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HomeMy WebLinkAboutH2018-0380 - Permits* 6ity of Newport Beach - Building Division 11111111111111111111111111111111111111111111111111 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 8 0 3 8 0 _ Permit Counter Phone (949)644-3288 �uz?vexs��� Job Address: 921 CLIFF DR BIdg:1 Floor: Suite: Description of Work: MECH - (2) A/C CONDENSORS *TIMER & TAMPER RESISTANT CAP REQUIRED* MECHANICAL Permit: H2O18-0380 Project No: 2002-2017 Inspection Requests Phone (949)644-3255 Inspector Area:2 Code Edit: 2016 FEES Legal Description: N TR 1218 LOT 96 FurnacesBoilers & Compressors Ventilation Owner: MANNAWI MASLANTI Contractor: AIR SERVICES MECHANICAL INC Worker's Comp Insurance - Other Up to 100K BTU/hr: Address: 24376 PACIFIC AVE Address: 211 S STATE COLLEGE BLVD #126 Carrier: SECURITY NATIONAL INS CO Bathroom Fan: 0 $0.00 MISSION VIEJO, CA 92691 0 $0.00 ANAHEIM CA 92806 Policy No: SWC1166685 Over 100K BTU/hr: 0 $0.00 Phone: 949-541-1226 Phone: 800-620-7821 Expire :10/0112018 Gas Line: 0 $0.00 $0.00 Con State Lic: 1023898 $0.00 >15 HP to 30 HP: 0 $0.00 Attic Fan: Issued Date:06/21/2018 Lic Expire: Bus Lic: 02/28/2019 BT30063599 er I Units >30 HP to 50 HP Processed By: Lic Exp Date: 06/30/2019 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: HVAC Items FEES FurnacesBoilers & 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: 2 $66.00 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: $0.00 Investigation: $0.00 Over 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $57.42 Up to 1 M BTU/hr: 0 $0.00 up to 1 O CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: CSAIBE48K Issuance: $33.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: MAYTAG 0°.' Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning P1,1.p° $37.50 soap 0 cpooc O TOTAL: $193.92 Plan Check Fee: $0.00 Fee Due at Permit Issuance : p O 6 p0 p $193.92 9 s• p • V Bp O 9 p 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. 0 0 • • ooppos p � c popoa.c peooeo 000•co oc p 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 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 L) 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 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 apply 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: By 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 Iegall 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 Professions Code, is available upon request when this application is submitted or at the following Web site:http://Www.leginfo.ca.gov/ca[aw.htmi. Signature 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 Section 7000) of Division 3 of the Business and Pr sions e, a as is in full force and effect. ,�/J License Class License No Date �/ /��^T / Contractor Signatur WORKERS' COMPENSATION DECLARATION WARNING: 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 COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty ofperjury one of the following declarations: 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 r ce of the work for which this permit is issued. Policy No. h 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' compensatio insur nce carrier and policy number are: Ca er Policy Number Expiration Date Name of Agent Phone # ❑I certify that, in the parforman of the work 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 agre that, if I should become s//ub' to the wor/k//grams/' censation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. - Signature of ApplicanC HM '�" '� / Date DECLARATION REG D 3 CONSTRUCTION rENDING AGENCY I 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). Lender's Name ° • • • Lender's Address By my signature lelewp rcertify to each of the following: • • here the pro erri�y.oNner or authorized to act on the property owner's behalf. • I have. read is application and the information I have provided is correct. • • I.agree to comply with all applicable city and county Drdi nces and ate laws raising to building construction. / • I authorize represaniatives of this city or count to r the abov ?!IdApey for inspection purposes. netuie of Propert Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name ��- r b' Date o*46 •••• AClIl7N•• DATE BY DEClA72ATfQN OF CQMPtfANCEtMTN CODEQF FOR OFFICE USE ONLY • • , • ° FEDERAt REQUtATIONS PART 61 QFTITLE 40AND .R€RMtT EXPIRE AQMD RULE 1403. ❑ f SUBMFTFEDASBESTQS bK3TtF1CARON TQ: PERNidTCANte[Lt=U; ❑ EFA P€Rle4fTEXTEhiDFa'i E3 Af7MD ••• ❑ ASBESTOS NQTf7iCA710N15 NOT APPLICABLE TO PERMtT F1NAt• • • b PROPOSED DEMOLITION. 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