HomeMy WebLinkAboutH2021-0455 - Permits (3)City of Newport F wilding Division H2O21-0455
r
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Job Address: 314 RUBY AVE BIdg:1 Floor: Suite:
Description of Work: MECH NEW HEAT PUMP *TAMPER PROOF CAP REQ*
Inspector Area:2 Code Edit: 2019
Legal Description: BALBOA ISLAND SEC 3 BLK 13 LOT 8
Owner: AUSTIN SHERRY M TR
Contractor:
Address: 314 RUBY AVE
Address:
NEWPORT BEACH, CA 92662
Phone: 9491612-9982
Phone:
Con State Lic:
Issued Date:08/04/2021=V
Lic Expire:
Bus Lic:
Processed By:
_Lic Exp Date:
POWER CUSTOM BUILDERS INC
5549 CERRITOS AVENUE
LONG BEACH, CA 90805
562-376-5675
1016547
07/31/2022
BT30076105
07/31 /2022
MECHANICAL Permit: H2O21
Project No : 0552-2021
Inspection Requests Phone (949)644-3255
Worker's Comp Insurance -
Carrier : NO EMPLOYEES
Policy No:
Expire :
,o m
AC Items
FEES
nacesBoilers & Compressors
Ventilation
Other 1
to 100K BTU/hr:
0
$0.00
Up to 3HP:
0 $0.00
Bathroom Fan:
0 $0.00
Fire Dampers:
0 $0.00
,r 100K BTU/hr:
0
$0.00
> 3 HP to 15 HP:
0 $0.00
Exhaust Fan:
0 $0.00
Gas Line:
0 $0.00
II/Floor Heaters:
0
$0.00
>15 HP to 30 HP:
0 $0.00
Attic Fan:
0 $0.00
Metal Fireplace:
0 $0.00
it Pumps & Package
Units
>30 HP to 50 HP
0 $0.00
Down -Draft Fan:
0 $0.00
Record Mgt Fee:
$0.00
to 100K BTU/hr:
1
$22.00
>50 HP:
0 $0.00
Residential Hood:
0 $0.00
Additional Fee :
$0.00
Investigation
:r 500K BTU/hr:
0
$0.00
Air Handling Units
Comm. Hood:
0 $0.00
Plan Check:
to 1 M BTU/hr:
0
$0.00
up to 1OK CFM:
0 $0.00
Repair/Alter/Add:
0 $0.00
Model:
MULT136HP730
Issuance:
to 1.75M BTU/hr:
0
$0.00
Over 10K CFM:
0 $0.00
Supplemental Fee:
$0.00
Manufacturer:
:r 1.75M BTU/hr:
0
$0.00
VAV Box:
0 $0.00
Zoning PC:
TOTAL: $131.14 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $131.14
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.
$0.00
-$0.00
$0.00
$19.14
$38.00
$52.00 1 1
)WNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason() 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
to 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
'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 (_) all of or (_) 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
nproved 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
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 Iicensure under the Contractors' State License Law for the following reason:
ly my signature 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 legaliy
ell a structure tha+ 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
'rofess`,ons Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Iignature of Property Cwner or Authorized Agent Date
'CEMSED CONTRACTOR'S DECLARATION
herPhy affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 of Division 3 of the Business an Profess! pe d"my license is in full force
nd effect. �)
.ict,nse• Class License No Da t �0 2 Contractor Signatur
VORKERS' COMPENSATION DECLARATION
IARNING. FAILURE T6 aECJRE 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
'OST OF COMPENSAT.'ON, 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 WA 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 thl
erformznce of the�7wort: for which this permit is issued. Policy No.
qr have and wijftmaintain 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
atura4ce carried and,deifcv number are:
Policy Number Expiration Date
of
I certify that, in the perf!me
ance f the work for which this permit 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
that, if I should becomes A t e workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /
Signature of Applican Date'. V
DECLARATION REGA DI UCTION LENDING AGENCY
I hereby affirm under Dena o perjury that there i5 a construction lending agency for the performance of the work for which this permit is issued (S( tion 097, 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 iisrrect.
I agree to comply with all applicable city and co ty ordinances a d state laws relating to building construction.
I authorize representatives of this city or cc to enter the abo'e-id Ified pro rty for inspection purposes. y 17
Signature of Property Owner or Authorized A e Print Property Owner's or Authorized Agent's Nam ' C 1 to L
ACTION
DATE
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONL
FEDERAL REGULATIONS PART 61 OF TITLE40 AND
AQMD RULE 1403.
PERMIT EXPIRED
❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERMIT CANCELLED
PERMITEXTENDED
❑ ASBESTOS NOTIRCATIONISNOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
CERTIFICATE OF
SIGNATURE:
OCCUPANCYISSUED