HomeMy WebLinkAboutH2021-0277 - Permits+� City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
100 Civic Center Drive, Newport Beach, CA 92660
r; Permit Counter Phone (949)644-3288 H 2 0 2 1 0 2 7 7
is y
Job Address: 1973 PORT CARDIGAN PL BIdg:1 Floor: Suite:
Description of Work: MECH/INSTALL (1) NEW A/C UNIT 40dB (CARRIER; 38MAQB18-3)
InspectorArea:4 Code Edit:
2019
Legal Description: N TR 7027 LOT 69
Owner: VASQUEZ DAVID
Contractor:
Address: 1007 EMERALD BAY
Address:
LAGUNA BEACH CA 92651
Phone:
Phone:
Issued Date:04/26/2021
Con State Lic:
Lic Expire:
Processed By:_
Bus Lic:
Lic Exp Date:
rnacesBoilers & Compressors
to 100K BTU/hr: 0 $0.00
er 100K BTU/hr:
0
$0.00
all/Floor Heaters:
0
$0.00
at Pumps & Package Units
to 100K BTU/hr:
0
$0.00
er 500K BTU/hr:
0
$0.00
to I BTU/hr:
0
$0.00
to 1.75M BTU/hr:
0
$0.00
ar 1.75M BTU/hr:
0
$0.00
RANCHO VIEJO A/C & HEATING
22596 COTTONWOOD CIR
LAKE FOREST CA 92630
949-212-4870
745018
11/30/2021
BT30031040
03/31/2022
Ventilation
�"Q
Up to 3HP:
1
$21.00
Bathroom Fan:
0 $0.00
> 3 HP to 15 HP:
0
$0.00
Exhaust Fan:
0 $0.00
>15 HP to 30 HP:
0
$0.00
Attic Fan:
0 $0.00
>30 HP to 50 HP
0
$0.00
Down -Draft Fan:
0 $0.00
>50 HP:
Air Handling$0.00
Units
0
$0.00
Residential Hood:
0
UP to 1OK CFM:
0
$0.00
Comm. Hood:
Repair/Alter/Add:
0 $0.00
0 $0.00
Over 10K CFM:
0
$0.00
Supplemental Fee:
$0.00
VAV Box:
0
$0.00
MECHANICAL Permit: H2O21-0277
Project No: 1394-2020
Inspection Requests Phone (949)644-3255
Worker's Comp Insurance -
Carrier: NORGUARD INSURANCE
Policy No: RAWC223022
Expire :01/01/2022
Fire Dampers:
0 $0.00
Gas Line:
0 $0.00
Metal Fireplace:
0 $0.00
Record Mgt Fee:
$0.00
Additional Fee:
$0.00
Model:
Issuance:
Manufacturer:
Other
$0.00
$0.00
Investigation:
$0.00
Plan Check:
$18.27
$37.00
Zoning PC: $46.25
TOTAL: $122.52 Plan Check Fee
$0.00 Fee Due at Permit Issuance : $122.52
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday - Friday 7:00 a.m.to •&:80ycv. q?,anJi ,9tOP4ay farm 84 aa.m. to 6:00 p.m,
c a a s a cac
O O M 00 !J O G
C O p D ® O f9 O
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f C G O (i C
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e item(s)
iWNER-BUILDER DECLARATION ipt
I hereby affirm under penalty of perjury that I am n exert
oomy that requires a perm tlto construct, oalter, improve, demolish, sh, or repair any structure, priorlt it ssuancehave placed eal iv sion reqxt to the uires the lap si ant for
Section 7031.5, Business and Professions Code y Y applicant to a civil penalty of
IS-roa permit
to file a signed
that statement that he or she
she is exempt from sicenns edpursuant to the and the basis foprovisions of the
exemption. Any violation lof Sect on 7031.5tby any applicant orJa permit subjeith Section cts the appon 3 of the Business an
of more than five hundred dollars ($500). ortions of the work, and the structure is not intended or offered for sale (Section 7044,
I, as owner of the property, or my employees with wages License
their sole compensation, will do owner o all of property
L) p
mprovemands are not mended or offered for sale. State
If, however. the builoes not ilding or improy to an vement vement ssoldfwithin one year of completioln, the Owner -Builder havle the ds rbu den of proving improves theproperty, that itwasnot built that fon
mproved for the purpose of sale). ly
] 1, as owner of
ply to an owner the property,
who exclusive
rs there and who contracts for the projects with a licensed C ntract r pursuant to he Contr actors' State L censerLaw)s' State License Law oils no
I am exempt from licensure under the Contractors' State License Law for the following reason:on of
By
a structure below
l have acknowledge
nbuilt all geowner--buris per
ilder if t has not beenconstructedco strutted sidence in mitt lmust
tirrety by licensed
ftsI understand that a copy of thehappl cable aw,tSection 7044s covered by fof the Businessnandlegal
Date
Professions Code, is available upon request when this application is submitted or at the following Wleginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencin0) of Division 3 of the Business and Professions C e my license is in u force
and effect. DContractor Signature
License Class License No
WORKERS' COMPENSATION DECLARATION
COST OF COMPENSATION, PENSATION DAMAGES AS a' COIDED FOR IN SECTIOMPENSATION N ]GE IS UNLAWFUL, AND SHALL THE LABOR CODE, INTEREST,CT AN AND EMPLOYERTORNEY'S TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNOREe THOUSAND DOLLARS ($700,000), IN ADDITION TO T
LURE TO SECURE WORKE
I hereby affirm under penalty of perjury one f the following declarations:
f onsent 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
I have and will maintain a certificate o c
of the work for which this permit is issued. Policy No.
for the performance of the work for which this permit is issued. My workers' compensatio
:dbrmance
tion insurance, as required by Section
3700 of the Labor Code,
I have and will int in workers' camp
surance carrier a ofcy number are: w
Expiration Date
P0" m
Phone #
arrier
ame of Agent: -er
so as to workers' compensation laws of California, an agree
Il
Perm shall forthwith complybwith hose pro i; Dose
prove lions of Selctionll3700 of not the Labor Code,loy any person
Ify mance of fwor o or which
L
es o
altc f I shouad becom act to thecompnsatis
De )`
ignature of Applicant
of the work for which this permit is issued (Section 3097, Civil Code).
iECLARATION REGA I CONSTR ION LENDING AGENCY
lending agency forLthe
hereby affirm under p ally of perjury th t there is a construction
enders Armance ddress
ender's Name
ly my signature belovi, I certify to each of the following:
to on the property owner's behalf.
I am the property owner or authorized act
the information I have provided iscpfrect.
I have read this application and
I agree to comply with all applicable city and county ordinanc s a tate laws relating to building construction.
property for inspection\ Date
I authorize representatives of this city or co ty enter th b I entified
Property Owner's or Authorized Agent' s Name L-
ii nature of Property Owner or Authorized Agen -
FOR OFFICE USE ONLY
DECLARATION OF COMPLIANCE WITH CODE OF
ACTION DATE BY •
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PERMITEXPIRED
PERMIT CANCELLED
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❑ ASBESTOS N071FICA77ON IS NOT APPLICABLE TO
PERMITEXTENDED
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CERTIFICATEOF
OCCUPANCYISSUED