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H2018-0766 - Permits
City of Nerxopc EY acpt o Beo-ilding Division IIII IIIIIIIII II IIIIIIIIIIIIIIIIII IIIII MECHANICAL Permit: H2O18-0766 100 Civic Cente ;Dnv&, �'ewport Beach,XCA 92,680 , H 2 0 1 8 0 7 6 6 Project No: 0068-2018 '} Permit Counter-Phone(949g6d'412.8t a ° ; FEES e • • ,r� *,• , • O e Inspection Requests Phone (949)644-3255 • O © O FurnacesBoilers & Compressors Ventilation Job Address: 606 BAY FRONT S Bldg:1 Floor: Suite: Description of Work: MECH - 2 FAU, 2 AIC CONDENSORS, RELATED DUCTWORK. TAMPER-RESISTANT CAPS & TIMERS REQUIRED Inspector Area:2 Code Edit: 2016 Legal Description: BALBOA ISLAND SEC 2 LOT 5 BILK 1(AND LOT 6 BILK 1 Owner: HANSEN ROBERT Contractor: CLIMATE AIR MASTERS INC Worker's Comp Insurance - Address: 841 APOLLO ST #450 Address: 1139 N ANAHEIM BLVD Carrier: SECURITY NATIONAL EL SEGUNDO, CA 90245 ANAHEIM CA 92801 Policy No: SWC1157439 Phone: Phone: 951-286-6822 Expire :06/25/2019 Con State Lic: 695854 ' Issued Date:12/10/2018 Lic Expire: 08/31/2019 Over 100K BTU/hr: Bus Lic: BT30059886�. $0.00 Processed By: (n Lic Exp Date: 12/31/2019 0 $0.00 HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 0 $0.00 Up to 3HP: 2 $38.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 $0.00 Over 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 Wall/Floor Heaters: 0 $0.00 >15 HP to 30 HP: 0 $0.00 Attic Fan: 0 $0.00 Metal Fireplace: 0 $0.00 Heat Pumps & Package Units >30 HP to 50 HP 0 $0.00 Down -Draft Fan: 0 $0.00 Record Mgt Fee: $0.00 Up to 1o0K BTU/hr: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee : $0.00 Investigation: $0.00 Over 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $33.06 Up to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: TCHE3654151Issuance: $35.00 Up to 1.75M BTU/hr: 0 $0.00 Over 1OK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: YORK Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $40.00 TOTAL: $146.06 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $146.06 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. )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 IV tQe chi, &1k(a) Thai: plat;d 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 eRy stTactur@, priof to its Issuance, also requires the applicant for is 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 subjgcts tltp 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�tllg strVturt isnDit intanded or Offereo 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 rrsor% effort, Jbtilde w improves theproperty, 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-Efullder 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 licensure under the Contractors' State License Law for the following reason: ly 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 legall, 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio7000 of Division 3 of the Business and Rrefe s o e, al yliicensin Is T nd effect. f, ( icense Class License No Date 1 U Contractor Signature) Y VORKERS' COMPENSATION DECLARATION DARNING: 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 ($100,000), IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37DG OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: k1have 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 th ance of the work for which this permit is issued. Policy No. d 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' compensatiol ce carrier and policy number are: Policy Number Date ame of Agent Phone P ]I certify that, in the performance rk for which this permit is issued, I shall not employ a y person in any manner so as to become subject to the workers' compensation laws of California, and agre let, if I should become s o th orkers' compensation provisions 0 e Labor Code, I shall forthwith comply with those pro isions. ignature of Applicant N, Dii�� C/ DECLARATION REGIC ENDING AGENCY hereby affirm under p of per ju at 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 y my signature below, I certify to each of the following: I am the properly owner or authorized to act on the propert behalf. I have read this application and the information I h Ided is correct. I agree to comply with all applicable city an y ordinanc sate laws relating t I ding construction. /�/ I authorize representatives of this city unty to t e-abovyidentified prop R or inspection purposes. " r i0nature of Properly Owner or Authoriz Print Property Owner's or Authorized Agent's Name Date ACTION DA RY DECLARATION OF COMPLIANCEWITHCODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 8t OF TITLE40AND AQMD ROLE 1403. ' PERMITEXPIRED - i SUBMfTFEDASSESTOS WIIFICATIONTO.' ❑ EPA PERMITCANCELLED PERMITEXTENDED[3AQMD ❑ ASBESTOS NORiiCAT/ONIS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL it 17 AZZ CERTIFiCAT€ O€ SIGNATURE: OCCUPANCYISSUEO