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Home My WebLink AboutH2021-0640 - PermitsCity of Newport Beach - Building Division H2O21-0640 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 'I Cal{Y19 N Job Address: 19 WHITESANDS DR BIdg:1 Floor: Suite: Description of Work: MECH CHANGE OUT (2) A/C UNITS *TAMPER PROOF CAP REQ* InspectorArea:6 Code Edit: 2019 Legal Description: N TR 14912 LOT 6 Owner: LEE DENNY HUBERT Contractor: MIGHTY DUCTS Address: 19 WHITESANDS DR Address: 2075 N SHAFFER ST NEWPORT COAST, CA 92657 ORANGE CA 92865 Phone: Phone: 714-505-7079 Con State Lic: 748387 Issued Date:11/10/2021 Lic Expire: 01/31/2022 n-Bus Lic: BT30077210 Processed By: 0 - Lic Exp Date: 11/30/2022 MECHANICAL Permit: H2O21-0640 Project No : Inspection Requests Phone (949)644-3255 TIMER REQUIRED ON EQUIPMENT TO SHUT OFF BETWEEN 10 P.M AND 7 A.M. Worker's Comp Insurance - Carrier : FALLS LAKE FIRE Policy No: FLA01536601 Expire :1010112022 VAC Items FEES irnacesBoilers & Compressors Ventilation Other p to 100K BTU/hr: 0 $0.00 Up to 3HP: 2 $44.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $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 tall/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: ver 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: p to 1 M BTU/hr: 0 $0.00 up to 10K CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: EL1 6XC1 Issuance: $38.00 p to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: LENNOX ver 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: TOTAL: $172.28 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $172.28 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. TIMERS RRU a i I'EF) ON HEAT PUMPS $0.00 $0.00 $0.00 $38.28 $52.00 )WNER-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 1e 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 Iicensure 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 U 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). 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 Iicensure under the Contractors' State License Law for the following reason: ly my signature oelow 1 acknowledge that, except for my personal residence in which 1 must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legal) 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 'rofesspons Code, is mailable upon request when this application is submitted or at the following Web site:http://www. leginfo.ca.gov/calaw.html. lignature of Property Owner or Authorized Agent Date -ICENSED CONTRACTOR'S DECLARATION hereby affirm under ne.nalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force nd effe:t. .icense Class ?0 License No 7y9387 Date I ( fV /2� Contractor Signature vy _— VORKERS' CCLIPENSATION DECLARATION IARNING: FAILURE TC SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$100,000), IN ADDITION TO THE C3 JI LOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. tiereby affirm u,ider penalty of perjury one of the following declarations: I have and w?'I mai7.tain 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 the e,funnance of the work for which this permit is issued. Policy No. �(I 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' compensation Yshrance carrier and policy number are: �i n :arrier � JIS 1-rl, �^ L-^-I't� CsSv-)4-7 Policy Number t-r.-+�O IS3Co6 --Of Expiration Date, �O�t/Z'Z lame of Agent _I-1(K- L15 .2; Phone# ` Ib' I certify 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 become subject to the workers' compensation laws of California, and agree Tat, if I should become subject t e workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prov'Itsioons. lignature of Applicant x �� Date x )ECLARATION REGAL 1 CONSTRUCTION LENDING AGENCY hereby 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). ender's Name Lender's Address Iy 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 ordinances and state laws relating to building construction. I authorize representatives of this city or county ante Yenter th��yy�t��Gve-identified property for inspection purposes. t,\ / ,t,� / ticnature of Prooertv Owner or Authorized Agent I \ /"'��d'" Print Property Owner's or Authorized Agent's Name Y �4++ 7 `('` N Dat ACTION DAIF BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40AND AQMD RULE 1401 PERMIT EXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMIT EXTENDED ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL 1• CERTIRCATEOf V I SIGNATURE: OCCUPANCYfSSU€D -* fit, (4f,NG U I,fr KAM