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Home My WebLink AboutH2019-0792 - PermitsCity of Newport Beach - Building Division H2O19-0792 MECHANICAL Permit: H2O19-0792 100 Civic Center Drive, Newport Beach, CA 92660 Project No: 0482-2019 M. ` Permit Counter Phone (949)644-3288 9V. �'is�y.4sy+` Inspection Requests Phone (949)644-3255 Job Address: 1700 SKYLARK LN BIdg:1 Floor: Suite: Description of Work: MECH/(3) NEW A/C UNITS "TAMPER RES CAP REQUIRED" InspectorArea:3 Code Edit: 2016 Legal Description: N TR 3082 LOT 63 Owner: MATSLER SEAN Contractor: GRAVES M H INC Worker's Comp Insurance - Address: 1700 SKYLARK LN Address: 5852 MULLER ST Carrier: OAK RIVER INSURANCE NEWPORT BEACH, CA 92660 BELL GARDENS CA 90201 Policy No: MHWC127932 Phone: Phone: 562-833-3703 Expire :01/01/2021 Con State Lic: 241731 Issued Date:12/08/2019 Lic Expire: 03/31/2022 ° Bus Lic: BT30034436 Processed By: Lic Exp Date: 04/30/2021 G...� rONmos ° G O ® 6 ° 00 G U 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 100K BTU/hr: 0 $0.00 > 3 HP to 15 HP: 0 $0.00 Exhaust Fan: 0 $0.00 Gas Line: 0 $0.00 $0.000 Wall/Floor Heaters: 0 $0.00 >15 HP to 30 HP: 0 $0.00 Attic Fan: 0 $0.00 Metal Fireplace: 0 $0.00 D Heat Pumps &Package Units >30 HP to 50 HP 0 $0.00 Down -Draft Fan: 0 $0.00 Record Mgt Fee: $0.00 D 4 B p ° Up to 0 BTU/hr: 0 0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee: $0.00 °°-mG Investigatlbn? ^ $0.00 Over 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 ° Plan Check ° ° $52.20 ` Up to 1M BTU/hr: 0 $0.00 up to 1 O CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: YHG30B21 S Issuance: $35.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: YORK Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $41.50 TOTAL: $188.70 Plan Check Fee : $188.70 Fee Due at Permit Issuance : $0.00 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. I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable item(s) lection 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 1e 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 'rofessions 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 of more than five hundred dollars ($500). I, 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, lusiness and Professions Code: The Contractors' Stale License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the nprovements 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 nproved for the purpose of sale). 11, 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 pply 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). 7 I am exempt from licensure under the Contractors' State License Law for the following reason: ly 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 legally ell 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 'rofessions 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 .ICENSED CONTRACTOR'S DECLARATION ��,��nnnnnn 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 Professions Code d y license is in full force nd is iceffect. / ense Class License No Date/ ///i 9126 Contractor Signature �o VORKERS'.(:QMAENSATION DECLARATION / I IARNIfIp: FAILURE TO S?CURE 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 Q 4)S: COMPENNATIONPDAMAGES AS PROVIDED FOR IN SECTION $706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ssess hereby affirm underspenalty of perjury one of the following declarations: 11 rdve andA maintain 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 mance of 1b.ejytd k for which this permit is issued. Policy No. ba3e 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' compensatior Vjvice carriyl9gd policy number are: iarrAr. Policy Number Expiration Date lagill Agent - rnoneP .. 3I cer6ty lhat,tiq jlfe 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 agree x4if.l.should be cone subb''e t to the /y/yk compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prowslo rgRature of AppZt • / /r1AA W- //n Date // X 9/?4 IECLARATION REGARDtG CONSTRUCTION LENDING AGENCY hereby affirm under penalty 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 ly 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. I authorize representatives of this city or county nter th b ve-identified property for inspection purposes. �f J�'1410Date / ,...,...,,.e ..f G....,e.f„ n,.n,er ,.r Anfhnri7=H Anent / W. J . Aiie Print Pronertv Owner's or Authorized ADent's Name M. �r-��' P. ACTION I DATE I BY I' FEDERAL IREf3ULATK3NSPART6tOFTITLEd0ANG IPERMITEXTENDED I I / I OCCUPANCY(SSUED ❑ ISUBMITTEDASBESTOS NDTIFICAT/ON TO:. ❑ EPA ❑ AQMD ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSEDDEMOLITION. SIGNATURE