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Home My WebLink AboutH2022-0328 - Permits9Proj�� , � City of Newport Beach - Building Division 111111111111p1111111111111111111111p1111111p1111 MECHANICAL Permit: H2O22-0328 �, 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 2 0 3 2 8 _, Permit Counter Phone (949)644-3288 ect NO : 2414-2019 u @��ii'Oil�'4 Inspection Requests Phone (949)644-3255 Job Address: 417 EDGEWATER PL BIdg:1 Floor: Suite: Description of Work: MECH (2) NEW A/C UNITS *TAMPER PROOF CAP REQ* S,a Inspector Area:1 Code Edit : 2019 Legal Description: ear ° Owner: WALSHJOHN Contractor: 0 L S HEATING & AIC Worker's Comp Insurance- as °be°o Address: 21731 VENTURE BLVD #205 Address: 8542 LARTHORN DRIVE Carrier: STATE FARM WOODLAND HILLS CA 91364 HUNTINGTON BEACH CA 92646 Policy No: 92GOK7865 Phone: 818-427-9890 Phone: 714-231-8002 Expire :0110612023 Con State Lic: 584220 IssuedDate:06/28/2022 Lic Expire: 01/31/2024 QI lc: BT98040420 Processed By: Lic Exp Date: 12/3112022 ce�ca Y 4i` a• v eb()9d a HVAC Items FEES = sa FurnacesBoilers & Compressors Ventilation Other Up to 1 OOK BTU/hr: 0 $0.00 Up to 3HP: 2 $44.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 $0.00 Over 1 OOK 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 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: NH4A41ssuance: $38.00 Up to 1.75M BTU/hr: 0 $0.00 Over IOK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: DAY & NIGHT Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $52.00 TOTAL: $172.28 Plan Check Fee : $172.28 Fee Due at Permit Issuance: $0.00 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. 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 iot more than five hundred dollars ($500). I, 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 mprovements 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 mproved 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). I am exempt from licensure under the Contractors' State License Law for the following reason: By my signature belwsl 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 1%614lyave 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 PR•pfe;%ions Code "available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Prcr%Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I}lens4 affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with ecton 7000) of Division 3 of the Business and Pro salons C y license is in full force 34 effect c� 1Z � Lfceh� , J se Class •' • License No Date �Contractor Signatur JyQP�jERS' CV"PFVSATION DECLARATION WWIWQ:6FAILURE 1D SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,00(l), IN ADDITION TO THE COST OF COMPENSATON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ••• j1er• � y affirm under penalty of perjury one of the following declarations: ••I•Fdave and w w1tain 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 @erfyrma�te-QF the w for which this permit is issued. Policy No. ('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' and policy number are: Policy Number me of Agent I certify that, in the performance of the It, if I should become subject to the wo (nature of ApplicaN9 areby affirm undeoenalty o perjury that there is a c2 lder's Name my signature below, I certify to each of the following: I am the property owner or authorized to act on the I have read this application and the information I ha I agree to comply with all applicable city and county I authorize representatives of this city or county�to of Date is issued, I shall not employ any person ny manner so as to become subject to the workers' compensation laws of California, and agree ions of Section 3700 of theb ode, I shall forthwith comply with those provisions. 61 20/�� 91y :Y ,n Ing agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Address and 3soaelav sting to building construction. )Omluatifie nspecfmmporposes. Da,\, Print Property Owner's or Authorized Agent's Name _ ACTION DATE BY DECLARATION OFCOMPLIANCE Ih7TN CODEOF FOR OFACE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40 AND AQMD RULE 1403. PERMIT EXPIRED ❑ I SUBMITTEDASBESTOS NOTIFICATION TO:. ❑ EPA ❑ AQMD PERMIT CANCELLED PERMITEXTENOED ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL U 2 CERDFICATEOF SIGNATURE OCCUPANCYISSUED