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Home My WebLink AboutH2021-0349 - Permits+vn. City of Newport Beach - Building Division H2O21-0349 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 �"rcruvxt��a Job Address: 1612 HIGHLAND DR BIdg:1 Floor: Suite: Description of Work: MECH (2) NEW A/C UNITS *TAMPER PROOF CAP REQ* Inspector Area:3 Code Edit: 2019 Legal Description: N TR 3800 LOT 8 Owner: AMBER REBECCA Contractor: OWNER/BLDR Address: 4 RENATA Address: SEE X2020-0495 NEWPORT BEACH, CA 92657 • ° Phone: 949-285-8933 Phone: FurnacesBoilers & Compressors Con State Lie: O/B Issued Date:06/02/2021 Lie Expire: Bus Lie: Processed By: Lie Exp Date: MECHANICAL Permit: H2O21-0349 Project No : 0385-2020 Inspection Requests Phone (949)644-3255 Worker's Comp Insurance - Carrier : Policy No: "Expire : e m amo e m4 m o • ° m m FurnacesBoilers & Compressors Ventilation mom. m c c .: .. m m a mmmoc m oosoc sm ° mmmQec 2 $42.00 Bathroom Fan: 0 $0.00 Fire Dampers: moocco 990®pm ° Over 100K BTU/hr: 0 HVAC Items FEES FurnacesBoilers & Compressors Ventilation .: .. Other Up to 100K BTU/hr: 0 $0.00 Up to 3HP: 2 $42.00 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 $0.00 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: $36.54 Up to 1M BTU/hr: 0 $0.00 up to 10K CFM: 0 $0,00 Repair/Alter/Add: 0 $0.00 Model: AUD60WIAlssuance: $37.00 Up to 1.75M BTU/hr: 0 $0.00 Over 1 OK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: AC PRO Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $46.25 TOTAL: $161.79 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $161.79 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. IWNER-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) lection 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, priorto its issuance, also requires the applicant for ie 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 an jFRMasions 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 nprovementspere Trot 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 r°Qved for t4s pareose of sale). as owner o"e property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not pptyto 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). T am exemlgl-*&1 licensure under the Contractors' State License Law for the following reason: Lv My signatSre.bebw I acknowledge that, except for my pe nal residence in which I must have resided for at least one year prior to completion of the improvements covered b this per 1 , I cannot legalll eM a structure jhatj j ave built as an owner -build if of b constrV d in its entirety by licensed contractors. I understand that a copy of the applicable law, Sectio Bu ness and 'safessions OodeTishvailable upon request whe t ' appliC i '��brlE I or at the fol wing Web site:http://www.leginfo.ca.gov/calaw.html. Ijgp#fU re of Property Owner or Authorized Agent Da .1(;FUSED CdNTRACTOR'S DECLARATION ITeret�y affirr i Onciel 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, and my license is in full force nd effect. • • • Wrfse Class License No Date Contractor Signature MKERS' COMPENSATION DECLARATION IARNING: 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. 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 the erformance of the work forwhich this permit is issued. Policy No. I 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' urance carrier and policy number are: Policy Number Expiration Date me of Agent Phone # I certify that, in the perform a for which this permit is issued, I shall not employ any person in any manner so as to become subj t to the wolf a co flpensation laws of California, and agre It, if I should becom b' ct the ke compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those p sions (nature of Applicant Dat i !CLARATION REG TRUCTION LENDING AGENCY areby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec I n 3097, Civil Code). nder's Name Lender's Address 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 a s state I s lating to building construction. I authorize representatives of this city or coun nter th a-identifi d party for inspection purposes. 1 / I .% Print Prooertv Owner's or Authorized Anent's Joe ACTION I DATE EXPIRED PERMIT EXTENDED PERMIT FINAL CERTIFICATEOF OCCUPANCYISSUED BY UC4.LAHA11014 Ur GUMI-LJANUC 4W r" 6UUC Ur FEDERAL REGULATIONSPART 61 OF TITLE40ANO AQMD RULE 1403. ❑ /SUBMITTED ASBESTOS NOTIFICATION TO., ❑ EPA AQMD ❑ ASBESTOS M077RCA710MISAOT APPLICABLE TO PROPOSED DEMOLITION, SIGNATURE:.