HomeMy WebLinkAboutH2020-0310 - PermitsCity of Newport Beach - Building Division 1111111111111111111111111111111111111111111111111
100 Civic Center Drive, NewportBeach, CA 92660 H 2 0 2 0 0 3 1 0
F,. Permit Counter Phone (949)644-3288
Job Address: 2107 VISTA ENTRADA Bldg:1 Floor: Suite:
Description of Work: MECH/FAU C/O (NOT TOUCHING COMMON WALL)
InspectorArea:8 Code Edit: 2019
Legal Description: TR 5878 (L.L.84-214031) PAR 17
Owner.' HESS RENEE Contractor: OWNER/BLDR'`
Address: 210 r9TX`ENTRADA Address:
NEWPORT BEACH. CA 92660
Phone:
Issued
Phone:
Con State Lic: O/B
Lic Expire:
Bus Lic:
Lic Exp Date:
AC Items
' /
FEES
•nacesBoilers & Cam
ssors
Ventilation
to 100K BTU/hr:
1
$20.00
Up to 3HP:
0
$0.00
Bathroom Fan:
0 $0.00
:r 100K BTU/hr:
0
$0.00
> 3 HP to 15 HP:
0
$0.00
Exhaust Fan:
0 $0.00
II/Floor Heaters:
0
$0.00
>15 HP to 30 HP:
0
$0.00
Attic Fan:
0 $0.00
it Pumps B Package
Units
>30 HP to 50 HP
0
$0.00
Down -Draft Fan:
0 $0.00
to 100K BTU/hr:
0
$0.00
>50 HP:
0
$0.00
Residential Hood:
0 $0.00
.r 500K BTU/hr.
0
$0.00
Air Handling Units
Comm. Hood:
0 $0.00
to 1 M BTU/hr:
0
$0.00
up to 1 OK CFM:
0
$0.00
Repair/Alter/Add:
0 $0.00
to 1.75M BTU/hr:
0
$0.00
Over 10K CFM:
0
$0.00
Supplemental Fee:
$0.00
-r 1.75M BTU/hr:
0
$0.00
VAV Box:
0
$0.00
MECHANICAL Permit: H2020-0310
Project No :
Inspection Requests Phone (949)644-3255
Worker's Comp Insurance -
Carrier :
Policy No:
Expire :
Fire Dampers:
Gas Line:
Metal Fireplace:
Record Mgt Fee
Additional Fee:
Model:
Manufacturer:
0 $0.00
0 $0.00
0 $0.00
$0.00
$0.00
Issuance:
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Of 46
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1f°9809
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Other
B
$0.0000(°
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$O.O�t0000-
°
0O0o
InvestigatiomB°
Plan Check:
$35.00
QoOeo
$20.0010°I
$0.00
Zoning PC: $0.00
TOTAL: $75.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $75.00
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.
DWNER-BUILDER DECLARATION et+
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).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do `) 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
improved for the purpose of sale).
as owner of the property, am exclusively contracting th licensed Contractors constru 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 the on, d who contracts f the pro' ct .nth a licensed Contractor pursuant to the Contractors' State License Law).
LJ I am exempt from licensure under the Contractors'
By my signature below I acknowledge that, except for In
sell a structure that I have built as an owner -build r if it
Professions Code, is available upon request when
Signature of Property Owner or Authorized Agent
LICENSED CONTRACTOR'S DECLARATIO
I hereby affirm under penalty of perjury that I am licens
and effect.
♦r.e
Law for the
at least one year prior to completion of the improvements covered by thi
[tractors. I understand that a copy of the applicable law, Section 7044 of
p://www.leginfo.ca.gov/calaw.htmi. /I
Date\/ /
of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
Date ) Contractor Signature) o
VORI;ERS' COrMPENSATION DECLARATION
PM*fN '': FAILU%? y.. ftURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000), 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 j,41"Jintain 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
esfor'mence of the work for which this permit is issued. Policy No.
�t b0ve 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' compensatiol
Isurarte carrieP2nd ISolicy number are:
I IT ' Po' umber Expiration Date
Agent,. . Phone #
..
k �Fy that, irj ytg�oe r nc o t e work for hich this per ' ' i s e , I shall not employ any person in any manner so as to become subject to the workers' compen lion laws of California, and ogre
vG ' should be: � �asu j ct t the r s' ensation p tar f action 3700 of the Labor Code, I shall forthwith comply with those prov'sio
ignature of Applicant Date
IECLARATION REG DI E CY
hereby affirm under penalt of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Ci II 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 p pert owner's beh
I have read this application and the information I h i pr Ided is come
I agree to comply with all applicable city and county rd' a es and sta ws rota o wilding construction.
I authorize representatives of this city or county to t th b4;e�i i prop y fo j spectiop purposes.
License No
ACT70N
DATE
BY
DECLARATION OF COMPUANCEMTNCODEOF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OFTITLE40AND
AQMD RULE 1403.
PERMITEXPIRED
I SUBMITTEDASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERMITCANCELLED
PERMITEXTENDED
❑ ASBESTOS .E
PROPOS DDEMOUTION. UONIS NOT APPLICABLE
FERMIT RNAI
2
S 4A-
CERTIFICATE OF
SIGNATURE:
OCCUPANCYISSUED