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Home My WebLink AboutH2022-0100 - PermitsCity of Newport Beach - Building Division III 1111111111111111111111111111111111111111111111 MECHANICAL Permit: H2O22-01( 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 2 0 1 0 0 Project No : 0212-2021 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 1521 KATHLEEN LN BIdg:1 Floor: Suite: Description of Work: MECH/INSTALL A/C UNIT 5OdB (CARRIER; 24AAA-24) �b Inspector Area:3 Code Edit: 2019 e� Legal Description: N TR 1806 LOT 4 fFF; Owner: WEICHMAN BARRY Contractor: PRO WEST MECHANICAL INC Worker's Comp Insurance - Address: 104E IRVINEAVE #148 Address: 15431 RED HILL AVE #F Carrier: EMPLOYEE SERVICE GRP I NEWPORT BEACH CA 92660 TUSTIN CA 92780 Policy No: C69981331 C) Phone: Phone: Con State Lic: 714-651-8737 974570 Expire :11 /01 /2022 '^; e,�/ : J Issued Date:02/24/2022 Lic Expire: 06/30/2022 Bus Lic: BT30051314 Processed By: `- Lic Exp Date: 05/31/2022 VAC Items FEES Other: urnacesBoilers & Compressors Ventilation 0 $0.00 $0.00 p to 100K BTU/hr: 0 $0.00 Up to 3HP: 0 $0.00 Bathroom Fan: 0 $0.00 Fire Dampers: ver 1 OOK BTU/hr: 0 $0.00 > 3 HP to 15 HP: 1 $39.00 Exhaust Fan: 0 $0.00 Gas Line: 0 $0.00 $0.00 /all/Floor Heaters: 0 $0.00 >15 HP to 30 HP: 0 $0.00 Attic Fan: 0 $0.00 Metal Fireplace: 0 $0.00 eat Pumps & Package Units >30 HP to 50 HP 0 $0.00 Down -Draft Fan: 0 $0.00 Record Mgt Fee: $0.00 p to 100K BTU/hr: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee : $0.00 Investigation: $0.00 ver 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $33.93 p to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: Issuance: $38.00 p to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: Zoning PC: $52.01 ver 1.75M BTU/hr: 0 $0.00 VAV Box: 0 . $0.00 TOTAL: $162.93 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $162.93 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 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). ❑ 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 legal 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/wiaw.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 Pr essio o e, and my license is full force and effect. r{ 2 2 License Class License No Date % 2Contractor Signatur WORKERS' COMPENSATION DECLARATION NARNING: 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 ADITTION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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 IN oe rmance of the work for which this permit is issued. Policy No. have and will m irit iiii[[[[ workers' corn nsation insurance, a Squired by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatior insurance carrier an olicknumber ar . Carrier `` N r Expiration Date Name of Agent Phone # ❑I certify that, in the performs of the r which this permit is issued, I shall not ploy any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become su je to th Ds_ation provisions of Section 3 of the Labor Code, I shall forthwith comply with those provisiions. Signature of Applicant DaA 2-2Y'�Zz DECLARATION REGA DI G ` hereby affirm under nalty peat there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name Lender's Address By my signature below, I certify to each of the following: I am the property owner or authorized to act on the property is behalf. I have read this application and the information I have pro dad i rre agree to comply with all applicable city and county or a laws relat" g building construction. I authorize representatives of this city or county r the ve-i n purposes. ��al/Q Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nam ACTION DATE 12"BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONSPART 61 OF TITLE 40 AND AQMD RULE 1403. PERMIT EXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: C EPA E1 AQP4J PERMiTCANCELLED PERMIT EXTENDED ❑ ASEES FOS N0711:CAi1ON 15 NOT APPLICABLE TO PROPOSED JEMOUTION. PERMIT FINAL CE,RT1FICATE OF OCCUPANCYrSSUED SIGNATURE: