HomeMy WebLinkAboutH2019-0362 - PermitsCity of Newport Beach - Building Division IIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
o 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 9 0 3 6 2
Permit Counter Phone (949)644-3288
MECHANICAL Permit: H2O19-0362
Project No: 1469-2018
Inspection Requests Phone (949)644-3255
Job Address: 3632 BLUE KEY BIdg:1 Floor: Suite:
Description of Work: MECH/INSTALL (2) A/C UNITS 48.5clB & 48.5dB (TRANE: XR SPLIT-4TTR404BL1000A & 4TfL6036A1000A)
InspectorArea:4 Code Edit:
2016
Legal Description: N TR 6152 LOT 32
Carrier: INSURANCE CO OF THE WEST
Owner: RESSLER BARRON
Contractor:
Address: PO BOX 745
Address:
CORONA DEL MAR, CA 92625
Phone:
Phone:
BT95002015
Con State Lie:
Issued Date:06/18/2019
Lie Expire:
{1-
Bus Lie:
Processed By: `'
�Ji
Lic Exp Date:
AIRSMITHS INC
Worker's Comp Insurance -
1474-A POMONA ROAD
Carrier: INSURANCE CO OF THE WEST
CORONA CA 92882
Policy No: WSA5024068
951-735-5225
Expire :07/01/2019
783449
08/31/2020
FurnacesBoilers & Compressors
BT95002015
10/31/2019
HVAC Items
FEES
FurnacesBoilers & Compressors
Ventilation
Other
Up to 100K BTU/hr:
0
$0.00
Up to 3HP:
1 $19.00
Bathroom Fan:
0 $0.00
Fire Dampers:
0 $0.00
$0.00
Over 100K BTU/hr:
0
$0.00
> 3 HP to 15 HP:
1 $35.00
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 100K 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:
$46.98
Up to 1M BTU/hr:
0
$0.00
up to 1OK CFM:
0 $0.00
Repair/Alter/Add:
0 $0.00
Model
Issuance:
$35.00
Up to 1.75M BTU/hr:
0
$0.00
Over 1OK CFM:
0 $0.00
Supplemental Fee:
$0.00
Manufacturer:
Over 1.75M BTU/hr:
0
$0.00
VAV Box:
0 $0.00
Zoning PC:
$40.00
TOTAL:
$175.98
Plan Check Fee:
$0.00
Fee Due at Permit Issuance:
$175.98
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.
LDER 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
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 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 (_) 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
n 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
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 legally
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 wi h Section 70000) of Division 3 of the Business an o as Ions Code, and Tv`icense is in full force
nd effect. 0 I Contractor Signaa
icense Class License No Dat
VORKERS' COMPENSATION DECLARATION
'ARNING: 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 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
I 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 Cade, for th
I formance ofQhe work for which this permit is issued. Policy No.
71 have and II aintain 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' compensatioi
isurance Carrie policy num re:
arrier licy Number Expiration Date
'.ame of Agen Phone #
]I certify that, in the performance of the work for whic his 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 agre
tat, if I should become s bje o th orkers' com sation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
ignature of Applicant - - DaV m //
iECLARATION I A NIS NSTRLIC I ION LENDING AGENCY
hereby affirm under p nalty 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
y 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 law elating to building construction.
I authorize representatives of this city or count y�tp/� enter ab ve-identifie aro a for inspection purposes.
innature of Prnnertv Owner nr Authorized Print Prooertv Owner's or Authorized Agent's Nand\/! "" �`°� �y Ic
AC77ON DATE By
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