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HomeMy WebLinkAboutH2021-0441 - PermitsCity of Newport Beach - Building Division H2O21-0441 100 Civic Center Drive, Newport Beach, CA 92660 '4 + Permit Counter Phone (949)644-3288 43 r'rUrnti�s , Job Address: 715 BAY HILL DR BIdg:1 Floor: Suite: Description of Work: MECH CHANGE OUT A/C UNIT *TAMPER PROOF CAP REQ* & FURNACE Inspector Area:4 Code Edit: 2019 Legal Description: TRACT 12105 LOT 1 OF PROJECT 931-79 LOCATED ON AP 442-033-04 Owner: PALMER KEITH STANTONIPALMER MIDRED WILSON Contractor Comp Insurance - Address: 715 BAY HILL DR Address: 21371 FLEET LANE NEWPORT BEACH CA 92660 HUNTINGTON BCH CA 92646 Phone: Phone: 949-355-2473 Con State Lie: 575335 Issued Date: Lie Expire: 08/31/2021 Bus Lie: BT30076089 Processed By: ��Lie Exp Date: 07/30/2022 MECHANICAL Permit: H2O21-0441 Project No: 0132-2018 ; Inspection Requests Phone (949)644-3255 I N S 1 EE CTO NORTON ERICK HEATING & A/C © ... Worker's Carrier: W/C EXEMPT Policy No: (NO EMPLOYEES) ® o . Expire ° . . . °. . . . °. . .. . . ° . HVAC Items FEES- FurnacesBoilers&Compressors Ventilation Other Up to 100K BTU/hr: 0 $0.00 Up to 3HP: 1 $22.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 $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: 0 $0.00 >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: $19.14 Up to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: ASX161ssuance: $38.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: AMANA Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $52.00 TOTAL: $131.14 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $131.14 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. 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 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 (_) 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). 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). I 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:hftp://www.leginfo.ca.gov/calaw.html. Signature of Properly Owner or Authorized Agent Date LICENSED CCVAACTOR'S DECLARATION I Aert6Q affirm Qnd&'ptnalty of perjury that I am licensed under provisions of Chapter 9 (commencing wkASection 7000) of Division 3 of the Busines and Professions C d m license is in full force and effect. • • 2 llcense.Class • License No Date 7 ''3 Contractor Signat e • ORr,ERS' C®NAP@NSATION DECLARATION WARNING! FAILURE Te SEOURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE tOSI*& COMPENSOT1q% DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 111&8s),affirm Epdt98nalty of perjury one of the following declarations: -I have and wiN maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th er$ormance of the werk for which this permit is issued. Policy No. •I, hvg and wiR fiaiAtain 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' compensatio Isuranee cardeivandpolicy number are: airier • • • • Policy Number Expiration Date lame of Ager--' Phone # I certify thaperformance of the work for wa Ihoulsubject to the workers' comignatua ofAECLARATIRDI CONSTRUCTION LENDING AGENCY hereby 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). Ender's Name Lender's Address ly my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owners behalf. I have read this application and the information I have provided is correct. '42 I agree to comply with all applicable city and ou�er the at an lawn ing rr nbu s ing construction. A , e I authorize representatives of this city or cou i to enter the ab Iden' 'ad a or Inspection purposes. /x yp,� inn nh— ^f ornn. w n—nor nr A„rhnrie Ancnfl Print Pmnerty Owner's or Authorized Agent's Name D ACTION DATE BY DECLARATION OFCOMPLIANCE IMTH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONSPART 61 OF TITLE40AND AQMD RULE 1403, PERMIT EXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMITEXTENDED ❑ ASBESTOS NONRCARONIS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL S'O s.2 CERTIFICATEOF SIGNATURE: OCCUPANCYISSUED