HomeMy WebLinkAboutH2020-0413 - Permits (3)City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIII�IIIIIIIPermit Counter Phone(949)644-3288 MECHANICAL Permit: H2O20-0413
100 Civic Center Drive, Newport Beach, CA 92660 H 2 9 2 0 0 a 1 3 PfOJ2Ct No : 0102-2019
(1)
DUPLICATEInspection Requests Phone (949)644-3255
Job Address: 511 36TH ST BIdg:1 Floor: Suite:
Description of Work: MECH (3) NEW A/C UNITS *TAMPER PROOF CAP REQ*
*updated 3/3/21*
InspectorArea:1 Code Edit:
2016
Legal Description: N TR 12528 LOT 2
Owner: HOLDINGS GARDEN GROVE SIMPSON
Contractor:
COMFORT HEATING & A/C Worker's
Comp Insurance -
Address: 21 AUTO CENTER
Address:
21962 COSALA
Carrier, WIC EXEMPT
IRVINE, CA 92617
MISSION VIEJO CA 92691
Policy No: (NO EMPLOYEES)
Phone:
Phone:
714-335-7055
Expire
Con State Lic:
632774
Issued Date:07/21/2020
Lic Expire:
12/31/2021
Bus Lic:
BT30005700
Processed By:
Lic Exp Date:
08/31/2021
HVAC Items
FEES
FurnacesBoilers & Compressors
Ventilation
Other
Up to 100K BTU/hr:
0
$0.00
Up to 3HP:
3
$60.00
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 1OOK 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:
$52.20
Up to 1 M BTU/hr:
0
$0.00
up to 1 OK CFM:
0
$0.00
Repair/Alter/Add:
0 $0.00
Model:
Issuance:
$35.00
Up to 1.75M BTU/hr:
0
$0.00
Over IOK CFM:
0
$0.00
Supplemental Fee:
$0.00
Manufacturer:
TRANEIMAYTAG
Over 1.75M BTU/hr:
0
$0.00
VAV Box:
0
$0.00
Zoning PC:
$41.50
TOTAL:
$188.70
Plan Check Fee
: $188.70
Fee Due at Permit Issuance :
$0.00
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 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 tile, Oontractors'-Spate 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 thealleged exem tion., Any vi�ilation 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). T s $
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) 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 pp{perty 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).
❑ 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.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.
License Class License No Date Contractor Signature
ORKERS' COMPENSATION DECLARATION
pRNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS I$100,0001, IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
I hereby affirm under penalty 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 th
performance of the work for which this permit is issued. Policy No.
I 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' compensatio
insurance carrier and policy number are:
r:Rnrier Policy Number Expiration Date
ie of Agent "---- --
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 1 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with those provisions.
nature of Applicant Date
CLARATION REGARDING CONSTRUCTION LENDING AGENCY
=.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
Idler's Name Lender's Address
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 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 above -identified property for inspection purposes.
,naB lre of Pmnarty Owner or Authorized Aqent Print Property Owners or Authorized Agent's Name
ACTION
DATE
BY
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FEDERAL REGULATIONS PART 69 OF TfTLE40AND
AQMORULE1403.
❑ ISUBMITUEDASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
❑ ASBESTOSNORRCARONlSMOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE:
PERMITEXPIREO
PERMIT CANCELLED
PERMiTEXTENDEO
PERMIT FINAL
=
CERTIFICATE OF
OCCUPANCYISSUED
Civil Code).
FOR OFFICE
Date