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Home My WebLink AboutH2019-0634 - Permitsv Lr,�r City of Newport Beach - Building Division III�IIIIIIIIIIIIIIIII�IIIIIII�IIIIIIIIII 100 Civic Center Drive, Newport Beach, CA 02660 H 2 0 1 9 0 6 3 4 Permit Counter Phone (949)644-3288 e f'�d1Yi�YY'1� Job Address: 1736 PORT MARGATE PL Bldg:1 Floor: Suite: Description of Work: MECH NEW A/C UNIT W/ DUCT WORK AND FURNACE C/O *TAMPER PROOF CAP* InspectorArea:4 Code Edit: 2016 Legal Description: N TR 6621 LOT 36 Owner: LONG MICHAEL Contractor: MITCHELL HEATING/AIR Address: 1736 PORT MARGATE PL Address: 5896 CARELL AVENUE NEWPORT BEACH, CA 92660 AGOURA HILLS CA Phone: Phone: Con State Lic: 558157 Issued Date:10116/2019 Lic Expire: 12/3112019 Bus Lic: BT30069337 Processed By: Lic Exp Date: 10/31/2020 MECHANICAL Permit: H2O19-0634 Project No : Inspection Requests Phone (949)644-3255 INSPECTOR Worker's Comp Insurance - Carrier: TRUCK INSURANCE EXCHANGE Policy No: A09324994 ' Expire :0611312020 iVAC Items FEES =urnacesBoilers & Compressors Ventilation Other Jp to 10oK BTU/hr: 1 $20.00 Up to 3HP: 1 $20.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 $0.00 Jver 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 Nall/Floor Heaters: 0 $0.00 >15 HP to 30 HP: 0 $0.00 Attic Fan: 0 $0.00 Metal Fireplace: 0 $0.00 ieat Pumps & Package Units >30 HP to 50 HP 0 $0.00 Down -Draft Fan: 0 $0.00 Record Mgt Fee: $0.00 Jp to 100K BTU/hr: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee : $0.00 Investigation: $0.00 Jver500K BTU/hr. 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $52.20 Jp to 1 M BTU/hr: 0 $0.00 up to 1OK CFM: 0 $0.00 Repair/Alter/Add: 1 $20.00 Model: 4A7A6061JIssuance: $35.00 Jp to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: AMERICAN STANDA Jver 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $41.50 TOTAL: $188.70 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $188.70 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 applibant 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 (_) 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 t0 construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner V 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 rr.y signature hPlow 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) sell o structu.e 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. Pign&:ure 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 ction 7000) of Division 3 of the Business and Pr a s'o e, and y license is in full force ono affect. f't ,I use Class License No Date V lit Contractor Signature Y&RKERS' COMPENSATION DECLARATION ;ARA,NAi FAILURr TO SE: URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLO R TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HIINORED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST O! COMPE;iSAnJN, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 11 here).• affirm under penalty of perjury one of the following declarations: I have and wi'! 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 pe rmanoe of the work for which this permit is issued. Policy No. have 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' compensation su ce carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # I certify that, in the perfor ante f he work to hich this permit is issued, I shall not employ any person in any manner so as to become subject to he workers' compensation laws of California, and agree hat, if I should become so fec t o ers' c pensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provi ' nS. Signature of Applicant Dot DECLARATION REGA I G CONSTRU TIO ENDING AGENCY I hereby affirm under p nalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issu (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 c unty ordin ces an fate laws relating to building construction. I authorize representatives of this city or coun t0 bove- entified property for inspection purposes. Signature of Property Owner or Authorized A ent Print Property Owner's or Authorized Agent's Na Q, to ACTION DATE BY DECLARATION OFCOMPIJANCEMTHCODEOF FOR OFFICE USE O Y FEDERAL REGULATIONS PART 610E TITLE 40AND PERMITEXPIRED AQMORULE 1403. ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: PERMITCANCELLED ❑ EPA PERMITEXTENDED ❑ AQMD ❑ ASBESTOS NOTIFTCATIONIS NOT APPLICABLE TO PERMITFINAL Worol q PROPOSED DEMOLITION. CERTIFICATE OF OCCOPANCYISSUED �K,] SIGNATURE: