HomeMy WebLinkAbouth2022-0032 - Permits0ProtRn' City of Newport Beach - Building Division IIII�IIIIIII�IIIIIIII�IIIIIIIIII MECHANICAL Permit: H2O22-0032
n 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 2 0 0 3 2
4 ` °j� Permit Counter Phone (949)644-3288
ect No : 1190-2021
u,
n;siruA�4 Inspection Requests Phone (949)644-3255
Job Address: 321 AVENIDA CERRITOS BIdg:1 Floor: Suite:
Description of Work: MECH -INSTALL HEAT PUMP. TAMPER -RESISTANT CAP REQUIRED.
Inspector Area:4 Code Edit: 2019
Legal Description: TR 5435 (L.L.84-214024) PAR 46
Owner: AMBERLEAF INVESTMENTS LLC Contractor: AIR MAX INC Worker's Comp Insurance -
Address: 2618 SAN MIGUEL DR #485 Address: 27260 LOS ALTOS #123 Carrier: STATE COMP.INS
NEWPORT BEACH CA 92660 MISSION VIEJO CA 92691 Policy No: 9170882
Phone: 949-945-8118 Phone: 626-468-9999 Expire :12/0812022
Con State Lic: 1015725
Issued Date: Lic Expire: 07/31/2022
Bus Lic: BT30065145 Ate(
Processed By: Lic Exp Date: 11/30/2022
VAC Items
FEES
urnacesSoilers & Compressors
Ventilation
Other
p to 100K BTU/hr:
0
$0.00
Up to 3HP:
0 $0.00
Bathroom Fan:
0 $0.00
Fire Dampers:
0
$0.00
$0.00
ver 100K BTU/hr:
0
$0.00
> 3 HP to 15 HP:
0 $0.00
Exhaust Fan:
0 $0.00
Gas Line:
0
$0.00
$0.00
fall/Floor Heaters:
0
$0.00
>15 HP to 30 HP:
0 $0.00
Attic Fan:
0 $0.00
Metal Fireplace:
0
$0.00
eat Pumps & Package
Units
>30 HP to 50 HP
0 $0.00
Down -Draft Fan:
0 $0.00
Record Mgt Fee:
$0.00
p to 100K BTU/hr:
1
$22.00
>50 HP:
0 $0.00
Residential Hood:
0 $0.00
Additional Fee :
$0.00
Investigation:
$0.00
ver 500K BTU/hr:
0
$0.00
Air Handling Units
Comm. Hood:
0 $0.00
Plan Check:
$19.14
p to 1 M BTU/hr:
0
$0.00
up to 1 OK CFM:
0 $0.00
Repair/Alter/Add:
0 $0.00
Model:
AUD60W/A-D (U)
Issuance:
$38.00
p to 1.75M BTU/hr:
0
$0.00
Over 1 OK CFM:
0 $0.00
Supplemental Fee:
$0.00
Manufacturer:
AC PRO
ver 1.75M BTU/hr:
0
$0.00
VAV Box:
0 $0.00
Zoning PC:
$52.00
TOTAL: $131.14 Plan Check Fee : $131.14 Fee Due at Permit Issuance : $0.00
PERMITS EXPIRE 180 DAYS AFTER IS9li*NGE OR LA32 VArly) INS',fCnlON6
Construction HourssP or - FridayZag0 a.rrl.to 6:4 p,#r.and Saturday from 8:1i0 a.m. to 6:00 P.M.
OJ OJJ ° 9 ° 0
03
ee °•°i �° a°° °®° o e o o a ®• °°• o
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) 1 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' 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 forth a 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 ( 1 all of or U 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).
❑ 1, 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 legallt
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:/Aw .leginfo.ca.gov/calaw.html.
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 Professions Code, and my license is in full force
and effect. 01 /21 /2022 n-, — "-�4J� -
License Class License No Date, Contractor Signature
WORKERS' COMPENSATION DECLARATION -
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYERTO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (E'100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
1 hereby affirm under penalty cf perjury one of the following declarations:
❑ 1 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
pgrfonnance of the work 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'
rance carver and policy number are:
of Agent
Policy Number Expiration Date
Phone # __...
certify 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 laws of California, and
if I should become subject to the works pens lion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
_..� y`1�A4 M=- 1 01/21/2022
CLARATION REGARDING CONSTRUCTION LENDING AGENCY Z N
)reby affirm under penalty 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 Lenders Address
my signature below, I certify to each of the following:
I am the property owner or authorized to act an the property owners behalf.
1 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 to enter. the abovgg-ide�n�tifi/ed property for inspection purposes. AIRMAX,INC 01/21/22
nature of Property Owner or Authorized AgQ NZZ r�+6"�.w , Print Property Owners or Authorized Agent's Nam Y IS
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DATE
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