HomeMy WebLinkAboutH2021-0337 - Permits�, City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII MECHANICAL Permit: H2O21-0337
�+ d„� 100 Civic Center Drive, Newport Beach, CA 92660 H 2 ` 2 1 - 0 3 3 7 Project No
:y 4, Permit Counter Phone (949)644-3288
u. �4
�"'crra�tc' Inspection Requests Phone (949)644-3255
Job Address: 705 BEGONIA AVE BIdg:1 Floor: Suite
Description of Work:
MECH/ A/C C/O "TAMPER RESISTANT CAP REQ"
s � �^-r
Inspector Area:5
Code Edit: 2019
Legal Description:
Owner: CONWAY TAYRN
Contractor:
KLONDIKE AIR INC
Worker's Comp Insurance -
Address: 705 B
IA AVE
Address:
1308 LOGAN STE E
Carrier: FALLS LAKE FIRE & CASUAL
C ONA D L MAR CA 92625
COSTA MESA CA 92626
Policy No: FLA00809502
Phone:
Phone:
714-979-2070
Expire:0110112022
Con State
Lic: 754456
Issued D te:05/21/2021
Lic Expire:
09/30/2022
....
Processe By:
Bus Lic:
Lic Exp Date:
BT30060482
09/30/2021
SUBJEC r'l 0 FIELD INSPP?C
Fol?.�'g °
REVIEW AND APPRCAPA
, e•""^
.
. ^
.
HVAC Items
FEES
FurnacesBoilers
ompressors
Ventilation
Other .
.. c
Up to 100K STU/hV
0 $0.00
Up to 3HP: 1
$21.00 Bathroom Fan:
0 $0.00
",....
Fire Dampers: 0 $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
Wall/Floor Heaters:
0 $0.00
>15 HP to 30 HP: 0
$0.00 Attic Fan:
0 $0.00
Metal Fireplace: 0 $0.00 D 9
`
Heat Pumps & Package Units
>30 HP to 50 HP 0
$0.00 Down -Draft Fan:
0 $0.00
Record Mgt Fee: $0.00
t C
Up to 100K BTU/hr:
0 $0.00
>50 HP: 0
$0.00 Residential Hood:
0 $0.00
Additional Fee: $0.00 InvestigatJ a e.
$0.60.. � `
Over 500K BTU/hr:
0 $0.00
Air Handling Units
Comm. Hood:
0 $0.00
Plan Check:
$18.27
Up to 1 M BTU/hr:
0 $0.00
up to 1 OK CFM: 0
$0.00 Repair/Alter/Add:
0 $0.00
Model: AULD36W21ssuance:
$37.00
Up to 1.75M BTU/hr:
0 $0.00
Over IOK CFM: 0
$0.00 Supplemental Fee:
$0.00
Manufacturer: AC PRO
Over 1.75M BTU/hr:
0 $0.00
VAV Box: 0
$0.00
Zoning PC:
$46.25
TOTAL: $122.52 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $122.52
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.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Lew for tht reason(s) indicated below by the checkmark(s) I have placed next to the applicable items)
(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
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 Business and
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 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
im 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, Section 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 ate
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 Pro ssions ode, a lice 's in f rce
and effect. C) Z I 2
License Class License No Date Contractor Signatur
WORKERS' CCWVPNSATION DECLARATION
NTAjtL.'I[J2'FAILURF�TO�SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0001, IN ADDITION TO THE
((�n�$TTTSJ ``•�OMPEN�y"yppiCKIE6AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm ufideroAnalty of perjury one of the following declarations:
❑ I 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 t 1
5mance of the wo�Itfor which this permit is issued. Policy No.
and will,main},pin workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this per it is issued. My workers' compensatior
car' xendpolicynumberare: a�.i ' Policy NumberL,� iD` Expiration DateAgent �� Phone#
that, indhe performance of th o for whit hie5�ufekdl shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agrefor ii iihould beOomesubject to the orker ' compe s tiion 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant - Da
DECLARATION REGAR G CONSTRUCTION LENDING AGENCY
I hereby affirm under pen Ity of perjury that there is a construction lending agency for the performance of the work for which this permit is issue (Section 3097, Civil Code).
Lender's Name Lender's Address
By 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 pirrided is correct.
I agree to comply with all applicable city and county ornanqes and to ws I ing to building construction.
I authorize representatives of this city or county to r th above-i . d p rty for inspection purposes. �iK'(�{'
.., - _- ....,....:-,_....e.,. _ � 1 Print Pronertv Owner's or Authorized Agent's Nam Date
ACTION
DATE
` BY
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FEDERAL REGULATIONS PART 61 OFTITLE40AND
AQMDRULE 1403
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❑ I SUBMITTED ASBESTOS NOTIFICATION TO:
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❑ AQMD
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