HomeMy WebLinkAboutH2022-0154 - Permits0 wi}rF City of Newport Beach-- ^- 11i'cding Division 111111111111p111111111111111111p11111p111111111 MECHANICAL Permit: H2O22-0154
100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 2 0 1 5 4 Project No : 0256-2022
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`•; Permit Counter Phone (949)644-3288
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Inspection Requests Phone (949)644-3255
Job Address: 114 EMERALD AVE BIdg:1 Floor: Suite:
Description of Work: MECH -INSTALL HEAT PUMP @ 2ND FL DECK (ACCESSIBLE BY STAIRS) TAMPER -RESISTANT CAP REQUIRED
Inspector Area:2 Code Edit: 2019
Legal Description: BALBOA ISLAND RESUB SEC 1 BLK 3 LOT 19
Owner: GUARDIA PHIL Contractor:
Address: 114 EMERALD AVE Address:
NEWPORT BEACH, CA 92662
Phone:
Phone:
Con State Lic:
Issued Date:03/21/2022 Lic Expire:
Bus Lic:
Processed By: Lic Exp Date:
SIRIUS MECHANICAL INC
16692 MARIPOSA
RIVERSIDE CA 92504
951-640-5097
851512
11/30/2023
BT30078031
02/28/2023
Worker's Comp Insurance -
Carrier: STATE COMP. INS
Policy No: 9055133
Expire :0510112022
4G Items
FEES
nacesBoilers & Compressors
Ventilation
Other
to 100K BTU/hr:
0
$0.00
Up to 3HP:
0 $0.00
Bathroom Fan:
0 $0.00
Fire Dampers:
0 $0.00
$0.00
:r 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
II/Floor Heaters:
0
$0.00
>15 HP to 30 HP:
0 $0.00
Attic Fan:
0 $0.00
Metal Fireplace:
0 $0.00
it Pumps & Package
Units
>30 HP to 50 HP
0 $0.00
Down -Draft Fan:
0 $0.00
Record Mgt Fee:
$0.00
to 100K BTU/hr:
1
$22.00
>50 HP:
0 $0.00
Residential Hood:
0 $0.00
Additional Fee :
$0.00
Investigation:
$0.00
ar 500K BTU/hr.
0
$0.00
Air Handling Units
Comm. Hood:
0 $0.00
Plan Check:
$19.14
to 1 M BTU/hr:
0
$0.00
up to I OK CFM:
0 $0.00
Repair/Alter/Add:
0 $0.00
Model:
Mxz-5c42NA2
Issuance:
$38.00
to 1.75M BTU/hr:
0
$0.00
Over 1OK CFM:
0 $0.00
Supplemental Fee:
$0.00
Manufacturer:
MITSUBISHI
:r 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.
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DECLARATION
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 items)
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
ie 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
'rofessions 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
of more than five hundred dollars ($500).
11, 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,
lusiness 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
rprovements 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
rproved for the purpose of sale).
3 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
pply 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).
I am exempt from licensure under the Contractors' State License Law for the following reason:
ly 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
ell 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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.govlcalaw.htmi.
signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
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 Pro ions Code, an y icense is in full force
nd effect.
icense Class License No Date % - ZZContractor Signature
VORKERS' COMPENSATION DECLARATION
IARNING: 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
'DST 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 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
ormance 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:
of Agent
certify that, in the performance
, if I should become subj ct to i
lature of Applicant
Policy Number Expiration Date
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
ZKprovisi o SecNn 3700 of the Labor Code, I shall forthwith comply with those provisions.
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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 ord' ces and state la r ting to building construction.
I authorize representatives of this city or county to a he bove-idel pert r inspection purposes. (� 2!
Signature of Property Owner or Authorized Agent) /l� C n Print Property Owners or Authorized Agent's Na l T6 Date 3 22—
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONSPART 61 OF PTLE40 AND
AQMDRULE 5403
PERMITEKPIRED
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PERMIT CANCELLED
PERMITEXTENDED
PERMIT FINAL
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CERTIFICATEOF
SIGNATURE: •e®
OCCUPAMCYfSSUED
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