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Home My WebLink AboutH2019-0714 - PermitsCity of Newport Beach - Building Division III 111111111111111111111111111111111111111111111 u ' 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 9 0 7 1 4 F s Permit Counter Phone (949)644-3288 �`�LaYxxd�'4� Job Address: 110 VIA PALERMO BIdg:1 Floor: Suite: Description of Work: MECH (2) NEW A/C UNITS ON ROOF *TAMPER PROOF CAP REQ* InspectorArea:1 Code Edit: 2016 Legal Description: TR 907 LOT 100(AND NELY 10 FT LOT 99 Owner: KING LISA & DAVE Contractor: AIRSMITHS INC Address: 110 VIA PALERMO Address: 1474-A POMONA ROAD NEWPORT BEACH CA 92663 massae CORONA CA 92882 Phone: 415-740.4557 Phone: 951-735-5225 Con State Lic: 783449 Issued Date:11/14/2019 Lic Expire: 08/31/2020 $0.00 Bus Lic: BT95002015 Processed By: Lic Exp Date: 10/31/2020 MECHANICAL Permit: H2O19-0714 Project No: 2665-2018 Inspection Requests Phone (949)644-3255 HVAC Items e Worker's Comp Insurance - ° e o me•oc Carrier: OAK RIVER INSURANCE massae ° Policy No: AIWC030566 .mme Other Expire :07/01/2020 Up to 100K BTU/hr: me e $0.00 comoco e o $20.00 ° m • e Fire Dampers: 0 $0.00 mm ° $0.00 •sem eemmm INSPECTOR > 3 HP to 15 HP: 1 $36.00 Exhaust Fan: mme°mm Gas Line: 0 $0.00 $0.00 mmmmmm ° ° $0.00 ° oomoom HVAC Items FEES FurnacesBoilers & Compressors Ventilation .mme Other Up to 100K BTU/hr: 0 $0.00 Up to 3HP: 1 $20.00 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 $36.00 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: $48.72 Up to 1M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: NH4A4/RXTQ48TAV Issuance: $35.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: DAIKIN/TEMPSTAR Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $41.50 TOTAL: $181.22 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $181.22 PERMITS EXP/RE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7:04 a.m.to 6:30 p.m.and Saturday from 8:00 a.m. to 6:00 p.m. ILDER 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 items) 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 he 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 ofthe BusLriess and Irofessions 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 acivil penalty of lot 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, 3usiness 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 mprovements 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 m 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 Ipply 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 1 am exempt from licensure under the Contractors' State License Law for the following reason: 3y my signature IIelow 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 legall, yell a structure thet l.heue 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 'rifessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. lignatur'e of Prq*4ty Tyner or Authorized Agent Date -ICENSED CONTRACTOR'S DECLARATION (he'P@Vaffirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with S rIon 7000) of Division 3 of the Business and P esus Code, a 1y license is in full force Ipd effect. • . r'!5 —/y �.iconse.Class •••••• License No Date Contractor Signature YQV1<ERS' COMPENSATION DECLARATION JQQ BIND FAILURE TOASWRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINE$ UP TO O HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE ;b i& COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. %M1 affirm under penalty of perjury one of the following declarations: 1 have and w11'r5$intain 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 ••••• erforniance of fflg wojk for which this permit is issued. Policy No. Kand vilhmaintain 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 1su ce carrier and policy number are: Policy Number Expiration Date me of Agent _Phone #. I certify that, in the perform c e work for whit is permit is issued, I shall not employ any person in any manner so as to become subject t the workers' compensation laws of California, and agre I, if I should become sub' ct th orkers' comp satio isions of Section 3700 of the Labor Code, I shall forthwith comply with those provis' ns. �q nature of Applicant _ Date / /�'� 7 CLARATION REGA G NSTRU N LENDING AGENCY =.reby affirm under p ally of perjury that there is a construction lending agency for the performance of the work for which this permit is issue (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 hve provided is correct. I agree to comply with all applicable city and cou y ordinances and state)"s relating to building construction. I authorize representatives of this city or county o ter above-ide led property for inspection purposes. /�D y nature of ProDertv Owner or Authorized ADent �-�''� Print Property Owner's or Authorized Aqent's Name / ; Date Z ACTION I DATE I I BY I PERMITEXPrR€D I I I I PERMITCANC€/LED I I I PERMIT FINAL CERT0CATEOF OCCUPANCYISSU€D FEDERAL REGULATIONS PART 61 OF TITLE40AND AOMD RULE 9403. I SUBMITTEDASSESTOS NOTIFICATION TO: ❑ EPA ❑ AOMD ❑ ASBESTOS U017RCA7IONIS NOT APPLICABLE TO PROPOSED DEMOLITION. 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