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Home My WebLink AboutH2017-0169 - PermitsW ty of N anr rt Beach - BuildinDivision I-� ISL P r : H2O17-0169 Civic Ce Dr e, Nfgh. CA 926i`Iy'"�3 H 2 0 1 7 0 1 6 9 • • • pPro ect Nomit Count oa(949)644-3288 ifi aPplicablo: 1 �❑u0 /n or ❑ ° V 0 h ne. 9644°32W f Lir UI"IG ) Y S1b � fi - _ • e° a°p O p p p ' p• p Job Address: 369 SANTA 11{B L A Floo _ . its • ° °. ° p •, • p p Description of Work: REPLA H I /SPLI YST NIP P REQUIRED -��ixnspectorArea:3 ode 6 Legal Description: TR 300�Y 5 POR OF LOT r� Owner: WORLEY ADRIEI IE �@�,C+ontractor: ORANGE COAST PLUMBING INC�Worker's Comp Insurance - Address: 369 SANTA [SABO-,,A E NEWPORT B AC C 92 ata, tyt�p4CA 9270 yg,�C�arnerEV OREST TL INS CO Phone: w Ph 714.953-1111 Uis`gxi el1l/2� an (�+b��fa�ruAb"tEA06002 (no work started) Issued Date:03/28/2017:: Lic Expire: 06/30/2018 s, .fOtC. Bus Lic: BT30010676 Processed By:---tic-ExlrBate. -07;0• s _ Insp. initials: �L HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 1 $18.00 Up to 3HP: 1 $18.00 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 Dawn -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: $53.16 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: 4A7A4060L Issuance: $33.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: AMERICAN STD Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 TOTAL: $122.16 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $122.16 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. ELECTRICAL METALLIC TUBING (EMT) IS NOT ALLOWED FOR EXTERIOR APPLICATIONS "UBJFCT TO FIELD TN,CpFCTOR'S REVIEW AND AI': RO VAL I I gereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable items) Sat)lf* 70313, 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 regyires the applicant for 1e permit to We %toned 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 df�a�-,,`,Isiness and Professions Cod) 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 ci,•i penalty of of More than five hundred dollars ($500). I, as owne' of4the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, - suslhBss 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 lnprovements 2rg ryaj 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 vproved for the purpose of sale). 11f e9 owner of the property, am exclusively contracting with lice Con acto to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not pply to.°an owner OfiprQperty who builds or improv4forpersona who co ra r the projects with a licensed Contractor pursuant to the Contractors' State License Law). *I-"exemp4 fro"ljpensure under the Contracse w f e to reason: IK meignature below I acknowledge that, except side in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally ell a structure til at I have built as an owner-buildeen c ructed..in it ty by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and 'rofessions Code, is available upon request w nis th Ilowing Web site:http://www.leginfo.ca.gov/calaw.html. signature of Property Owner or Authorized Agen Dat moi' .ICENSED CONTRACTOR'S DECLARATI 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 Professions Code, and my license is in full force nd effect. icense Class License No Date Contractor Signature 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 HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 7e 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 th rmance of the work for which this permit is issued. Policy No. dlyflave 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' compensatiol rance carrier and policy number are: :arrier Policy Number Expiration Date lame of Agent Phone # 31 certify that, in the p ce e r or which this ermit 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 tat, if I should becom su ect pe o rovisions of Section 37 of the Labor Code, I shall forthwith comply with those provisions. signature of Applican Dato IECLARATION REG NG CON RUCTION LE DING AGENCY hereby 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, Civil Code). Ender'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 propert Ialf. I have read this application and the information I have r Ide Is rre-t. I agree to comply with all applicable city and cou din e d 11 state law relating to building construction. I authorize representatives of this city or cou rty for inspection purposes. signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name LLe;�'d Z—�6--Jj—oelld Da ACTION DATE BY DECLARATIONOFCOMPLIANCE Ili CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40 AND P BMI7TEDASBEST05PI071FICATiONTO: AEP QMDESTO O N N APPLICABLE TO E MO OCCUPANCYISSUED