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Home My WebLink AboutH2021-0401 - Permits0..rj City of Newport Beach - Building Division 1111111111111111111111111111111111111111111111111 MECHANICAL Permit: H2O21-0401 ' . A 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 1 0 4 0 1 Project No H v. Permit Counter Phone (949)644-3288 �„ri1��s Inspection Requests Phone (949)644-3255 Job Address: 2012 VISTA CAJON BIdg:1 Floor: Suite: Description of Work: MECH - R/R FAU, INSTIL NEW AIC CONDENSER. TAMPER-RESISTANT CAP REQUIRED Inspector Area:4 Code Edit: 2019 Legal Description: TR 5480 (L.L.84-214026) PAR 23 AND PAR 23G Owner: ENGLEBRECHT ROY Contractor: Address: 2012 VISTA CAJON Address: NEWPORT BEACH, CA 92660 Phone: Phone: Con State Lic: Issued Date:07/01/2021 Lic Expire: Bus Lic: Processed By: Lic Exp Date: BREATHE EASY HVAC Worker's Comp Insurance - 277 CALIFORNIA ST Carrier: EXEMPT MISSION VIEJO CA 92692 Policy No: no employees 714-713.0566 Expire: 1047628 Ventilation 12/31/2021 BT30073500 to 100K BTU/hr: 11/30/2021 $22.00 Up to 3HP: �/,8p. n` I CTU AC Items FEES •nacesBoilers & Compressors Ventilation to 100K BTU/hr: 1 $22.00 Up to 3HP: 1 $22.00 Bathroom Fan: 0 $0.00 �r 100K BTU/hr: 0 $0.00 > 3 HP to 15 HP: 0 $0.00 Exhaust Fan: 0 $0.00 II/Floor Heaters: 0 $0.00 >15 HP to 30 HP: 0 $0.00 Attic Fan: 0 $0.00 at Pumps & Package Units >30 HP to 50 HP 0 $0.00 Down -Draft Fan: 0 $0.00 to 100K BTU/h r: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 �r 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 to 1.75M BTU/hr: 0 $0.00 Over 1 OK CFM: 0 $0.00 Supplemental Fee: $0.00 :r 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 11CA '�'J`,14;j Other Fire Dampers: �.%y�///� 0.00 $0.00 Gas Line: S $0.00 $0.00 Metal Fireplace: 0 $0.00 Record Mgt Fee: $0.00 Additional Fee: $19.14 Investigation: $0.00 Plan Check: $0.00 Model: AULD36W2IA-DU Issuance: $38.00 Manufacturer: AC PRO Zoning PC: $52.00 TOTAL: $153.14 Plan Check Fee : $153.14 Fee Due at Permit Issuance PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Noursr. Pnon#Ay -Friday 7.00 a.m. to 6:30 p.m.and Saturday from 8:00 a.m. to 6:00 p.m. fl It C L P. O VI Gf-O G O O t t t C U t(1 p fU VU � r.t $0.00 )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). 3 I, as owner of the property, or my employees with wages as their sole compensation, will do U 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-Builderwill 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: iy 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 Iegall) 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. signature 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 7000) of Division 3 of the Business and Professions Code, and my license is in full force nd effect. 2�Signature icense Class License No Date Contractor VORKERS' COMPENSATION DECLARATION IARNING: 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 ($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: 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 thi erformance of the work for which this permit is issued. Policy No. ;- ]I have and will maintain workers' compensation..nsurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatior Isurance carrier and policy number are: :arrier . -Policy Number Expiration Date rtify 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 Taws of California, and ogre t f I should become subject to the workers' compensation pyovisIons of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. % nature of Applicant ^`'` ��-— Date CLARATION REGARDI - TION LENDING AGENCY ;reby affirm under pen of perjury that there is a construction lending agency for the performance of the work for which this permit is issued4illifection 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 county ordinances and state laws relating to building construction. I authorize representatives of this city or county a er the above-identifi r party for inspection purposes. ,,�/q �'��p nature of Prnnedv Owner or Authorized Acent. — PnHt�Property Owner's or Authorized Agent's Name,/)5' 16- M/ ��7i°vvrlf D9te 2� ACTION DATE BY DECLARATIONOF COMPLIANCE MTH CODE OF FOR OFFICES ONLY FEDERAL REGULATIONS PART 61 OF TITL.E40AND AQMORULE1401• +.• ."a PERMITEXP1RED [IISUBMITrgA$BESTO%,NQTi�CATiONIG: ❑ EPA- s • : >e PERMIT CANCELLED ❑ AQhfO + • • a • • +: • ASBESTOSVbTWFM@AT1ONiSNOT APPLICABLE TO PROPOSED DEMOLITION. • • so°°• PERMITEXTEND£D PERMIT FINAL /y CERTIFICATEQE SIGNATURE:. .>e • OCCLrPANCYISSUEO a e ° • i • ° • w