HomeMy WebLinkAboutH2020-0655 - PermitsMECHANICAL Permit: H2O20-0655
. City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
H 2 0 2 0 0 6
5 5
Project No:
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Job Address: 201 MORNING CANYON RD BIdg:1 Floor:
Suite:
Description of Work: MECH CHANGE OUT FURNACE
Inspector Area:S Code Edit: 2019
°
Legal Description: N TR 1116 LOT 13
°
Owner: IRELAND JOHN A Contractor:
POWER PRO PLUMBING INC
Worker's Comp Insurance -
Carrier :PREFERRED PRO INS
Carrier:
Address: 201 MORNING CANYON RD Address:
P O BOX 6970
TORRANCE CA 90504
Y No: ON090RED
o
CORONA DEL MAR, CA 92625
800-584-4116
Expire :0710612021
p
Phone: Phone:
Con State Lic: 766254
Issued Date:11/09/2020 Lic Expire:
01/31/2022
BT30070038
Bus Lic:
Processed By: Lic Exp Date:
12/31/2020
o CDOc3 ® OC'O°
0
000°
HVAC Items
FEES
Other
FurnacesBoilers & Compressors Ventilation
Up to 3HP: 0
$0.00 Bathroom Fan: 0
$0.00
Fire Dampers: 0 $0.00
0.00
$0.00
Up to 100K BTU/hr: 1 $21.00
Over 100K BTU/hr. 0 $0.00 > 3 HP to 15 HP: 0
$0.00 Exhaust Fan: 0
0
$0.00
$0.00
Gas Line: 0 $0.00
Metal Fireplace: 0 $0.00
Wall/Floor Heaters: 0 $0.00 >15 HP to 30 HP: 0
Heat Pumps & Package Units >30 HP to 50 HP 0
$0.00 Attic Fan:
$0.00 Down -Draft Fan: 0
$0.00
Record Mgt Fee: $0.00
Additional Fee: $0.00
Investigation: $0.00
Up to 100K BTU/hr: 0 $0.00 >50 HP: 0
$0.00 Residential Hood: 0
Comm. Hood: 0
$0.00
$0.00
Plan Check: $0.00
Over 500K BTU/hr: 0 $0.00 Air Handling Units
up to 10K CFM: 0
$0.00 Repair/Alter/Add: 0
$0.00
Model: Issuance:
$37.00
Up to I BTU/hr: 0 $0.00
Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0
$0.00 Supplemental Fee:
$0.00
Manufacturer:
Zoning PC: $0.00
Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0
$0.00
Plan Check Fee:
$0.00
Fee Due at Permit issuance:
$58.00
TOTAL: $58.00
PERMITS EXPIRE 18o 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.
OWNER -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).
IL_I 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 p[operfy, 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).
lam exemptfrorr, ifcpnsure under the Contractors' State License Law for the following reason:
�_y my_ signature belovk a'llcknowledge 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 legali
sell a s ructureC 1. 1 IFr ve bulilt 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��.vailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Sfgpatsre of Property Owner br Authorized Agent Date
! ICENSED Cr�NTRACTOR'S DECLARATION
I i'lereby affirm under penaltyof perjury that I am licensed under provisions of Chapter 9 (commencing "t Section 700) of Division 3 of the Business a ` P o essio Cod {any-lieei se is in full force
and effect.
Lice.ise Close; License No Date Contractor 5ignatur
,r C C
A(dRKERS' COMPENSATION DECLARATION -
-AR�NING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOY TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDMON TO THE
IOSTr7F COMP,.Er4SA7ZN, DAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
k €r` by affimS' under- penalty of perjury one of the following declarations:
3`I have ond`wni 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 thi
2 ormance orfi9 work for which, this permit is issued. Policy No.
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
s nce carrier and policy number are:
;artier P
ie of Agent _
certify that, in the
, if 1 should becon
ignature of Applicant
hereby affirm under pedal
ender's Name
�y my signature below, I ce
1 am the property owlei
1 have read this appliI I'
I agree to comply with El
I authorize representati
iqnature of Prooertv OwnP
o Icy Number
Expiration Date
Phone #
ran�Iher�ke��
Is Issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
ct sions of Section 3700 of the Labor Code, i shall forthwith comply with those prov"sio s.
Date
NCO CTION LENDING AGENCY 2ection
iffr#erjury that there is a construction lending agency for the performance of the work for which this permit is issued (3097, Civil Code).
Lender's Address
Fy to each of the following:
authorized to act on the property owner's behalf,
and the information I have •s correct.
Iplcableity and coin o finance and state
af;this cityor couniX enter the n i lea
ACnON
DATE
BY
PERM[T.E3fPIRED
PEIfF41T C01CFaEL
PERA11TOCTOIDED
PEIiBrJ)`IT f"INAL
CER ICATEOF
OCCUPANCYISS€1ED
[
Y.16r H7gto building construction,
property for inspection purposes.
Print Property Owner's or Authorized
r ISUBMITTEDAi +' ll:
■ EPA
■' aQ#
PROPOSED ! ASBESTOS DEMOUMN.
SIGNATtl .
FOR 0MCE USE 01UY
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