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ho*,r City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIII MECHANICAL Permit: H2O20-0270
u o 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 0 0 2 7 e Project No:
F, Permit Counter Phone (949)644-3288
"+�arrxw Inspection Requests Phone (949)644-3255
Job Address: 305 CARNATION AVE Bldg:1 Floor: Suite:
Description of Work: MECH -C/O FAU & A/C CONDENSOR. TAMPER-RESISTANT CAP REQUIRED
6Inspector Area:5
Legal Description:
TOGETHER
Code Edit: 2019
P M 222-29 PAR 1 UNIT 3 OF PROJECT LOCATED ON AP 052-013-37
Owner: WASEEM IBRAHIM
Address: 305 CARNATION AV
CDM CA 92625
Phone:
Issued Date:05/27/2020
Processed
•nacesBoilers & Compressdrs
to 100K BTU/hr: 1 $20 d0
ar 100K BTU/hr:
0
$0 00;. 1
II/Floor Heaters:
0
$0.00x:
at Pumps & Package Units
to 100K BTU/hr:
0
$0.00
ar 500K BTU/hr:
0
$0.00
to 1M BTU/hr:
0
$0 00
to 1.75M BTU/hr:
0
$0.00
ar 1.75M BTU/hr:
0
$0.00
TOTAL: $1
� ,end
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Contractor: 1V/��or}}�� r'�o surance -
Addr 41085 GOLDEN GAGE-EIf7 3Og&rr'iA : SERVICE GROUP
U0 779RRIET GA 92562 Policy No: WC0800337��49
0700 x x O,ZlO1./3020
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3te Bum?06f2l to NN
NOC
6 04
1. 779604
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UpaJ5
209throom Fan:
> 3 0 Exhaust Fan:
15$0.00 Attic Fan:
300 $0.00 Dow D n:
0 HP: 0 $0.00 H od:
u to UniIs� Alter/Add:
O r 10aCF $Q.O�t��mental Fee:
BoOoqh&
Plan
�CAJ' the
0 0. 0 elD rp $0.00, $0.00
0 G $(� ' $0.00
0 Fire
0 Fy�sd ee: $0
0 0.00 A�kffAtional Fee: nve 'g ion: $0.00
0 $0.00 r he k: $0.00
0 $0.00 Model, M. nce: .00
$0.01�M na ufacturer: y(ISP•LENNO
�' �— Zoning PC: $41.50
Fee Due at Permit Issuance: $133.90
WST9PIRE 180 DAYS AFTER ISSUANCE OR EAST VALID INSPECTION
Monday - Friday 7:00 a.rrt.tp.0:30 p 6aAd €iaturday from 8:00 a.m. to 6:00 p.m.
C Ia �� 4
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O
f60 � p IJ �• 489
DINNER -BUILDER DECLARATION
1 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).
❑ 1, 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).
❑ 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 legall)
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:hftp://www.leginfo.ca.gov/calaw.htmi.
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 Sectio 7000) f Division 3 of the Business n '6na Code, and my license is in full force
and effect. rn
License Class - - License No Date `6 U Contractor Signature
WORKERS' COMPENSATION DECLARATION
✓DARNING: 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.
I hereby affirm under penalty of perjury one of the following declarations:
111 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
gfiTiprmance of the work for which this permit is issued. Policy No. _
9I ave 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' compensatio
in nce carrier and policy number are:
ier Policy Number Expiration Date
Name of Agent Phone #
I certify that, in the performance%f the ork for which this permit is issued, I sh employ any person in any manner so as tobecomesubject to the workers' compensation laws of California, and agre
that, if I should become subject to lh pe o ection 3700 of the Labor Code, I shall forthwith comply with those provisions. l
Signature of Applicant Date ,e
DECLARATION REGARD G CO RUCTION LENDING AGENCY
I hereby affirm under penal ry that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Cade).
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 p Ide�ia correct.
I agree to comply with all applicable city and county or inan as and state gelatin build'
tr+iation.
I authorize representatives of this city or county to e t v - y or inspection purposes.
Signature of Property Owner or Authorized Agent _ Print PropertyOwner's or Authorized Agent's Name Date [
ACTION DATE BY
DECLARATION OF COMPLIANCEtMTH CODEOF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TITLE40AND
AQND RILE 1403.
PERMITEXPIRED
I5PASMIT(E.
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PROPOSEDDEMOLITI •�
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PERMIT EXTENDED
PERMITRNAL
CERTIFICATE OF
OCCUPANCYISSUED
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