HomeMy WebLinkAboutH2020-0150 - Permits�w�,.„kh City of Newport Beach - Building Division 11111111111p11111111111111111111111111 ��II III MECHANICAL Permit: H2O20-0150
a° ,_ 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 0 0 1 5 0 Project No
ti S I"',, Permit Counter Phone (949)644-3288
r
oy�, *py> Inspection Requests Phone (949)644-3255
Job Address: 1613 ARCH BAY DR BIdg:1 Floor: Suite:
Description of Work: MECH - R/R A/C CONDENSOR. TAMPER -RESISTANT CAP & TIMER REQUIRED
Inspector Area: S Code Edit: 2019
Legal Description: N TR 15222 LOT 22
Owner: MALOY DENNIS Contractor:
Address: 1613 ARCH BAY DR Address:
NEWPORT BEACH, CA 92660
Phone: Phone:
Con State Lie:
Issued Date:02/26/2020 Lie Expire:
j Bus Lie:
Processed By: d1 Lie Exp Date:
KALKA KEVIN J HEATING & A/C
15550 ROCKFIELD BLVD #A-100
IRVINE CA 92618
949-458-6600
677889
10/31/2020
BT30054832
06/30/2020
Worker's Comp Insurance -
Carrier : EMPLOYEE SERVC GRP
Policy No: WCO290817
Expire :07/01/2020
�1�ta nb�nt 1thke ON Q%A
arnacesBoilers & Compressors
Ventilation
Other
p to 100K BTU/hr:
0
$0.00
Up to 3HP:
1 $20.00
Bathroom Fan: 0
$0.00
Fire Dampers:
0 $0.00
$0.00
ver 100K 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
fall/Floor Heaters:
0
$0.00
>15 HP to 30 HP:
0 $0.00
Attic Fan: 0
$0.00
Metal Fireplace:
0 $0.00
eat Pumps & Package
Units
>30 HP to 50 HP
0 $0.00
Down -Draft Fan: 0
$0.00
Record Mgt Fee:
$0.00
p to 100K BTU/hr:
0
$0.00
>50 HP:
0 $0.00
Residential Hood: 0
$0.00
Additional Fee :
$0.00
Investigation:
$0.00
ver 500K BTU/hr:
0
$0.00
Air Handling Units
Comm. Hood: 0
$0.00
Plan Check:
$17.40
p to 1 M BTU/hr:
0
$0.00
up to 1 OK CFM:
0 $0.00
Repair/Alter/Add: 0
$0.00
Model:
4A71_6060A1000AA
Issuance:
$35.00
p to 1.75M BTU/hr:
0
$0.00
Over 10K CFM:
0 $0.00
Supplemental Fee:
$0.00
Manufacturer:
AM STANDARD
ver 1.75M BTU/hr:
0
$0.00
VAV Box:
0 $0.00
Zoning PC:
$41.50
TOTAL:
$113.90
Plan Check Fee:
$0.00
Fee Due at Permit Issuance :
$113.90
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.
,
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).
❑ 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
im 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
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).
❑ I 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
LICENSED CONTRACTOR'S DECLARATION ,c< <� ���� ,,, Iert rmanLof or f which
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencin ^Division 3 of the Business b'ect r c a license is in full force
and effect. 'ovisions. p 1 �'1
License Class License No Date 2' t.i Z.' Contractor Sigr tL, _
WORKERS' COMPENSATION DECLARATION
WARNING: 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 tS100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
111 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 thl
ggrtormance of the 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'
rance carrier and policy number are:
Policy Number Expiration Date
of Agent
certify that, in the pert ma a of the or, f which this permit is issued, I shall not employ any person in any manner so as to become subject to the work rs' ompensation laws of California, and agref
t, if I should becomes bject the wor r c e lotion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant, Date 2 u
CLARATION REGARDING CONSTRUCTION LENDING AGENCY
:reby affirm under penalty of 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 prosx4Lowner's behalf.
I have read this application and the information I ha provided is correct.
I agree to comply with all applicable city and cou orrVinances an¢ 4`a� laws relating to building construction.
I authorize representatives of this city or county ant r the above-�id4ntijie roperty for inspection purposes.
ACTION
DATE BY
DtLLAHA IIUA1 Ur LUMPLMM-L VW I rr (-vut Ur
FEDERAL REGULATIONS PART 61 OFT17LE40AND
FOR OFFICE USE ONLY
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