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Home My WebLink AboutH2019-0696 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Other MECHANICAL Permit: H2O19-0696' c� 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 9 0 6 9 8 Project - Permit Counter Phone (949)644-3288 $0.00 No: 0 $0.00 Up to 100K BTU/hr: _ $20.00 Up to 3HP: 0 $0.00 Inspection Requests Phone (949)644-3255 Job Address: 545 HAZEL DR_ BIdg:1 Floor: Suite: 0 $0.00 > 3 HP to 15 HP: Description of Work: MECH/CHANGE OUT (E) A/C UNIT 22.5dB (CARRIER; 24APB648A0030010) $0.00 - Exhaust Fan: InspectorArea:5 Code Edit: 2016 Wall/Floor Heaters: 0 $0.00 Legal Description: N TR 673 BILK B LOT 15 0 $0.00 Attic Fan: LANE PATRICIA M Contractor: GREENSTAR HOME SERVICES Workers Comp Insurance - MOwner: Address: 545 HAZEL DR Address: 1951 N MAIN ST Carrier: LIBERTY INS " CORONA DEL MAR, CA 92625 ORANGE CA 92865 Policy No: WA763D508631019 >50 HP`. Phone: Phone: 949-885-0102 Expire :10/01/2020 0 $0.00 Con State Lic: 795556 $0.00 0 Issued Date:11/05/2019 Lic Expire: 02/29/2020 Comm. Hood: 0 $0.00 Bus Lic; BT30056111 $0.00 .�6J Processed By:_ Lic Exp Date: 06/31/2020 Repair/Alter/Add: 0 $0.00 HVAC Items Other Fire Dampers: 0 $0.00 FEES $0.00 FurnacesBoilers & Compressors Ventilation $0.00 Metal Fireplace: 0 $0.00 Up to 100K BTU/hr: 1 $20.00 Up to 3HP: 0 $0.00 Bathroom Fan: 0 $0.00 Over 100K BTU/hr. 0 $0.00 > 3 HP to 15 HP: 0 $0.00 - Exhaust Fan: 0 $0.00 Wall/Floor Heaters: 0 $0.00 >15 HP to 30 HP: 0 $0.00 Attic Fan: 0 $0.00 Heat Pumps & Package Units >30 HP to 50 HP 0 $0.00 Down -Draft Fan: 0 $0.00 Up to 100K BTU/hr: 0 $0.00 >50 HP`. 0 $0.00 Residential Hood: 0 $0.00 'Over 500K BTU/hr. 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Up to 1M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Up to 1.75MBTU/hr: -0 $0.00 Over 1OK CFM: 0 $0.00 Supplemental Fee: $0.00. Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 TOTAL: $113.90 Plan Check Fee : $0.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7.00 a.m.te o6:3fl�sm.an d Saturday from 8:00 a.m. to 6:00 p.m. °o° eon o Other Fire Dampers: 0 $0.00 $0.00 Gas Line: 0 $0.00 $0.00 Metal Fireplace: 0 $0.00 Record Mgt Fee: $0.00 Additional Fee : $0.00 Investigation: $0.00 Plan Check: $17.40 Model: Issuance: $35.00 Manufacturer. Zoning PC: $41.50 Fee Due at Permit Issuance : $113.90 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Monday - Friday 7.00 a.m.te o6:3fl�sm.an d Saturday from 8:00 a.m. to 6:00 p.m. °o° eon o OWNER -BUILDER DECLARATION 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 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). i❑ 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. Date Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 00)f Division 3 of the Business and P�pfesciwre -d my license is in full force and effect. License Class License No Is"h i 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 ($700,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3703 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: , I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th pe ormance of the work for which this permit is issued. Policy No. I have and w9hmaintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatiol policy Date me of Agent VWt V� _ I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree I, if I should become 1SUN ct to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. (nature of Applicant ICLARATION REGA G CONSTRUCTION LENDING AGENCY =.reby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). 'Ider's Name Lender's Address my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and co rdina es and state laws relating to building construction. I authorize representatives of this city, un t antert - V = y for inspection purposes. mature of Prooertv Owner or Authorized Agent Print Property Owner's or Authorized Agent's Named F ` ACTION DATE BY I UtLLAKA riU1Y urt.urvrrusErra.�. FFnFRAI r7Ff ul ATfON5PART6? OFTITLE40AND PERMITEXPIRED ... • ;• ;[j rSUBMIjTEQA$BEST05 M071FICATION TQ: : :�❑ Ew �•• • A(. 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