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HomeMy WebLinkAboutH2019-0348 - Permits0City of Newport Beach - Building Division H2O19-0348 MECHANICAL Permit: H2O19-0348 100 Civic Center Drive, Newport Beach, CA 92660 '`; Permit Counter Phone (949)644-3288 Project No ny��. Inspection Requests Phone (949)644-3255 Job Address: 4006 INLET ISLE DR BIdg:1 Floor: Suite: Description of Work: MECH/ A/C C/O "TAMPER RESISTANT CAP REQ" Inspector Area:4 Legal Description: Code Edit: 2016 N TR 6425 LOT 44 v 60 Owner: MC Address: 06 INLEil HENRY MARK Contractor: LE DR KALKA KEVIN J HEATING & A/C Worker:s Comp Insurance - Address: CORONA D L MAR, CA 92625 ROCKFIELD BLVD #A-100 Carrier: SERVC GRP ..... Phone -Policy 949302-575 Phone: IRVIN IRVINE CA 92618 ..... No: WCO290817 949-458-6600 •°°° ° Expire:07/01/2019 '°° Con State Issue Date:06/11/2019 Lie: 677889 • ° Lie Expire: 10/31/2020 Processed By: Bus Lie: ST30054832 Lie Exp Date: 06/30/2020 a ° ° ° % SUBJECT TO FIELDTNSI'F?@Y�>c •°°° REVIEW AINDAPPROVAL •°°°°° HVAC Items °°°.. Furnaces Boilerso°©©°° Compressors Ventilation FEES Up to 100K BTU/hr: Over 100K BTU/hr: 0 $0.00 U to 3HP: 0 P 0 $0.00 > 3 HP to 15 HP: 1 $0.00 Bathroom Fan: 0 $0.00 • Other ° ° Fire Dampers: 0 $0.00 '®o $0.017°, Wall/Floor Heaters: 0 $0.00 >15 HP to 30 HP: 0 $35.00 Exhaust Fan: $0.00 0 $0.00 ° ° Gas Line: 0 $0.00 $0.00 Heat Pumps & Package Units >30 HP to 50 HP 0 Attic Fan: $0.00 Down -Draft Fan: 0 $0.00 0 $0.00 Metal Fireplace: 0 $0.00 Up to 100K BTU/hr: Over 500K BTU/hr: 0 $0.00 >50 HP: 0 0 $0.00 Air Handling Units $0.00 Residential Hood: 0 $0.00 Record Mgt Fee: $0.00 Additional Fee: $0.00 Investigation: $0.00 Up to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 Comm. Hood: $0.00 Repair/Alter/Add: 0 $0.00 0 $0.00 Check: $3 Model: .0 Up to 1.75M BTU/hr: Over 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 0 $0.00 $0.00 Supplemental Fee: $0.00 4A7L6048AIssuance.Plan Manufacturer: AMERICAN STAND $35.0 VAV Box: 0 $0.00 Zoning PC: $40.00 TOTAL: $140.45 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $140.45 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. INER-BUILDER DECLARA I IUN 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 items) coon 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'1 ontractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business aolgg permit to file a signed statement that he or she is licensed pursuant to the provisions of the C fessions 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 ofi 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, siness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, throughlemployees' or personal effort, builds or improves the property, provided that the Movements 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 )roved for the purpose of sale). I, 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 Ily 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: my signature below 1 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 Segall I 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 Aessions Code, is available upon request when this application is submitted or at the following Web site:http:/Iwww.legiinfo.ca.govlcalaw.html. Date (nature gf2M8perty, Owner or Authorized Agent -ENSED•CONTRACTOR'S DECLARATION p%eby affirMlfdtler penalty of perjury that I am licensed under provisions rotf�Cllapter 9 (COmmencin with coon 7QOlj) of Division 3 of the Business and Pr fe,, ons C nd my license is in full force d-effect.. • •.+fL I � ��'�r Date frill �� I `) Contractor Signatu Jam' sense Class YY _License No 9 DRKERS'.COWENSATION DECLARATION • • • IN ADDITION TO THE MING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (E100,000), gbF COMPENSATICy, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ;Wby-affrAmddr•,penalty of perjury one of the following declarations: I.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 ante of jhe work for which this permit is issued. Policy No. j • .o. h e and owill..mafitain workers' co pensat'ot n insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this rmil is issued. My workers' compensatior e ` eta policy umber are. p (� v3, -111� Policy Number -I ZZD Expiration Date 31 �— Phone # ime of Agent It certify that, in the perform ce f the w0r which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree at, if I should beco a subj ct to t e workers p sation provisions Of Section 3700 of the Labor Code, I shall forth pith comply with those pr visions Da gnature of Applicant ECLARATION RE ARDIN CONSTRUCTION LENDING AGENCY iereby affirm unde penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is iss d (Section 3097, Civil Code). mders 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 prop&rty owner's behalf. I have read m application and theinformation city and �l h pr I agree to comply with all applicable city and cou o di ,_e al d fate laws relating to building construction. I authorize representatives of this city or co nt o ent t e abov - led property for inspection purposes. [ Dale^—� Print Proneriv Owner's or Authorized Agent's Name x I AMON I DATE ' I BY PERMIT RIVAL OCCUPANCYISSUED ❑ t SUBMITTED ASBESTOS NODFICARON TO. EPA ❑ AQMD [[9� ASBESTR9111077RCARONIS NOT APPLICABLE TO f'f20POSE•7MOL/MA" SlGNATU \0/1— Vo