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Home My WebLink Abouth2021-0287 - PermitsCity of Newport Beach - Building Division MECHANICAL Permit: H2O21-0287 c 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 1 0 2 8 7 Project No : 0380-2019 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 1227 OUTRIGGER DR BIdgA Floor: Suite: Description of Work: MECH - INSTL 2 A/C CONDENSERS. TAMPER -RESISTANT CAPS REQUIRED Inspector Area:6 Code Edit: 2019 Legal Description: N TR 6634 LOT 43 Owner: GALLOWAY CINDY & BRUCE Contractor: AIR MAX INC Worker's Comp Insurance - Address: 1227 OUTRIGGER DR Address: 27260 LOS ALTOS #123 Carrier: STATE COMP.INS CORONA DEL MAR, CA 92625 MISSION VIEJO CA 92691 Policy No: 9170882 Phone: 949-870-2653 Phone: 626-468-9999 Expire:12/08/2021 Con State Lie: 1015725 Issued Date:04/29/2021 Lie Expire: 07/31/2022 f, Bus Lie: BT30066145 Processed By: X \ Lie Exp Date: 11/30/2021 cz HVAC Items FEES ° a Furnaces Boilers & Compressors Ventilation Other Up to 1OOK BTU/hr: 0 $0.00 Up to 3HP: 0 $0.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 $0.00 Over 1OOK 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 1OOK BTU/hr: 2 $42.00 >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: $36.54 Up to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: RXTQ48TAVJUA Issuance: $37.00 Up to 1.75M BTU/hr: 0 $0,00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: DAIKIN Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $46.25 TOTAL: $161.79 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $161.79 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. .ao • e a O APB I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) 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 U 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). ❑ 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://w .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 Code, and my license is in full force and effect. / ,q License Class License No G7o ld%72] Date VW_ —7.yJ� Contractor Signaturs�[Y1__Li,--I' d '" WORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUWECT 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. I hereby affirm under penalty of perjury one of the following declarations: ❑ 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 thf rformance of the work for which this permit is issued. Policy No. ave 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' compensatior ins, Ice carrier and policy number are: i Policy Number Expiration Date Name of Agent Phone # ❑1 certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agref that, if I should become subject to the workers' compensation provi§ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant �i._�` Da P.2� DECLARATION REGARDI CONSTRUCTION LENDING AGENCY I hereby 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). 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 nter the above -identified pro/�rty for inspection purposes. Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name ��/ L✓"Y _ Date Bu2y_2&t ACTION DATE BY DECLARATION OF COMPLIANCE MrfTH CODE OF FOR OFFICE USE ONLY FEDERAL REGULA TIONS PART 61 OF TITLE40ANO AOMD RULE 1403: PERMITEXPIRED ❑ ISUBMtTFEDASBESTCN MOnFirATt AJO:. ❑ EPA �. ' �• •F ❑ AQMD[3 " 'e PERMIT C4NCELLED PERMITEXTENDED ASBESTOS PROPOSED DEMOLITION. TIDNis NOT APRLfCRBtc�'t'4J PERMIT FINAL —1 }-2'G i— CERTiFICATEOF OCCUR; NCYISSUED SIGNATURE: e `