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Home My WebLink AboutH2021-0414 - PermitsCity of Newport Beach -Building Division H2O21-0414 MECHANICAL Permit: H2O21-0414 100 Civic Center Drive, Newport Beach, CA 92660 PfOJ2Ct NO Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 %..0 1�rzCTONR Job Address: 1721 MARLIN WAY BIdg:1 Floor: Suite: Description of Work: MECH FURNACE C/O InspectorArea:3 Code Edit: 2019 Legal Description: N TR 3097 LOT 35 Owner: EMMEL DREW & CHRISTINE Contractor: OWNER/BLDR Worker's Comp Insurance - Address: 1721 MARLIN WAY Address: CHRISTINE EMMEL Carrier: NEWPORT BEACH, CA 92660 O/B ATTACHED TO Policy No: Phone: 949-285-3292 Phone: H W 7,1 - U 35 L Expire Con State Lic: OIB Issued Date:07/09/2021 Lic Expire: - ��/� �� Z_ Bus Lic: Processed By: Lic Exp Date: HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 0 $0.00 Up to 3HP: 0 $0.00 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: $0.00 Up to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: Issuance: $38.00 Up to 1.75M BTU/hr: 0 $0.00 Over 1 OK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $0.00 TOTAL: $38.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $38.00 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. 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 ar nj': intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner-Builderwill have the burden of proving that it was not built or ,in ved for the m ,.r?ise of sale). x I, cE owner of th2 p.operty, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not �p to an owne, 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 exempt from licensure under the Contractors' State License Law for the following reason: t3y my signature hPinw 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, SO a structure :hat I have built as an owner-buil r if't h I of been constructed in its entirety by licensed contractor . understand that a copy of the applicable law, Sect i n 7 44 of the Business and ^rofcs3ions Code, is available upon request when aQjPli i i�'SuI d or at the foil rig Web site:http:// 6gi.nfo.ca.gov/calaw.html. Ire of Property Owner or Authorized Agenf \ — LeC . li�A a p . �_n.. Dat I,ICFNSED CON1 FACTOR'S DECLARATI 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 Co , a d my license is in full force Lnd effect. License Class License No Date Contractor Signature COMPENSATION DECLARATION FAILURE TO SEC:RE 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 OMPENSATION, 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: 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 mance 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' urance carrier and policy number are: Policy Number of Agent Date I certify that, in the perfor nce of the work for which this permit is issued, I shal of employ any person in any manner so as to become subject to the workers' compensation laws of California, and agref It, if I should becp'ma Li R /t(��tje/yvor jrs�' compensationroovision's�1of Sectio 00 of the Labor Code, I shall forthwith comply with those prows ns. Gar Inature of Applicant /mil II' VI// Oaf I �!� G'f/uV 1/�� Date `7 / / / iCLARATION REG RDITIC CONSTRUCTION LENDING AGENCY . / " areby affirm under enalty oiperjury that there is a construction lending agency for the performance of the work for which this permit is issued ect n 3097, Civil Code) riders 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 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 ccVnty ordinances and state laws relating to buildi construction. EC I authorize representatives of this city or co to a the ack�cye�Ident'rfie r perty for insp,`./,n,''g(on purposes. lature of Property Owner or Authorized Age nt'✓% /'Y./�/Le— �fit'Property Owner's or Authorized Agent's Name Y Ltf�J'l.��i/vOt Dat 7 ACTION DATE BY DECLARATION OFCOMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF T/TLE40 AND AQMO RULE 1403_ PERMIT EXPMED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMITEXTENDED ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL CERTIFICATEOF SIGNATURE: OCCUPANCYISSUED