HomeMy WebLinkAboutH2021-0602 - Permits0City of Newport Beach - Building Division 1111111111111111111111111111111111111111111111111
da 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 1 0 6 0 2
�' Permit Counter Phone (949)644-3288
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MECHANICAL Permit: H2O21-0602
Project No: 2777-2019
Inspection Requests Phone (949)644-3255
Job Address: 706 MARIGOLD AVE BIdg:1 Floor: Suite:
Description of Work: MECH/INSTALL (1) A/C UNIT 47.7dB (CARRIER; 25VNA4-48)
Inspector Area: (o Code Edit: 2019
Legal Description:
Co
Owner: INOUYE WAYNE/SHANNON Contractor:
MCMASTER HEATING & AC INC
Worker's Comp Insurance -
Address: 703 HELIOTROPE AV Address:
2 MCLAREN #C
Carrier: HARTFORD
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CORONA DEL MAR CA 92625
IRVINE CA 92618
Policy No: 72WECZU8138
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Phone: Phone:
949.481-7995
Expire :02102/2022
Con State Lie:
726607
Issued Date:10/19/2021 Lie Expire:
1213112021
_ Bus Lie:
BT30041972
Processed By: -Lie Exp Date:
01/31/2022
HVAC Items
FEES
FurnacesBoilers & Compressors
Ventilation
Other
Up 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
Over 100K BTU/hr:
0
$0.00
> 3 HP to 15 HP:
1
$39.00
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:
$33.93
Up to 1 M BTU/hr:
0
$0.00
up to 1 OK CFM:
0
$0.00
Repair/Alter/Add:
0 $0.00
Model:
Issuance:
$38.00
Up to 1.75M BTU/hr:
0
$0.00
Over 10K CFM:
0
$0.00
Supplemental Fee:
$0.00
Manufacturer:
Over 1.75M BTU/hr:
0
$0.00
VAV Box:
0
$0.00
Zoning PC:
$52.00
TOTAL:
$162.93
Plan Check Fee:
$0.00
Fee Due at Permit Issuance :
$162.93
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday - Friday 7:dM5.rr7.?J 6:39-p..m!and Sapta®dapo om 8:00 a.m. to 6:00 p.m.
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OWNER -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 (_) 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 AWES 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 licensure 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 legal
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://www.leginfo.ca.gov/calaw.htmi.
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 Busine fessio C a my license is in full force
and effect.
License Class License No Date . C \ Contractor �igHa
VORKERS' COMPENSATION DECLARATION
ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE ED THOW� USAND OOLL`ARS 1$ 0.0 0), IN DITION 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 a for the
erprmance of the work for which this permit is issued. Policy No.
have and will airtt-a'n workers' compel ation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation
isurance carrier a -d poll.'y number are: _
arner a Po u r Expiration Date
lame of Agent Phone #
]I certify that, in the performance of the wor 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 s ject to the workers c of the Labor Code, I shall forthwith comply with those provisions
ignature of Applicant
iECLARATION REGARDING CONSTRLICTION LENDING AGEN
hereby affirm under enalty of perjury is a construction lending pednrma for which this permit is issued (Section 3097, Civil Code).
Ender's Name er's Address
y 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
I agree to comply with all applicable city and county ordinances and state laws rya to buildia�... col
I authorize representatives of this city or county tg0Pnter the ab �J
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