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HomeMy WebLinkAboutH2019-0761 - Permits0,., City of Newport Beach - Building Division III III 11111p111111111111111111p111p1111111111 MECHANICAL Permit: H2O19-0761 *t, 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 9 0 7 6 1 Project No: 0004-2019 F. '_ ` Permit Counter Phone (949)644-3288 ngY"i'PiFR�S Inspection Requests Phone (949)644-3255 NO GONSTRI 10TION MOI ' Job Address: 3920 SEASHORE DR BIdg:1 Floor: Suite: Description of Work: MECH NEW (2) A/C UNITS *TAMPER PROOF CAP REQ* p Inspector Area:1 Code Edit: 2016 ON THE WEEKEND �+� �� • T �g Legal Description: ®� .'e�.71 m^ o msumm m n 0 Owner: FLOOD BRIAN & DANA Contractor: PRO WEST MECHANICAL INC Worker's Comp Insurance - • ^ `mm . Address: 412 DE SOLA TER Address: 12962 EVENINGSIDE DR Carrier: EMPOLYEE SERVICE GROUP CORONA DEL MAR CA 92625 SANTA ANA CA 92705 Policy No: C66371955 • • • • • • • ° ^ Phone: 949.613-5058 Phone: 714-651-8737 Expire :11/01/2020 °°•° •• ^ Con State Lic: 974570 ° ^ ©� ^ • • m ° ^ o m memo^ Issued Date:11 /2 612 01 9 Lic Expire: 06/30/2020 ...... � Bus Lic: BT30051314 • ° ° ommmom ° ^ Processed By: =J Lic Exp Date: 05/31/2020 m om m ° m mmoo HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 0 $0.00 Up to 3HP: 2 $40.00 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 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: $34.80 Up to 1 M BTU/hr: 0 $0.00 up to 10K CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: 24AAA51ssuance: $35.00 Up to 1.75M BTU/hr: 0 $0.00 Over 1 OK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: CARRIER Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $41.50 TOTAL: $151.30 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $151.30 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. 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) ction 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 tfie applicant for 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 fessions 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 more than five hundred dollars ($500). - 1, as owner of the property, or my employees with wages as their sale compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, riness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the ,rovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or roved for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not ily to an ownai;gfpS*erty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I am.exempt from licensure under the Contractors' State License Law for the following reason: A; %nature ftov4 Cacknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legal1 a %ructure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and fessions Code, 4s available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. nature of Property "uner or Authorized Agent Date 1EASED C6VJ1R$CTOR'S DECLARATION :r* affirm urLVI; Qenalty of perjury that I am licensed under provisions of Chapter 9 (commencing wit Section 7000) of Division 3 of the Businessand MIS C =an 'n full force Pdffe�C 0 !lase Class License No Dat 1 17-toI Contractor Signatur :RKVRS' COMPENSATION DECLARATION INING! FAILURE 6 EBWRE 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 jr"COMPENSATION, 19AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. telyy'affirm QrIAL p1nalty of perjury one of the fallowing declarations: I have and wilt 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 the 'ormance of the work for which this permit is issued. Policy No. 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' compensatio mSur nce carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # ❑1 certify that, in the perfor ance of w for w ch this p mit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that, if I should become su feat to t work o pensation p it of Section 3700 of the Labor Code, I shall forthwith comply with those pro is' ns. 1 Signature of Applicant �-" Date DECLARATION REGAAD' G C E NCY I hereby affirm under enalt :jury that there is a construction lending agency for the performance of the work for which this permit is issue (Section 3091, 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 providrbve-iden SC eat. I agree to comply with all applicable city and county rdinanand st e f ws relati to building construction. I authorize representatives of this city or county to 1eed pr P rt inspection purposes. f' Signature of Property Owner or Authorized Agent `'Print Property Owners or Authorized Agent's Nam to ACTION DATE By DECLARATION OF COMPLIANCEWITR CODEOF FOR OFFICE USED LY FEDERAL REGULATIONS PART 61 OF TITLE40AND AQMD RULE 1463. - PERMIT EXPIRED ❑ I SUBMITTED ASBESTOS M077FICATION TO: ❑ EPA ❑ AQMD PERMITCANCELLED PERMIT EXTENDED 0 ASBESTOS PROPOSED DEMOLITION.RONfS NOF APPLICABLE TO PER 4ITFINAL /U� l� O /vim. 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