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H2019-0778 - Permits
sr 't u r City of Newport Beach - Building Division III III IIIIIpIII111111111111111p1111p111p11111 MECHANICAL Permit: H2O19-0778 ri 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 9 0 7 7 e Project No : 1273-2018 ``-i ` Permit Counter Phone (949)644-3288 - 9) '. "w� Vis" Inspection Requests Phone (949)644-3255 Joh Address: COAST :1 FlooC/O Suite: Description of Work: Work: A/C & F ' MECH/NEW AIC & FAU CIO "TAMPER RESISTANT NEW CAP REQ" \ INSPECT Inspector Area:7 Code Edit: 2016 Legal Description: TR 7530 LOT 1 UNIT 6 OF PROJECT LOCATED ON AP 423-031-01 TOGETHER Owner: HOWELLJH Contractor: TWIN AIR CONDITIONING Worker's Comp Insurance - Address: 4411 W Address: 2545 E WARD TER #D Carrier: EXEMPT NEWP 'R663 ANAHEIM CA 92806 Policy No: Phone: Phone: 714-768-0404 ExpireCon State Lie: 975245Issued Date:12/03/2 1Lie Expire: 07/31/2020 Bus Lie: BT30069961 Processed By: Lie Exp Date: 10/31/2020 ©° ooze, OffC G G t C C O OG f GCC®11 HVAC Items FEES FurnacesBoilers&Compressor Ventiation Other Up to 100K BTU/hr: 1 $20.00 Up to 3HP: 1 $20.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 =° ° $0.0 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 $0.0,0 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 f C0° Up to 100K BTU/hr: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee : $17.40 Investigation: $0.00 Over 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $0.00 Up to 1M BTU/hr: 0 $0.00 up to 1 O CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: 4A7L6036A1000A Issuance: $35.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: AMERICAN STAND Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $41.50 TOTAL: $133.90 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $133.90 PERMITS EXPIRE 980 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION ,�'a F3Jt'C1-TO FII�LI7 tNSPF.CTOR'' Construction Hours: Monday- Friday 7:00 a.m.to 6:30 p.m.and Saturday from 6:00 a.m. to 6:00 p.m. REVIE\4' AND APPItO VAL TIMER REQUIRED ON EQUIPMENT TO SHUT OFF BETWEEN 10 P.M. AND 7 A.M. )WNER-BUILDER DECLARATION ' 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(si 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 ie 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 'rofessions 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). 0 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, lusiness 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). 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). I am exempt from licensure under the Contractors' State License Law for the following reason: ly 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 legal) 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. signature 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 7000) of Division 3 of the Business and Professions ode, and li is in full force nd effect. • • • !!dd icense Class C". 2C� License No 97�, Z 9,� Date I Z ` � �� Z01contractor Signature vaKr$RS' C$ON?PNSATION DECLARATION DARNING: FAILURE TO SEOURE 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 a§T dkLOMPENSATJON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. her-Aby affirm ugcjpt penalty of perjury one of the following declarations: M have and vril} 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 the erformance ofthe work for which this permit is issued. Policy No. j Uv2 and All nMntain 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' compensation 1gg4rance carrier and policy number are: -:-.-. • Policy Number Expiration Date kgent Phone # that,41n• the ili-formance 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 of California, and agrel Iould bAM fle subject to e wo ers' c/om'gen tip provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prowslon - of Applicant � <-/ L / 7 Date � /0 ? /� :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 (Section 3097, Civil Code) Ider's Name Lender's Address my signature below, I certify to each of the following: qyU� 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 t me the ve-identifigd pf arty for inspection purposes. , ^// nature of Prnnerty Owner or Authorized ADent ee.9✓-- �9 /Oa?,1rint ProDertV Owner's or Authorized Agent's Name`t--� /, /, 1 i ACTION I DATE 1\ BY PERMIT FINA! CERPRCATE OF OCCDPANCYISSdIED FEDERAL REGULATIONS PART fit OF TITLE 40 AND AQMDRULE1403. ❑ t SUBMITTED ASBESTOS NWIFICATION TO. ❑ EPA ❑ AQMD ❑ ASBESTOS NORFICATIONIS NOT APPLICABLE TO PROPOSED DEMOLITION. 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