HomeMy WebLinkAboutH2022-0156 - PermitsCity of Newport Beach - Building Division III 11111111111111111111111111111111111111111111
d 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 2 0 1 5 6
n, Permit Counter Phone (949)644-3288
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MECHANICAL Permit: H2O22-0156
Project No:
P
Inspection Requests Phone (949)644-3255
Job Address: 198 HARTFORD DR BIdg:1 Floor:
Suite:
`y ' V
Description of Work: MECH CHANGE OUT A/C UNIT
*TAMPER PROOF
CAP REQ*
Inspector Area:4 Code Edit: 2019
Legal Description: TR 11604 LOT 5 UNIT 118 OF
PROJECT LOCATED
ON AP 442-291-40
TOGETHER
Owner: TAVARES HUMBERTO C
Contractor:
SADDLEBACK PLUMBING INC
Worker's Comp Insurance -
Address: 198 HARTFORD DR
Address:
23901 REMME RIDGE
Carrier: EVEREST
NEWPORT BEACH, CA 92660
LAKE FOREST CA 92630
Policy No: SNP1296829
Phone:
Phone:
949.829-0910
Expire :07/01/2022
Con State Lic:
414946
Issued Date:03/22/2022
Lic Expire:
01131/2024
Bus Lic:
BT30076374
Processed By:
Lic Exp Date:
08/31/2022
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HVAC Items
FEES
FurnacesBoilers & Compressors
Ventilation
Other
Up to 100K BTU/hr:
0
$0.00
Up to 3HP:
1 $22.00
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:
$19.14
Up to 1 M BTU/hr:
0
$0.00
up to 1 OK CFM:
0 $0.00
Repair/Alter/Add:
0 $0.00
Model:
ML14XC1-0361ssuance:
$38.00
Up to 1.75M BTU/hr:
0
$0.00
Over 10K CFM:
0 $0.00
Supplemental Fee:
$0.00
Manufacturer:
LENNOX
Over 1.75M BTU/hr:
0
$0.00
VAV Box:
0 $0.00
Zoning PC:
$52.00
TOTAL:
$131.14
Plan Check Fee:
$0.00
Fee Due at Permit Issuance:
$131.14
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.
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 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 ($500).
1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
improved for the purpose of sale).
1, as owner of th: property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
.eee
I am exempt from Iicensure under the Contractors' State License Law for the following reason:
VV Signature WOW acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall)
sell a structureetMat' Lave built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm].
Sigrfature of Property.Owner or Authorized Agent Date
I210EN$ED CONiRACTOR'S DECLARATION
I hel28y affirm upder"nalty of perjury that I am licensed under provisions of Chapter 9 (commencing ith cti 700 of Division 3 of the Business ajid rofessions e iense is Cadcin full force
arld effect. e e e e
Liceaae Class License No Date /N Contractor Signature
PTR4fRS' C&PFNSATION DECLARATION
NARNIN01 FAILURE TO BEOU RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS )r100,000), IN ADDITION TO THE
WQ.1TeC(FFOMPENSAIMON, BAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
�he`rgVaffirm yrl tA§nalty of perjury one of the following declarations:
ee e
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 thi
ierfformance of the work for which this permit is issued. Policy No.
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'
carrier and policy number are:
Policy Number
of Agent
Date
I certify that, in the perforrance of the work for which this pe sued, I shall not employ any person in any manner so as to become subject to a workers' compensation laws of California, and agree
that, if I should become ub ct to thew ers' comp n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pro at s.
Signature of Applicant Date LZ
DECLARATION REGAR I CTION LENDING AGENCY
I hereby affirm under penaltyM7erjury that there is a construction lending agency for the performance of the work for which this permit is issued ( cti n 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 orrect.
I agree to comply with all applicable city and ou ty ordinanced state Is sting to building construction.
1 authorize representatives of this city or coun o en er the ove-I w led property for inspection purposes. •/�/ r �� �I ���' . w' 2 rL
Signature of Property Owner or Authorized Agent - Print Property Owner's or Authorized Agent's Nam F�titi ` (J�/t�(A/lJ-Lt D `�.
ACTION
DATE Q
DECLARATION OF COMPLIANCE KITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF T17LE40AND
AQMD RULE 1403.
PERMIT EXPIRED
❑ I SUBMiTTEDASBESTOS NORFICATION' TO:
❑ EPA
❑ AQMD
PERMITCANCELLED
PERMfT.EXTENDED
❑ ASBESTOS NOTIFICATIOIVIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
7—
CERTIRCATEOF
OCCUPANCYISSUED
SIGNATURE:
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