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HomeMy WebLinkAboutH2018-0571 - PermitsCity of Newport Beach - Building Division MECHANICAL Permit: H2O18-0571 i 100 Civic Center Drive, Newport Beach, CA 92660 H. 2 0 1 8 0 5 7 i. Project No: 0229-2018 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 200 VIA CORDOVA BIdg:1 Floor: Suite: Description of Work: MECH/ (2) A/C UNITS47dB* & 46dB (DAY&NIGHT, NH4A435AKA & NH4A448AKA) *REVISED 07/03/2019 Up to 100K BTU/hr: 0 Inspector Area:1 Code Edit: 2016 Up to 3HP: 1 (D Legal Description: N TR 907 LOT 1052. 0 $0.00 Fire Dampers: 0 $0.00 $0.00 Over 100K BTU/hr: 0 Owner: TERRY MICHAEL Contractor: D L S HEATING & A/C Worker's Comp Insurance - $33.00 Address: 3419 VIA LIDO #455 Address: 8542 LARTHORN DRIVE Carrier: FALLS LAKE 1 1 NEWPORT BEACH CA 92663 HUNTINGTON BEACH CA 92646 Policy No: FLABOB068 ^1 Phone: 949-466-0900 Phone: 714-231-8002 Expire :01/01/2020 ` J J Con State Lic: 584220 Metal Fireplace: 0 $0.00 Issued Date:09/12/2018 Lic Expire: 01/31/2020 Heat Pumps & Package Units (� y^y/ Bus Lic: BT98040420 $0.00 �y Processed By: S / Lic Exp Date: 12/31/2019 $0.00 GAJ 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 100K BTU/hr: 0 $0.00 > 3 HP to 15 HP: 1 $33.00 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 10OK 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: $44.37 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: $33.00 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: $37.50 TOTAL: $165.87 Plan Check Fee : $165.87 Fee Due at Permit Issuance: $0.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE: OR LAST VALID INSPECTION Construction Hours: Monday; Frtday 7:00 a.m.tmo 6:30 p m.and Saturday from 8:00 a.m. to 6:00 p.m. m O • O L L. G OmG mob ? e c mm mm c ¢mo 0o mm c v •40 m0 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 he 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 lot 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, 3usiness 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 m(�roved for the purpose of sale). J 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 Ipply 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: 3y 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 lega113 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 rrofesslons 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 .000) of Division 3 of the Business and. Pro salons nd my license is in full force Ind effect. .icense Class License No Date-- Contractor Signa e YORKERS' COMPENSATION DECLARATION 1ARNING: 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: 1 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 erforryence of the work for which this permit is issued. Policy No. and willa sin 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' carrier id pd Icy number a �'S / �_ .♦ Iler>l�ie Expiration Date of Agent I certify that, in the performance of the work for w ' flmit is issued, I shall not employ any person inanymanner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to workers' nsation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pro isions. Signature of Applicant .,- Date DECLARATION REGA D C TRUCTION LENDING AGENCY I hereby affirm under penal perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Cade). 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 propert " n 71aw, I have read this application and the information I hay rovided is corr I agree to comply with all applicable city and county o anoes and stlating to buildin wclirni---- I authorize representatives of this city or counjy toEnter t boy ' grope ' spection purposes. Sionature of PrODertv Owner or Authorized AGent \ Print Property Owner's or Authorized Agent's Name y ^o9 , CJ dee- BaIT1 ACTION DATE I BY IPERNIrT€XPIR€D I I I PERMITCANCECIED PERMIT:EKT€ND€D I PERMIT FINAL 17- ci -I Ei 1 /ISI OCCUPANCYISSUED A4(ii7D HU T40i. • Q i U8 MED tSBES2-O� N031F!); FIMI* TD: 13 • EPA • • • a • • s Q • AQMD D ASBESTOS NOUHCARONJS NOT APPLICABL.E TO PROPOSED DEMOLITION. SIGNATYU. • ;