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Home My WebLink AboutH2016-0661 - Permitsors-ros City of Newport Beach - Building Division IIIIII I IIIIII II'll ll ll ll 111 l ll II 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 6 0 6 6 1 Permit Counter Phone (949)644-3288 ar a Job Address: 2815 CASSIA ST BIdg:1 Floor: Suite: Description of Work: MECH/INSTALL A/C UNIT 48.5dB (GOODMAN; GSX14) Inspector Area:8 Code Edit : 2013 Legal Description: N TR 5018 LOT 94 Owner: TOVTIN BRIAN P & KRISTIN Contractor: MEYERS CONSTRUCTION CO Address: 2815 CASSIA ST Address: 7020 EAST EL CEDRAL ST NEWPORT BEACH, CA 92660 LONG BEACH CA 90815 Phone: Phone: 562-841-8405 Con State Lic: 988356 Issued Date:09/27/2016 Lic Expire: 1113012017 Bus Lic: BT30052492 Processed By: Lic Exp Date: 09/3012016 MECHANICAL Permit: H2O16-0661 Project No : Inspection Requests Phone (949)644-3255 Worker's Comp Insurance --, Carrier: STATE COMP INS FUND _ - Policy No: 9158630 €: Expire :05110/2017 e' "�j HVAC Items FEES Furnaces Boilers & Compressors Ventilation Other Up to 100K BTU/hr: 0 $0.00 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: 1 $32.00 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 : $37.50 Investigation: $0.00 Over 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $27.84 Up to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: Issuance: $32.00 Up to 1.75M BTU/hr: 0 $0.00 Over 1 OK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 TOTAL: $129.34 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $129.34 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION u u IWNER-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 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 (_) all of or (_) 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 mprovements 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 legal) 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) 9f Division 3 of the Business and Pr I ns a my license is in full force nd effect.'97 icense Class License No �ll=e (JLJ Date Contractor Signatur VORKERS' COMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDR HOUSAND DOLLARS (E100,000), IN ADDITION TO THE 'DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEV'S FEES. hereby affirm under penalty of perjury one of the following declarations: D 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 erforpance of the work for which this permit is issued. Policy No. al have and will Intaih workers' com ensation 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 Isurance carrier an olicy number are:j� :arrier ( Po r Expiration Date lame of Agent \ Phone # ]I certify that, in the performance of the r f r 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 agree iat, if I should become subject to the w e ' co ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions./��//� signature of Applican DK�� IECLARATION RE ARDING CONSTRU ON LE ING G hereby affirm under penalty of perjury that there is a construction le agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). adder's Name Lender's Address ly my signature below, I certify to each of the following: I am the property owner or authorized to act on the property ow 's behalf. I have read this application and the information I have provid is orrect. li(/ I agree to comply with all applicable city and county ordina es nd state laws relating to building construction. I authorize representatives of this city or county to nter -i tifi party for inspection purposes. 27 signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Date ACLION DATE BY DECLARATION OF COMPLIANCE IMTN CODE OF FOR OFFICE USE ONLY FEDERAL kEGULAI IONS DART 61 OF IME40AND ACMD RULE 1403, ❑ I SUPNITI'EPASB[STOS NOTI.`ICATIONTO: "❑ EPA QND ❑ ASBESTOS NOTiHcATION IS NOT APPLICABLE TO PROP&SE[i 004011T10M. SIGNPTI'RE: PERMIT FXPiRED P€RMITCANCELLED PERMITEXTENDED PERMIT FINAL 11 / Z Z / I % f V✓ CERTIFICATEOF OCCUPANCYISSUED