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Home My WebLink AboutH2018-0788 - PermitsCity of Newport Beach - Building Division III 111111111111111111111111111111111111111111111 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 8 0 7 8 8 Permit Counter Phone (949)644-3288 Job Address: 21 BODEGA BAY DR BIdg:1 Floor: Suite: Description of Work: MECH/CHANGE OUT F.A.U. Inspector Area:4 Code Edit : 2016 Legal Description: N TR 7844 LOT 11 Owner: SHOCKEY JOSEPH/TERESA Contractor: Address: 21 BODEGA BAY DR Address: CORONA DEL MAR, CA 92625 Phone: Phone: Con State Lic: Issued Date:12/18/2018 Lic Expire: Bus Lic: Processed By: Lic Exp Date: MECHANICAL Permit: H2O18-0788 Project No : Inspection Requests Phone (949)644-3255 PIERS VERIFICATION REQ M T R CONSTRUCTION INC 10842 NOEL ST,STE 111 LOS ALAMITOS CA 90720 714-315-9114 929602 03/3112019 BT30050473 03/31/2019 Worker's Comp Insurance - Carrier : FALLS LAKE FIRE Policy No: FLA000799 Expire :08/0512019 7- HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 1 $19.00 Up to 3HP: 0 $0.00 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 100K BTU/hr: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee : $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 10K CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: Issuance: $0.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $10.00 Manufacturer: Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $0.00 TOTAL: $29.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $29.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7:00 a.rn.to 8,0 p:m.anc+5aturday from 8:00 a.m. to 6:00 p.m. )WNER-BUILDER DECLARATION 1 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 3rofessions 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 (_) 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 mproved for the purpose of sale). 111, 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). 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 legally 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.himl. 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 Prof essia s-6 de, and my license is in full force and effect. j �I 16 (I8 License Class License No Date Contractor Signatu WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUWECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOI SAND DOLLARS ($100,000(, IN ADOFTION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I 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 the :e of the work for which this permit is issued. Policy No. as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' have and will ma' workers' car rance carrier and IICV• umber are: Date ne of Agent ' .—.-- 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 I, if I should become su 'ect to the wT sation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prov(sivor}s nature of Applicant Date /� I a Z I I CLARATION REGAR IN C IN ENCY neby affirm under pe alty of perjury onstruction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). N Lender's Address Ider s ame 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 ordinances pnff—staWlaws relating to building construction. I authorize representatives of this city or coun t enter th ab ve-identifiAd-prioperty for inspection purposes. Pajs Del Arv, y (nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nam ACTION DATE BY DECLARATION OF 0MPLIANCEiMTH CODE OF L FOR OFFIO FEDERAL REGULATIONSPAPT61 OFTITLE40AND :y'QWD RULE 1403. C I SUDMr TTE")ASBESTOS ND3IFICATION TO: ❑ ETA ❑ AQMD ❑ ASBESTOS NORftCATIONIS NOT APPLICABLE TO -- PROPOSED DEMOLITION, " S.'GNA T UFE: PERMfT IXP7RED PERMIT CANCELLED PERMIT EKTENDED PERM7TFINAL Q%/Ol jq _ CERTIHCATE OF O'CCUPANCY/SSUED