HomeMy WebLinkAboutH2020-0213 - PermitsCity of Newport Beach - Building DivisionIIII�IIIIIIIIIIIIIIIIIIIIIIIIIINIIIIIIIIIIIIII MECHANICAL Permit: H2O20-0213
100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 0 0 2 1 3 PfOJBCt No
Permit Counter Phone (949)644-3288
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"eernuc*' 4/ HERS VERIFICATION p � REQ Inspection Requests Phone (949)644-3255
HERS
Job Address: 210 PEARL AVE BIdgA Floor: Suite:
Description of Work: MECH/INSTALL (1) A/C UNIT 55db (AMERIAN STD; 4A7L6036a) @ DECK, REMOVE/RELOCATE F.A.U, W/SOME DUCT WORK *STOP WORK 120-1122
InspectorArea:2 Code Edit: 2019 z
Legal Description: BALBOA ISLAND RESUB SEC 1 BILK 8 LOT 29 (D
Owner: OHLS TAMARA Contractor: ABC HEATING AND A/C Worker's Comp Insurance - a
Address: 4790 IRVINE BLVD #105-432 Address: 306 COLLEN PL Carrier: STATE FARM Iii
IRVINE CA 92620 COSTA MESA CA 92627 Policy No: 92GRQ1006
Phone: Phone: 949-756-0064 Expire :09/24/2020
Con State Lic: 940181
IssuedDate:04/28/2020 Lic Expire: 11/30/2021 LIQ CONSTRUCTION NOISE
Bus Lic: BT30043258 0
Processed By: Lic Exp Date: 03/31/2021 pg g /��/S
®N SATURDAYS
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HVAC Items FEES
FurnacesBoilers & Compressors Ventilation Other
Up to 100K BTU/hr: 1 $20.00 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 10OK BTU/hr: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee : $31.25 Investigation: $76.00
Over 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $0.00
Up to 1M BTU/hr: 0 $0.00 up to 1 O CFM: 0 $0.00 Repair/Alter/Add: 1 $20.00 Model: Issuance: $35.00
Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer:
Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $41.50
TOTAL: $259.75 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $259.75
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday - Fri ft 7:00 @.m.to.6:30°p®m.a0IY6Sgftday 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
:he permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' Slate License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professions Cade) 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
Tot more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or L) 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
i�m 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 improvements covered by this permit, I cannot legally
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, Sec' 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 Pr ions C e, and my license is in full force
and effect.
License
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License Class License No Date Z Contractor Signatur
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 7706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
111 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
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ormance of the work for which this permit is issued. Policy No.
I 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' compensatioi
Number
Date
THS of Agent - ' I n
certify that, in the performanc he 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 agre,
t, if I should becomes bjec a workers' compensation provisions of Section. 3700 of the Labor Code, I shall forthwith comply with those provisions. c+
nature of Applicant - Date
CLARATION REG
A ING CONSTRUCTION LENDING AGENCY
rreby affirm under natty 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 have pr ed is correct.
I agree to comply with all applicable city and county or ances and state laws relating to building construction.
I authorize representatives of this city or cou t te�e;; r the above -identified property for inspection purposes. w `� f�,(�•�� lotjv mltA- t
mature of Proneriv Owner or Authorized Agent�d"s" Print Property Owner s or Authorized Agent's Na D
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