HomeMy WebLinkAboutH2017-0617 - Permitsw� City of Newport Beach - Building Division
a 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 7 0 6 1 7
H Permit Counter Phone (949)644-3288
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MECHANICAL Permit: H2O17-0617
Project No : ° • _ •
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Inspection Requests Phone (949)644-3259•
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Job Address: 1712 GALAXY DR BIdg:1 Floor: Suite:
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Description of Work: MECH (1) NEW A/C CONDENSER ***TIMER REQUIRED*** "TAMPER RES CAP REQ"
NEIGHBOR AGREEMENT ATTACHED
InspectorArea:3 Code Edit: 2016'_
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Legal Description: N TR 4224 LOT 40
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Owner: MATHEWS JOHN Contractor:
FOLGER HEATING & AIR INC
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Worker's Comp Insurance -
Address: 1712 GALAXY DR Address:
8842 LUSS DR
Carrier: TWIN CITY FIRE INS CO
NEWPORT BEACH CA 92660
HUNTINGTON BCH CA 92646
Policy No: 57WECAA5MCI
Phone: Phone:
714-334-4433
Expire :10/01/2018
Con State Lie:
763312
Issued Date:a6/3ti2B Lie Expire:
04/30/2018
Bus Lie:
BT30047641
Processed By: = Lie Exp Date:
l
06/30/2018
HVAC Items
FEES
FurnacesBoilers & Compressors
Ventilation
Other
Up to 1OOK BTU/hr:
0
$0.00
Up to 3HP:
1 $18.00
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
Dawn -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:
$15.66
Up to 1 M BTU/hr:
0
$0.00
up to 1 OK CFM:
0 $0.00
Repair/Alter/Add:
0 $0.00
Model:
60GKA
Issuance:
$33.00
Up to 1.75M BTU/hr:
0
$0.00
Over 1 OK CFM:
0 $0.00
Supplemental Fee:
$0.00
Manufacturer:
LENNOX
N4A6
Over 1.75M BTU/hr:
0
$0.00
VAV Box:
0 $0.00
Zoning PC:
$37.50
TOTAL:
$104.16
Plan Check Fee
: $0.00
Fee Due at Permit Issuance:
$104.16
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday - Friday 7:00 a.m.to 6:30 p.mDEn�cj,$�turday from 8:00 a.m. to 6:00 p.m.
30" WIDE X 36 11�t
REQUIRED FOR ELECTRICAL METALLIC TUBING
(EMT) IS NOT ALLOWED FOR
` ar zcti a> A/C DISCONNECTS
EXTERIOR APPLICATIONS
4ER-BUILDER DECLARATION
I herebyl`3{rlrm vender 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)
tan 7031 y5r Dysiness 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 themapplicant for
Iermit tofile a ligned 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
sSsions CoI%} or that he or she is exempt from icensure 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
lore than file hundred dollars ($500).
i as owner of tIT&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,
loss and-Pro2`ssions 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
ovements area Qsintended 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
Ovid for 6e purpose of sale). I
A 1,, as owner of -the property, am exclusively contracting with licensed Contractors to construct the project (Section 70
Q an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contra(
.....
I alfi exempt from ;censure under the Contractors' State License Law for the following reason:
y m1y 9ignaturp bebvwl acknowledge that, except for my personal residence in which I must have resided for at least or
e4a afructureJ4t I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I
professions Code, is available upon request when this application is submitted or at the following Web site:http://www.le
ignature of Property Owner or Authorized Agent
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700(
effect. is [ p lD
icense Class License No Date X
COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PED
: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
qr%Vance of the work for which this permit is issued. Policy No.
7ave and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the
rance carrier and policy number are:
:arrier Policy Number
1e of Agent
certify that, in the perfo nce of the work for h this permit is issued, I shall not employ any person in any
if I should become sub ct a workers' visions of Section 3700 of the Labor Code, I shall
nature of Applicant \
CLARATION REGARD ONSTRUCTION L NDING AGENCY
areby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for
lder'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 ordinances and a laws relating to building construction
I authorize representatives of this city or county„tt of the abov operty for inspection purposes.
Business and Professions Code: The Contractors' State License Law does not
pursuant to the Contractors' State License Law).
year prior to completion of the improvements covered by this permit, I cannot
nderstand that a copy of the applicable law, Section 7044 of the Business and
Date
Division 3 of the Business and fessions Cod and my license is in full force
F % Contractor Signature
I
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
Industrial Relations as provided for by Section 3700 of the Labor Code, for
of the work for which this permit is issued. My workers'
Date
o as to become subject to the workers' compensation laws of California, and agree
comply with those provisions.
Date
this permit is issued (Section 309�7, Civil Code).
AC770N
DATE
BY
DECLARATIONOFCOMPLIANCEVWTNCODEOF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART &? OF TIME40AND
AOMDRULE 1403.
PERMIT EXPIRED
'❑ ISUB'MtTTE➢ASBESTOS.N0;77fiCATIONTO.
❑ EPA
❑--'AQMD `..
PERMITCANCELLED
PERMITEXTENDED
❑ ASBESTOS NO17FIC417ONIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMITFINAL
I
CER77FIC4TEOF
SIGNATURE
OCCUPANCYISSUED