HomeMy WebLinkAboutH2020-0288 - Permitsa1 City of Newport Beach - Building Division MECHANICAL Permit: H2020-0288
o`t 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 0 0 2 8 8 Project No
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
Job Address: 4 CLIFFHOUSE BLUFF Bldg:1 Floor: Suite:
Description of Work: MECH - NEW AIC CONDENSOR/COIL. (1 EXISTING). TAMPER-RESISTANT CAP REQUIRED
Inspector Area:6 Code Edit:
2019
Legal Description:
Owner: SHAW DAVID
Contractor:
ALISO AIR INC
Worker's Comp Insurance -
Address: 4 CLIFFHOUSE BLUFF
Address:
29736 AVE DE LAS BANDERAS
Carrier: LIBERTY MUTUAL
NEWPORT COAST CA 92657
RSM CA 92688
Policy No: WC2Z61036218098
Phone:
Phone:
949-589-2021
Expire :07/01/2020
Ventilation
Can State Lic:
526420
Issued Date:06/03/2020
Lic Expire:
03/31/2022
ther
Bus Lic:
BT30019236
$0.00
Processed By:
Lic Exp Date:
02/28/2021
Bathroom Fan:
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday - Friday 7:00 a.m.to 6:30 p.m.iind Saturday from 8:00 a.m. to 6:00 p.m.
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HVAC Items
FEES
6
FurnacesBoilers & Compressors
Ventilation
ther
Up to 100K BTU/hr:
0
$0.00
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:
$17.40
Up to 1 M BTU/hr:
0
$0.00
up to 1 OK CFM:
0
$0.00
Repair/Alter/Add:
0 $0.00
Model:
24AHA41ssuance:
$35.00
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:
$41.50
TOTAL: $113.90
Plan Check Fee
: $0.00
Fee Due at Permit Issuance:
$113.90
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday - Friday 7:00 a.m.to 6:30 p.m.iind Saturday from 8:00 a.m. to 6:00 p.m.
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)WNER-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
ie 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
of 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,
lusiness 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
nproved 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
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).
I am exempt from licensure under the Contractors' State License Law for the following reason:
ly 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 legally
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 applicable law, Section 7044 of the Business and
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
lignature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 000) of Division 3 of the Business andrJ= ^^ m I' ense is in full force
nd effect.
icense Class License No Date w Contractor Signature.
VORKERS' COMPENSATION DECLARATION rr
DARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLITR$ ($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:
3 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 IN
eeNormance of the work for which this permit is issued. Policy No.
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'
carrier and policy number are:
Policy Number
of Agent
Date
certify that, in the performance of the %york for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workefs' [Zir,) pensation laws of California, and agree
t, if I should becomme ssuubjectject to t1na�.rs'-cTmpensation provisions ^! c=_^_�_�-, -3700 of the Labor Code, I shall forthwith comply with those provisions. (-7
nature of Applica camD `�
CLARATION REGARDING CON218MTION LENDING AGENCY
Ireby affirm under pen fury that there is a construction lending agency for the performance of the work for which this permit is issued (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 co ty ordina sand state laws relating to building construction. /J
I authorize representatives of this city or celuutgSc-elite edentified propert fo ' tion purposes. /( -. �/��
nature Of PrODertv Owner or Authorized ADI Z _ Print Property Owner's or Authorized Agent's Name i� / Date
III-�ACT/ONCLARATION OF COMPLIANCEINITH CODE OF
I DATE BY II FEDERAL REGULATIONSPART61 OFTITLE40ANB I FOR OFFICE USEONtY I
PERMIT EXPIRED
PERMITCANCELLED
PERMIT EXTENDED • •qs • i ~••
OCCUPANCYISSUED
1403.
,O P•SRBMfTFEDASBESTOS NOTIFICATION TO.
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ASBESTOS NOTIFICAITONIS NOT APPLICABLE TO
PROPOSED DEMOLITION.