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Home My WebLink AboutH2021-0610 - PermitsCity of Newport Beach - Building -Division 100 Civic Center Drive, Newport Beach, CA 92660 . Permit Counter Phone (949)644-3288 v g '�bFSc11C� Job Address: 404 BELVUE LN Bldg:1 Floor: Suite: Description of Work: MECH INSTALL (3) A/C UNITS "SAMSUNG SPLIT SYSTEMS" ACO24KNZDCH/AA/AM048TXMDCH/AA Inspector Area:1 Code Edit: 2019 Legal Description: N TR 1090 LOT 29 Owner: POMA VICTOR Contractor: Address: 404 BELVUE LN Address: NEWPORT BEACH, CA 92661 Phone: Phone: Con State Lie: Issued Date:10/26/2021 Lie Expire: Bus Lie: Processed By: Lie Exp Date: XTREME AIR TECHNOLOGIES INC 9784 DESMOND DR OAK HILLS CA 92344 714-334-4109 878051 05/3112022 BT3003738 12/31/2021 MECHANICAL Permit: H2021-0610 Project No : 1821-2019 Inspection Requests Phone (949)644-3255 Worker's Comp Insurance - Carrier : EXEMPT Policy No: Expire : a]ORY ;aaaat a o oaoca 0 ooaau HVAC Items FEES . ®° FurnacesBoilers& Compressors Ventilation Other oaaaoo aa.oa 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: 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: 3 $66.00 >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: $57.42 Up to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: SEE DESCRIPTION Issuance: $38.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: SAMSUNG Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $0.00 TOTAL: $161.42 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $161.42 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. JWNER-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 U all of or (_) 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). ❑ 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 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 legally 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 vailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. S1gnature of Property Owner or Authorized Agent Date L;IE€idFrED COMS9J\CTOR'S DECLARATION I her affirm untlS.pBnalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Prof s Cq�e a d ;v li en is �ful orce aD2�ff€r�t. D/ L4cenW Class License No Date,,/ /Z�/2 Contractor Signature WORRERS' CCWPDE14SATION DECLARATION NfARNRJ& FAILURE TcO�I�LLS �URE 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 00670GCOMPEN%AI I{r , D/1MAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. Ilhe+sby affirm under'p'enalty of perjury one of the following declarations: y.l jIlAZe 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 thl performance of the work for which this permit is issued. Policy No. .. ®1 -Fiavo and will mainjain 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' compensatioi ins'IA'ARce carriet-WId policy number are: Carrier Policy Number Expiration Date a of Agent rUu,,u n ertify that, in the perfor a of the ork ch this Is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre if I should become su e h w r e a I ons of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ature of Applicant Date 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 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 co ect. I agree to comply with all applicable city and county Inanc e I Is relating to building construction. I authorize representatives of this city or county to r - ed op rty for inspection purposes. ,L1 !d l� Date signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Yft HATE BY DECLARATION OF COMPLIANCE AgTN CODE OF FOR OFFICE USE ONLY ACTION FEDERAL REGULATIONSPART 61 OF TT2E40 AND AQMD RULE 1403. ❑ I SUBMITTEDASSESTOS NO7IFICATION' TO:. ❑ EPA ❑ AQMD' PERMITEXPIRED PERMITCANCELLED PERMIT EXTENDED ❑ ASBESTOS NOITRCA77ONIS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE:. PERMIT FINAL CERTIFTCATEOF OCCUPANCYISSUED