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HomeMy WebLinkAboutH2022-0192 - PermitsCity of Newport Beach - Building Division 11111111111111111111111111111111 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 2 0 1 9 2 Permit Counter Phone (949)644-3288 Job Address: 612 IRIS AVE BIdg:1 Floor: Suite: Description of Work: MECH FURNACE CHANGE OUT Inspector Area: (p Code Edit: 2019 Legal Description: CORONA DEL MAR BLK 636 LOT 14 Owner: IRCJ HOLDINGS LLC Contractor: Address: 2355 WESTWOOD BLVD #678 Address: LOS ANGELES CA 90064 Phone: Phone: Con State Lic: Issued Date:04/13/2022 Lic Expire: Bus Lic: Processed By: l c xp Date: MECHANICAL Permit: H2O22-0192 Project No : 1880-2021 Inspection Requests Phone (949)644-3255 K L P M INC Worker's Comp Insurance - °•°° 12188 CENTRAL AVE #269 Carrier: NO EMPLOYEES CHINO CA91710 Policy No: No employees •°o° v°°°�� 949-246-2923 Expire 831751 °°° 02/29/2024 °°°�• BT30075810 ,Q•••© 07/31/2022 •® • ••°• °°°•° • HVAC Items FEES FurnacesBoilers & Compressors Ventilation °°°.. Up to 100K BTU/hr: 1 $22.00 Up to 3HP: 0 $0.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 Other°•• $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: $0.00 Up to 1 M BTU/hr: 0 $0.00 up to 1OK 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: $0.00 TOTAL: $60.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $60.00 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. 'NER-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) ction 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 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 `essions 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 mnrr+. 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 Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of com improved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044 apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contract( I 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 sell a structure-M;t I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I u Professiod5.Oode is available upon request when this application is submitted or at the following Web site:http://www.iegi work, and the structure is not intended or offered for sale (Section 7044, ployees' or personal effort, builds or improves the property, provided that the ion, the Owner -Builder will have the burden of proving that it was not built or Business and Professions Code: The Contractors' State License Law does not pursuant to the Contractors' State License Law). to completion of the improvements covered by thl that a copy of the applicable law, Section 7044 of cannot ;ss and Signature gfptpperty Owner or Authorized Agent Date EMNSED GOVZRACTOR'S DECLARATION i/ I hereby affirunder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing w h S ction 7000) of Division 3 of the Business an rof sions ode, am, F ense is in full force end -effect. License Cla;4... a License No Date i3� Z Contractor Signatur - l� WORKERS' COMPENSATION DECLARATION WARNING: FAILIR6T0 SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE UNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE 10OST QF COMPENSATIUN, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ileRby affirm under penalty of perjury one of the following declarations: 4 have and* ImRintain 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 ofUTe work forwhich this permit is issued. Policy No. ••• •• ha4e 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' compensatiol s ri ce carrier and policy number are: Carrier Policy Number ' Expiration Date Name of Agent i Phone # I certify that, in the perforipian oft a work for w1)'dh f Ihlh s pe it is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and ogre that, if I should become su 'e�c-t(tfo: orkers' color. (enssation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions / Signature of Applicant \ �J��% "`i I � Date /J` DECLARATION REGA I ONSTRUCTION I-E-NDING AGEN1 Y I hereby affirm under penalty of perjury that there is a constructiohAnding agency for the performance of the work for which this permit is issued (Sectio 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 I have provided ismcorrect. I agree to comply with all applicable city and coun In ncesand/state law'Delating to building construction. I authorize representatives of this city or co ty e e al%idep'fied properly for inspection purposes. Signature of Property Owner or Authorized Agent 77t1g / 7 Print Property Owners or Authorized Agent's Name V ACTION DATE BY DECLARATION OF COMPUANCE WITH CODE OF �/ FOR OFFICE rr. r.cnAi n� FPI ATen.rcnA=94nFTin FAn All 1 PERMITEXPIRED ❑ ISUBMITTEDASBESTOSNO7IFICAAONTO: PERMIT CANCELLED ❑ EPA PERMITEXTENDED ❑ AQMO ASBESTOS PERMIT FINAL — ]-7. �%ti—YL� PROPOSED DEMOLITION. NOT APPLICABLETO CERTIFICATE OF SIGNATURE: OCCUPANCYISSUED