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HomeMy WebLinkAboutH2021-0392 - Permits€'� wr•"k+' City of Newport Beach - Building Division H2O21-0392 c ,y `ter 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 INSPECTOR Job Address: 1628 OCEAN FRONT W BIdg:1 Floor: 1 Suite: 5 Description of Work: MECH FURNACE C/O InspectorArea:1 Code Edit: 2019 Legal Description: NEWPORT BEACH SEC B BILK 16 LOT 13 Owner: AMERICAN ENTERPRISE ELITE Contractor: OWNER/BLDR Address: 17700 CASTLETON ST #266 Address: AUTH AGENT: CITY OF INDUSTURY CA 91748 CHOW BILL Phone: Phone: 626-833-2188 Con State Lie: OIS Issued Date:06/24/2021 Lie Expire: Bus Lie: Processed By: Lie Exp Date: MECHANICAL Permit: H2O21-0392 Project No : 0534-2020 Inspection Requests Phone (949)644-3255 A - r I . Worker's Comp Insurance - Carrier : Policy No: Expire : HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 1 $21.00 Up to 3HP: 0 $0.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 $0.00 Over 1 OOK BTU/hr: 0 $0.00 > 3 HP to 15 HP: 0 $0.00 Exhaust Fan: 0 WOO 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 IOOK 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 1M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: Issuance: $37.00 Up to 1.75M BTU/hr: 0 $0.00 Over 1 OK 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: $58.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $58.00 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. 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 L) all of or L) 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 uf the p. operty, 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). I apl exemp: frOM lipensure under the Contractors' State License Law for the following reason: % 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 legal cell a rtructure that I have built as an owner -builder if Mas not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Sec io 7044 of the Business and Professions Code, is mailable upon request when application is sub tte or t the following Web site:http://www.leginfo.ca.gov/calaw.htm]. 3igoatwe of Property Owner or Authorized Agent _ LICENSED C^_ NTRACTOR'S DECLARATI I hereby affirm under o=nalty of perjury that I am Fbensedwnder provisions of Chapter ommencing with Section 7000) of Division 3 of the Business and Professions o , and my license is in full force and effect. -_icause Class License No Date Contractor Signature COMPENSATION DECLARATION 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 ($100,000), IN ADDITION TO THE ;OMPEPP4TION, OAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABORCODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 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 "mance of the work for which this permit is issued. Policy No. I have 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' urance carrier and policy number are: Policy Number me of Agent Date I certify that, in the pert ance of the work for which 'isionssued, I shall not employ any person in any manner so as to became subject to the workers' compensation laws of California, and agre that, if I should becom ject to the workers' Insation provo ction 3700 of the Labor Code, I shall forthwith comply with those provi ios. % Signature of Applicant Date b DECLARATION REGJftDIN&4QONSTRUCTi6N LENDIRdAGENCY I hereby affirm under penalty of p6Tjwy4hSt there is a constructio Ing agency for the performance of the work for which this permit is issued (Se ion 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 h ve provided is correct. ' d t � �e c� I agree to comply with all applicable city and c un ordinances and state laws relating to building construction. 1 authorize representatives of this city or coun enter the above ' e ifi for inspection purposes. ed Signature of Property Owner or AuthorizAgent Tint Property Owner's or Authorized Agent's Name Dat ACTION DATE BY DECLARATION OF COMPLIANCE K4TH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 6f OF TITLE40AND AQMD RULE 1403. PERMIT EXPfRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMIT£XTENDED ❑ ASBESTOS NOTIHCA170NIS NOTAPPLICABLE TO PROPOSED DEMOLITION. 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