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Home My WebLink AboutH2019-0636 - PermitsI City of Newport Beach - Building Division III III IIIIIpIIIIIIIII1111111111p11p11p11111111 'f 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 9 0 6 3 6 F t Permit Counter Phone (949)644-3288 Job Address: 77 BRADBURY Bldg:1 Floor: Suite: Description of Work: MECH C/O A/C UNIT & FAU. *TIMER & TAMPER PROOF CAP REQ* Inspector Area:8 Code Edit: 2016 Legal Description: TR 12164 LOT 3 UNIT 39 OF PROJECT LOCATED ON AP 442-291-39 TOGETHER FEES Owner: ROCKEFELLER KIRWAN Contractor: HOME COMFORT USA Address: 77 BRADBURY Address: 1120 N TUSTIN AVE NEWPORT BEACH, CA 92660 ANAHEIM CA 92807 Phone: 949-887-1932 Phone: 888-769-3009 Con State Lic: 974908 Issued Date:10/17/2019 Lic Expire: 07/31/2020 Up to 3HP: Bus Lic: BT30056727 Processed By: Lic Exp Date: 10/31/2020 MECHANICAL Permit: H2O19-0636 Project No : Inspection Requests Phone (949)644-3255 Worker's Comp Insurance - Carrier : TRAVELERS PROPERTY Policy No: UB2L764577 Expire :11/01/2020 HVAC Items FEES FurnacesBoilers & Compressors Ventilation 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 $0.00 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: $34.80 Up to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: SL18XC1-036issuance: $35.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: LENNOX Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $41.50 TOTAL: $151.30 Plan Check Fee: $151.30 Fee Due at Permit Issuance : $0.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7:00 a.m.fo 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). J 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 coven 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://Ww .leginfo.ca.gov/calaw. html. 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 an rofessions de, and my license is in full force nd effect. icense Class License No Date !7_ 2 del Contractor Signat IIORKERS' COMPENSATION DECLARATION IARNING: 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 (E700,000I, IN ADDITION TO THE OST 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: I 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 th e ormance of the work 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' compensatioi r nce carrier and policy number are: of the Business and 'ler Policy Number Expiration Date is of Agent Phone # certify that, in the performance of t 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 become subjec the w kers' comoensation_orovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions S z�Jzd lature of Applicant Date / 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: 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 provi3e is correct. I agree to comply with all applicable city and county ordina as and state laws relating to building construction. I authorize representatives of this city or county to�ie a -I an I is property for inspection purposes. nature of Property Owner or Authorized Print Property Owner's or Authorized Agent's Name / ACTION DATE BY DECLARATION OF COMPLANCEIAITHCODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 67 OFTITLE40AND AQMD RULE 1403. P€RM;TEXPIRED ❑ ISUBMITTEDASSESTOSN07IFICATION70. Q EPA ❑ AQMD PERMITCANCELLED PERA41TEXTENDED ❑ ASBESTOS NORHCAIIOMIS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMfT FINAL CERTtFfCATE OF SIGNATURE: OCCUPANCYtSSUEO