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Home My WebLink AboutH2019-0433 - Permits��wtvlk City of Newport Beach - Building Division III 111111111111111111111111111111111111111111111 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 9 0 4 3 3 r Permit Counter Phone (949)644-3288 Job Address: 15 HILLSDALE OR BIdgA Floor: Suite: Description of Work: MECH DUCT REPLACEMENT Inspector Area:8 Code Edit: 2016 Legal Description: TR 11785 LOT 2 UNIT 1 OF PROJECT LOCATED ON AP 442-301-69 TOGETHER Owner: WATUMULL ANITA Contractor: SERVICE CHAMPIONS HTG Address: 15 HILLSDALE DR Address: 3150 E BIRCH NEWPORT BEACH, CA 92660 BREA CA 92821 Phone: Phone: 714-777-7777 Con State Lic: 799170 Issued Date: 6 2019 Lic Expire: 09130/2019 Bus Lic: BT01080105 Processed By: i Lic Exp Date: 07/31/2019 nacesBoilers & Compressors to 100K BTU/hr: 0 $0.00 :rLOOK-B-TU/lu: 0- _Woo - II/Floor Heaters: 0 $0.00 it Pumps & Package Units to 100K BTU/hr: 0 $0.00 :r 500K BTU/hr: 0 $0.00 to 1M BTU/hr: 0 $0.00 to 1.75M BTU/hr: 0 $0.00 :r 1.75M BTU/hr: 0 $0.00 Ventilation Up to 3HP: 0 a-3-HPAo-1-5 HP 0- >15 HP to 30 HP: 0 >30 HP to 50 HP 0 >50 HP: 0 Air Handling Units up to 10K CFM: 0 Over 10K CFM: 0 VAV Box: 0 TOTAL: $142.12 FEES $0.00 Bathroom Fan: 0 $0.00 $0.00 Exhaust -Fan: 0$0.00 $0.00 Attic Fan: 0 $0.00 $0.00 Down -Draft Fan: 0 $0.00 $0.00 Residential Hood: 0 $0.00 Comm. Hood: 0 $0.00 $0.00 Repair/Alter/Add: 4 $76.00 $0.00 Supplemental Fee: $0.00 $0.00 Plan Check Fee : $0.00 MECHANICAL Permit: H2O19-0433 Project No : Inspection Requests Phone (949)644-3255 IINSPECTOR Worker's Comp Insurance - Carrier: PACIFIC COMP Policy No: WA000607 Expire :03/22/2020 Other Fire Dampers: 0 $0.00 $0.(•0 -Gas-Line: 0 $0-00 $0.00 Metal Fireplace: 0 $0.00 Record Mgt Fee: $0.00 Additional Fee: $0.00 Investigation: $0.00 Plan Check: $66.12 Model: Issuance: $0.00 Manufacturer: Zoning PC: $0.00 Fee Due at Permit Issuance: $142.12 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday- Friday7:00 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 (_) 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). - 111, 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). ❑ 1 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 legal) 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 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Divi of the Bu ness and rof Code, and my license is in full force and effect. License Class License No Contrary Signature WORKERS' COMDENSATION DECLARATION 1^rPPN'N 1FAILUR^ TO -FC'IRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLO TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF LOMPENiAT.ON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. I harety affirm under penalty of perjury one of the following declarations: EI eve 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 IN pe rmance of .he worm for which this permit is issued. Policy No. ve and v ill madntain 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' compensatio surance came, anr+ policy number are: f.arrie Policy Number Expiration Date !ame o«:.Agent, Phone # I cer iry that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to becomesubjec to the workers_' compensation laws of California, and agre Ciat, if I d - ome-su ject o the rk re compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with tFiosa provi ions. Signature o plicanf Date DECLARATION N LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is is (Section 3097, 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 is correct. I agree to comply with all applicable city and county o nces and state laws relating to building construction. I authorize representatives of this city or county t t t above -identified property for inspection purposes. II Signature of Property Owner orAuthori - Print Property Owner's or Authorized Agent's game (1' .IPrtc ate 23 h ACTION DATE BY DECLARATION OF COMPLIANCE KITH CODE OF FOR OFF) SE ONLY FEDERAL REGULATIONS PART 61 OF R7LE40AND AQMD RULE 1401 PERMIT EXPtREO ❑ ! SUBMlTTEDASDESTO5 fJOTIFICAPON TO: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMIT EXTENDED ASBESTOS � PROPOSED PERMIT FINAL