HomeMy WebLinkAboutH2018-0629 - PermitsCity of Newport Beach - Building Division III 111 11111111 MECHANICAL Permit: H2O18-0629
100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 8 0 6 2 9 Project No: 0343-2018
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Job Address: 1320 BALBOA BLVD W BIdg:1 Floor: Suite:
Description of Work: MECH/ NEW A/C "TAMPER RESISTANT CAP REQ"
Inspector Area:1
Legal Description: TR 234 LOT 6
Owner: BE HRISTINE
Address: 20 W BAL OA BLVC
NEWPORT B ACH CAI
Phone' 714-287-7931
Date:10/09/2018
3 ELY 30 FT -_" -,�.•
ate:
on ram } � r----<JQ 4MJUWE CONSTRUCTION INC
Address: 6186 BEACH BLVD
K O6
Ph 7
LJ CoG1487111f,'
.Lic E
Bus Lic: BT30063301
nacesBoilers & C presso ., Ventilation
to 100K BTU/hr: 0 $0.00 3H 1 $19.00 Bathroom Fan: 0
'r 100K BTU/hr: 0 $0.00 3 $ st Fan:
II/Floor Heaters: 0 $0.00. P to 0 $ tc an: 0
at Pumps &Package Units >30 HP to �a Down -Draft Fan:
to 100K BTU/hr: 0 $0.0 >50 HP: k tar .9D Residential Hood: 0
;r 500K BTU/hr: 0 $0.0 I Ir Handling Units Comm. Hood: 0
to 1M BTU/hr: 0 $0.0 Q �to�01<CFM: 0 $0.00 Repair/Alter/Add: Repair/Alter/Add: 0
to 1.75M BTU/hr: 0 0.0 Over 10K CFM: 0 e:
'r 1.75M BTU/hr: 0 $0.0 --Yg
TOTAL: $110.53
$0.00 �Q
Plan
ifrrlnsurance-
Polior ompUARD INS CL
No: JCW88371
ED 6
4W1 y"0% re -fund
to whom:
REVIEW
$0.00 Fire Dampers:
Gas Line:
ArKtion
St@rt@Ci)
$0.00 Model:
$0.00 Manufacturer:
0 $0.00
0 $0.00
�y0 $6.06
i` $o.o°
AJ036JCJ5CH/AA
SAMSUNG
(OIL—Insp.
6tlltlalS:
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday -Friday 7:00 a.m.fo 6:30 p.m -and Saturday from 8:00 a.m. to 6:00 p.m.
DINSPFC,T( R1S
APPROVAL
°
0000ca
0
• n
0000 •00000
P �
Other °•°•
$0.00•
••°° °
0000
Investigation.' $O.Op°,,,.�
PlanChsok;Pe°$16.$3 °
Issuance: $35.01f4°°
00 0 0
m 0 0 ooP•
Zoning P� ° $40.00
:1 $110.53
UWNEK-13UILUtK UtI:LAKAI IUN
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 applicajit 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 per-ilty of
not more than five hundred dollars ($500).
❑ 1, 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,
Business andProfessionsCode: 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
im roved for the purpose of sale).
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 improvementscoveredby this permit, I cannot legall)
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.htmi.
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 Pro�si s ode, and y license is in full force
and effect. �+ _ r/
License Class License No Date `7 X 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 HU ED THOUSAND DOLLARS (Et00,0001, IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm pPgPr.*nalty 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
ce of.Ag Wbik for which this permit is issued.' Policy No.
....
e nd willlrlaintain 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' compensatiol
vsu6anc carrier and Dolicv number are:
Policy Number
Date
amewf Agent vnone iF
1Pcer4fy thatla iFie.performance a work for which this ermit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
tat,lAl should become s 'e o th worke compens provisions ofSection 3700 of the Labor Coda, I shall forthwith comply with those pro\visions.
igflatuse of ADDWc rl D t ^ � / �r�
ECLARATION REGARDING CONSTRUCTION LENDING AGENCY
hereb•K',affirmuBdespenalty perjury that there is a construction le r the performance of the work for which this permit is issued (Section 3097, Civil Code).
srr&fls Nam e• ' gency foLender's Address
my signature below, I Wrlify to each of the following:
I am the property owner or authorized to act on the property owner's behalf.
I haveread this application and the information I have provided is correct.
I agree to comply with all applicable city and county ordinap4 anyl state Is
I authorize representatives of this city or county to a bov-identiflgf
ACTION
PERMIT FINAL
CERTf6ICATEOF
OCCUPANCYISSUED
DATE I / BY
relating to building construction.
)party for inspection purposes.
Print Prooertv Owner's or Authorized
FEDERAL REGULATIONS PART 61 OF TIILE40AND
AQMD RULE 1403.
❑ 1SUBMITTEDASBESTOS NOTIFICA7/ONTO:
EPA
❑ AQMD
❑ ASBESTOS N017RCA170MIS NOT APPLtCABL.E TO
PROPOSEDDEMOLITION.
SIGNATURE: