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Home My WebLink AboutH2021-0695 - Permits (2)City of Newport Beach - Building Division III 11111111111111p111111111111111 c� " ✓,� 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 1 0 6 9 5 Permit Counter Phone (949)644-3288 � a aC lYitt�� Job Address: 33 501>3(_C'A 514 Bldg:1 Floor: Suite: Description of Work: MECH/CH, rium J T (E) F.A.0 & A/C UNIT 47.5dB (LENNOX; XC21-060) Inspector Area:6 Code Edit: 2019 Legal Description: TR 11935 LOT 3 UNIT 301 OF PROJECT LOCATED ON AP 458-311-08 TOGETHER Owner: MC LEAN ROBERT Contractor: SERVICE CHAMPIONS HTG Address: 33 BODEGA BAY DR Address: 3150 E BIRCH NEWPORT BEACH, CA 92625 BREA CA 92821 Phone: Phone: 714-777-7777 Con State Lie: 799170 Issued Date:12/08/2021 Lie Expire: 10/31/2023 (� Bus Lic: BT01080105 Processed By: \_ Lie Exp Date: 07/31/2022 MECHANICAL Permit: H2O21-0696 Project No : Inspection Requests Phone (949)644-3255 HERS VERIFICATION REQ i� rill Worker's Comp Insurance - Carder: EVEREST NATIONAL INS CO Policy No: RM8WC00054211 Expire :04/01/2022 0 DJ HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 1 $22.00 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: 1 $39.00 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: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee : $33.93 Investigation: $0.00 Over 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $0.00 Up to 1 M BTU/hr: 0 $0.00 up to 10K CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: Issuance: $38.00 Up to 1.75M BTU/hr: 0 $0.00 Over 1OK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $52.00 TOTAL: $184.93 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $184.93 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR PdsIr VIADD INSPECTION Construction Hours: Monday - Friday':00 a.m.to 6:30 o.r}t.imi Saturday from 8:00 a.m. to 6:00 p.m. JWNER-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 improved for the purpose of sale). ❑ 1, 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 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). ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By 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 legally sell 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 Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 000) of Division 3 of the Business and S Rs-C e, and my license is in full force and effect. _ License Class License No Date Z U Contractor Si re WORKERS' COMPENSATION DECLARATION NARNING: 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 COST 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: ❑ 1 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 th pert ance of the work for which this permit is issued. Policy No. e and will ma ain 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' compensatiol insurance carrier and 2s\ cy number ar Carrier 1 I ',v, N Polic Nu (-) /- _ _ Expiration Date of Agent certify that, in the pe orman a work for which this permit is issued _ ILnot employ any person in any manner so as to become subjecttothe workers' compensation laws of California, and agre I, if I should be c a ubject to the wor compe Ions of Section 3700 of the Labor Code, I shall forthwith comply with those prov lions. e`%1 � . // nature of Applican D f r%l/'J�l/ CLARATION RE CTION LENDING AGENCY veby affirm and r pena o perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Ider'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 relati IFtg -Construction. I authorize representatives of this city or count art a -iden " operty for inspection purposes. t �/'!�,///,O nature of Property Owner or Authorized Agent _ Print Property Owner's or Authorized Agent's Name Dd[2 — Le ACTION DATE 8Y DECLARATION OF COMPUANCE WITH CODE OF FOR OFFICE USE ONLY FFItERAL REGU'.ATIONS PAPT IF OF TITLE 40 AND .4QMD RULE 140. PERMfT EXPIRED f 0 I EUOMI-TTEDAS3ESTOS A'DTIFICATIONTO: ❑ FPA ❑ AQMD PERMITCANCELLED PERMITEXTENDED ❑ ASBESTOS N077RCATIONIS NOTAPPLICABLETO PPOPOSED'JEMCUTnN. PERMIT FINAL _Ilr.LL �qr� '� CERTIFICA TE OF SIGNATURE: OCCUPANCYISSUED