HomeMy WebLinkAboutH2015-0200 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II
a` o� 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 5 0 2 0 0
H Permit Counter Phone (949)644-3288
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MECHANICAL Permit: H2O15-0200
Project No : 2070-2014
Inspection Requests Phone (949)644-3255
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Job Address: 20172 ORCHID ST BIdg:1 Floor: Suite:
Description of Work: MECH - (2) CONDENSERS @ SIDE YARD "TAMPER-RESISTANT CAP REQUIRED" (X2014-2611)
InspectorArea:3 Code Edit:
2014
Legal Description: N TR 1500 LOT 38
FEES
Owner: NGUYEN BEVA
Contractor:
HOANG HUY TRANQUOC
Address: 9315 BOLSA AVE
Address:
10907 GILBERT STREET
WESTMINSTER CA 92683
ANAHEIM CA 92804
Phone:
Phone:
714-/37-3802
Con State Lic:
869898
Issued Date:
Lic Expire:
01/31/2017
Up to 3HP:
Bus Lic:
BT30049017
Processed By: Y=6z
Lic Exp Date:
11/30/2015
Worker's Comp Insurance -
Carrier : STATE COMP
Policy No: 9105652
Expire :05/09/2016
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HVAC Items
FEES
Furnaces
Boilers & Compressors
Ventilation
Misc
Other
Up to 10OK BTU/hr:
2
$38.00
Up to 3HP:
0 $0.00
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:
2 $98.00
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
ICBO App. #:
Record Mgmt Fee:
$0.00
Up to 100K BTU/hr:
0
$0.00
>50 HP:
0 $0.00
Residential Hood:
0 $0.00
Investigation:
$0.00
Over 500K BTU/hr:
0
$0.00
Air Handling Units
Comm. Hood:
0 $0.00
Plan Check:
$97.92
Up to 1M BTU/hr:
0
$0.00
up to 10K CFM:
0 $0.00
Repair/Alter/Add:
0 $0.00
Issuance:
$0.00
Up to 1.75M BTU/hr:
0
$0.00
Over 1OK CFM:
0 $0.00
Supplemental Fee:
$9.00
Over 1.75M BTU/hr:
0
$0.00
VAV Box:
0 $0.00
TOTAL:
$242.92
Plan Check Fee
: $0.00
Fee Due at Permit Issuance:
$242.92
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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 Codv) ar that he or she is exempt from Iicensur ,Rand thc1basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
�dt"Cre than f1Vg,htnared dollars ($500).
*1* 9 towner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
pu�mes*P and Mr fbg tlijns 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
lmpro"TIents 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
impraue l for the purpose of sale).
®.Itas owner of theroperty, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
apply fp an owner Uproperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
Ell am exempt from licensure under the Contractors' State License Law for the following reason:
By nW signature NIAI 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)
%I -a VRicture thaf 1 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, IEPS vailable upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.htmi.
Mileature- of Property Owner or Authorized Agent Date
LICENSED COMMRACTOR'S DECLARATION r,
I hereby affirm dndeapAalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 00) Division 3 of the Business and Professions Codea d my license is in full force
and effect. C ,7 Q ,I�, (i11I
License Class License No Date J Contractor Signature
NOOK
NORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLIS ($'100,000), 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:
1 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,
Eftrmance of the work for which this permit is issued. Policy No.
�ve 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
nce carrier and policy number are:
rner Policy Number Expiration Date
me of Agent Phone #
certify that, in the performance of the work for whit i 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
t, if I should become subject to the workers' compen ti n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisiio%ns.
nature of Applicant Date _/` —/� q CB
CLARATION REGARDI CONSTRUCTION LENDI GI ENCY
�reby affirm under penalty of perjury that there is a constrtion lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
ider's Name IT 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 provided is correct.
I agree to comply with all applicable city and county ordinances and statR I�lws relating to building construction.
I authorize representatives of this city or county to inter the above -Iden ie�l property for inspection purposes. ^ 11.I _%�Lf"
nature of Prooertv Owner or Authorized Aoent n ^ Print Property Owner's or Authorized Agent's Name X `)- y(� Date\
ACTION
DATE I BY
I PERMIT EXPIRED I I I
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCYISSUED
FEDERAL REGULATIONS PART 67 OF TITLE 40 AND
AQMD RULE 1403.
❑ i SUBMITTEDASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
❑ ASBESTOS N017RCA170NIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE.,
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