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H2019-0700 - Permits
City of Newport Beach -Building Division MECHANICAL Permit: H2O19-0700 100 Civic Center Drive, Newport Beach, CA 92660 H 11 0 1 9 0 7 0 0 Project No : 2709-2018 Permit Counter ,Phone (949)644-3288 cr�xanx��� Inspection Requests Phone (949)644-3255 Job Address: 404 FULLERTON AVE BIdg;1 Floor: Suite: Description of Work: MECH/RELOCATE EXTG CONDENSER "TAMPER RESISTANT CAP REQ" ����® Inspector Area:2 Code Edit: 2016 Legal Description: FIRST ADD TO NEWPORT HEIGHTS BILK 29 LOT 2 Owner: KEELING GREG Contractor: SCOTT AIR INC Worker's Comp Insurance - Address: 404 FULL VE Address: 19015 SUNDOWN LN Carrier: SECURITY NATIONAL INS ..... NEWP T BEAC , CA 92663 YORBA LINDA CA 92886 Policy No: SCWC060118 Phone: 94 -278-6643 Phone: 714-404-5807 Expire :03/01/2020 ° Con State Lic: 928382 Issued Date: 1/06/2019 Lic Expire: 11/30/2019 Bus Lic: BT30066720 Processed By:- Lic Exp Date: 04/30/2020 TIMER REQUIRED ON EQUIPMENY ° TO SHUT OFF BETWEEN 10 P.M. AND%"` tJh HVAC Items FEES cmn>cro w` FurnacesBoilers & Compressors Ventilation Other . Up to 1OOK BTU/hr: 0 $0.00 Up to 3HP: 1 $20.00 Bathroom Fan: 0 $0.00 .... Fire Dampers: 0 $0.00 ° $010 ..° Over 1 OOK 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 1 OOK 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: $17.40 Up to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model 4TTR6048JIssuance: $35.00 Up to 1.75M BTU/hr. 0 $0.00 Over IOK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: TRANS Over 1.75M BTU/hr. 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $41.50 TOTAL: $113.90 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $113.90 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. SI-IBJECT TO FIELD INSPECTOR'S REVIEW AND APPROVAL DWNER-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 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:http://www.leginfo.ca.gov/calaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED COVM,CTOR'S DECLARATION 1:f ejq,"ffirm urlper p®nalty of perjury that I am licensed under provisions of Chapter 9 (commencing with S do -7000n) ofI Division 3 of the Business and Profession Code, nd my license is in full force and effect. ..... �v'_ Li%ense Class License No Date Contractor Signatural &OIRKERS' cooliNSATION DECLARATION NARNIN& FAILURE O SECtt 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 00811 V. COMPENSAI IMIDAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. here �j affirm ullat pl'palty of perjury one of the following declarations: 1^F�awe 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 the eCf t ce'of the work for which this permit is issued. Policy No. iejand wfi'hialat'lin workers' compensation insurance, as required by Section 3700 of the Labor Code, s®carrier and policy number are: .• Policy Number for the performance of the work for which this permit is issued. My workers' Date lame of Agent I— — 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 agref Hat, if I should become subject to the rs' comp nsation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.. ignature of Applicant Date iECLARATION REG CONS_ U T LENDING AGENCY hereby affirm under 1pnalty 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). ender's Name Lender's Address y 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 state laws relating to building construction. lit . (, , I C'( I authorize representatives of this city or cou ty toe r t e e -identified property for inspection purposes. signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Dat ACT/ON DATE BY PERMITEXPIRED PERPAIT CANCELLED PERMITEXTEMDED PERMITFINAL CERTIFICATE Jar - - OCCUPANCYISSUED FEDERAL REGULATIONS PART 01 OF 71111-1:40AND AQMD RULE 1403. I SUBMLTTEDASBESTOS NDDFICATION TO: © EPA p AOMD ASBESTOS NOFRRCADONIS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: