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Home My WebLink AboutH2020-0244 - Permitsa L;Ity or Newport tteacn - Wuiiding Uivision III III IIIIIPIII 111111111111111111111111111111111 100 Civic Center Drive, New port Beach, CA 92660 H 2 2 0 0 2 4 4 Permit Counter Phone (949)844-3288 Job Address: 16 SANANTONIO Bldc Ploor: Suite: Description of Work: MECH - R/R FAU & 2 A/C CONDENSORS. TAMPER RESISTANT CAPS REQUIRED Inspector Area:4 Code Edit: Legal Description: N TR 15517 LOT 58 MECHANICAL Permit: H2O20-0244 Project No : Inspection Requests Phone (949)644-3255 Owner: SMITH CHAD Contractor: MIGHTY DUCTS Worker's Comp Ins urance- Address: 16 SAN ANTONIO Address: 2075 N SHAFFER ST Carrier: BENCHMARK INS CO NEWPORT BEACH, CA 92660 ORANGE CA 92865 Policy No: CST5017404 Phone: Phone: 714-505-7879 Expire :1 010112 0 2 0 Can State Lie: 748387 Issued Date: Lie Expire: 01/31/2022 Up to 100K BTU/hr: �f Bus Lie: BT30068399 2 Processed By: '� ` Lie Exp Date: 08/31/2020 Fire Dampers: HVAC,Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 2 $40.00 Up to 3HP: 2 $40.00 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 100K BTU/hr: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee: $34.80 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 O CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: XC201ssuance: $35.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: LENNOX Over 1.75M BTU/hr: 0 $0.00 VAV Box 0 $0.00 Zoning PC: $41.50 TOTAL: $191.30 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $191.30 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID I/VS -Et TWA Construction Hours: Monday - Friday 7:00 a.m.to 6:30 p.m.and Saturday froth 8:db a.m. to 6:00 p.m. ° °°° iWNER-BUILDER DECLARATION 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 Items) 'action 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 is 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 rofessions 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 of more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do U 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 nprovements 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 nproved for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Sectton 7044, Business and Professions Code: The Contractors' State License Law does not pply 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 exempt from licensure under the Contractors' State License Law for the following reason: ;y my signature below I acknowledge that, except for my personal residence in which 1 must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally ell 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 'rofessicns Code, is available upon request when this application is submitted or at the following Web site:http:/Avww.leginfo.ca.gov/calaw.html. �tgnature of Property Owner or Authorized Agent Date 3CENSED CONTRACTOR'S DECLARATION 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 ProfessionsCod and my license is in full force nd effect. 5/15/20 icense Class License No Date Contractor Signatu VORKERS' COMPENSATION DECLARATION IARNING: 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 OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the followingdeclarations: 7 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 We mrance 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' compensattol Isurance carver and policy number are: ,_47,111A 1n/1/gn of Agent 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 I, if I should become subject to the wor rs' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Appifc t - _ Date 5/15/20 CtARAT10N REG�ING CONSTRUCTION LENDING AGENCY areby 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 county ordinan s and state laws relating to building construction. I authorize representatives of this city or county to enter ttabove4dentified property for inspection purposes. I Policy Number CST50Expiration Date Phone # ACRON VATE BY L)LLLARAr1D1Y ur t,umrummuc VY] r n wr�c ur FEDERAL REGULATIONS PART61OFTI LE40AND PERMITDCPIRED AOMDRULE1403. ❑ I SUBMITTEDASBESTOS NO77FICATION TO: PERMITC4NCELLED • • . •� • ..• • ❑ EPA PERMIT EXTENDED •• ❑ AQMD PERMIT.RNAL •••n.-.• •_• PROPOSEDDEMOLIDOM ❑ ASBESTOS AF077FTCA170MIS NOT APP E3 OCCUPANCYISSUED I ... • _I I�SfGNATURE: