HomeMy WebLinkAboutH2020-0031 - PermitsL ''oar City of Newport Beach - Building Division 1111111111111111111111111111111111111111111111111
100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 0 0 0 3 1
Permit Counter Phone (949)644-3288
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Job Address: 14 BAYCREST CT BIdg:1 Floor: Suite:
Description of Work: MECH/CHANGE OUT (E) F.A.0
MECHANICAL Permit: H2O20-0031
Project No :
Inspection Requests Phone (949)644-3255
InspectorArea:8 Code Edit: 2019 �`
Legal Description: TR 12362 LOT 1 U T LOCA3� AP 283-06
TOGETHER C� ` - 0 �iJ io of � 10G
Owner: ROBERTS S ANDREA D �' ontrac or: SE E ' & Worker's Comp Insurance -
Address: 14 BAYCREST CT Add re 50 1 H ' j to4im 1HV IONAL INS I
NEWPORT BEACH, CA 266� E 8 `� Policy No: RM8WC00044191
Phone: ho 7 - Expire :05/29/2020
Issued Date:01/15/2020 icExpire 10/31/2027 y gr o� y- �t y3L�y
Bus Lic: r. T',` A . ! I'i✓i a IO N RlEQ
Processed By: c Ex a!, . 13fP v
I ci
•nacesBoilers & Compressors
to 100K BTU/hr: 1 $20.00
:r 100K BTU/hr:
0
$0.00
II/Floor Heaters:
0
$0.00
it Pumps & Package Units
to IOOK BTU/hr:
0
$0.00
;r 500K BTU/hr:
0
$0.00
to 1M BTU/hr:
0
$0.00
to 1.75M BTU/hr:
0
$0.00
1r 1.75M BTU/hr:
0
$0.00
FEES
tilation
to - F n:
H to 1 HP .00y chaust Fan:
i H H 0
) HP to 50 HP 0. own -Draft Fan:
) HP: 0 $0.00 Residential Hood:
Ai HanQdlinngg Units
Ov '0VO CFM: Ol— OA
VA�Box: 0 _S0 60
0 Llra F�' D g :Startgd) $0.00
0 $0.00 DLme: 0 $0.00
0 $0.00 Metal Fireplace: 0 50�0
0 $0.00 Record M : _--$
�0 i tonal Fee : initials
le
$0.00 W.P
0 tU0— MadT- nce:
$0.00
'p
$0.00
I
I±1�.
sti tit1;
$0.00
eck.
$0.00
$35.00
Zoning PC: $0.00
TOTAL $55.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $55.00
PERMITS EXPIRE 180 DAYS AFNA ISS6Jf4CE•OR LA.%V'VACQ INSPECTION
Construction Hours: Monday - Friday 71.,00 a. ,;.to. 6:90 p m.'and SatutVav from 6:00 a.m. to 6:00 p.m.
U O(ID E U
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C U U C W• �
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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 applicantto a civil penalty of
of more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not Ji[ ended or offered for sale (Section 7044,
lusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal cta(9 ilds or Improves the propbrty, provided that the
nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Ow @ er will have the burden of proving tqt it Was not built or
nproved for the purpose of sale)."
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (SectionJ7,C44f u6� siness and PrQQfp ¢f.�Gdr7`e: The Cc t a `t e Lic nse Law does not
pply to an owner of property who builds or improves thereon, and who contracts for the projects with a lice. sed°Contractor pursuant t�JhO&¢ AArractors' Stale NifPaw).
I am exempt from licensure under the Contractors' State License Law for the following rea c�-o" M1 V 1
ly my signature below I acknowledge that, except for my personal residence in whit .(>oav�avg eside t least egear prior to e N t e improvements covere Is p mit,?,cannot legal
ell a structure that I have built as an owner -builder if it has not been constr Its entirej�y cerrse �n ors. I understand that opy of the applicable law a on 7044 of the usiness and
'rofessions Code, is available upon request when this application i b i red o at the ffo g b-sife:http://www.ii )�,ifg.c � ov/calaW.html.
signature of Property Owner or Authorized Agent, _' Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed ay0de &p�oyiiAton o Ch ptter 9 (c me ew% tic 0 --,c t I$Ia of the Business and P dons Cc e, an m
nd effect. ,,j``��ii++ ,r��
icense Class License No k`Y �' tr) ". 7ti Ftor Signature
VORKERS' COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGFy S UNLAW AND
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3T0 F THE LA COI
hereby affirm under penalty of perjury one of the following d,
I have and will maintain a certificate of consent to self -insure for worke
Rormance of the work for which this permit is issued. Policy No
have and wiIJ,N�.aintain workers' compensation insurance, a req Ar
is of Agent'—
certify that, in the perfor e_work-for which this permit is
if I should becomes 'eat"to t e compensatiori-�
T AN EMPLOYER TO I ` ALT1E$(1¢CJO v.r JFI UPTO ONE HUNDRED THOUSAND DOLLARS ($700,000), IN A
AND ATTOR E r+j
..
,aas
eY}iss by th 4ctor of Industrial Relations as provideiAcfP00 of the Labor
6 f the Labor Code, for the perfor ce - MID'
k� hlch thi&&A� 451issued. My workers'
_rk , s.
nature of Applicant '4
CLARATION REG DING RUCTION LENDING AGENCY
meby affirm under penalty of perjury that there is a construction lending agency for the performance
Ider's Name Lender's Aciftse
my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owner'TAO'W
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and coun and state law�.rel mat iltlifr'
I authorize representatives of this city or a a r Spectlol
any manner so as to become subject to
shall forthwith comply with thosq�vii c
which this perriiINstssue3097, Civil Code).
or Authorized
ACT70N
DATE
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