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Home My WebLink AboutH2019-0565 - Permitsrrtr City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIII o, 100 Civic Center Drive, Newport Beach, CA 92660 H 2. 0 1 9 0 5 6 5 `< Permit Counter Phone (949)644-3288 Job Address: 1399 GALAXY DR Bldg:1 Floor: Suite: Description of Work: MECH NEW A/C UNIT ON GROUND AND FURNACE C/O *TAMPER PROOF CAP REQ* InspectorArea:3Code Edit: 2016 Legal Description: N TR 4224 LOT 246 Owner: REITER CHARLES & ANNE Contractor: Address: 1399 GALAXY DR Address: NEWPORT BEACH, CA 92660 Phone: Phone: Policy No: (NO EMPLOYEES) Con State Lic: Issued Date:09/1912019 Lic Expire: SP/� � Bus Lic: Processed By: Lic Exp Date: STORTZ STEVEN P 9581 SCOTSTOWN DR HUNTINGTON BEACH CA 92646 714-969.8478 739917 08/31/2021 BT30068973 09/30/2020 MECHANICAL Permit: H2O19-0565 Project No Inspection Requests Phone (949)644-3255 INSPECTOR ee•• FEES Worker's Comp Insurance- Carrier: WIC EXEMPT e e Policy No: (NO EMPLOYEES) Ventilation ° e Expire: 40..°.. o. Other ee o e •o 1 $20.00 Up to 3HP: e e.. $20.00 Bathroom Fan: e.. d. e 0 $0.00 $0.00 Over 100K BTU/hr: 0 ommem• ® o 0 $0.00 Exhaust Fan: 0 $0.00 Gas Line: 0 $0.00 HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 1 $20.00 Up to 3HP: 1 $20.00 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: $34.80 Up to 1M BTU/hr. 0 $0.00 up to 1 O CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model CSA1BFlssuance: $35.00 Up to 1.75M BTU/hr. 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: SEER Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $41.50 TOTAL: $151.30 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $151.30 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. IWNER-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) lection 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 is 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 'rofessions 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 at more than five hundred dollars ($500). 7 I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (S&tion 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 nprovements 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 n 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 nut pply 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). 7 1 am exempt from licensure under the Contractors' State License Law for the following reason: y my signatum e%wJ 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, ell a squcture t1fal I M1ave 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 'f0faftfons Code!!§§ aIIqStable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. ignetuiNBe of PropBrY, Car or Authorized Agent Date .TCEED CONTRACTOR'S DECLARATION herg9y affirm ugder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing wit Section 7000) of Division 3 of the BusinesWTIOAND ratey license is in full force %effgct. icense Class License No Date Contractor Signatu II RKJERS' CQ�,2NSATION DECLARATION ARNING: FAILURE TQ SECURE WORKERS' COMPENSATION COVERAGE I5 UNLAWFUL, AND SHALL SUBJECT AN EMPL ER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO 0100,000), IN ADDITION TO THE Q�TJjFFOMPEN9AYlON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORN Y'S FEES. hEreby affirm yrpt penalty of perjury one of the following declarations: ] a dere 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 wWra;lance oftFie wort for which this permit is issued. Policy No. .. 11 have and will .m.aintain 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' compensatio Isurance carrier and policy number are: Trier Policy Number Expiration Date mg of Agent Phone # I certify that, in the perfor ance of the 0 o for we this permit is issued, I shall no employ any person in any manner so as to become subject to th�orkers' compensation laws of California, and agrei if I should become su ject to the r s' c nsation provi ' Ion 3700 of the Labor Code, I shall forthwith comply with those provisi1O G/9 mature of Applicant Date / CLARATION REGA DI CO LENDING AGENCY ;reby affirm under D.�nalty of rjury that ere is a construction lending agency for the performance of the work for which this permit is issued ( action 3097, Civil Code). ider's Name %% Lender's Address my signature below, 1 certify to each of the following: I am the property owner or authorized to act on the property owner's ehalf. 1 f I have read this application and the information I have provide Treat. I agree to comply with all applicable city and county o Ina d s relatin to action. I authorize representatives of this city or county to an r arty for inspection purposes. //J mature of PropertyOwner or Authorized Agent Print Property Owner's or Authorized Agent's Name �/��i D Ze ACTION DATE BY DECLARATION OF COMPLIANCEMITHCODEOF FOR OFFICE USEON FEDERAL REGULATIONSPART &1 OFTITLE40AMD AQMO RULE 1403. I SUBMITTED ASBESTOS NOTIFICATION TO. ❑ EPA ❑ AQMD ❑ ASBESTOS N011F(CATION/S NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE. 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