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HomeMy WebLinkAboutH2019-0268 - Permits (2)City of Newport Beach - Building Division H2O19-0268 s 100 Civic Center Drive, Newport 13each, CA 92660 Permit Counter Phone(949)644-3288. Job Address: 560 HARBOR ISLAND DR BIdgA Floor: Suite: Description of Work: MECH/ NEW A/C & FAU C/O "TAMPER RESISTANT CAP REQ,, Inspector Area:2 Code Edit: 2016 FEES Legal Description: N TR 3867 LOT 31 Owner: EGGLESTON DAVID W & LARAINE Contractor: BEST AIR COND & HEATING INC Address: 560 HARB ND DR Address: 959-A N ELM ST NEWP T BEA , CA 92660 ORANGE CA 92867 Phone: Phone: 714-771-2330 Con State Lic: 419737 Issued bate: 5/10/2019 tic Expire: 03/31/2020 $19.00 Bus Lic: BT30065307 Processed Lic Exp Date: 12/31/2019 MECHANICAL Permit: H2O19-0268 Project No: Inspection Requests Phone (949)644-3255 �T • o Worker's Comp Insurance - Carrier: STATE COMP INS FUND Policy No: 92GBX0541 ° • e' Expire :06/28/2019 •e o giJBJFC i TOFIELDlN1SPF,'-J,t1Prig, °•e•em kFVIEWAND APPROVAL 000meo • • ° m ° mm eo•mo m o oommeo o mm o 0 HVACItems® FEES ---- FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 1 $19.00 Up to 3HP: 1 $19.00 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 Down -Draft Fan: 0 $0.00 Record Mgt Fee: $0.00 Up to I OOK BTU/hr. 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional fee : $16.53 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 1 O CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: 124ANSO481ssuance: $35.00 Up to 1.75M BTU/hr: 0 $0.00 Over IOK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: BRYANT Over 1.75M BTU/hr. 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $40.00 TOTAL: $129.53 Plan Check Fee : $129.53 Fee Due at Permit Issuance : $0.00 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 8:00 a.m. to 6:00 p.m. VNER-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) Iction 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 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 Ifessions 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 penaltypf more than five hundred dollars ($500). T I 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, 3iness 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 wovements 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 )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 lot )1y 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). I am exempt from licensure under the Contractors' State License Law for the following reason: my signature.bei'oW 6acknowledge 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 I a strycture thA9 fi9ve 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 Ifesa (Ins Code! is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. nature of Properl)h Owner or Authorized Agent Date :EI&ED CONTRACTOR'S DECLARATION �rebv 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 Codea f 1 force 1Pff6it. ..... J.- ense Class License No Date Contractor Signatu 5RKQ RS' COfiQ€NSATION DECLARATION 1hIRe: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTI a AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE I'( QF�r.OMPENSATILN, DAMAGES AS PROVIDED FOR IN SECTION 370$ OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. baby �fgrm LW§%r p4alty of perjury one of the following declarations: 10 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 IN -)prrnance of the vwrk for which this permit is issued. Policy No. •... h ve 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' compensation .rra ce carrier and policy number are: TI Policy Number Expiration Date fie of Agent rnone s certify that, in the performance 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 agree •'-'--- pro ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. I, if I should beco\me/subj�t� work�.y�yya»•aae��Jd nature of Applicant?—' ��� Date CLARATION REG RDING CONS TI LENDING AGENCY Ireby affirm under enalty 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). 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 ordinances and stateI s relating to building construction. I authorize representatives of this city or county to ter bov ' ' ar ins action purposes. ,,�i�® C�jyj, „ /� ^ nature of Prooertv Owner or Authorized ADeISf_ ® Print Property Owner's or Authorized Agent's Name Date e2 ACTION DATE I BY f.fct.L Iffvff Ur wffi VU IVY CVWrrr vuur=ur run urr". we.11r FEDERAL REGULATIONSPARTOL OFTITLE40AND AQMD RULE?403. PERAOTEXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: PERMITCANCELLED ❑ EPA AQMD PERWITEXTENDED❑ ASBESTOS M07IRCAIIONIS NOT APPLICABLE TO PERAWFINAL�j j PROPOSED DEMOLITION, CERTIFICATE OF SIGNATURE: OCCUPANCYISSUED