HomeMy WebLinkAboutH2018-0245 - Permits (3)City of Newport Beach - Building Division 11111111111111111111111111111111 IN 1111111111111
100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 8 0 2 4 5
Permit Counter Phone (949)644-3288
v w
Job Address: 409 MORNING STAR LN BIdg:1 Floor: Suite:
Description of Work: MECH ADD A/C MINI SPLIT "TAMPER RES CAP REW
Inspector Area:3 Code Edit :
2016
Legal Description: N TR 4224 LOT 175
Owner: OMMID LLC
Contractor:
ONE STOP GARAGE DOORS
Address: 409 MORNING STAR LN
Address:
P.O. BOX 1904
NEWPORT BEACH CA 92660
CORONA CA 92878
Phone:
Phone:
951-545-4114
Con State Lic:
930287
Issued Date:04/19/2018
Lic Expire:
03131/2019
Bus Lic:
BT300
Processed By:
Lic Exp Date:
MECHANICAL Permit: H2O18-0245
Project No:
Inspection Requests
Workers Comp Insurance -
Carrier : W/C EXEMPT
Policy No:
Expire :
! # 1
HVAC Items
FEES
FurnacesBoilers & Compressors
Ventilation
Other
Up to 100K BTU/hr:
0
$0.00
Up to 3HP:
1 $18.00
Bathroom Fan:
0 $0.00
Fire Dampers:
0
$0.00
$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
$0.30
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:
$15.66
Up to 1M BTU/hr:
0
$0.00
up to 1OK CFM:
0 $0.00
Repair/Alter/Add:
0 $0.00
Model:
MSO-012HI1517-0
Issuance:
$33.00
Up to 1.75M BTU/hr:
0
$0.00
Over 1OK CFM:
0 $0.00
Supplemental Fee:
$0.00
Manufacturer:
WHYNTER
Over 1.75M BTU/hr:
0
$0.00
VAV Box:
0 $0.00
Zoning PC:
$37.50
TOTAL:
$104.16
Plan Check Fee
: $0.00
Fee Due at Permit Issuance :
$104.16
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.
OWNER -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 ($5q0).
❑ I, as owner of the property, or my.employees with wages as their sole compensation, will do U all of or (_) 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
improved 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
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).
❑ 1 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.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm Dnd=r Penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profes ion m r license is in full force
and effect- License glass License No Date 7ft Contractor Signature
L-Z
WJRKERS' COMPENSATION DECLARATION 7
V.ARNIAd : 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 COMPENS4 ❑ON,. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I neleb,, affirm under penalty of perjury one of the following declarations:
Q ::iLve and will rlailltain 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,
pgrfnr, ance of the work for which this permit is issued. Policy No.
.idve 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'
rancu came, ..r.d pclicy number are:
'er- _ _ Policy Number Expiration Date
of Agent _ _ -
ify 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,
should become subject to the workers' ,om ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. { PP�
re of Applicant Date — L/ le
CLARATION REGAR ING CONSTRUCTION LENDING AGENCY
Ireby 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
ider's Name Lender's Address
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 acounty ordinances and state laws relating to building construction.
I authorize representatives of this city or 96unty to enter the above -identified R[Werty for insoecfDn �poses. �—
of Property Owner or
Print Property Owner's or
Civil Code).
d�C r1lYV Date A-1�
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PARTtit OF TITLE40AND
AQMD RULE 1403.
PERMIT EXPIRED
❑ I SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERMITCANCELLED
PERMITEXTENDED
❑ ASBESTOS NQTIACATIONIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
CERTIFICATEOF
SIGNATURE:
OCCUPANCYISSUED
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