HomeMy WebLinkAboutH2022-0037 - Permitsa
City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII MECHANICAL Permit: H2O22-0037
100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 2 0 0 3 7 Project No : 0220-2021
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Job Address: 1600 BALBOA BLVD E BIdg:1 Floor: Suite:
Description of Work: MECH (1) HEAT PUMP & (1) A/C UNIT ON ROOF *TAMPER PROOF CAP REQ*
Inspector Area:1 Code Edit:
2019
Legal Description: BALBOA TR EAST SIDE ADD BLK 25 LOT 12
Owner: GALVEZ KRISTINA & OSCAR
Contractor:
Address: 1600 BALBOA BLVD E
Address:
NEWPORT BEACH, CA 92661
Phone: 562/686-1188
Phone:
Con State Lie:
Issued Date:03/02/2022
Lie Expire:
Bus Lie:
Processed By:
Lie Exp Date:
CARHARTT DEVELOPMENT INC
11511 GARFIELD AVE
SOUTH GATE CA 90280
323-997-3282
1038854
05/31/2022
BT30075117 +++
04130/2022
I
Worker's Comp Insurance -
Carrier: NO EMPLOYEES
Policy No:
Expire :
HVAC Items
FEES
FurnacesBoilers & Compressors
Ventilation
Other
Up to 100K BTU/hr:
0
$0.00
Up to 3HP:
1 $22.00
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:
1
$22.00
>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:
$38.28
Up to 1 M BTU/hr:
0
$0.00
up to 1 OK CFM:
0 $0.00
Repair/Alter/Add:
0 $0.00
Model:
TVA9lssuance:
$38.00
Up to 1.75M BTU/hr:
0
$0.00
Over 1 OK CFM:
0 $0.00
Supplemental Fee:
$0.00
Manufacturer:
TEMPSTAR/GREE
Over 1.75M BTU/hr:
0
$0.00
VAV Box:
0 $0.00
Zoning PC:
$52.00
TOTAL:
$172.28
Plan Check Fee
: $0.00
Fee Due at Permit Issuance:
$172.28
PERMITS EXPIRE 180 DAYS AFTF;R fSSU. N gE OR LASTWVALIQ INSPECTION
Construction Hours: Monday - Friday 7:00e.m.1ti 6:30 p. q.ap d Saturdyy! rom 8:00 a.m. to 6:00 p.m.
oc ••ro • • • cWa
G o 0 o W o W• e
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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).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) 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
irmrroved for the purpose of sale).
LJ 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
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 legali
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://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty 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
and effect.
License Class _ License No Date h 3 Z ZL. Contractor Signature
WORKERS' COMPENSATION DECLARATION
NARNING: 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
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
1 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 Code, for the
Derformance of the work for which this permit is issued. Policy No.
:1I 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
nsurance carrier and policy number are:
Policy Number
of Agent
Date
rtify 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
if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant Date _ A
CLARATION REGARDING CO RUC ON 14NDING AGENCY
;reby 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).
Ider's Name Lender's Address
my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owners 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 to enter the above -identified property for inspection purposes. n / -.
nature of Prnoertv Owner or Authorized Anent l�l �— � Print Property Owner's or Authorized Agent's Name I X /�' �l *A AJ?f61!1V Date
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
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