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HomeMy WebLinkAboutH2019-0814 - PermitsIK„� City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII MECHANICAL Permit: H2O19-0814 o.. a G 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 9 0 8 1 4 Project No: 1381-2019 F a'- Permit Counter Phone (949)644-3288 047 �����e.. Inspection Requests Phone (949)644-3255 Job Address: 133 VIA JUCAR BIdg:1 Floor: Suite: Description of Work: MECH/INSTALL (2) NEW AIC UNITS 36dB & 33dB (MITSUBISHI; PUZ-A36NKA7) Inspector Area:1 Code Edit: 2016 ° Legal Description: Owner: LIDO ISLE LP Contractor: AUTUMN AIR INC Worker's Comp Insurance - ° Address: 655 BREA CANYON RD Address: 1119 W COLLINS AVE Carrier: COMPWEST INS WALNUT CA 91789 ORANGE CA 92867 Policy No: WCV550234601 Phone: Phone: 714-744.4432 Expire :06/1612020 Con State Lic: 1057685 IssuedDate:12/12/2019 Lic Expire: 09/30/2021 Bus Lic: BT30064735�ERFCAT II ION REQHERS Processed By: Lic Exp Date: 10/31/2020 GfIbQ 00 f. C ° O OAOC�O OO O G ,�} 9 O p BtlOG HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 0 $0.00 Up to 3HP: 2 $40.00 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 10oK BTU/hr: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee : $0.00 Investigation: $0.00 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $34.80 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 ,Over 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: $151.30 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $151.30 it 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 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(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 ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or `) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ I am exempt frmi litensure under the Contractors' State License Law for the following reason: By my signature below i acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally QejlAgitaicture that I We built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professitns Code jft%pilable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm]. SignatMre of Property Owner or Authorized Agent Date GICtN$ED CONYRACTOR'S DECLARATION I hpre4 affirm urldespeinalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business an Prpfess" ns Code, and my license is in full force TidVpLicense . �: t21t2 (, Contractor Signature ,/ J License Class - License No Date Vpff �!RS' COMPENSATION DECLARATION 3CyllgF: FAILURE T&SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,00D(, IN ADDITION TO THE S5.. 66 4OMPENSA710N, 4AMAGES AS PROVIDED FOR IN SECTION 5706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I liereby%ffirm AM€r'6&alty of perjury one of the following declarations: �•... . ua%% and V111•rraiatain 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 pe#formance of thew k for which this permit is issued. Policy No. have 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' 'ance carrier arOP-Ngcy number arm /'t _. Expiration Date is of Agent SJ Ul certify that, in the perfor nc f th ork 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 that, if I should becomes j ct to t e rs' com ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisi s. Signature of Applicant Date i2 �12� L� DECLARATION REG G CONSTRUCTION LENDING AGENCY I hereby affirm under enalty 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). Lender's Name Lender's Address By 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 an ou ordin a and state laws relating to building construction. I authorize representatives of this city or co my t Ater th arty for inspection purposes. Signature of Property Owner or Authorized Age t Property Owner's or Authorized Agent's NameXM��"1""�''13_Djj,Sze ACTION DATE BY DECLARATION OF COMPLIANCE MTH CODEOF FEDERAL REGULATIONSPART 61 OFTITLE40AND AQMDRULE1403. ❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO: j] EPA ❑ AQMD ❑ ASBESTOS NOTIFICATIONISNOTAPPLICABLETO PROPOSED DEMOLITION. SIGNATURE: FOR OFFICE USE ONLY PERMITEXPIR€D PERMITCANCELLED PERMIT EXTENDED PERMITFINAL 2p �, CER77FICATE OF OCCUPANCYISSUED