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Home My WebLink AboutH2014-0420 - PermitsCity of Newport Beach - Building Division IIII�IIIIIIIIIIIIIIIIIIIIII II MECHANICAL Permit: H2O1 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 a 0 a 2 0 PfOfBCY NO Per F Permit Counter Phone (949)644-3268 u natimw�s Inspection Requests Phone (949)644-3255 Job Address: 2826 IRVINE AVE BIdg:1 Floor: Suite: Description of Work: MECH/INSTALL (1) A/C UNIT 47dB & CHANGE OUT F.A.U.-----m Inspector Area:3 Code Edit: 2013 Legal Description: TR 3068 LOT 1 FOR OF LOT Owner: NATIONWIDE CAP GRP INC Contractor: TRUE BLUE HEATING A/C Worker's Comp Insurance - Address: 2826 IRVINE AVE Address: 2910S ARCHIBALD AVE #A-335 Carrier: EXEMPT NO EMPLOYEES i. NEWPORT BEACH, CA 92660 ONTARIO CA 91761 Policy No: Phone: Phone: 909-923-7071 Expire Con State Lic: 872168 Issued Date:11/19/2014 Lic Expire: 02/29/2016 j Bus Lic: BT30049166 Processed By: Lic Exp Date: 11/30/2015 F HVAC Items FEES Furnaces Boilers & Compressors Ventilation Misc Other $0.00 Up to 1 OOK BTU/hr: 1 $19.00 Up to 3HP: 1 $19.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 Over 1 OOK 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 ICBO App. #: Record Mgmt Fee: $0.0 Up to 100K BTU/hr: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Investigation: $0.00 Over 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $0.00 Up to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Issuance: $35.00 Up to 1.75M BTU/hr: 0 $0.00 Over 1 OK CFM: 0 $0.00 Supplemental Fee: $0.0 Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 TOTAL: $86.68 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $86.68 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION )WNER-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 he 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 lot 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 U portions of the work, and the structure is not intended or offered for sale (Section 7044, 3usiness 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 mprovements 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 mproved 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 Ipply 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: 3y 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 ;ell 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www,leginfo.ra.gov/calaw.html. Signature of Property Owner or Authorized Agent Date -ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 700,) of Division 3 of the Business and Profess' n Co �, nd license is in full force Ind effect. .icense Class License No Date / t Contractor Signature PORKERS' COMPENSATION DECLARATION IARNING: 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 :DST 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: 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 thr erformance of the work for which this permit is issued. Policy No. 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' compensatiol rance carrier and policy number are: ier Policy Number Expiration Date le of Agent Phone # certify that, in the performance of the wort for wh t 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 if I should become subject t work co a ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ature of Applicant Date/C •1 ADAnnu DCCA DMI\In rnAFQYMIrr T. I Cunlur A/^_C\IrV T ' I 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). 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 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 ordina nd s law a ting to building construction. I authorize representatives of this city or count to r th a -id tiff party for inspection purposes. Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name,, _J None Date ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL REGOLA DONS PJ^.RT 6'' O�7 T.T,240 AND AQMDRULE 7403. ❑fSUBMiTTEDASEST3SWllt1(.ATP)NTO: Q EFA ❑ AQMD ❑ ASBESTOS N07IRCAiION IS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: FOR OFFICE USE ONLY PEiMlT EXPIRED PERMITCANCELLED PERMITEXTENDED PERMI7'F�NAL — �— C CERTIFICATEOF OCCUPANCYISSUED