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Home My WebLink AboutH2021-0356 - PermitsCity of Newport Beach - Building Division H2O21-0356 MECHANICAL Permit: H2O21-0356 t 100 Civic Center Drive, Newport Beach, CA 92660 �� Project NO : 2684-2019 a Permit Counter Phone (949)644-3288 �r ,�1 7►r�d °� Inspection Requests Phone (949)6443255 Job Address: 1437 DOLPHIN TER BIdg:1 Floor: Suite: - Description of Work: MECH (3) HEAT PUMPS *TAMPER PROOF CAP REQ* Inspector Area:2 Code Edit: 2019 Legal Description: TRACT NO 2334 LOT 12 POR OF LOT Owner: LONG RANDY Contractor: GRAVES M H INC Worker's Comp Insurance - Address: 1437 DOLPHIN TER Address: 5852MULLERST Carrier: OAK RIVER INSURANCE °°°°• ° CORONA DEL MAR, CA 92625 BELL GARDENS CA 90201 Policy No: MHWC232915 ° ° • ° ° .... Phone: Phone: 562-833-3703 Expire:01/01/2022 Con State Lic: 241731 Issued Date:06/07/2021 Lic Expire: 03/31/2022 Bus Lic: BT30034436 .... Processed By: Lic Exp Date: 04/30/2022 ° HVACltems FEES FurnacesBoilers & Compressors Ventilation °'°°° Up to 100K BTU/hr: 0 $0.00 Up to 3HP: 0 $0.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 Other ;`°°°° $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 $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 100K BTU/hr: 3 $63.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee : $0.00 Investigation: $0.00 Over 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $54.81 Up to I BTU/hr: 0 $0.00 up to 10K CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: YHG30B21 S Issuance: $37.00 Up to 1.75M BTU/hr: 0 $0.00 Over 1 OK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: YORK Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $46.25 TOTAL: $201.06 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $201.06 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. INER-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 applicaft item(s) .ction 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 applicapt for permit to file a signed statement that he or she is licensed pursuant to the provisionsofthe Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and fessions 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 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 intended or offered for sale (Section 7044, siness 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 Irovements 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 (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 )ly 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: my signature below I acknowledge that, except for my personal residence in which 1 must have resided for at least one year prior to completion of the improvement covered by this permit, I cannot legal I 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 la Section 7044 of the Business and )fessions Code, is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.html. nature of Propb?t79Jwner or Authorized Agent to !l!N3ED C9%TR4CTOR'S DECLARATION :rebv affirm ender penalty of perjury that I am licensed under provisions of Chapter 9�(commencing w h�Secti n 7�)00) of Division 3 of the Business apd�rofe :on � de, my license is in full force cerise Class License No Date Contractor Signature r v FORRERS' LGMFIENSATION DECLARATION 4RNING: FAILURE TO EEQIJRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SU&IECT AN EMPLOYER TO C MI AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,D00(, IN ADDITION TO THE !I&IM;C OMPENS ATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. T&e&y affirm under penalty of perjury one of the following declarations: -[Maae and will n"ntain 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 the A m�ance oftbg d"o13c for which this permit is issued. Policy No. e'Eand wiMmaintain workers' compensation insuranceas required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatiol nce carrier aniJ%iicy numb are: artier Policy Number Expiration Date ame of Agent Phone # 1 certify that, in the perfor n of t e work for which th rnit is issued, I shall not employ any person in any manner so as to become subject to the workers' c mpe sation laws of California, and agre lat, if I should becom su ect t e ers' co ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pro isi s. ignature of Applicant Dat ECLARATION REGA - I UCTION LENDING AGENCY hereby affirm under penalty f erjury that there is a construction lending agency for the performance of the work for which this permit is issued action 3097, Civil Code). Ender's Name Lender's Address y my signature below, I ertify to each of the following: I am the property owner or authorized to act on the pro rty ner's behalf. I have read this application and the information I have ovi d is correct. I agree to comply with all applicable city and c my ina as and state laws relating to building construction. I authorize representatives of this city or cou toe er t bove-id roperty for inspection purposes. �) 'ignature of Property Owner or Authorized A'gen Print Property Owner's or Authorized Agent's Name D e ACTION 4DATE 081yDECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY' FEDERAL REGULATIONS PART 61 OF I]ILE40AND PERMfTEXP1RED AQMD RULE 1403, ❑ I SUBMITTED ASBESTOS NOTIFICATION TO.' PERMIT CANCELLED [I [I PERMPTEh7ENDED [I AQMD ❑ ASBESTOS M017RCA710NIS NOT APPLICABLE TO PERMIT FINAL PROPOSEDDEMOLITION. CERTIFICATEOF SIGNATURE. OCCUPANCYISSUED