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HomeMy WebLinkAboutH2019-0285 - PermitsCity of Newport Beach - Building. Division IIIIIIIIIIIIIIIIIIIIillllllllllllllllllllllllllll MECHANICAL Permit: H2O19-0285 y' 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 9 0 2 8 5 Permit Counter Phone (949)644-3288Project No . 1 TIMER REQUIRED ON EQUIPMENT Inspection Requests Phone (949)644-3255 TO SHUT OFF BETWEEN 10 P.M. AND 7 A.M. Job Address: 62 LESSAY BIdg:1 Floor: Suite: Description of Work: MECH A/C UNIT *TAMPER PROOF CAP REQ* & FURNACE C/O *LETTER ATTACHED* . =` • ° e • ' FurnacesBoilers & Compressors InspectorArea:6 Code Edit; 2016 ry E f )_ € � r, 0 ..° ,.�f 4 Legal Description: 14798 LOT 10 OF PROJECT 936-46 LOCATED ON AP 461-231-48 • • ° ®.° o Up to 100K BTU/hr: 1 ° ° Owner: KATH JOHN JOSEPH Contractor: ALICIA AIR CONDITIONING Worker's Comp Insurance - so Bathroom Fan: Address: 62 LESSAY Address: 26824 VISTA TERRACE Carrier: SERVICE GROUP o ° • ° NEWPORT BEACH, CA 92657 LAKE FOREST CA 92630 Policy No: WC047015951 0 $0.00 Phone: 949-689.4837 Phone: 949-770-2495 Expire :07/0112019 °Op° • °O ° Con State Lic: 525314 0 $0.00 Issued Date:05/17/2019 Lic Expire: 02/28/2020 0 $0.00 Bus Lic: BT20102054 ° °°•°°° Processed By:_!W \ Lic Exp Date: 09/30/2019 0 $0.00 Heat Pumps & Package ° 00 000000 0 $0.00 Of00 000° HVAC Items 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 1OOK 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: $33.06 Up to 1M BTU/hr: 0 $0.00 up to 1 O CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: 24AAA536AO03 Issuance: $35.00 Up to 1.75M BTU/hr: 0 $0.00 Over IOK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: CARRIER Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $40.00 TOTAL: $146.06 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $146.06 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 herebbyy 'IYCReILYG rn ty ofp .. 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) ction 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 fessions 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 pehalty 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 or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, iness 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 rovements 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 tthp property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not 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 exemptfroo g licensure under the Contractors' State License Law for the following reason: gnatuF 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 a structure thaf?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 fessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Date rTffiure of Property Owner or Authorized Agent : ESySED COf4 rWCTOR'S DECLARATION Aeby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing wit Section 7000) of Division 3 of the Business an5vorofessions Code, and my license is in full force I effect. Waass , License No Date S Contractor Signature JRMRS' CQMP4NSATION DECLARATION ININCa FAILURE TO SC4�IRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,0001. IN ADDITION TO THE tT OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37DS OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. •..• �braffirm yrRiEi; penalty of perjury one of the following declarations: t I have and welll 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, fort i formance of the work for which this permit is issued. Policy No. 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' compensatioi Nance carrier and policy number are: Tier Policy Number Expiration Date TIE of Agent Phone # 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 It. if I should become bject t he workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisi ns. -7 nature of Applicant Date CLARATION REG RDING CONSTRUCTION NDING AGENCY ?reby affirm under enalty of perjury that there is a construction Is agency for the performance of the work for which this permit is issued Section 3097, Civil Code). ider's Name Lenders 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. 1 have read this application and the information I have provided is correct. I agree to comply with all applicable city and counW ordinances and state laws relating to building construction. I authorize representatives of this city or county ent e�ab j�e-I ntified+w-peerty for inspection purposes. e'e, i4, Date inntum- of Pronertv Owner or Authorized ,2 Print Property Owner's or Authorized Agent's Name ACT70M DATE ( 6Y .1..O.F..TT_T_L_E_40_A. ,7.7.0.,N.. S_P..A,.R..T._6 FEDERAL REG UL AND AQMU RULE 1403. XPlR€D [3 I SUSMITTEOASSESTOS NOTIFICATION TO: ANCELLED [3 EPA [3 AQMDXMNDED [3 ASBESTOS NOTIRCAAONIS NOT APPLICABLETO : rmm ' ,� C S PHOPOSEDDEMOCt€ION LCn I"I1+...vrI _�I SIGNATURE: OCCUPANCYlSSUED C J Z W J Q W J CQ J oU) Z Z Z =W 00- U- W w (J) U Z 0 _ Lo 0Ur Nom¢. 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