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Home My WebLink AboutH2019-0156 - PermitsCity of Newport Beach - Building Division IIII�IIIIIIIIIIIII�IIIIIII�III�III�IIIIIII 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 9 0 1 5 6 Permit Counter Phone (949)644-3288 Job Address: 3504 MARCUS AVE BIdgA Floor: Suite: Description of Work: MECH A/C UNIT (1) ON ROOF *TAMPER PROOF CAP REQ* InspectorArea:1 Code Edit: 2016 Legal Description: CANAL SECTION BLK 335 LOT 3 Owner: MILGROM ETAN & DEBORAH Contractor: Address: 281 BELLINO DR Address: PACIFIC PALISADES, CA 90272 Phone: Phone: Con State Lic: Issued Date:03/18/2019 Lic Expire: �Q Bus Lic: Processed By: <� IJ Lic Exp Date: ENCLAVE REMODELING INC 18100 VON KARMAN AVENUE#850 IRVINE, CA 92612 714-747-3409 1021471 12/31/2020 BT30060787 10/31/2019 MECHANICAL Permit: H2O19-0156, Project No: 2248-2017 Inspection Requests Phone (949)644-3255 Worker's Comp Insurance - Carrier : STATE FUND Policy No: 9169229 Expire :11105/2019 HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 0 $0.00 Up to 3HP: 1 $19.00 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: $0.00 Investigation: $0.00 Over 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $16.53 Up to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: A $0.00 Model: AOU36RLXFZI Issuance: $35.00 Up to 1.75M BTU/hr: 0 $0.00 Over 1OK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: FUJITSU Over 1.75M BTU/hr. 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $40.00 TOTAL: $110.53 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $110.53 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7:00 a.mAo 6:30 p.m.and Saturday from 8:00 a.m. to 6:00 p.m. 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 U 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). ❑ I, as owner of ft 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 owr2j 9tW5perty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). p,IMexempj frorrlicensure under the Contractors' State License Law for the following reason: By my signature belQvii 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 Iegall sail a structure Slat 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 Qrole"rons Code,ls available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Signature of ProNgwner or Authorized Agent Date JIAg5ED CONTRACTOR'S DECLARATION I here�by affirm ur!de s penalty of perjury that I am licensed under provisions of Chapter 9 (commencing wt 997000)of Division 3 of the Business an rofessions Code, and my license is in full force L1S2nSP Class License No Dat U Iancre �� . Contractor Signature RERS' COMPENSATION DECLARATION JARNING FAILUR?TO SECyRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$100,0001, IN ADDITION TO THE M Oi eOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 1 hem affirm undeppenalty of perjury one of the following declarations: **.o 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 th performance of the work for which this permit is issued. Policy No. I e 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' compensatio insurance carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # I certify that, in the pe ormance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to a workers' compensation laws of California, and agre that, if I should become ubject tothe �rkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prvi ons. Signature of Applicant ----�b Do DECLARATION RI IING CONS ING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issue (Section 3097, Civil Code). Lender's Name Lender's Address By 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 1 have provided is correct. I agree to comply with all applicable city and coun ordinances and state laws relating to building construction. I authorize representatives of this city or county enter the above -identified property for inspection purposes. 1 / Signature of Prope Owner or Authorized Agent Print Propert Owner's or Authorized A ent's Name c YY1 V t IA,1 Date 2 .J ��! "tl ACDON DATE BY DEClARATiONQF CQMPliANCEkiRTt#CQDEQF FOROFFlLE USE NtY FEDERAL REGDtATlONSPARr 61 QF7lTLE40ANd AQMD RULE 1463. PFRMITEXPiR€Q ❑ } SUBMITTED ASBESTOS N071FICATiDN IO: ❑ EPA ❑ AQMD PERMf€CANCEl1ED PE{2M(TEYTFNOEO ❑ ASBESTOS NQnrfCAnoNis NQrAPPUCABlE TO PRQPQSEDDEdfQfJTlQN PERMITFfNAE CERTtFtCA7EOF SIGNATURE. OCCdtPANCYlSSttED