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HomeMy WebLinkAboutH2019-0329 - Permits (2)City of Newport Beach - Building Division m �II��IIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 100 Civic Center Drive, Newport Beach, CA 92610 m m ° m2 9 0 3 2 9 ¢. y Permit Counter Phone (949)644-3288 o e e e e o m �� m ® e m • e e e m e m• � eoe • •® o ooe om ��t.SpCil4i4Y D o e • e o •m o 0 m o mm a m m o e m m m �-m • o m® o m m m Job Address: 216 VIA ORVIETO BIdg:1 Floor: guite:m ° m e m • e Description of Work: MECH - C/O FAU IN CLOSET Inspector Area:1 Code Edit: 2016 Legal Description: TR 907 LOTS 78/79 Owner: SCHILT STEPHEN J Contractor: ADEEDO Address: 216 VIA ORVIETO Address: 8599 VENICE BLVD NEWPORT BEACH, CA 92663 LA CA 90034 Phone: Phone: 310-623-4888 Con State Lia 1042744 Issued Date: Lic Expire: 08/31/2020 Bus Lic. BT30067578 Processed By: Lic Exp Date: 06/30/2020 MECHANICAL Permit: H2O19-0329 Project No : Inspection Requests Phone (949)644-3255 Worker's Comp Insurance - Carrier: STATE FUND Policy No: 9040692 Expire :01/01/2020 HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 1 $19.00 Up to 3HP: 0 $0.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 $0.00 Over 1001K 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 1OOK 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: $0.00 Up to 1M BTU/hr: 0 $0.00 up to 1OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: Issuance: $35.00 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: $0.00 TOTAL: $54.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $54.00 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. )WNER-BUILDER DECLARATION •• ••• •• •• ••• 1 hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law forthereaaan(It) 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, alerf improve# demclisb, dr repaitany 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•Stafe ticenSe LaN (Ch2pter•9iiCommencing with Section 7000) of Division 3 of the Business and Irofessions 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). I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of oI-(_) QOrtign sof4haw@rk, and llne efrracture is not intended or offered for sale (Section 7044, lusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property wM, lhroulA9n!pl4yees'.o} $4o fal 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 .gpe jar of campletigrt, the OyaflerRglYilder will have the burden of proving that it was not built or nproved 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 doe= mm p ly 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: 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 legalli. 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 Tofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. lignature 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 7000)of Division 3 of the Business and! Profession and my license is in full force and effect. fU� .!cense Class License No Date 1 Contractor Signatures 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 3108 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: I have and aintain 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 of the work for which this permit is issued. Policy No. 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' compensatioi ,sura cec rriera d oli num,bygrare: /j©6 r C' Policy Number `�j Expiration Date—SM l L lame of Agent Phone # 3 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 agre iat, if I should become subject to th om tion ovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /I lignature of ApplicalltlX, . Date )ECLARATION REGXROI ON UCTION LENDING 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 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 state laws relating to building construction. I authorize representatives of this city or county to ante o f l-�'a7any for inspection purposes. �/ �(�' ,rj�� ,�✓���jT Date V ! 1 lignature of Property Owner or Authorized Agent N. roperty Ow or Authorized Agent's Name - - ACTION DATE BY uca.c.r rrasrs air . v. FEDERAL REGULATIONS PART 61OFTITLE40AND AQMORULE1403. PERMITEXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO:- ❑ EPA ❑ AOMD PERMITCANCELLED PERMIT EXTENDED ❑ ASBESTOS H017RCA170NIS NOT APPLICABLE TO PROPOSED DEMOUTION, PERMITFINAL CERTIFICATE OF SIGNATURE: OCCUPANCYISSUED