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H2019-0649 - Permits
ti City of Newport Beach - Building Division, 11111111111111111111111111111111111111111111111111 MECHANICAL Permit: H2o19-osa9 ' 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 9 0 6 4 9 Project NO Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 108 EMERALD AVE° Bldg:1 Floor: Suite: Description of Work: MECH/NEW A/C ON ROOF "TAMPER RESISTANT CAP REQ" ! INSPECTOR Inspector Area:2 Code Edit: 2016 Legal Description: ` BALBOA ISLAND RESUB SEC 1 BLK 3 LOT 22 • - Dace •s. Owner: EMERAL ILL Contractor: CUNEOAIR 'INC • Worker's Comp Insurance- •••• ••••^° Address: 108 RALD A Address: 3565 LATHROP AVE Carrier :STATE COMP . • ° N PORT BEAC CA 92662 SIMI VALLEY CA, 93063 e Policy No: 9262380 e • e o Phone: Phone: 805-526-1765 Expire:1010712020 •°© °° e e Con State Lie: 783055 _ • •' Issued Date: /22/2019 Lie Expire: - 08/31/2020 ee °O ° Bus Lie: BT30069432 • • • ° Processed By: ' Lie Exp Date: 1013112020 .S'LTBJFCT TO FTFCD INSPF(TY(().t? f} REVIEW ANL)-APPR()VFtLo HVAC Items IfFEES .... FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 0 ' $0.00 Up to 3HP: 1 $20.00 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 Over500K BTU/hr: 0 ' $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check:-$17.40 Up to 1 M BTU/hr: 0 $0.00 ' , up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: AM060MXMDCH/AA Issuance: $35.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer:- SAMSUNG Over 1.75M BTU/hr: 0 $0.00 VAVBox: 0 $0.00 Zoning PC: $41.50 TOTAL: $113.90 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $113.90 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE R LAST VALID INSPECIOM Construction Hours: MondayFriday 7 00 6 30 Saturday from 8:T GON&TRUCTION NOISE a.m.to p.mpand . ON THE WEEKEND 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 6ind 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 U all of or L) 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). ❑ I, asowner 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 Iicensure under the Contractors' State License Law for the following reason: By my signature.*Iop l.acknowledge that, except for my personal residence in which 1 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 4fcasions Code* is. available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Slgnaturg of Prof,94y, Qfiner or Authorized Agent Date QCf_NgED CONJRACTOR'S DECLARATION I fierebf affirm under pe. alty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profe e, and foe se is in full force and effect. . . . 4ceAca Class License No Date /I% Contractor Signature WORKERS' CCrIMIR NSATION DECLARATION W NIWQ: 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 (E100,000), IN ADDITION TO THE CPIT OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. I : ereby affirm un d er�p�e�ealty of perjury one of the following declarations: C-I..6l ame 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 p rMd1i of (tl@WprKfor which this permit is issued. Policy No. .... �hvce 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 nsecarrier and policy number are: Policy Number Expiration Date Name of Agent le Phone # 131 certify that, in the performance of for hich t arm' sued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre that, if I should become subject to ers' o ion I ns of Section 3700 of the Labor Cade, I shall forthwith comply with those provisions: G� Signature of Applicant Date), JO�y/ DECLARATION REGA DIN NSTRUCTIO ND G AGENCY I hereby affirm under penalty of perjury that th is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil 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 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 to ant above -identified property for inspection purposes. � Signature of Property Owner or Authorized Agent Print Property Owners or Authorized Agent's Name St DaTe� i AL'T/OM DATE BY DEClARATfflNOFCOMPLIANCE WtTff CODE OF FOR .OFFICE USE ONLY FEDERAL REGULATIONS PART 61'flFT17LE40AN0 AQMD RULE 7403. '.. PEftMiTEXPfttED ❑ t SUBMfTTEf}ASBESTflS NOTIFICATION TO: ❑ EPA ❑ AQMD '.PEftMfTCtkNCE!!ED PEJ2MfTEXTENDED �OPOSf6liEMOUTION.UDN15 NOT APPLICABLE TO 'PEFAflTF11VAt ' fERTlF1C41TE OF SIGNATURE: .occUPArvcvrssU;=D