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Home My WebLink AboutH2019-0595 - PermitsCity of Newport Beach - Building Division III 111111111p111IIN 111111111111111111111111111 o. �r 100 Civic Centevs;ive, Newport Beach, CA 92660 H 2 0 1 9 0 5 9 5 Permit CcMnter Phone (949)644-3288 Job Address: 503 AVENIDA LUCIA BIdg:1 Floor: Suite: Description of Work: MECH -NEW A/C CON DENSOR & FALL TAMPER-RESISTANT CAP REQ'D Inspector Area:8 Code Edit: 2016 Legal Description: TR 5692 (L.L.84-214027) PAR 48 AND PAR 48G Owner: SHAMOO FRANK Contractor: PACIFIC CONSTRUCTION Address: 503 AVE IlDiLUCIA Address: 27984 VIA DE COSTA N PORT B ACH, CA 92660 o SAN JUAN CAPD, CA 92675 Phone: 949-295-6491 Phone: 949-439-8515 / Con State Lic: 1038228 Issued "Dae:09/27/2019 Lic Expire: 04/30/2020 $20.00 us-Lic- BT30067999 Processed B . Lic Exp Date: 07/31/2020 MECHANICAL Permit: H2O19-0595 Project No: 1509-2019 Inspection Requests Phone (949)644-3255 HVAC Items I N S PEUT FEES o. • e occc e a • o Worker's Comp Insurance - " Carrier: NO EMPLOYEES °c Policy No: o... m. Up to 100K BTU/hr: Expire: $20.00 e- 1 $20.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 $0.00 e 9 T& O 0 OT.O f HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 1 $20.00 Up to 3HP: 1 $20.00 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 10oK BTU/hr: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee : $17.33 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 1 O CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: CSAIBE4M1SN36K Issuance: $35.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: MAYTAG Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $41.50 TOTAL: $133.83 Plan Check Fee: $133.83 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. s�• I hereby affirm under penalty of perjury that 1 am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have plead next.40 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 im roved 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 toean owper 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 aPn Mehtt from licensure under the Contractors' State License Law for the following reason: By my sjgnatge 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 91ructvrethat 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 Cade, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature`of Property Owner or Authorized Agent Date LICEUI¢�p,�ONTRACTOR'S DECLARATION I 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 Profess' s C , a se is in full force and effect. /� t `Z t k ` License CIASs: License No Date�-' b Contractor Signature WORKERS' COMPENSATION DECLARATION FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO OIIII-ONSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. affirm_ under penalty of perjury one of the following declarations: DOLLARS ($100,000), IN ADDITION TO I Avq:vt 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 thl ormance of the work for which this permit is issued. Policy No. I 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' compensatior U nce carrier and policy number are: mer Policy Number Expiration Date me of Agent Phone # certify that, in the performance oft wor 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 agrel I, if I should become subject to - Rrpe ion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant Dat IZ11I 201 CLARATION REGARDING CO -LENDING AGENCY ;reby 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). lder'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' ract. I agree to comply with all applicable city and county ordinan s an lating to building construction. I authorize representatives of this city or county to th ove nti d prop rty for inspection purposes. nature of ProDertv Owner or Authorized Anent �--{� Print Property Owner's or Authorized Agent's Name ACTION I DATE PERMIT EXPIRED PERMIT CANCELLED PERMITEXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCYISSUED 8Y UtLL7AKA r iulY ur LviwvUARLC "iP n I vvc ur FEDERAL REGULATIONS PART fit OFTIILE40AND AQMD RULE 1603. ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD ❑ ASBESTOS NORFlCATIONIS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: