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Home My WebLink AboutH2018-0309 - PermitsCity of Newport Beach - Building Division H2O18-0309 ` rr 100 Civic Center Drive, Newport Beach, CA 92660 ?" Permit Counter Phone (949)644-3288 H Job Address: 1106 DOVER DR BIdg:1 Floor: Suite: Description of Work: MECH - INSTIL (2) A/C CON DENSORS *TAMPER-RESISTANT CAPS REQUIRED* Inspector Area:3 Code Edit: 2016 Legal Description: N TR 3000 LOT 12 FEES Owner: RYAN LANCE Contractor: HALTON CORPORATION Address: 1106 DOVER DR Address: 1203 CHARCO NEWPORT BEACH CA 92660 Ventilation SAN CLEMENTE CA 92673 Phone: 310-952-6424 Phone: 949-600-5770 Con State Lie: 767300 Issued Date:06/2612018 Lie Expire: 03/31/2019 $0.00 Bus Lie: BT30061116 Processed By: Lie Exp Date: 11/30/2018 MECHANICAL Permit: H2O18-0309 Project No: 1165-2018 Inspection Requests Phone (949)644-3255 Worker's Comp Insurance - Carrier : WIC EXEMPT Policy No: NO EMPLOYEES Expire : HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 0 $0.00 Up to 3HP: 2 $36.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 $0.00 Over 10oK 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 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: $31.32 Up to 1M BTU/hr: 0 $0.00 up to 1 O CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: 124ANS Issuance: $33.00 Up to 1.75M BTU/hr: 0 $0.00 Over 1 O 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: $37.50 TOTAL: $137.82 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $137.82 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. OWNER -BUILDER DECLARATION �1 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 III%purpose of sale). ❑ 1, as ownes ®610e property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and_ Professions Code: The Contractors' State License Law does not . anpVto an owliIII property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors'. State License Law). I Qm exerilpiNom licensure under the Contractors' State License Law for the following reason: mXa gnature,bSlow 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 s 6 structurelhatl rave 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 de, -is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Sigier.ns of PrEperty Owner or Authorized Agent Date LIGfENSED 1;C6ViRACTOR'S DECLARATION Hereby affimfunA? penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with action 7000) of Division 3 of the Business a Profession ode, and my license is in full force 1r1tl'Llifact. pp - LgL••2h8Q Class • License No Date rte Contractor gnatur ORKERS' FOMPENSATION DECLARATION QRIQ(: FAILURET06E'C�URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLO ER TO CRIMINAL PENALTIES AND CIVIL FINES U NDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE GST•(F COMPEN%0'hQt{ 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: 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 t performance of the work for which this permit is issued. Policy No. I have 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 insurance carrier and policy number are: Carrier Policy Number Expiration Date kme of Agent Phone # I certify that, in the p rformance of w 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 tha , 'f I should becomof Section 3700 of the Labor Code, I shall forthwith comply with those provisi �. Signature of Applican subject wor rs' compensation provisions Date l DECLARATION RE RD CONSTRUCTION LENDING AGENCY I hereby affirm and ally 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 below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. Ihave read this application and the information I have provided is correct. I agree to comply with all applicable city and cou {y ordinanc and state laws relating to building construction. I authorize representatives of this city or er bove-ide ' is d prop rty for inspection purposes. Si nature of Property Owner or Authorized gent Print Property Owner's or Authorized Agent's Nam./7� 'tWlrb4+• to `sem ACDON DATE 8Y DECLARATION OF COMPEtANCEtMTN CODEOF FOR OFRCE USED Y FEDERAL R€GULATIONSPART 61 flFT17LE40AND PERMITFXP/RED AQMDRULE1403. EE3 ASBESTOS 3f5U8MFTFEDtiS8E5TO5ND71FlCATfONTO: PERM(TCANCELdED ❑ EPR PERMlTEXf£NDED ❑ AOPo$D PERMITRNAt PROPOS DDEMOLlT ON.RONtS NOT APPLICABLE TO GERTiffCAT€OF QCCUPANCYISSUED SIGNATURE: