The URL can be used to link to this page

Home My WebLink AboutH2019-0537 - PermitsCity of Newport Beach - Building Division III IIIIIIIIIIIIIIIIIIIIIIIIIIIIIINIIIIIIIIIIIII p 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 9 0 5 3 7 - Permit Counter Phone(949)644-3288 Job Address: 2191 MESA DR BIdg:1 Floor: Suite: Description of Work: MECH NEW A/C ON ROOF DECK (2) *TAMPER PROOF CAP REQ* InspectorArea:6 Code Edit: 2016 Legal Description: m Owner: MOORE SEPERATE PROPERTY Contractor: Comp Insurance - Address: 2191 MESA DR Address: NEWPORT BEACH, CA 92660 Phone: Phone: E0 Con State Lic: Issued Date:08/29/2019 Lic Expire: ��/ Bus Lic: Processed By: GNN Up to 100K BTU/hr: Lic Exp Date: GOMEZ HEATING & AIR CONDITIONING INC 9631 FLOWER ST BELLFLOWER, CA 90706 562-804-2891 920850 08/31/2020 BT30055298 02/28/2020 MECHANICAL Permit: H2O19-0537 Project No 1309-2018 Inspection Requests Phone (949)544-3255 Carrier: STATE COMP Policy No: 9223193 Expire :12/21/2019 v I m°®m°m Bmmmfe ° me mmroo ° m 'Worker's 9C40 OOft° m 9. 0 0°mm°C m FurnacesBoilers & Compressors o E0 Carrier: STATE COMP Policy No: 9223193 Expire :12/21/2019 v I m°®m°m Bmmmfe ° me mmroo ° m 'Worker's 9C40 OOft° m ° f m FurnacesBoilers & Compressors o e,ea^ momo 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 1OOK 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 Dawn -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 1M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: 4A7A4060LIssuance: $35.00 Up to 1.75M BTU/hr: 0 $0.00 Over IOK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: AMERICAN STAND 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 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 ($500). .. ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and POMIcips Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improveGients ar6 f dlointended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner-Builder will have the burden of proving that it was not built or TMV for the purps se of sale). , as owner ofthl?groperty, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not �111X Lo an owner of property who builds. or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I sfn exemRt4romlicensure under the Contractors' State License Law for the following reason: Py TV Agnaturebelow:l acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot Iegall sell a structure tgat I have built as an owner-builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and rofeggions Cdtlg• %available upon request when this application is submitted or at the following Web site:http://www. leginfo.ca.gov/calaw.htmi. JrATure of Property Owner or Authorized Agent Date VSVED COATRACTOR'S DECLARATION I hereby affirm.Lnfle41$enalty of perjury that I am licensed under provisions of Chapter 9 (commencing with coon 7000) of Division 3 of the Business an ions Co ,and my license is in full force ,j%W8 Cl • Z% WGenSe Class • • License No Date Contractor Sig natUr ignatur WORKERS' bUMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP T ONE HUNDRED THOUSAND DOLLARS (§100,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I 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 t Kn ance of the work for which this permit is issued. PolicyNo. ve and willmaintain 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' compensatioce carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone 0 I certify that, in the performance of the 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 that, if I should become sub' wo/rkg[�s�' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisi Signature of Applicant - ✓ Date Ig fes/ ' q DECLARATION REGA ING CONSTRUCTION LENDING AGENCY I hereby affirm under pally of perjury that there is a construction lending agency for the performance of the work for which this permit is issu (Section 3097, Civil Code). Lender's Name t 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 rovided is correct. I agree to comply with all applicable city and county o inances and state laws relating to building construction. I authorize representatives of this city or county to r ab dentified property for inspection purposes. \I Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nam/wc6 tof, ACTION OATS BY DECLARATION OF COMPLIANCE MTH ODEDF FOR OFFICE USE ON FEDERAL REGULATIONS PART 67 DFTtTCE40AND P€RMITEXP/R€O AQMDRULE ?403. ❑ tSUBMITi'EDA58E5T05N071F1C4T10NTD. PERMfTCRNC€LLED [3 EPA PERMITEXT€NOEO ❑ ALiNtD PERA7ITFINAL � PROPOSED E OLtil �71DNI5 NDTAPPLfCABLE TO C€R7tFtCR7€DF - SIGNATURE: QCCUPANCY75SUEO