HomeMy WebLinkAboutH2019-0564 - PermitsCity of Newport Beach Building Division III 1111111111111111111111111111IN1111111111111 MECHANICAL Permit: H2O19-0564
3 100 Civic Center Drive, Newport Beach, CA 92660 Project No:
Permit Counter Phone (949)644-3288
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Inspection Requests Phone (949)644-3255
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Suite:
INSPECTOR
Job Address: 309 ORCHID AVE
Bldg:1 Floor:
Description of Work: MECH - NEW
A/C CONDENSOR (FRONT)
& HEATPUMP/CONDENSOR (GAR).
TAMPER
-RESISTANT CAPS REQ'D
ON THE WEEKEND
InspectorArea:5
Code Edit: 2016
Legal Description: CORONA DEL
MAR LOT 9 BILK 241(AND
NELY1/2 LOT 7 BLK241
Owner: HOLMAN DAVID C
Contractor:
A C COOL INC
Worker's Comp Insurance -
Address: 309 ORCHID AVE
Address:
P O BOX6868
Carrier: EVEREST NATIONAL
CORONA DEL MAR, CA 92625
ORANGE CA 92863
Policy No: 760007408191
Phone:
Phone:
714-720-3938
Expire :0610112020
Con State
Lic: 804056
Issued Date:09/19/2019
Lic Expire:
Bus Lic:
01/31/2020
BT30042073
ELECTRICAL IVc..;_.�=.LUC TUBING
Processed By:
Lic Exp Date: 01/31/2020
(EN1Tj IS NOT ALLOWED FOR
DI r T I
HVAC Items
FEES
Other
FurnacesBoilers & Compressors
Ventilation
0 $0.00 $0.00
Up to 100K BTU/hr: 0 $0.00
Up to 3HP: 1
$20.00 Bathroom Fan:
0 $0.00
Fire Dampers:
Over 10oK 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
$0.00
Up to 100K BTU/hr: 1 $20.00
>50 HP: 0
$0.00 Residential Hood:
0 $0.00
Additional Fee: $0.00 Investigation:
$34.80
Over 500K BTU/hr: 0 $0.00
0 $0.00
Air Handling Units
up to 1 OK CFM: 0
Comm. Hood:
$0.00 Repair/Alter/Add:
0 $0.00
0 $0.00
Plan Check:
Model: 24AHA43OA003 Issuance: $35.00
Up to 1 M BTU/hr:
Up to 1.75M BTU/hr: 0 $0.00
Over 1OK CFM: 0
$0.00 Supplemental Fee:
$0.00
Manufacturer: CARRIER
$41.5
Over 1.75M BTU/hr: 0 $0.00
VAV Box: 0
$0.00
Zoning PC:
TOTAL: $151.30 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $151.30
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construct/on Nours Mondvy - Friday 7:00 a.m.to 6:30 p.m.and Saturday from 8:00 a.m. to 6:00 p.m.
ILDER 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 fc^
ie 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 any
'rofessions 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
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 C-) portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
nprovements 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
n 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
pply 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).
I 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 year prior to completion of the improvements covered by this permit, I cannot legally
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 applicable law, Section 7044 of the Business and
'rofessions 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
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Se lion 7000) of Division 3 of the Bug iness and�Profession lies in full e
nd effect.
icense Class License No Date Contractor Si natu're.y ,b
VORKERS' COMPENSATION DECLARATION v\
ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLO O CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY 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 Industrial Relations as provided for by Section 3700 of the Labor Code, for th[
Vormance of the work for which this permit is issued. Policy No.
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'
carrier and policy number are:
Policy Number
1e of Agent
certify that, in the performance
if I should become s�ubject t
lature of ADDlicaniN r
Date
employ any person in any manner so as to become subject to the workers' compensation laws of California, and
of the Labor Code, I shall forthwith comply with those provisions.
)reby affirm under penalty of perjury that there is a construction lending agCrncy for the performance of the work for which this permit is issued
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 ordy nce a at a reyaJiwp to building construction.
I authorize representatives of this city or coup(y jd e r th a -id fi r arty for inspection purposes.
of Property Owner or
_ Print Property Owner's or Authorized Agent's Name
9
ACTION
DATE
BY
ECLARATION OF COMPLIANCE MTN CODE OF
FEDERAL REGULATIONS PART 61 OF TITLE40AMO
AQMO RULE 1403.
❑ I SUBMITTED ASBESTOS NOPHC 4TION TO:
❑ EPA
❑ AQMO
ElASBESTOS NOTIFICARONIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE.
FOR OFFICE USE ONLY
PERMITEXPIRED
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL
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