HomeMy WebLinkAboutH2019-0161 - PermitsCity of Newport Beach - Building Division IIIIIIII�1111IIIIIII111111811111111111111111111
100 Civic Center Drive, Newport Bea* CA 92660 Ii 2 0 1. 9 0 1 6 1
F Permit Counter Phone (9497644-3288
MECHANICAL Permit: H2O19-0161
Project No :
Inspection Requests Phone (949)644-3255
Job Address: 404 OCEAN FRONT E BIdg:1 Floor: Suite:
Description of Work: MECH INSTIL (2) A/C UNITS @ THE SIDE YARD, RPLC (2) FURNACES "NOISE AGREEMENT & TAMPER RESISTANT CAPS REQ11
NOISE AGRMT ATTITO PLAN
Inspector Area:1 Code Edit: 2016*�
Legal Description: BALBOA TR BLK 4 LOT 13 r
C K(,;
Owner: JOHN THOMAS SHERMAN Contractor: A C COOL INC Worker's Comp Insurance - La
Address: 9149 LINDANTE DR Address: P O BOX 7316 Carrier: EVEREST NATIONAL
WHITTIER CA 90603 FULLERTON CA 92834 Policy No: 7600007408181
Phone: Phone: 714-532-2467 Expire :06101/2019
Con State Lic: 804056
Issued Date:03/20/2019 Lic Expire:
Bus Lic:
Processed By: Lic Exp Date:
01/31/2020 1TJBJECT TO EIFI -)INSPECT( P',Y
BT31/20203 REVIEW AND 1P.P1;(,VAI
ov3vzozo TIMER REQUIRED ON EQUIPMENT
a e
Damm
TO SHUT OFF BETWEEN 10 P.M. AND 7 A.M. m °mmmm[
a m m m e
mo mo
HVAC Items
FEES
FurnacesBoilers & Compressors
Ventilation
Other
Up to 100K BTU/hr:
2
$38.00
Up to 3HP:
2
$38.00
Bathroom Fan:
0 $0.00
Fire Dampers:
0 $0.00
®`
$o.boam
Over 1 OOK BTU/hr.
0
$0.00
> 3 HP to 15 HP:
0
$0.00
Exhaust Fan:
0 $0.00
Gas Line:
0 $0.00
0 ° O C ° °
$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
mmmm.,
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:
$38.00
Investigatienmt m
soho
Over 500K BTU/hr:
0
$0.00
Air Handling Units
Comm. Hood:
0 $0.00
Plan Check:
$0.00'...,
Up to 1M BTU/hr.
0
$0.00
up to1OKCFM:
0
$0.00
Repair/Alter/Add:
0 $0.00
Model
Issuance:
$340&"
m!m°°
Up to 1.75M BTU/hr:
0
$0.00
Over 10K CFM:
0
$0.00
Supplemental Fee:
$0.00
Manufacturer:
mmmm
Over 1.75M BTU/hr.
0
$0.00
VAV Box:
0
$0.00
-
Zoning PC:
$40.00
TOTAL:
$189.00
Plan Check Fee:
$0.00
Fee Due at
Permit Issuance:
$189.00
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 6:00 a.m. to 6:00 p.m.
IWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' Stale License Law for the reason(s) indicated below by the checlharkp) Lhave 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
IS 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).
7 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
Usiness 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
nprovements 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).
1, 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
only to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' Stale 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 legally
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/calhtml.
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 (commenc' with Section 700 ) of Divisio*othe usiness and Prof Bions C sic a s in full force
nd effect.icense Class License No Date 3 7_-!J ignature
VORKERS' COMPENSATION DECLARATION
IARNING: FAILURE TQQ SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER O CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,0001, IN ADDITION TO THE
OST OF COMPENSp,1'[84,, U@.MAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm unddr'ptnalty of perjury one of the following declarations:
.••••
1 have and will anaiatain 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
e4grmence of IN work for which this permit is issued. Policy No.
I h9Jh and will Jrlaigtgin 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
g oran•� c rler � �d•policy number are:
g ieT •�QO f 4AW Policy Number % L O b O t7 7Ly pg/ g Expiration Date G • / • / 3
•w. ,c .,.e.,------ • Phone #
in the performance o e a r which this per is issued, I shall not employ any person in any manner so as to become
oaso�ubie he work o pEaeetipn ov, Ans o,,964on 3700 of the Labor Code, 1 shall forthwith comply with the
:ret; affirm underyenalty of perjury that there is a construction lending agency for the performance of the work for which this permit is
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 property owner's behalf.
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and county ordi es and stat we relating to building construction.
I authorize representatives of this city or county t e".r a -i a ifirty for inspection purposes.
..�n,ro of G,nnuAv rn.,nor nr Ai ithnrivorl An oot i Print Prooertv Owner's or Authorized ADenl
ACTION
PERMITFINAL
CERTIRCATEOF
OCCUPANCYISSUED
DATE 1 BY
AQMD RULE 1403.
0 I SUBIWTTED ASBESTOS M077FICATION TO:
0 EPA
0 AQMD
0
ASBESTOS N017TTCA170MIS NOT APPLICABLE TO
PROPOSEDDEMOLITION.
SIGNATURE:
to the workers' compensation laws of California, and
(Section 3097, Civil Code).
Date
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