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Home My WebLink AboutH2022-0114 - PermitsCity of Newport Beach - Building Division III 11111111111111111111111111111111111111�1111111 '+ .,100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 2 0 1 1 4 f' Permit Counter Phone (949)644-3288 a Job Address: 2226 PORT CARLISLE PL Bldg:1 Floor: Suite: Description of Work: MECH/INSTALL (2) A/C UNITS 52.5dB' & 55.25dB- (CARRIER; 24APB6-42-30 Inspector Area:6 Code Edit: 2019 Legal Description: N TR 7845 LOT 60 Owner: JENSEN JACK . Contractor: OWNER/BLDR Address: 2226 PORT CARLISLE PL Address: JENSEN JACK NEWPORT BEACH, CA 92660 W/X2021-0252 Phone: Phone: Con State Lic: O/B Issued Date:03/03/2022 Lic Expire: Bus Lic: Processed By: V 'v Lic Exp Date: MECHANICAL Permit: H2O22-0114 Project No : 0275-2021 Inspection Requests Phone (949)644-3255 TINIER REQUIRED ON EOUIPMLN I TO SHUT OFF BETWEEN 10 P.M. AND 7 A.M. CC I - Workers Comp- C� Carrier: Insurance LJJ Policy No:� Expire HERS VERIFICATION REQ HVAC Items FEES Other Furnaces Boilers & Compressors Up to 100K BTU/hr: 0 $0.00 Ventilation Up to 3HP: 0 $0.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 $0.00 Over 10DK BTU/hr: 0 $0.00 > 3 HP to 15 HP: 2 $78.00 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 $0.00 Up to 100K BTU/hr: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee : $0.00 Investigation: Over 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $67.86 Up to I BTU/hr: 0 $0.00 up to 1OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: Issuance: $38.00 Up to 1.75M BTU/hr: 0 $0.00 Over 1 OK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: Zoning PC: $52.00 Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 TOTAL: $235.86 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $235.86 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Mondry - F iday 7:00 a.m:.,to 6:20[2.rg aid Saturday from 8:00 a.m. to 6:00 p.m. DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indi Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, den- ie permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License L Irofessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Sect! of more than five hundred dollars ($500). 7 I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of t Iusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through F nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of comp red for the purpose of sale). , s owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor 1 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 y ell a structure that I have built as an owner -builder if i as n been constructed in its entirety by licensed contractors. I un Irofessions Code, is available upon request w i i ti n'a �klb It ad or at the following Web site:http://wwotJegin Iignature of Property Owner or Authorized Ag .ICENSED CONTRACTOR'S DECLARATI fl hereby affirm under penalty of perjury that I am lic nse provisions of Chapter 9 (commencing with Section 7000) of nd effect. icense Class License No Date COMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL' CST 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: I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of erformance 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 pe Isurance carrier and policy number are: :arrier Policy Number ie of Agent ad below by the checkmark(s) I have placed next to the applicable tem(s) ;h, or repair any structure, prior to its issuance, also requires the applicant for (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of work, and the structure is not intended or offered for sale (Section 7044, ployees' or personal effort, builds or improves the property, provided that the on, the Owner -Builder will have the burden of proving that it was not built or and Professions Code: The Contractors' State License Law does not to the Contractors' State License Law). to completion of the improvements covered by this permit, I cannot legal that a copy of the applicable law, Section 7044 of the Business and Icalaw.html. D� !N -Ze22� 3 of the Business and Professions Code, and my license is in full force Contractor Signature CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$100,0007, IN ADDITION TO THE Relations as provided for by Section 3700 of the Labor Code, for of the work for which this permit is issued. My workers' Expiration Date LNi certify that, in the perfor ance of the work for which this permit is issued, I shall not employ any person in any manners as to become subject to the workers' compensation laws of California, and agre tha if I should become b orkers' c pensation provisions of Section 3700 of the Labor Code, I shall forthwith omply with those provisions. Ir1/y, Signature of Applicant Datf\Xonr�hl-� DECLARATION REG RD NG O ST UCTION LENDING AGENCY I hereby affirm under pen Ity f peg that there is a construction lending agency for the performance of the work for which his permit is issued (Section 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 have provided is correct. I agree to comply with all applicable city and c�toab state laws relating to building construction. 7�(f2r I authorize representatives of this city or coun roparty for inspection purposes. 'y/1 A�� Signature of Property Owner or Authorized Agent Print Property Owner's or Aut orized Agent's Named JC"'�1—/- Da ACTION DATE DECLARATION OF COMPLIANCE MTHCODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 51O- TITLE 40 AND AQMCI:ULE ,W3. - PERMITEXPIRED ❑ I SUBMITTED ASBESTOS NC77FI�ATiJh TO: Ei EPA ❑ AWD PERMITC'ANCEILED PERMITEXTEN'DED ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION, PERMIT FINAL -1, -7L,) CERTIRCATEQF QCCUPANCYISSUED SIGNATUCE: