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Home My WebLink AboutH2019-0507 - PermitsagKgVA o4 City of Newport Beach - Building Division MECHANICAL Permit: H2O19-0507 o� 0 100 Civic Center Drive, Newport Beach,CA 92660 H 2 0 1 9 0 5 0 7 Project No : 1762-2018 Permit Counter Phone (949)644-3288 si ' GeV i Inspection Requests Phone (949)644-3255 Job Address: 1100 BALBOA BLVD W BIdg:1 Floor: Suite: m Description of Work: MECH/INSTALL (2) NEW A/C UNITS @ ROOF WELL 31.25dB & 42.75dB (MITSUBISHI; MXZ-AC36NAHZ & BRYANT; 124ANS) �✓ Inspector AreaA Code Edit: 2016 Legal Description: N TR 234 BILK 111 LOT 1 Owner: ALEXANDRIA GLADSTONE Address: 1100 W BALBOA BLVD Contractor: Address: SEASIDE AIR ENT INC 32959 CALLE PERFECTO #C Worker's Comp Insurance - Carrier: INS CO. OF THE WEST ` J NEWPORT BEACH CA 92661 SAN JUAN CAP, CA 92675 Policy No: WVE5049609 s1 Phone: Phone: 949-496-3639 Expire :07121/2020 Con State Lic: 736214 Issued Date:08/21/2019 - tic Expire: 08/31/2020 Bus Lic: BT30018420 Processed By: Lic Exp Date: 01/31/2020 HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 0 $0.00 Up to 3HP: 2 $38.00 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: $33.06 Up to I BTU/hr: 0 $0.00 up to 1OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: Issuance: $35.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $40.00 TOTAL: $146.06 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $146.06 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday-Ar?dW7:00 o:.r..to :6:30 Arv.agq 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 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 L) all of or L) 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). ❑ 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 lega11 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, an my and effect. li is in full force _/� / // License Class License No Date L I Contractor Signature Y WORKERS' COMPENSATION DECLARATION WARNING: 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 ($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. 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 thf p oTrance of lhg work for which this permit is issued. Policy No. have and wil r ' tain 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 carrier d olicy numperyare: f\ ie of Agent 4=r ' t�_V., i certify that, in the performance of the work for , if I should become subject to the wofts oe Number Date 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 agree provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Dpar visi . ^ 2�_ y ^ CLARATION REGJRDING CONSTRUCTION LENDING AGENCY X areby affirm under Jenalty 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 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 la pjali utlding construction. I authorize representatives of this city or cou"ri�v r/�, e r the - nh ' d pro for inspection purposes. _ nature of Property Owner or Authorized Agent X Z Print Property Owner's or Authorized Agent's Name C AMON DATE BY DECLARATION OFCOMPLIANCE IMTHCODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OFTITLE40AND AQM,0PULE 140:: .... - -- PERMITEXPIRED C I SUHMITTEDASBESTO.S N0IIF/CA.7014 TO: i] ;EPA 0 AQMD PERMITCANCELLED PERMIT EXTENDED P❑ROPOSED DEMOLITION. 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