HomeMy WebLinkAboutH2019-0595 - Permits (2)+ " h City of Newport Beach - Building Division III III 11111111111111111111111111111111111111
- 100 Civic Center Drive, Newport Beach, CA 92660 H 2 O 1 9 0 5 9 5
F Permit Counter Phone (949)644-3288
Cti{lYt I1L�ry�
Job Address: 503 AVENIDA LUCIA BIdgA Floor: Suite:
Description of Work: MECH -NEW A/C CON DENSOR & FAU. TAMPER -RESISTANT CAP REQ'D
Inspector Area:8 Code Edit: 2016
Legal Description: TR 5692 (L.L.84-214027) PAR 48 AND PAR 4BG
Owner: SHAMOO FRANK
Address: 503 AVENIDA LUCIA
NEWPORT BEACH, CA 92660
Phone: 949-295-6491
Issued Date:09/27/2019
Processed By:
Contractor:
PACIFIC CONSTRUCTION
Address:
27984 VIA DE COSTA
SAN JUAN CAPO, CA 92675
Phone:
949-439-8515
Con State Lie:
1038228
Lie Expire:
0413012020
Bus Lie:
BT30067999
Lie Exp Date:
07/31/2020
MECHANICAL Permit: H2O19-0595
Project No : 1609-2019
Inspection Requests Phone (949)644-3255
Worker's Comp Insurance -
Carrier : NO EMPLOYEES
Policy No:
Expire :
INSPECTOR
HVAC Items
FEES
Furnaces Boilers & Compressors
Ventilation
Other
Up to 100K BTU/hr:
1
$20.00
Up to 3HP:
1 $20.00
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 :
$17.33
Investigation:
$0.00
Over 500K BTU/hr:
0
$0.00
Air Handling Units
Comm. Hood:
0 $0.00
Plan Check:
$0.00
Up to I BTU/hr:
0
$0.00
up to 1OK CFM:
0 $0.00
Repair/Alter/Add:
0 $0.00
Model:
4AC16L18P-50A
Issuance:
$35.00
Up to 1.75M BTU/hr:
0
$0.00
Over 1 OK CFM:
0 $0.00
Supplemental Fee:
$0.00
Manufacturer:
OMNIGUARD
Over 1.75M BTU/hr:
0
$0.00
VAV Box:
0 $0.00
Zoning PC:
$41.50
TOTAL:
$133.83
Plan Check Fee
: $0.00
Fee Due at Permit Issuance :
$133.83
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Constructior: Hours: r4orroay - Friday 7:00 a.m.to 6:30 p.m.and Saturday from 8:00 a.m. to 6:00 p.m.
DWNER-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 U all of or U 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
im roved 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
ap ly 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).
ff 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 legal[I
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.htmi.
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 In ode, an y license is in full force
and effect.
License Class License No Date 1 2.01� Contractor Signatu
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.
1 hereby affirm under penalty of perjury one of the following declarations:
tPI 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
beelormance of the work for which this permit is issued. Policy No.
01 qqva 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' compensatioi
insu ha carriep-and Dolicy number are:
Policy Number
of Agent
Date
I 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 agre
that, if I should become subject to tl7s-ta ers' m ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant A (E/- DatPl �129
DECLARATION REGAR I-b NG CON NDING AGENCY
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 owners 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.
Signature of ProDertv Owner or Authorized Agent Print Property Owners_ or Authorized Agent's Name ( lj Date a'
ACTION DATE 8Y II PF RECLAAL REG �ATONS PART51 FTTLE 40 AND I _ F COMPLIANCE MTH CODEOF FOR OFFICE USE ONLY
PERMIT EXPIRED
ALIMU HUr_t 7eus.
❑ I SUBMITTED ASBESTOS ,d0'1FICPTION TJ:
❑ EPA
El AQMD
PERT.^IT CANCELLED
PERMIT EXTENDED
❑ ASBESTOS NOTIACATIONIS NOT APPLICABLE TO
PROPOSED DEMOLITION,
PERMIT ANAL
'j,-1 ' DID
g6arn
CERTfFICATEOF
SIGNATURE:
OCCUPANCYISSUED