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Home My WebLink AboutH2021-0332 - Permits (3)City of Newport Beach - Building Division H2O21-0332 - 100 Civic Center Drive, Newport Beach, CA 92660 M Permit Counter Phone (949)644-3288 ��t iYiliGKi% MECHANICAL Permit: H2O21-0332 Project No : Inspection Requests Phone (949)644-3255 Job Address: 1721 MARLIN WAY BIdg:1 Floor: Suite: /� Description of Work: MECH NEW A/C UNIT *TAMPER PROOF CAP REQ* EC-To Inspector Area:3 Code Edit: 2019 SUBJECT TO FIELD INSPE,CTOR'3 Legal Description: N TR 3097 LOT 35 REVIEW AND APPROVAL Owner: EMMEL DREW & CHRISTINE Contractor: OWNER/BLDR Worker's Comp Insurance - Address: 1721 MARLIN WAY Address: CHRISTINE EMMEL Carrier: NEWPORT BEACH, CA 92660 OIB ATTACHED Policy No: - • - Phone: 949-285-3292 Phone: Expire: Con State Lic: O/B Issued Date:05/20/2021 Lic Expire: Bus Lic: Processed By: Lic Exp Date: HVAC Items FEES FurnacesBoilers & 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: 1 $21.00 >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: $18.27 Up to 1M BTU/hr: 0 $0.00 up to 1OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: YCS60B21SIssuance: $37.00 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: $46.25 TOTAL: $122.52 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $122.52 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. ER -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 U all of or U 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 Z oved for the purpose of sale). 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 to an owner o, property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I m exempt from licensure under the Contractors' State License Law for the following reason: dy my signature oAow.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 legally sell a structure that ::lave built as an owner -builder if it lkas not been constructed in its entirety by I'.j0prised contractors. I understand that a copy of the applicable law, Section 4 of the Business and Orcfess'ons Code, is available upon request when t ti s mitted or a following b site:http://www.leginfo.ca.gov/calaw.htmi. Signau m of Pronerty Owner or Authorized Agent Date LICEIJSED CJNTRACTOR'S DECLARATI(� hela�y affirm under penalty of perjury that I am li ensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force 3.1d affect. license Class License No Date Contractor Signature 'P-'ORKERS' COMPENSATION DECLARATION 'VARNINC: FAILUPS TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,0001, IN ADDITION TO THE COST OF COMPENSA'. ION, ]AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereb} affirm u;.der 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 of Industrial Relations as provided for by Section 3700 of the Labor Code, for tht performance 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' compensatior insurance carrier and policy number are: Policy Number of Agent Date I certify that, in the performance of the work for which this permit is issued, I shall n employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree It, if I should became je t ,yy10 ke 'compensation pro 'sions of Section 3 0 of the Labor Code, I shall forthwith comply with those provisio s. lnature of Applicant n l Date ,�1J 2i :CLARATION REGA DIN ONSTRUCTION LENDING AGENCY ereby affirm under p nalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (4, tl 3097, Civil Code). rider'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 state laws relating to buildiriPpristruction. I authorize representatives of this city or county to��,r/�� the bsve- eentified pro It for ins ec o purposes. lnature of Property Owner or Authorized Agent All Y' OX 1 bU- ' t y Owner's or Authorized Agent's Name /�l AI IU.7 I �)J l� atE Li'�1d/mil ACTION DATE VBY DECLARATION OF COMPLIANCE 141TN CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403, PERMIT EXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMO PERMIT CANCELLED PERMITEXTENDED ❑ ASBESTOS NOTIFCATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT RIVAL CER77FICATEOF SIGNATURE: OCCUPANCYISSUED 4 n(l O C L m N C w m >, ` d - V - a m m w N `- m m T 5�. .a m �LE-G mL `wY m E N m.°O 4E.. 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