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Home My WebLink AboutH2017-0732 - Permitsw,r City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIII�II�III��II o 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 7 0 7 3 2 N Permit Counter Phone (949)644-3288 �+'dFa7X� MECHANICAL Permit: H2O17-0732 Project No: Inspection Requests Phone (949)644-3255 Job Address: 200 INTREPID ST BIdg:1 Floor: Suite: Description of Work: MECH/INSTALL A/C UNIT 52dB* (BRYANT; 105ANA-48-A) *TIMER REQUIRED (RENEW EXPIRED PERMIT H2O16-0344) InspectorArea:3 Code Edit: 2013 Legal Description: TR 7852 LOT 1 UNIT 88 OF PROJECT LOCATED ON AP 424-031-01 TOGETHER Owner: FLEMING LIVING TRUST Address: 9021 MUSTANG RD ALTA LOMA CA 91701 Phone: Issued Date:12/13/2017 Processed Bv: Contractor: ABC HEATING AND A/C Worker's Comp Insurance - Address: 306 COLLEN PL Carrier: NORGUARD COSTA MESA CA 92627 Policy No: NAWC636055 Phone: 949-756-0064 Expire :09/24/2018 Con State Lic: 940181 Lic Expire: 11/30/2019 60000 Bus Lic: BT30043258 , b._,.'<0 Lic Exp Date: 03/31/2018 Up to 3HP: HVAC Items 0 e�usc�crn ° c o .. 0 FurnacesBoilers & Compressors Ventilation 60000 Other , b._,.'<0 0 $0.00 Up to 3HP: 0 $0.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 10oK 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: 0 $0.00 Exhaust Fan: 0 $0.00 Gas Line: 0 $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: $64.67 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: $0.00 Manufacturer: Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $0.00 TOTAL: $64.67 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $64.67 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 iterr(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 ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or L) 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 own(ea ".property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' St Cense Law does not apply to an owner of {hoperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ® •lam exerrO froMicensure under the Contractors' State License Law for the following reason: By my signaturd'9elov9 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 overed by this permit, I cannot legal s@jl a'sjructure 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 ection 7044 of the Business and Pro%Ssions Code, is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.html. Signature of Plfol!iftf Qwner or Authorized Agent Date LICEdSED C,ONT�2ACTOR'S DECLARATION ylzrppy affirm aid erpEnalty of perjury that I am licensed under provisions of Chapter 9 (commencing wit Section 7000) of Division 3 of the Business P Tessio ode, and my license is in full force a4 j gfj4ct. ? —7 license Class License No Date.' 3 ! Contractor Signatu (IIORKViRS' GOMP11INSATION DECLARATION NAA�Rj�II jJ�6FAILORE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL sueJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THI `W I SS77 VOMPENSATION!17AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hbf* affirm Bader penalty of perjury one of the following declarations: I Ave 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 thi ance of the work for which this permit is issue Policy No. ave and will maintain workers' compensaY 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 r nca carrier and policy number are: Tier Policy Number Expiration Date Tie of Agent Phone # certify that, in the pe rma a t ork 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 agree I, if I should become 1t t -e orke -f Section 3700 of the Labor Code, I shall forthwith comply with those provsi/op�. 22 nature of Applican Date / �% —� J^'7 CLARATION RE DING CONSTRUCTION LENDING AGENCY ireby affirm and enalty of perjury that there is a construction lending en-' or the performance of the work for which this permit is issued(Section 3097, Civil Code). 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 prop rt ow is behalf. I have read this application and the information I %av rove d i rrect. I agree to comply with all applicable city and co ' n and state laws relating to building construction. I authorize representatives of this city or co ta above -identified property for inspection purposes. nature of Property Owner or Authorized nt Print Property Owner's or Authorized Agent's Name Date ACTION 911ATE BY DECLARATION OF COMPLIANCE M TH CODE OF / FOR OFFICE USE ONjr FEDERAL REGULATIONS PART Of OF TITLE40AND �� P€RMITEXPIREO AQMDRULE1403. ❑ ISUBMITTEDASBESTOSN07IFfCATIONTO: PERMITCANCELLEO ❑ EPA P€RMITEXTENDED ❑ AQMD ❑ ASBESTOS NOTIRCARON1S NOTAPPLICABLE TO PERMlTFiIVA1. I Pi-� po — S PROPOSED DEMOLITION CER77FICATEOF OCCUPANCY7SSUED SIGNATURE: