HomeMy WebLinkAboutH2020-0165 - Permits., City of Newport Beach - Building Division 11111111111111111111111111111111111111111111111111
100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 0 0 1 6 5
u '*. Permit Counter Phone (949)644-3288
�'°Ixrcbv.�a:
Job Address: 1414 DOVER DR BIdg:1 Floor: Suite:
Description of Work: MECH NEW A/C UNIT ON GROUND *TAMPER PROOF CAP REQ*
InspectorArea:3 Code Edit:
2016
Legal Description: N TR 1645 LOT 37
Owner: MONTGOMERY RICHARD
Contractor:
Address: 603 IVY LN
Address:
SAN ANTONIC TX 78209
o n
Phone:
Phone:
HVAC Items
Con State Lie:
Issued Date:03/0412020
Lie Expire:
Carrier: WIC EXEMPT
Bus Lie:
Processed By:
Lie Exp Date:
AC CREW HEATING AND AIR INC
2813 CORAL STREET
CORONA, CA 92882
(951)427-9540
971817
01131/2022
BT30065386
12131/2020
MECHANICAL Permit: H2O20-0165
Project No: 2453-2019
Inspection Requests Phone (949)644-3255
TIMER REQUIRED ON EQUIPMENT
TO SHUT OFF BETWEEN 10 P.M. ANeEA. di
e,
e°ueoo
®'oea
o n
°000
HVAC Items
Worker's Comp Insurance- °n•9e` °m
°° `
Carrier: WIC EXEMPT
Policy No: NO EMPLOYEES
cm
Expire:
FurnacesBoilers & Compressors
Ventilation
INSPECT®r °s'°.
eo ;
Up to IOOK BTU/hr:
�
$0.00
1,f1911
0
$0.00
CC(CC4
C l
G
0 $0.00
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.
°000
HVAC Items
FEES
FurnacesBoilers & Compressors
Ventilation
Other
Up to IOOK BTU/hr:
0
$0.00
Up to 3HP:
0
$0.00
Bathroom Fan:
0 $0.00
Fire Dampers:
0 $0.00
$0.00
Over 100K BTU/hr:
0
$0.00
> 3 HP to 15 HP:
1
$36.00
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:
$31.32
Up to 1 M BTU/hr:
0
$0.00
up to 1 OK CFM:
0
$0.00
Repair%Alter/Add:
0 $0.00
Model:
NH4A4-601ssuance:
$35.00
Up to 1.75M BTU/hr:
0
$0.00
Over 10K CFM:
0
$0.00
Supplemental Fee:
$0.00
Manufacturer:
TEMPSTAR
Over 1.75M BTU/hr:
0
$0.00
VAV Box:
0
$0.00
Zoning PC:
$41.50
TOTAL:
$143.82
Plan Check Fee
: $0.00
Fee Due at Permit Issuance:
$143.82
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.
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 ayyplicant 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'Busineseand
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 penalty of
not 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,
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
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
improved for the purpose of sale).''
I, as owner of tbP, property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
ply to an owner ofproperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
@p>:exemr4 from ;censure under the Contractors' State License Law for the following reason:
my FgnatureXbtft Facknowledge 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 legalll
'ba e...vuctureAat ITave 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
)f4 bns CcloNsevailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
ptaflge of PropVtp Owner or Authorized Agent Date
DZ,19ED Ctaq%%CTOR'S DECLARATION ,//
F
L9 affirm e7Aetpenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with action 7000) of Division 3 of the Business and r.fe S1Dns C an icense �s1n full force
' t e -Class .G"Z-CJ License No $R-@ "" � ��%�� � Date . C) Contractor Signature i
WORS' CCIM44SATION DECLARATION
RN'iW:FAILUR?- SEC0RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYE TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO THE
W egCOMPENJATIOM TAMAGES AS PROVIDEDFORIN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
':'�✓affirm under penalty of perjury one of the following declarations:
lhave and wilf 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
formance of t11 Idrk for which this permit is issued. Policy No.
have 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' compensatiol
urance carrier and policy number are:
rrier Policy Number Expiration Date
fie of Agent Phone #
certify that, in the perfor ante oft work f r hich this per is �Ss/ueds//hall not employ any person in any manner so as to become subject to he workers' tom ensation laws of California, and agree
Pif I should become su act h orke�s'c pensati visioon 3700 of the Labor Code, I shall forthwith comply with those provis' ns.
nature of Applicant Date
CLARATION REGA ING CONSTRUCTION LENDI ENCY
ereby affirm under p alty 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).
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 h e provided is corrZepettly
I agree to comply with all applicable city and coun ordinances a9d stg o building construction.
I authorize representatives of this city or county en r tk�e abp4�deor inspection purposes. 7nature of Property Owner or Authorized Agent ��i Prin roperty Owner's or Authorized Agent's Nam Date ✓
AC77ON DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FEDERAL REGULATIONS PART 61 OFT/RE40AND
AQMD RULE 1403.
I SUBMITTEDASBESTOS N071FfCATION TO:
❑ EPA
❑ AQMD
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION
SIGNATURE:
FOR OFFICE USED LY
PERMITEXPIRED
PERMITCANCELLED
PERMITEXTENDED
PERMITFINAL _
CEPTIFICATEOF
OCCOPANCYfSSUED
W Z
O
J Q
W J
CQ Q
oF-
ZCQ
z_
C7 �-
= Z
W
00 -
LL
H
W w
U) Q
Z
Lo _
� �
Ur
ya>"'
Ua � 3
a) C_
L
a) O U
+L '3
Co
C '6
N
Na) U
o,E�m
cc -0
NP
`m
L
c n—
O O
aE
2E�
CL 0
=Qo
aa) 0)
Q0)E
ri
N N C "t
_oo
Z c N
2 � � o
r
aa) -a .� a)
o a o
CD
2 'c—
noa)f6m
o E E c °
w E C:
(6 X O' N 7
E y L
O) cm) 0
N = C m
TS u a) C
aa)oEo
y n. nn
U U 7 7 3
0 NL 6a)
— a ur a) Z
O
z
Um
H Uo
r;
o
U M
F+M.I
qz 0)
o a�
Z0
a q co °
y�C
O v
=
a F/Jy
x
W
Amo
z
Woo
�1
a
o
�A7aC
� c
�
ISI
U
U
o
U v
O
O
W Z
O
J Q
W J
CQ Q
oF-
ZCQ
z_
C7 �-
= Z
W
00 -
LL
H
W w
U) Q
Z
Lo _
� �
Ur
ya>"'
Ua � 3
a) C_
L
a) O U
+L '3
Co
C '6
N
Na) U
o,E�m
cc -0
NP
`m
L
c n—
O O
aE
2E�
CL 0
=Qo
aa) 0)
Q0)E
ri
N N C "t
_oo
Z c N
2 � � o
r
aa) -a .� a)
o a o
CD
2 'c—
noa)f6m
o E E c °
w E C:
(6 X O' N 7
E y L
O) cm) 0
N = C m
TS u a) C
aa)oEo
y n. nn
U U 7 7 3
0 NL 6a)
— a ur a) Z