HomeMy WebLinkAboutH2022-0064 - PermitsCity of Newport Beach - Building Division H2O22-0064 MECHANICAL Permit: H2O22-0064
a 100 Civic Center Drive, Newport Beach, CA 92660
Project No : 2062-2021
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Job Address: 1712 TRADEWINDS LN Bld :1 Floor: Suite:
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Description of Work: MECH (2) A/C UNITS *TAMPER PROOF CAP REQ*
Inspector Area:3 Code Edit: 2019
Legal Description: N TR 3082 LOT 72
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Owner: SAMEN MICHAEL & MARINA Contractor: OWNER/BLDR
Worker'sCompinsurance-
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Address: 1712 TRADEWINDS LN Address:
Carrier :
°°
° •
NEWPORT BEACH, CA 92660
Policy No:
° ° •
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Phone: 949-629-8263 Phone:
Expire :
• • °
Con State Lie: O/B
Issued Date:02/08/2022 Lie Expire:
®
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° .
Bus Lic:
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Processed By: -Lie Exp D e:
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AG Items
FEES
° •
°°
nacesBoilers & Compressors
Ventilation
Other
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
: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:
0
$0.00
>50 HP:
0 $0.00
Residential Hood:
0 $0.00
Additional Fee:
$0.00
Investigation:
$0.00
)r 500K BTU/hr:
0
$0.00
Air Handling Units
Comm. Hood:
0 $0.00
Plan Check:
$38.28
to 1M BTU/hr:
0
$0.00
up to 1OK CFM:
0 $0.00
Repair/Alter/Add:
0 $0.00
Model:
AJ036TXJ4CH
Issuance:
$38.00
to 1.75M BTU/hr:
0
$0.00
Over 1 OK CFM:
0 $0.00
Supplemental Fee:
$0.00
Manufacturer:
SAMSUNG
:r 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
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.
DWNER-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 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 L) 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).
/ , 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
�, 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:
By my signature belovrd 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 legalll
sell a structure tft j b3Jb built as an owner -builder if if has not been constructed in its entirety by li sect contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
P19fe%sjTs Code,is available upon request whe thi applicaf s Itted or at th follow' eb site:http://www.leginfo.ca.gov/calaw.htmi.
Synatureof Property a;ner or Authorized Agent s Date^ m�
LIGENSED COIVRAtTOR'S DECLARATION N�
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, a d my license is in full force
anrj effect. • • • • ••
LjCen: et3lass • ... License No Date Contractor Signature
VVQMRS' CV4PEVSATION DECLARATION
wAVI[W-FAILURE TG SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001, IN ADDITION TO THE
COST OF COMPENSATIQN, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I $erEg) 2ffirm unrjer pEpalty of perjury one of the following declarations:
• I•fjw and wiNmaintain 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
performance of the wod for which this permit is issued. Policy No.
1 have and will"ainthin 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'
lsurance carrier and policy number are: '
Policy Number
of Agent
Date
I certify that, in the performance of
the work for which this permit is ' sued, I shall not employ any person in any manner so as to become subject to the workers' comp satign laws of California, and agreI, if I should e
C nature
of ON li I, ubl G CO UCTION LENDINIG AGENCY s of Section 3700 of the Labor Code, I shall forthwith comply with thoseDate.' is" n�
Ict
nature of Applican
ereby 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).
lder'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 ordina s and state laws relating ilding construction. -
I authorize representatives of this city or county tolenterL�eGe-identified orooek�fcrTnsoectioa purposes. A It
ACITON
DATE
BY
DECLARATION OF COMPLIANCE IMTH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TITLE 40 AND
AQMDRULE1407:
PERMITEXPIRED
❑ I SUBMI TTED ASBESTOS M071FICATIOIV TO:
❑ EPA
❑ AQMO
PERMIT CANCELLED
PERMITEXTENDED
❑ ASBESTOS N07IACA71ON IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMITFINAL
CERTIFICATEOF
SIGNATURE:.
OCCUPANCYISSUED