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Home My WebLink AboutH2019-0710 - PermitsCity of Newport Beach - Building Division III III IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII MECHANICAL Permit: H2019-0710 A 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 9 0 7 1 0 Project No: 2334-2017 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 25 HARBOR POINTE BIdg:1 Floor: Suite: Description of Work: MECH - (3) A/C CON DENSORS. TIMERS REQ'D ON #2 & 3. TAMPER-RESISTANT CAPS REQ'D ON ALL nspectorAreaA Code Edit: 2016 Legal Description: N TR 10625 LOT 18 Owner: VINH PHAN Contractor: OWNER/BLDR Worker's Comp Insurance - Address: 25 HARBOR ISLAND Address: Carrier : CORONA DEL MAR CA 92625 Policy No: Phone: 303-523-8585 Phone: Expire FurnacesBoilers & Compressors Con State Lie: O/B Issued Date:11/13/2019 Lie Expire: Processed By: y Bus Lie: Lic Exp Date: INSPECTe%R HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 0 $0.00 Up to 3HP: 3 $60.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 $0.00 Over 1 o0K 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 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: $52.20 Up to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: SEE PLANlssuance: $35.00 Up to 1.75M BTU/hr: 0 $0.00 Over 1OK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: CARRIER Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $41.50 TOTAL: $188.70 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $188.70 PERMITS EXPIRE 980 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Frtday tV0 a..tn to `00 p. MmanaVaturday from 8:00 a.m. to 6:00 p.m. a O O 0 0 E O 6 r v G 4Ei0 (+ 0 O O� JGC. m O G Gt4 C C C G G E C E G `O iG GY4 i Y (i4E YG GNV 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 L) 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 im roved 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 legal) 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 Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and ProfEd s Code, and y license is in full f and effect. License Class License No Date t I Contractor Signatur WORKERS' COMPENSATION DECLARATION WARNING: 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: :11 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 performance of the work for which this permit is issued. Policy No. ❑1 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' compensatio insurance carrier and policy number are: arrier Policy Number Expiration Date am of Agent Phone # I c rtify that, in the performance of the ork fo hich 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, I should become subject to the w rkers' co pensation provisions o ection 3700 of the Labor Code, I shall forthwith comply with those provisions. -` Z o1 nature of Applicant Dare 1 I DECLARATION REGARDING CONSTRUCTION LEN AGEN Y I hereby affirm under penalty of perjury that there is a construction I nding agency for the performance of the work for which this permit is issued (Section 3097, ivil Code). 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 hav vide d is correct. I agree to comply with all applicable city and cou ordin ces and state s rela' gt'b bulldmg construction. I authorize representatives of this city or county entert ov pr erty for inspection purposes.-�1.. Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name ✓" (I I ' Date t t pC'Tlortr 70ATE8DECLAAAT]DN OF COMFtlANCE4YiT8COD£OF FOROFFICEQSEQNtY F69EA'A6REGJ/LATfQNSFAfj$$]Q✓rT]TLEdQAl+]➢ PFRMlTEXPtRED MD{=ULF14Gy?.t�AgStfBM►77C-0AS✓��STOSM}QlIF1�TlDNTO: FERA9lTCAfWCEttED LJ: EPA•iPERMlTEXTENDED❑ADM➢ A58EST05NQTJRCAitQNtSNDT APPtfCABLE TO PAOPO&Ef}DEh9atdTdL]N. • • • • • i • i• i i i i i i FERMlTFtNAt d..Y., GERTIFfCATE OF S]GNAFURE:• • o • es • r CrGCQPANCYISSttED