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Home My WebLink AboutH2021-0499 - PermitsCity of Newport Beach - Building Division H2O21-0499 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 V fi !'df iraiti�;b Job Address: 715 GOLDENROD AVE BIdg:1 Floor: Suite: Description of Work: MECH NEW A/C UNIT ON ROOF DECK *TAMPER PROOF CAP REO* ADDED UNIT FROM H2O21-0474 Inspector Area:& Code Edit: 2019 Legal Description: CORONA DEL MAR BLK 733 LOT 15 Owner: CUSHMAN ELIZABETH Contractor: Address: 1325 PACIFIC HWY#3402 Address: SAN DIEJO CA 92101 Phone: Phone: Con State Lic: Issued Date:08/25/2021 Lic Expire: Bus Lic: Processed By:- / Lic Exp Date: MECHANICAL Permit: H2O21-0499 Project No : 1047-2021 Inspection Requests Phone (949)644-3255 CONSTRUCTION WpRKrTrc� T kBb`!EWAD� OVgrop,S ON SATURDAWZ HHCM CORPORATION PO BOX 12784 NEWPORT BEACH CA 92658 949-812-6300 978935 11 /30/2022 BT30073531 11/30/2021 Worker's Comp Insurance. - Carrier: EXEMPT Policy No: NO EMPLOYEES Expire : IN SID EICTR, HVAC Items FEES Other Furnaces Boilers & Compressors Up to 100K BTU/hr: 0 $0.00 Ventilation Up to 3HP: 1 $22.00 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 $0.00 Heat Pumps & Package Units >30 HP to 50 HP 0 0 $0.00 $0.00 Down -Draft Fan: Residential Hood: 0 $0.00 0 $0.00 Record Mgt Fee: Additional Fee : $0.00 Investigation: $0.00 Up to 100K BTU/hr: Over 500K BTU/hr: 0 0 $0.00 $0.00 >50 HP: Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $19.14 Up to 1 M BTU/hr: 0 $0.00 up to 10K CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: 4A7L6042A11ssuance: $38.00 Up to 1.75M BTU/hr: 0 $0.00 Over 1 OK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: AMERICAN STAND Zoning PC: $52.00 Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 TOTAL: $131.14 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $131.14 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. TIMER REQUIRED ON EQUIPMENT TO SHUT OFF BETWEEN 10 P.M. AND 7 A.M. K 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) .tion 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 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 'essions 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 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, iness 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 rovements 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 'oved 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 y 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: By my signature below 1 acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of t. sell a stricture 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 Frotessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Sinnature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Segtlofi 7000) f Division 3 of the Business End effe ,t. License Class License No Date 2 Z Contra ignatun INORkFRS' COMPENSATION DECLARATION covered by this permit, 1 cannot ection, 7144 of the Business and is in full force IARNING: FAILURE TP SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND IVIL FINES UP TO ONE HUNDRED THOUS D 0 LLARs ($7 ,D00), IN ADDITION TO THE LSr O.' COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm ruder penalty of perjury one of the following declarations: I ha,,e and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provide ction 3700 of the Labor Code, for thr enoaaance of�:he wort; for which this permit is issued. Policy No. I have and will maintain worke 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' compensatior Isurance carrier and policy numb qre: ne of Agent ,gertify that, in the pe !, if I should become 1 nature of Applicant CLARATION REGM affirm :reby affirm u r per der's Nam my signatLre below, I I am the pr owner or authorized to t on the I have read this applicati-0—n—a-01Tre Information I hE I agree to comply with all applicable city and count I authorize representatives of this city or co F ature of Property Owner or Authoriz gent Policy Number Date Phone # this permit is issued, I shall not employ any person in any manner so as to become subject to the work s' compe sation laws of California, and agre ation provisions Section 3700 of the Labor Code, I shall forthwith comply with those prov' io AGENCY Date istr ction lending agency for the performance of the work for which this permit is issued (Sectn 3097, Civil Code). Lender's Address to building construction. purposes. Ie�1 rty Owner's or Authorized Agent's Nam S ACTION DATE 8Y DECLARATION' OF COMPLIANCE I49TN CODE OF FOR OFF FUSE ONLY FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403. PERM)7 EXPIRED ❑ !SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERM)TCANCELLED PERMITEXTENDED ❑ ASBESTOS N077FICA77ON IS NOT APPLICABLE TO PROPOSED DEMOLITION, PERMIT FWAL CERTIRCATEOF I�t—�—' OCCUPANCYISSUED SIGNATURE: