HomeMy WebLinkAboutH2020-0218 - Permits (3)City of Newport Beach - Building Division H2O20-0218
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
Job Address: 1516 BRUINBARK LN BIdgA Floor: Suite:
Description of Work: MECH CHANGE OUT A/C UNIT ON ROOF & FURNACE *TAMPER PROOF CAP REQ*
Inspector Area:8
Legal Description:
Code Edit: 2019
Owner: WHITE RACHEL
Contractor:
Address: 1516 BRUINBARK LN
Address:
NEWPORT BEACH, CA 92660
Phone: 818-645-8316
Phone:
Con State Lic:
Issued Date:04/29/2020
Lic Expire:
Bus Lic:
Processed By: som
Lic Exp Date:
BASIC AIR INC
1157 SALINAS AVENUE
COSTA MESA CA92626
714-469-4542
909834
01/31/2022
BT30045172
10/31/2020
MECHANICAL Permit: H2O20-0218
Project No :
Inspection Requests Phone (949)644-3255
INSPECT
Worker's Comp Insurance -
Carrier : OAK RIVER INS
Policy No: BAWCO21077
Expire :10/22/2020
'
' o
Items
FEES
ces Boilers & Compressors
Ventilation
100K BTU/hr:
1
$20.00
Up to 3HP:
1
$20.00
Bathroom Fan:
0 $0.00
Fire Dampers:
0 $0.00
Other
$0.00
00K 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
loor Heaters:
0
$0.00
>15 HP to 30 HP:
0
$0.00
Attic Fan:
0 $0.00
Metal Fireplace:
0 $0.00
umps & Package
Units
>30 HP to 50 HP
0
$0.00
Down -Draft Fan:
0 $0.00
Record Mgt Fee:
$0.00
L7te
100K BTU/hr:
BTU/hr:
0
0
$0.00
$0.00
>50 HP:
Air Handling Units
0
$0.00
Residential Hood:
Comm.
0 $0.00
Additional Fee :
$0.00
Investigation:
$0.0000K
M BTU/hr:
0
$0.00
up to 1 OK CFM:
0
$0.00
Hood:
Repair/Alter/Add:
0 $0.00Plan
0 $0.00
Model:
Check:
$34.801
.75M BTU/hr:
0
$0.00
Over 1 OK CFM:
0
$0.00
Supplemental Fee:
$0.00
Manufacturer:
N4A530GKClssuance:
SEER
$35.00
.75M BTU/hr:
0
$0.00
VAV Box:
0
$0.00
Zoning PC:
$41.50
TOTAL :
$151.30
Plan Check Fee
: $0.00
Fee Due at Permit Issuance :
$151.30
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-BISILDER DECLARATION
I hereby affirm under penalty of perjury that I am exemptfrom the Contractors' State License Law forthe mason(A) indicati
(Section 7031.5, Business and Professions Code: Any city or county that requires a permitto construct, alter, improve, demolis
the permitto file a signed statemam that he or she is licensed pursuant to the provisions of the Contractors' State License Law
Professions Code) or that he or she Is exempt tram licensureand the basis for the alleged exemption. Any violation of Section'
not more than five hundred donara ($500).
❑ I. as owner of the property, or my employees with wages as their sole compensation, will do U all of or (, portions of the I
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through emp
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completi(
roved for the purpose of sale).
tJ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Bul
rally to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor put
LJ I am exempt from licansure under the Contractors' State License Law for the following reason:
By my sigrztvn: below 1 acknowledge that, except for my personal residence In which 1 must have resided for at least one year
sell a structure that I have built as an owner-Bullder if It has not been constructed in its entirely by licensed contractors. I under
IlProfessions Ccde, is available upon request when this application is submitted or at the following Web site:http9Awm-leglnfo.0
Sgnature of Property Owner or Authorized Agent
I LICENSEE; CONTRACTOR'S DECLARATION
I hereby affirm cr.der penally of perjury that I am licensed under provisions of Chapter 9 (commencing ectio 7000 of of
land effedr.
License Class _ License No Date 2
il7WRKERS' JGMPENSATION DECLARATION
^YARNING: FAILURETO SECURE WORx - cM,pENSAT1oN cioweAGE 53 UNLAWFUL, AND SHALL SUSUS01" AN EnPLDY TO CRUaNAL PENALTIES
COST OF COMP aNSATON, DAMAUESAS PROVIDED FOR IN SecTa1N 3700 OME LAaW COUF- INTEREST. AND ATTORNEV S FEES
I hereby aff:: m u.ider penalty of perjuryone of the following declarations:
I have tired wid maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of In
e om uanGn a't'ie work for which this permit is issued. Policy No.
have 21.6 �,&I maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the perfo
Insurance carrier and policy number ale:
Cartier Policy Number
to of Agent
certify that, in thkpennance of the work for which this perm@ is issued. I shall not employ any person in any manner e
m
. if I should beco`ipp stibied to thp4drkers'tompensation pmyfsigns of Section 3700 of the Labor Code, I shall forthwith
lature of Ar
:retry affirm under peFialty'\f perjury that there is a construction lending agency for the performance of the work for which
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 unfy roinances and state laws relating to butidi .construction.
1 authorize representatives of this city or coun o ,ntert abyve- rrGRad� 9 nppu uses.
mature of Property Owner or Authorized Again l/ / arty Owners or Aut
ACBON I OAYE /1 \ By
rcrrrnr I
❑ tSUBWT)"EDASBESTOSN077FIC
❑ EPA
❑ AQMD
❑ ASBESTOS N07IRC4TIONI5 NOT
PROPOSEDDEWLITION.
SIGNATURE:
PERMITCAINC;11ED
PERMIT FXFFNOEO
PERMTTFINAt
o-a2
5 fow
CFR71FfCATEOF
OCCUPANCYISSLIED
below by the checkmark(s) I have placed next to the applicable item(s)
or repair any structure, priorto its issuance, also requires the applicant for
hepter 9 (commencing with Section 7000) of Division 3 of the Business and
31.5 by any applicant for a permit subjects the applicant to a civil penalty of
It, and the structure is not intended or offered for sale (Section 7044,
,am' or personal effort, builds or knproves the property, provided that the
the Ovmer-Bullder will have the burden of pmving that It was not built or
and Professions Code: The Contractors' State License Law does not
to the Contractors' State License Law)_
that a copy of the applicable law, Section 7044 of the Business and
In 3 of the Business vdjProte/ssii CC a, and y liceenn�/ems in full force
Contractor Signature d //
UP TOME HUNDRED THOUSAND DOLLARS IS'100,00oA IN ADDITION
Relations as provided for by Section 3700 Of the Labor Code, for
of the work for which this permit is issued. My workers'
Date
to become subject th orkers' compensation laws of California, and agree
ply with those proves
Date Zt�
permit is issued (Se 1 3097, Civil Code).
10
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FOR