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Home My WebLink AboutH2021-0643 - Permitsitfa City of Newport Beach - Building Division H2O21-0643 MECHANICAL Permit: H2O21-0643 c 10 100 Civic Center Drive, Newport Beach, CA 92660 Project No: 2199-2020 �^, �, Permit Counter Phone (949)644-3288 Inspection Requests Phone (949 644-3255 Job Address: 5 LEESBURY CT BIdg:1 Floor: Suite: Description of Work: MECH REPLACE (2) A/C UNITS (TAMPER RES CAP REQ) (RA1460CJ1 /RAI 460CJ1 NA) » ° InspectorArea:4 Code Edit: 2019 Legal Description: TRACT NO 11605 LOTS 7 AND 8 POR OF LOT 8 ®a®a= 0 » Owner: ROBERTS LUKE Contractor: MICHAEL ROBERTS HOME BUILDER INC Worker's Comp Insurance- ° Address: 5 LEESBURY CT Address: 6 CALLE ALIMAR Carrier: FALLS LAKE FIRE NEWPORT BEACH, CA 92660 RANCHO SANTA MARG CA 92688 Policy No: MIWC255788 Phone: Phone: 949-858-7540 Expire:01/2412022 Con State Lic: 681116 » ° Issued Date:11/15/2021 Lic Expire: 09/30/2023 etc-_Lic Bus Lic: BT30060668 Processed By: Exp Date: 09/30/2022 ° 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 I BTU/hr: 0 $0.00 up to 1OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: RA1460CJlNA Issuance: $38.00 Up to 1.75M BTU/hr: 0 $0.00 Over 1 OK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: RHEEM Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $52.00 TOTAL: $172.28 Plan Check Fee: $90.28 Fee Due at Permit Issuance : $82.00 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. /NER-BUILDER DECLARATION I 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) action 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 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. �fessions 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 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, siness 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 )rovements 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 )roved for the purpose of sale). I, as owner of the Iroperty, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not )ly to an owUr'of%operty, who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). l am exempt>from licensure under the Contractors' State License Law for the following reason: my Signatur'bleeTc%] 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 legally astructure th%t 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 fa 2Aons Code, is available upon request when this application is submitted or at the following Web site:http://www.ieginfo.ca.gov/calaw.html. najure of Preve. ,l;wner or Authorized Agent Date -�J,SED CONTRACTOR'S DECLARATION r� by affirm pnjerpEnalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code an my lice se is in full force en eeClass- License Noy �� l� Date �, Z Contractor Signature /��i%ec�/ M*4RS' COMPENSATION DECLARATION . . 2NING: FAILURE i® SEQIRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($106,006), IN ADDITION TO THE 711CF-COMPENSI'TION, QAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. ;retry affirm er/o2t ¢malty 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 the formance 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 JI 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 agree iat, if I should become subject to the vgorkers' Al-comp Io provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Iignature of Applicant x 1�� l` DateK--t )ECLARATION REGA DING CONSTRUCTION LENDING AGENCY 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). Ender's Name Lender's Address ly 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 r the a -id fed property for inspection purposes. signature of Property Owner or Authorized Agent;;C Print Property Owner's or Authorized Agent's Name !� �`'�"`�''� L Y�O D �/�/5 Date (_ ( .22 ACTION DATE BY DECLARATION OF COMPLIANCE AIITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONSPART 51 OF TI7LE40AND AQMD RULE 9403. PERMIT EXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMITEXTENDED ❑ ASBESTOS NORFICARON IS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL /ilfY CERTIFICATEOF SIGNATURE:. OCCUPANCYISSUE➢