HomeMy WebLinkAboutH2016-0600 - Permitsv� City of Newport Beach - Building Division IIuIIIIIIIIIIIIIIIIIII�IIIIIIII�llll II
100 Civic Center Drive, Newport Beach, CA 92660 p 2 0 1 6 0 6 0 0
- Permit Counter Phone (949)644-3288
�gLYea:iP�}s
Job Address: 1724 ANTIGUA WAY Bldg:1 Floor: Suite:
Description of Work: MECH -RELOCATE (E) AC UNITS, 40.75dB & 46.25 dB "TAMPER RESISTANT CAP REQ"
InspectorArea:3 Code Edit:
2013
Legal Description: N TR 4224 LOT 282
Owner: NETHERTON DREW & LAUREEN
Contractor: OWNER/BLDR
Address: 1724 ANTIGUA
Address: NETHERTON LAUREEN
NEWPORT BEACH CA 92660
Phone:
e Lie: O/B
Issued Date:08/31/2016
e:
axp
Processed By:
Date:
MECHANICAL Permit: H2O16-0600
Project No: 2761-2015
Inspection Requests Phone (949)644-3255
Worker's Comp Insurance -
Carrier :
Policy No:
Expire :
HVAC Items
FEES
FumacesBoilers & Compressors
Ventilation
Other
-
Up to 100K BTU/hr:
0
$0.00
Up to 3HP:
2 $36.00
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 :
$37.50
Investigation:
$0.00
Over 500K BTU/hr:
0
$0.00
Air Handling Units
Comm. Hood:
0 $0.00
Plan Check:
$31.32
Up to 1 M BTU/hr:
0
- $0.00
up to 10K CFM:
0 $0.00
Repair/Alter/Add:
0 $0.00
Model:
Issuance:
$32.00
Up to 1.75M BTU/hr:
0
$0.00
Over 1 OK CFM:
0 $0.00
Supplemental Fee:
$0.00
Manufacturer:
LUXAIRE & YORK
Over 1.75M BTU/hr:
0
$0.00
VAV Box:
0 $0.00
TOTAL:
$136.82
Plan Check Fee
: $0.00
Fee Due at Permit Issuance:
$136.82
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
SITBJFCT TO FIELD INTSPECTOR'S
REV I E`N , iND APP ;OVAL
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 5tem(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).
111, 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 it was not built or
�im roved for the purpose of sale).
1. 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
Ply
to: n owne4of{tldperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
12R�exempt kom.licensure under the Contractors' State License Law for the following reason:
By my signature belp�y T acknowledge that, except for my personal residence in which I must have resided for at I ast one year prior to completion of the improvements covered by this permit, I cannot legally
aeila strucure that I have built as an owner -builder if it ha not been constructed in its entire by licensed on ors. I understand that a copy of the applicable law, Section 7044 of the Busi ss and
ProfASSions Code, is available upon request when this ap II 'o i s b ifted or at the foil ing si htt Info.ca.gov/calaw. html.
Sign atare of Propertyilwner or Authorized Da
LICENSED COTIYRACTOR'S DEC ION
Yhere4y affirm yddArponalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
awl gl&t
�"I;%%Class License No Contractor Signatir
WOR*RS' QQXV gNSATION DECLARATION
rrA6WrdcY FAILURE TO SEOURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF•COMPENS VQIl j, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'$ FEES.
Mety affirm Inde:rAnalty, of perjury one of the following declarations:
LJ 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
performance of the work for which this permit is issued. Policy No.
have 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'
ranoe carrier and policy number are:
Policy Number Expiration Date
Phone #
4ify that, in the performance of the work for which this permit is issued, I shall
I should become sLypject to t}he workers' compensation provisigps of Sectiol:
of
any person in any manner so as to become subject to the workers' compensatiorrr}}} laws of Califomia, and agre,
.abor Code, I shall forthwith comply with those provisions.
/31
Da e
CLARATION REGARDING COWSTRUCTION LENDING AGENCY v
:reby 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
ider'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 rdinances and state laws ref g to building construction.
I authorize representatives of this city or co" to fntgi 9 Ogve-identifigiprope for inspection purposes.
Owner's or Authorized
Civil Code).
ACAON
DATE
BY
DECLARATION OF COMPLIANCE WTH CODEOF
FOR OFRLEUSELNILY
FEDERAL REGULA77ONSPART 61 OF TFILE40AND
AQMD RULE 1403,
PERMITOWIRED
❑ I SUSMITTEDASEESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERMITCANCELLED
PERMITEXTENDED
PROPOSED DEMOLIT ASBESTOS M TLONlS NOT APFUCAL3LE 7Q
PERMIT FINAL
CERTIFICATEOF
SIGNATURE:
OCCUPANCYiSSUED