HomeMy WebLinkAboutH2021-0413 - Permits0��, City of Newport Beach - Building Division p11111111111111111p111111111111p11111p111111111 MECHANICAL Permit: H2O21-0413
100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 1 0 4 1 3 Project No : 0959-2020
�.`y n Permit Counter Phone (949)644-3288
�'rtrra�i�+"�'n Inspection Requests Phone (949)644-3255
Job Address: 2415 SIERRA VISTA BIdg:1 Floor: Suite:
Description of Work: MECH - INSTIL 2 A/C CONDENSERS. TAMPER -RESISTANT CAPS & TIMERS REQUIRED. LETTER ON PLAN
Inspector Area:3 Code Edit:
2019
Legal Description: N TR 1801 LOT 7
Owner: MANSOUR NICK
Contractor:
Address: 2415 SIERRA VISTA
Address:
NEWPORT BEACH, CA 92660
Phone:
Phone:
Con State Lic:
Issued Date:0710912021
Lic Expire:
Bus Lic:
Processed By: =A
Lic Exp Date:
VOGEL CHARLES M
1601 MANZANITA LANE
MANHATTAN BEACH CA 90266
310-613-3602
388241
Worker's Comp Insurance -
Carrier: NO EMPLOYEES
Policy No:
Expire :
BT300549 / ���rrry^•
BT300021 N�-MV p
06/30/2021 ` T
HVAC Items
FEES
FurnacesBoilers & Compressors
Ventilation
Other
Up to 100K BTU/hr:
0
$0.00
Up to 3HP:
2 $44.00
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:
$38.28
Up to 1 M BTU/hr:
0
$0.00
up to 1 OK CFM:
0 $0.00
Repair/Alter/Add:
0 $0.00
Model:
N4A648GKBIssuance:
$38.00
Up to 1.75M BTU/hr:
0
$0.00
Over 1 OK CFM:
0 $0.00
Supplemental Fee:
$0.00
Manufacturer:
TEMPSTAR
Over 1.75M BTU/hr:
0
$0.00
VAV Box:
0 $0.00
Zoning PC:
$52.00
TOTAL:
$172.28
Plan Check Fee
: $0.00
Fee Due at Permit Issuance :
$172.28
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Gonsrryct111n`Hours:.',Mr1n(1ay- Friday 7:00 a.m.to 6:30 p.m.and Saturday from 8:00 a.m. to 6:00 p.m.
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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 Iicensure 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 `) 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, 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
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 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
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
Professions 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
LICENSED CONTRACTOR'S DECLARATION
I 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 Cod - nd y_ticense is in full force
and effect.
License Class License No Dat l Contractor Signatu��L✓J�
WORKERS' COMPENSATION DECLARATION
NARNING: 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
COST 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:
❑ 1 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
oerformance of the work forwhich this permit is issued. Policy No.
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'
rance carrier and policy number are:
Policy Number
Date
ertify that, in the performance of the H,,,oml'mit 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
if I should become subject /I/ f4h wor_vlslons of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of ApplicantR /i��� Da t � ' Y (ntJ
CLARATION REG,4 IN CONSTRUCT LE A NCY
:reby 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).
ider'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 ordinances a d to laws relating to building construction.
I authorize representatives of this city or county to ant t e - �nr-inspection purposes.
nature of Property Owner or Authorliz(
4 Print Property Owner's or Authorized Agent's Name
ACTION
DATE
BY
DECLARATION OF COMPLIANCE MTH CODE OF
FOR OFF
FEDERAL REGULATIONSPART 51 OF TITLE4Q AVD;
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❑ ISUBMITTEDASBESTOS NOTIFICATION fA:: •.
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❑ ASBESTOS A107IRCAIJONIS NOTAPPLICABLETO
PROPOSED DEMOLITION. ';' , •
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PERMIT EXPIRED
PERMIT CANCELLED
PERMITEXTENDED
PERMIT FINAL
OCCUR
SIGNATURE: : •
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NCYIS
OCCUPANCYlSSUED
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