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Home My WebLink AboutH2021-0600 - Permits��w.,., fr City of Newport Beach -Building Division III 11111111p1111111111111111111111111111p111p1 MECHANICAL Permit: H2O21-0600 r' ya8 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 1 0 6 0 0 Project No : 1484-2020 �, i ,, Permit Counter Phone (949)644-3288 t °" Inspection Requests Phone (949)644-3255 +<q uuti`� Job Address: 1620 KINGS RD BIdg:1 Floor: Suite: tY Description of Work: MECH/INSTALL (2) A/C UNITS 48dB & 43dB (AC PRO;4SCU20LX) cc Inspector Area:3 Code Edit: 2019 Legal Description: N TR 1221 LOT 12 Owner: FOROUTAN Contractor: RC A/C & HEATING Worker's Comp Insurance - I Address: 1620 KINGS RD Address: 169 N MAPLE ST STE D Carrier: STATE COMP -a NEWPORT BEACH, CA 92663 CORONA CA 92880 Policy No: 1354374 Phone: Phone: 951-735-8046 Expire :0710112022 Con State Lic: 657924 - ;a Issued Date:10/19/2021 Lic Expire: 06/3012023 Bus Lic: BT30066849 Processed By: Lic Exp Date: 04/30/2022 Items FEES Other ces Boilers & Compressors IOOK BTU/hr: 0 $0.00 Ventilation Up to 3HP: 0 $0.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 $0.00 OOK BTU/hr: 0 $0.00 > 3 HP to 15 HP: 2 $78.00 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 1 OOK BTU/hr: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee : $0.00 Investigation: $0.00 00K BTU/hr: L 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $67.86 1M BTU/hr: 0 $0.00 up to 10K CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: Issuance: $38.00 1.75M BTU/hr: 0 $0.00 Over 1 OK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer:.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $52.00 TOTAL: $235.86 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $235.86 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7:0%n,f.m-LO 6:30 P.m.ard Sa'urdayfrom 8:00 a.m. to 6:00 p.m. )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) 1 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 ie 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 'rofessions 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 of 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, lusiness 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 nprovements 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 nproved 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 pply 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: ly 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.ca.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 Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force nd effect. pp icense Class C_—Lr', License No %17,2:f DateX Contractor Signature_ VORKERS' COMPENSATION DECLARATION 'ARNING: 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 I$100,0001, 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 thl er'90mance of the work for which this permit is issued. Policy No. have and will Ih workers' rance carrier an Doll number is of Agent insurance, as rygquired by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' Date LJI 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 subj ct to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prov sions. Signature of) Date DECLARATION REGA CONSTRUCTION LENDING AGENCY I hereby affirm under Onalty 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. 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. authorize representatives of this city or county t e abov Ified property for inspection purposes. Signature of Property Owner or Authorized Agen Print Property Owner's or Authorized Agent's Name ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDEI u^L .TE9ULATIONS PART III OF TITLE40 AND AQMO RULE 1403. PERMIT EXPIRFD SUBM;TTEDASELSTJS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMITCANCELLED PERMIT EXTENDED ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEVOL17CV. PERMIT FINAL CE,4TIFICATE OF IF OCCUPANCYISSUED S-GNATURE: