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Home My WebLink AboutH2017-0097 - Permitswroa City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II o 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 7 0 0 9 7 N Permit Counter Phone (949)644-3288 Job Address: 401 CATALINA DR BIdg:1 Floor: Suite: Description of Work: MECH/F.A.0 (GARAGE) & GAS LINE Inspector Area:2 Code Edit: 2016 Legal Description: N TR 1136 LOT 62 Owner: BARKER HEATH & ROBIN Contractor: Address: 401 CATALINA DR Address: NEWPORT BEACH, CA 92663- - - - Phone: 714.585-7118 Phone: Expire : Con State Lic: Issued Date:02/17/2016 Lic Expire: Ventilation #171f Bus Lic: Processed By: -Lic Exp Date: MECHANICAL Permit: H2O17-0097 Project No : 1699-2016 Inspection Requests Phone (949)644-3255 HVAC Items OWNER/BLDR Worker's Comp Insurance - FEES BARKER HEATH Carrier : --Policy No: Expire : a1 Furnaces Boilers & Compressors Ventilation #171f HVAC Items FEES Furnaces Boilers & Compressors Ventilation Other Up to 1 o0K BTU/hr: 1 $18.00 Up to 3HP: 0 $0.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 $0.00 Over 1 OOK BTU/hr: 0 $0.00 > 3 HP to 15 HP: 0 $0.00 Exhaust Fan: 0 $0.00 Gas Line: 1 $9.00 $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: $33.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 TOTAL: $60.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $60.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION m m s • m m a s • •• s a 0 o e • •s t <c ! O V O •:i0 • 004 OC• • O • iE0 O • p• G U• U �C a m a e c a 6 00 0 C 009 •• 00 O i OJO fiOV DWNER-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 (commnmcin�-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 (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, 5 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 im am is 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 p ed fo the purpose of sale). as ner 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 an owner of property who builds or improves thereon, and who contracts fort rojects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ 1 am exempt from licensure under the Contractors' State License Law for th ollow� g reason: By my signature below I acknowledge that, except for my*n=",rconst idence wh I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot Iegall) sell a structure that I have built as an owner -builder if it hI irety 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 thi at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. 7, / Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATIOIII hereby affirm under penalty of perjury that I am licen d under provision apter 9 (commencing with Region 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No Date Contractor Signature NORKERS' 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 :OST 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 th, Jerformance 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' compensatior urance carrier and policy number are: trier Policy Number Expiration Date VrtiAgent Phone # fy that, in the performa4toh or o h�nsation rmit 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 1y„if should become Sul iect rke rovisions of Section 3700 of the Labor Code, I shall forthwith comply with those pro vislops. 7 -2- 'WG nature of Applicant Date CLARATION REGA I NSTRUCTI NDING 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 issuedXection 3097, Civil Code). lder'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 owner's behalf. I have read this application and the information I have provided is correct. 7 agree to comply with all applicable city and county ordinances t ?N lating to building construction. authorize representatives of this city or county t_ o Qnter e= d property for inspection purposes. nature of Property Owner or Authorized Agent '� LM Print Property Owner's or Authorized Agent's Name /Z ppm ACTION DATE Ry • ••• DEG6ARATICMOFGOMPUANCEWITHCODEOF I FOR OFFICE USE ONLY CEDgRAL REGULDTI )PIS PART 61 OF 7-ITLE40AND •ACIMORUL[ 403• :. ® `$UBMA7ED•ASbBTOS AmAFICATION TO:. ❑ EPA AOMD PERMITEXPIRED • • • PERMITCANCELL£D PERMIT EXTENDED " "• • ❑•A BEST' NO17H Nl5 OT LICABLE TO •P EDD • $O O PERMIT FINAL �J ` • CERTIFICATE OF • e •• • OCCUPANCYISSUED " • • ` ` a