6 1 4 • •V • O • V06 `GO 70 V O 4.O L©e 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: 1 $35.00 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 : $46.98 Investigation: $0.00 Over BOOK BTU/hr. 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $0.00 Up to 1 M BTU/hr: 0 $0.00 up to 10K CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: Issuance: $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: $40.00 TOTAL: $175.98 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $175.98 PERMITS EXPIRE 180 DAYS AF•7ER 4SSUANQA OR.L,AST V411 JELINSPECTION Construction Hours: Monday - Friday 7:09a.2n.to *6:301tm.aijd Satutday febm 8:00 a.m. to 6:00 p.m. • O O •• ♦ • OJ M 4 O BGC' • D • O' •i• • 00• (O C OVO O OV G C G 6 6 1 4 • •V • O • V06 `GO 70 V O 4.O L©e 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 applicable item (a) (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 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 a licensed Contractor pursuant to the Contractors' State License Law). 11 1 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 legally 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 Section 7000) of Division 3 of the Business and Prof ns Code, and my ense is in full force and effect. License Class License No Date � ._!Z._ � �% Contractor Signatur NORKERS' COMPENSATION DECLARATION NARNING: 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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 1 have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for thi 3ertormance of the work for which this permit is issued. Policy No. and will m workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' carrier an�Vt�,,olicy umber are: (� �i , PnIT.,xNa4m)Inl �l Expiration Date of Agent certify that, in the performance oft work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre if I should beco e s j�qt to orkers' compensatioad1mvisions of Section 3700 of the Labor Code, I shall forthwith comply with those pro'yiysJPns. / lature of Applicant Dat 3 r 2 :LARATION REGA DI NSTRUCTION LENDING AGENCY "eby affirm under p nalty o perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Jer's Name Lender's Address ny signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinan s and state laws relating to building construction. �� /f I authorize representatives of this city or county to nt above -id ropert f ion purposes. r �/d _ lature of Prooertv Owner or Authorized Acent Print ProDertv Owner's or Authorized Acent's Nam //moi � J er e 3�2 AC77ON DATE BY uctLstnurirsn Ur t,UlBruxnl.c earn t,vuc Ur FLWUrrlLt Ust UIVLT ••• • • FEGe$AC4'EGUL4T1VKS'P4RT67 OF TFILE40.AND AQM0RUL£1403.- , • (] •t SUB&jTtDA BEkT0s mOT7FJCATION TO: E3 EPA "• PERMiTEXP1RED • • • • PERMITCANCELLED • ❑ AQMD PERW EXTEMDED 70SMN00? itONfS NOT APPLICABLE TO PERMI'TFINAt •,: ,:O DUOS CERT{RCATEOF : : ' . ! • • ' S�fGi'lA'dtlR�a OCCUPANCYfSSUEQ • i • • • • i