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HomeMy WebLinkAboutH2017-0071 - Permitsr 061-44—veo City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 427 SANTA ANA AVE Bldg:1 Floor: Description of Work: MECH - FURNACE C/O InspectorArea:2 Code Edit: 2016 Legal Description: TR 27 LOT 6 BLK 12 SE I Owner: SINYKIN MARCtraf Address: 427 SANTA ANA V ✓✓ ddres NEWPORT BEAC Phone: Phone: Issued Processed urnacesBoilers & Compressors p to 100K BTU/hr: 1 $18.00 ver 100K BTU/hr: 0 $0.00 fall/Floor Heaters: 0 $0.00 eat Pumps & Package Units p to 10oK BTU/hr: 0 $0.00 ver 500K BTU/hr: 0 $0.00 p to 1M BTU/hr: 0 $0.00 p to 1.75M BTU/hr: 0 $0.00 ver 1.75M BTU/hr: 0 $0.00 TOTAL:$51 Ventilation Suite: II�II�I� III0II�III0�III0�IIII71 II MECHANICAL Permit: H2O17-0071 Project No: Inspection Requests Phone (949)644-3255 72 -FT LOT 7BLK 12 V' l 66-��AAiI ICANINT'LALLIANCE INC 1p §'SC®pinsura 6840 HAYNENHURST AV ` arne VAN N S CA 91406 oli yJ i s ��- 0 OWS 585 � xpire 18 V0 4-fto OS e: 02/28/2018 — Up to 3HP: 0 $0.00 Bathroom Fan: > 3 HP to 15 HP: 0 $0.00 Exh us >30 HP to�30 HP ;0----$0 ,Q({D�t ttl� an: EO >30 HP to $0. 0 Down -Draft ?5 0 $0.00 o j2ps'd ntial H d it Handling Units n -3O /p Hood: j to 10K V '--$0.00 R air((Iter/Add: veF fC��N1,OQ�0 '�Q,Q��)�1�Mp1Aental Fee: $0. acturer: V Box: 0 D0� Plan Check Fee: $0.00 Fee Due at Permit Issuance PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Other $0.00 $0.00 Investigaoio©: $0.00 Plan Cl�cao°° $0.00 Issuance ° $33.00 o • o u ooma $51.00 ° • ° © • moocc .... ° 00.0°0 0 0 0 • o 00000• 0 0 ` oc0000 000 o e 00 UVV NCK-r3UILUCK UCULAKAI JUN 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). U I, as owner 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, 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 legalh 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:http://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent - e LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 700kof Division 3 of the Business nd P. egsions Code and my license is in full force and effect. License Class License No Da d Contractor Signat 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 DOLLARS ($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. ®rmanby affirm under penalty of perjury one of the following. declarations: ce 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 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' rance carrier and policy number are: Policy Number Date flame of Agent Phone # :1I certify that, in the performanc of t work f 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 hat, if I should become subjec o theCorke( ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. signature of ApPiaawt. DEA/ 1:_ 2FQ1,91jATION f3EG DING CONSTAUCTFDNbLENDING AGENCY (/l. -hereby-affirm un.. ere is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). .enders Name Lender's Address 3y Ifiy §l nature below, I certify to each of the following: I aWi the prop"y owner or authorized to aGt on the propert wnel's behalf. - 1 bade read thWaplication and the information I have r led is correct. • • j agree to cgrflllly w:h all applicable city and county nano nd state laws relating to building construction. • • j IpVtnorize rep125Entatives of this city or countAt me the a o id ntified property for inspection purposes. ygrl,plILrg of PropeRy Owner or Authorized Agent nt Property Owner's or Authorized Agent's Name,1 — U W ACL Date ` 1 AC77ON DATE BY DECLARATION OFCOMPLIANCE WITH CODE OF FOR OFFICE USE ONLY • • • • • • • • FEDERAL REGULATIONSPART 64 OF TITLE40 AND AQMDRULE 4403. —PERMITT EXPOVipl ❑ I SUBMTTEDASBESTOS M071FICATIONTO: ❑ EPA 13 AQMD PERMIT CANCELLED PERMITEXTENDED ❑ ASBESTOS N07IRCA770NIS NOTAPPLICABLETO PROPOSED DEMOLITION. PERMITFINAL CERTIFICATE OF OCCUPANCYISSUED SIGNATURE: