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HomeMy WebLinkAboutH2019-0421 - Permits9.1 City of Newport Beach- Building Division IIII�IIIIIIIIIIIIIIII�llllllllllldllllllllllllll MECHANICAL Permit: H2019-0421 �'- 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 0 4 2. 1 Project No i Permit Counter Phone (949)644-3288 x: Inspection Requests Phone (949)644-3255 Job Address: -16 VERSAILLES BIdg:1 Floor: Suite: Description of Work: MECH CHANGE OUT (E) F.A.U. & A/C UNIT 38dB AMERICAN STD; 4A6L9048A1000A) W/ DUCT WORK REVISED 10/07/2019, ...� z!!l111 Inspector Area:6 Code Edit: 2016 Legal Description: Other Up to 100K BTU/hr. 1 $19.00 Up to 3HP: 0 ...-U) Owner: ALJIAN REED Contractor: TACTICAL AIR INC Worker's Comp Insurance - Address: 16 VERSAILLES Address: 23382 MADERO UNTI J Carrier: STATE FARM INS , ,�, NEWPORT COAST CA 92657 $35.00 MISSION VIEJO, CA 92691 Policy No: 92GJT3642 Gas Line: Phone: Phone: 949-303-5525 Expire :0211712020 0 Issued Date:07/16/201 Con State Lie: Bic Expire: 1010956 31/2021 BT3005522 $0.00 Attic Fan: Processed By: V Bus Lie: Lic Exp Date: 9 05/31/2020 HERS VERIFICATION REQ Heat Pumps & Package Units >30 HP to 50 HP 0 $0.00 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 100K BTU/hr. 0 $0.00 > 3 HP to 15 HP: 1 $35.00 Exhaust Fan: 0 $0.00 Gas Line: 0 $0:00 $0.00 Wall/Floor Heaters: 0 s $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 `. $30.45 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 OK CFM: 0 $0.00 Repair/Alter/Add: 0 ' $0.00 Model: 4A6L9046A1000A Issuance: $35.00 Up to 1.75M BTU/hr. 0 $0.00 Over 10K CFM: , 0 $0.00 Supplemental Fee: $0.00 Manufacturer: AMERICAN STD Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $40.00 TOTAL: $159.45 Plan Check Fee: $159.45 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. 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 (_) all of or U 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 improved 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 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 legally '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/calaw.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 Section000) f Division 3 of the Business and Profes%EE:6 le se is in full farce and effect. - --��� License Class License No Date © � Contractor Signature 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 ($700,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I 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 IN pelformance of the work for which this permit is issued. Policy No. and will tin 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 SRO poli number a, carrier �1 (� ;- ^ A,%0 11 1 PDIir"VIpbe, /% Expiration Date of Agent I 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 agrec tat, if I should become sul c} to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pr ysions. ignature of Applicant '/YV Da( 10 f %h� , IECLARATION REGARDIKG CONSTRUCTION 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 _. By 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. 1 agree to comply with all applicable city and count g to building construction. I authorize representatives of this city or cou o e e ntl led S. Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Date AC77ON DATE BY DECLARATIONOFCOMPLtANCEMTNCOBEOF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40 AND PERA41TEXPIRED AQMORULE 1403. I SUBMITTED ASBESTOS NOTIFICATION TO. PERMITCANCELLED 0 EPA PERMITEXTENDED D AQMD ASBESTOS N017HCA170NIS NOT APPLICABLE TO PERMITFINAL PROPOSED DEMOLITION. CERTIFICATEOF OCCUPANCYISSUEO SIGNATURE: