HomeMy WebLinkAboutH2021-0532 - PermitsCity of Newport Beach -Building Division H2O21-0532 MECHANICAL Permit: H2O21-0532
100 Civic Center Drive, Newport Beach, CA 92660 Project No : 0482-2021
y 1 Permit Counter Phone(949)644-3288 TIMERS PROHIBITED
Inspection Requests Phone (949)644-3255
ON HEAT PUMPS
J ECT EVT TO F'D INSpEil K'S
Job Address: 1720 KINGS RD BIdg:1 Floor: Suite: 4NDMPROVAL
Description of Work: MECH (3) NEW HEAT PUMPS *TAMPER PROOF CAP REQ*
InspectorArea:3 Code Edit:
2019
Legal Description: N TR 1221 LOT 15
Owner: WERNER ERIC LAWRENCE
Contractor:
Address: 1720 KINGS RD
Address:
NEWPORT BEACH, CA 92663
Phone:
Phone:
Con State Lie:
Issued Date:09/15/2021
Lie Expire:
�-
Bus Lie:
Processed By:
Lie Exp Date:
GRAVES M H INC
5852 MULLER ST
BELL GARDENS CA 90201
562-833-3703
241731
03/31/2022
BT30034436
04/30/2022
-I
Worker's Comp Insurance -
Carrier : OAK RIVER INSURANCE -
Policy No: MHWC232915
Expire :01101/2022 -
HVAC Items
FEES
Furnaces Boilers & Compressors
Ventilation
Other
Up to 100K BTU/hr:
0
$0.00
Up to 3HP:
0
$0.00
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
Down -Draft Fan:
0 $0.00
Record Mgt Fee:
$0.00
Up to 100K BTU/hr:
3
$66.00
>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:
$57.42
Up to 1 M BTU/hr:
0
$0.00
up to 10K CFM:
0
$0.00
Repair/Alter/Add:
0 $0.00
Model:
HMH72B48151ssuance:
$38.00
Up to 1.75M BTU/hr:
0
$0.00
Over 10K CFM:
0
$0.00
Supplemental Fee:
$0.00
Manufacturer:
YORK
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 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.
rNER-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
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 of
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 (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
iness and Professions CodeThe. 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
rovements 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
ly tc an owner or 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 frcm 'icensure under the Contractors' State License Law for the following reason:
y m;• 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
ell 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 al
'rofessions Code, is cvailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
ignatcre 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 Sec'Jn70) of Division 3 of the Business a
nd effect.
i-crsn Class License No Date Contractor Signature.
:s covered by this permit, I cannot
Section 7044 of the Business and
Code, and my license is in full force
:RS' COrAPENSATION DECLARATION ✓ " I ,%\
FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO RIMI AL PENALTIES AND CIVIL FINES UP TOO HUNDRED THOUSAND DOLLARS I$100,000I, IN ADDITION TO THE
'COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FE S.
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
Prance of the work for which this permit is issued. Policy No.
have and will maintain
rance carrier and policy
of Agent
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'
are:
Policy Number
Date
I certify that, in thonalty
a of a work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the wor ters' compensation laws of California, and agrer
hat, if I should becoth orkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pr vi ons.
signature of ApplicaDate
)ECLARATION RE RUCTION LENDING AGENCY
hereby affirm undeerjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec ion 3097, Civil Code).
-ender's Name Lender's Address
3y my signature below, I certify to each of the following:
I am the property owner or authorized to act on the prop y ow is behalf.
I have read this application and the information I have ovide is correct.
I agree to comply with all applicable city and county inan s and state laws relating to building construction.
I authorize representatives of this city or cou ty er th ove-ide Ified property for ins ction purposes. // y �7 __ ,,/
signature of Property Owner or Authorized Agent tint Property Owner's or Authorized Agent's Name X A/Zty � ��.2A✓ " Date
o"
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TITLE40 AND
AQMD RULE 1403.
PERMIT EXPIRED
❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERMIT CANCELLED
PERMITEXTENDED
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
_ -Z"tj
CERTIFICATEOF
SIGNATURE:
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