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Home My WebLink AboutH2022-0130 - PermitsrEu•.rok City of Newport Beach - Building Division H2O22--0130 .,� 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 t'arsri�u�"� Job Address: 941 VIA LIDO SOUD BIdg:1 Floor: Suite: Description of Work: MECH (4) A/C UNITS IN ROOF WELL (X2021-0385) SUZ-KA36NA2, Inspector Area:2 Code Edit: 2019 Legal Description: N TR 907 LOT 323 Owner: GABRIEL ANDREW Contractor: LEGACY CUSTOM HOMES INC Address: 419 EVENING STAR Address: 1000 QUAIL ST, STE 220 NEWPORT BEACH, CA 92660 NEWPORT BEACH CA 92660 Phone: Phone: 949-887.4750 Con State Lie: 986194 Issued Date:03/1112022 Lie Expire: 08/31/2023 Bus Lie: BT30045036 Processed By: Lie Exp Date: 1013112022 MECHANICAL Permit: H2O22-0130 Project No : 0379-2021 Inspection Requests Phone (949)644-3255 Q4f d7� Worker's Comp Insurance - Carrier: OAK RIVER INSURANCE CO Policy No: LEWC219928 Expire :12102/2022 AC Items FEES •nacesBoilers & Compressors Ventilation to 100K BTU/hr: 0 $0.00 Up to 3HP: 1 $22.00 Bathroom Fan: 0 $0.00 Fire Dampers: =r 100K BTU/hr: 0 $0.00 > 3 HP to 15 HP: 3 $117.00 Exhaust Fan: 0 $0.00 Gas Line: II/Floor Heaters: 0 $0.00 >15 HP to 30 HP: 0 $0.00 Attic Fan: 0 $0.00 Metal Fireplace: A Pumps & Package Units >30 HP to 50 HP 0 $0.00 Down -Draft Fan: 0 $0.00 Record Mgt Fee: to 100K BTU/hr: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee -r 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 to 1 M BTU/hr: 0 $0.00 up to 10K CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: 3r 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Other 0 $0.00 $0.00 0 $0.00 y0.00 0 $0.00 $0.00 $0.00 Investigation: $0.00 Plan Check: $120.93 SUZ-KA18NA2 Issuance: $38.00 MITSUBISHI Zoning PC: $52.00 TOTAL: $349.93 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $349.93 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). 111, as owner of the property, or my employees with wages as their sole compensation, will do L) 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). ❑ 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://w .leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions C , and my license is II force and effect. // �Z Z Contractor Licens= Class License No Date Signature WOR'<ERS' COMPENSATION DECLARATION .VARt'ING: FAILURE TU SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DO ARS ($100,000), IN ADDITION TO THE COST GF COMPENS%TION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm Under penalty of perjury one of the following declarations: ' have and will r.iaintain 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 onnance 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: :e of Agent certify that, i.1 the performance 9J the , if I should become subjecttothe wq of Applicant Policy Number Date 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 compensation orovis6s of Section 3700 of the Labor Code. I shall forthwith comply with those provisions. Date / ////_� Z CLARATION REG ING:09NSTRUCTION LENDING AGENCY 3reby 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). lder'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 ordinance�s and state laws relating to building construction. I authorize representatives of this city or county to enter above= Ified Pr for inspection purposes. p / nature of Property Owner or Authorized Agent 1-/-?�� Print Property Owner's or Authorized Agent's Name b/•'dCt:.i-�1..161L4 AC77ON DATE BY DECLARATION OF COMPLIANCE IMTH CODE OF FOR OFFICE USE 6NIY FEDERAL REGULATIONS PART 01 OF TITLE 40 AND AQMD RULE 1403. PERMIT EXPIRED ❑ I SUBA41TFED ASBESTOS NOTIFICATIONTO:. ❑ EPA ❑ AQMD PERMITCANCELLED PERMITEXTENDED ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL Q-�-2 ,C../v-� CERTIFICATEOF SIGNATURE: OCCUPANCYfSSUED