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HomeMy WebLinkAboutH2018-0061 - PermitsCity of Newport Beach - Building Division III III 11p1p11111p11111111111IN1111111111111 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 8 0 0 6 1 n: Permt.Counter Phone (949)644-3288 Job Address: 4 EBB TIDE CIR BIdg:1 Floor: Suite: Description of Work: MECH -A/C UNIT "EBB TIDE" "TAMPER RES CAP REQ" (X2017-2737) InspectorArea:2 Code Edit: 2016 Legal Description: Owner: EBB TIDE LLC Contractor: M B K BUILDERS INC Address: 4 PARK PLAZA, STE 1000 Address: 175 TECHNOLOGY DRIVE IRVINE CA 92614 IRVINE CA 92618 Phone: 949-789-8441 Phone: 949-789-8441 Con State Lie: 844533 Issued Date:02/01/2018 Lie Expire: 08/31/2018 FurnacesBoilers &Compressors Bus Lie: BT30057158 Processed By: Lie Exp Date: 11/30/2017 MECHANICAL Permit: H2O18-0061 Project No: 0092-2016 Inspection Requests Phone (949)644-3255 Worker's Comp Insurance - Carrier : MITSUI SUMITOMO Policy No: WCP9110109 Expire :07101/2017 0 iA eso• • e 0 0 0 o e o 0 m o0 ° 00 000m e e e o some o 0 0 ee o • e moomom 000eo m o ° meeom 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. HVAC Items FEES FurnacesBoilers &Compressors Ventilation Other 00000c Up to 100K BTU/hr: 0 $0.00 Up to 3HP: 1 $18.00 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: $15.66 Up to 1 M BTU/hr: 0 $0.00 up to 10K CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: GSX14043 Issuance: $0.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $9.00 Manufacturer: GOODMAN Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $0.00 TOTAL: $42.66 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $42.66 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. VNER-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 items) Iction 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 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 Ifessions 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). 1, as owner of the property, or my employees with wages as their sole compensation, will do L_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, siness 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 lrovements 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 Ay 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). I am exempt from licensure under the Contractors' State License Law for the following reason: 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 improvements covered by this permit, I cannot legall I 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 Ifessions Code, -is available upon request when this application is submitted or at the following Web site:hftp://www.leginfo.ca.gov/calaw.html. nature of ProperW dwner or Authorized Agent Date :BNSED CONTRACTOR'S DECLARATION :rebyPaffirm dW penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force J.effec't11/!� Contractor ansa Class License No Date Signature IRKFRS' OQrPFPdSATION DECLARATION 2NIN6: FAILURE TO SURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE il.01COMPEN$- �Q4MAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. Iggpy affirm under penalty of perjury one of the following declarations: i Neve 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 thr Po nce of #"C for which this permit is issued. Policy No. 'Matic and wil%maiPtain 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 Relicy number are: Tier Policy Number Expiration Date ne of Agent Phone # certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agrer I, if I should become suu lett to;he workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant /� Date/!�/iv CLARATION REGg5DKG CONSTRUCTION LENDING AGENCY weby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). War'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 county ordinances and state laws relating to building construction. I authorize representatives of this city or county to n the above -identified property for inspection purposes. nature of Property Owner or Authorized ADent ,—y �'` Print Property Owner's or Authorized Agent's Name ACTION DATE ' BY UrLLAKAUI UV yr Lumruul R_C min uv"r yr FEDERAL REGULATIONS PART 61 OFT17LE40AND AQMDRULE1403. PERMITEXPIRED t SUBMITTEDASBESTOS NO77FICATION T0: ❑ EPA ElAQMD PERMITCANCELLED PERMIT!NDED [I ASBESTOS M017RCARONIS NOTAPPLICABLETO PROPOSED DEMOLITION. PERMITF1NAL CERTIFICATEOF SIGNATURE. OCCUPANCYISSUED