The URL can be used to link to this page

Home My WebLink AboutH2021-0519 - PermitsN r City of Newport Beach - Building Division III IIII 1111111111111111111111111111111111111111111 %, 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 1 0 5 • , Pr Permit Counter Phone (949)644-3286 i �':,��y, µ*�, t 1 9 MECHANICAL Permit: H2O21-0519 Project No : 1624-2021 Inspection Requests Phone (949)644-3255 Job Address: 2001 CENTELLA PL BIdg:1 Floor: Suite: Description of Work: MECH - R/R 3 A/C CONDENSERS. TAMPER -RESISTANT CAPS REQUIRED InspectorArea:3 Code Edit: 2019 Legal Description: N TR 3379 LOT 1 Owner: SACKMAN PAUL Contractor: TRUE HOME HEATING A/C Worker's Comp Insurance - Address: 204 ONYX AVE Address: 4 FARADAY Carrier: CYPRESS INS NEWPORT BEACH CA 92663 IRVINE CA 9261E Policy No: TRWC122609 Phone: Phone: 949-382-6337 Expire :1210112021 Issued Date:09103/2021 Con State Lic: Lic Expire: 1025397 04/30/2023 / �- ;,e � �.��'`� E CTOr" Bus Lic: BT30064629 fl L Processed By: Lic Exp Date: 10/31/2021 0 HVAC Items Furnaces Boilers & Compressors Ventilation FEES �j� 0, Other Up to 10DK BTU/hr: 0 $0.00 Up to 3HP: 3 $66.00 Bathroom Fan: 0 $0.00 Fir a 0 $0.00 $0.00 Over 1 OOK BTU/hr: 0 $0.00 > 3 HP to 15 HP: 0 $0.00 Exhaust Fan: 0 $0.00 Gas 0 $0.00 $0.00 Wall/Floor Heaters: 0 $0.00 >15 HP to 30 HP: 0 $0.00 Attic Fan: 0 $0.00 Meta la 0 $0.00 Heat Pumps & Package Units >30 HP to 50 HP 0 $0.00 Down -Draft Fan: 0 $0.00 Recor F $0.00 Up to 1 OOK BTU/hr: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additiona :O $0.00 Investigation: $0.00 Over 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $57.42 Up to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: 24AHA460Issuance: $38.00 Up to 1.75M BTU/hr: 0 $0.00 Over 1 OK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: CARRIER Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $52.00 TOTAL: $213.42 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $213.42 PERMITS EXPIRE 190 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday°- rdday 7:00 a.m.to 6:30 p.m.and Saturday from 8:00 a.m. to 6:00 p.m. IWNER-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 1e 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 'rofessions 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 of more than five hundred dollars ($500). D 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, lusiness 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 nprovements 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 nproved for the purpose of sale). 7 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 pply 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 am exempt from licensure under the Contractors' State License Law for the following reason: ly 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) ell a structure that 1 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://wvvw.leginfo.ca.gov/calaw.htmi. signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sec ion 000) of Division 3 of the Business and Pro of s.efis Code, and m license is in full force nd effect. Q' �( j icense Class License No D 4 J Contractor Signa�iYP VORKERS' COMPENSATION DECLARATION rARNING: 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 '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: ave 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 ;ne ce of the work for which this permit is issued. Policy No. Iand 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' compensatior sucarrier and policy number are: ie of Agent certify that, in the performance of the work for Policy Number Date >t�r not employ any person in any manner so as to become subject to the workers' compensation laws of California, and tat, if I should became subject to the workers' comp provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �7 ) ignature of Applicant Date �) �5,2/ DECLARATION REGARDING CON -TION LE NG AGENCY hereby affirm under penalty of perjury th a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ender's 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 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 ordinance state laws relatin ns mction. p/ n (1�., I authorize representatives of this city or county to enter above-identif erty for inspection purposes. A F!I ,,Ajl d. _ _ N h / / _1 of Property or Authorized Agent's Name AC77ON DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 51 OF TI TLE 40 AND AQMD RULE 1403. ❑ ISU9MITEDASPEETOSi4OTIFIC.BTIOh TOr ❑ `PA ❑ , Q+1413 PERMIT EXPIRED PERMIT CANCELLED PERMIT EXTENDED ❑ ASBESTOS NOTIHCA17ON IS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: PERMIT FINAL CERTIRCATEOF OCCUPANCYISSUED