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HomeMy WebLinkAboutH2018-0471 - PermitsCity of Newport Beach - Building Division MECHANICAL Permit: H2O18-0471 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 8 0 4 7 1 Project No H Permit Counter Phone (949)644-3288 ) N 'r+rxarnx Inspection Req fi`v- L Job Address: 3000 BREAKERS DR Bldg:2 Floor: Suite: Description of Work: MECH INSTIL (3) A/C UNIT @ THE REAR YARD" TIMER REQ ON UNIT #1, TAMPER RESISTANT CAP REQ uITBJFCTTO FIELD INSPECTOR'?. REVIEW AND APPROVAL Inspector Area:5 Code Edit: 2016 Legal Description: P BK 314 PG 23 PAR 2 FEES Owner: DUONG HANH THI Contractor: AIRSMITHS INC Worker's Comp Insurance - Address: 3002 BREAKERS DR Address: 1474-A POMONA ROAD Carrier: INSURANCE CO OF THE WEST CORONA DEL MAR, CA 92625 CORONA CA 92882 Policy No: WSA5024068 3i)° WIDE X 36" DEPTH Phone: Phone: 951-735-5225 Expire :0710112019 3 $54.00 Con State Lic: 783449 REQUIREi�q Issued Date: 8/0 018 Lic Expire: 0813112018 .PCM 0 Bus Lic: BT95002015a� o am®oo°o Processed Lic Exp Date: 10131/2018 A/C DISCONNECTS m o e o o c Wall/Floor Heaters: ce u 6®m0 O A 0 « HVAC Items FEES o e s FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 0 $0.00 Up to 3HP: 3 $54.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 $0.06"" 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 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 Fa Up to 1 OOK BTU/hr: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee $0.00 Investigation -0 $0.00 ` V U 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 1 O CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: 25HHA424/436 Issuance: $33.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K 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: $37.50 TOTAL: $171.48 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $171.48 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) :tion 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demglish, or repair any structure, prior to its issuance, also requires the applicant for permit.to filea signed statement that he or she is licensed pursuant to the provisions of the Contractors' State Lscense 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).. 4 as ownerpf 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, iness 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 ly 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). J I am exempt from licensure under the Contractors' State License Law for the following reason: ly my signature below I acknowledge that, except formy personal residence in which I must have resided for at least one year prior to completion of t 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 'rofessions 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 Tents covered by this permit, I cannot law, Section 7044 of the Business and Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Busines a 'oRa Code, and my license is in full force is effect.�� icense Class -•••• License No / Date �'�� GCJ d Contrac Igna VORKPRV &WPENSATION DECLARATION 'ARNMGOFAILURF TO SEtrRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL INES UP ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE OST OF COMPENS4TI%6DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. lfafeb�.affirm under penalty of perjury one of the following declarations: I h.ave and yAIP Mlintain 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, erFormance of the -work for which this permit is issued. Policy No. and 411 Glahliain 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' carrichand Policy number are: Policy Number Expiration Date o(Agent.i ICOKIfy that, in the Performance of the work for wh' F?this permit is issued, I shall not employ any person in any manner so as to becom 'ect to the workers' compensation laws of California, and agre, 4 Vi should 4emme.su the workers' c provisions of Section 3700 of the Labor Code, I shall forthwith comply with those p ovi/sio��g ? nature pp Scan • '�`E� CLARA ION REG RDING C CT�LENDING AGENCY rreby affir ndeFfIemal of perjury that there is a construction lending agency for the performance of the work for which this permit is is d (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 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 cou ordinances and to laws relating to building construction. I authorize representatof this city or counter the 9PAvBAIanfiroperty for inspection purposes. AC77ON DATE By DECLARATION OF COMPLIANCEiMTN CD OF FOR OFFICE USE ONLY L FEDERAL REGULATIONS PART BTQFTI. N AQMORULE1403. PERMITEXPIR€D ❑ I SUBMITTEDASBESTOS NOBFICAT/ON TOr ❑ EPA AQMD PERMITCANCELL€D PERMITEXTEND€D❑ ASBESTOS NOBRCAITOMIS NOT. APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE. PERMIT FINAL CERTIFICATE OF V1. _Lob