HomeMy WebLinkAboutH2020-0600 - PermitsIrl City of Newport Beach - Building Division IIII�IIIII,I'IIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIII
c5 ' 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0
Permit Counter Phone (949)644-3286
Job Address: 224 GOLDENROD AVE BIdg:1 Floor: Suite:
Description of Work: MECH *REPLACE EXPIRED H2O19-0434 & CHANGE OF CONTRACTOR* REPLACE (2) FURNACES
Inspector Area:5 Code Edit:
2019
Legal Description: RESUB OF CORONA DEL MAR BILK 134 LOT 6
Owner: MOSKOWITZ ANN
Contractor:
SADDLEBACK PLUMBING INC
Address: 224 GOLDENROD AVE
Address:
23901 REMME RIDGE
CORONA DEL MAR, CA 92626
HVAC Items
LAKE FOREST CA 92630
Phone:
Phone:
949-829-0910
FEES
Con State Lic:
414946
Issued Date:10/19/2020
Lic Expire:
01/31/2022
FurnacesBoilers & Compressors
Bus Lic:
BT01080105
Processed Bt ._ QAM • ooe
Lic Exp Date:
07/31/2021
MECHANICAL Permit: H2O20-0600
Project No :
Inspection Requests Phone (949)644-3255
Worker's Comp Insurance -
Carrier: EVEREST
Policy No: SNP1296829
Expire :07/01/2021
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.
HVAC Items
FEES
omoc+
mmomao
FurnacesBoilers & Compressors
Ventilation
Other •••O0°
m
Up to 100K BTU/hr:
2
$42.00
Up to 3HP:
0 $0.00
Bathroom Fan:
0 $0.00
Fire Dampers:
0 $0.00
$091°°°
V
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
°
$0.0p
Wall/Floor Heaters:
0
$0.00
>15 HP to 30 HP:
0 $0.00
Attic Fan:
0 $0.00
Metal Fireplace:
0 $0.00
°m;^^°
m
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 IOOK BTU/hr:
0
$0.00
>50 HP:
0 $0.00
Residential Hood:
0 $0.00
Additional Fee :
($21.00)
Investigati&hF
$O.fl(1m,�„
Over 500K BTU/hr:
0
$0.00
Air Handling Units
Comm. Hood:
0 $0.00
Plan Check*
$0.0Qm
Up to 1M BTU/hr:
0
$0.00
up to 1 O CFM:
0 $0.00
Repair/Alter/Add:
0 $0.00
Model:
Issuance:
$37b00• ••
"
Up to 1.75M BTU/hr:
0
$0.00
Over 10K CFM:
0 $0.00
Supplemental Fee:
$0.00
Manufacturer:
° °
Over 1.75M BTU/hr:
0
$0.00
VAV Box:
0 $0.00
Zoning V&. • ° °
• m, • °
$O.t)jl• •„`
mmmm
TOTAL:
$58.00
Plan Check Fee:
$0.00
Fee Due at Permit Issuance:
$58.00
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.
)WNER-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 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
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 (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
Jroved 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 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:
ly 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 legall,
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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ce.gov/calaw.htmi.
signature of Property Owner or Authorized Agent Dale
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Secti� 00) of Division 3 of the Business a2Professis Code, and m license is in full force
,nd effect. Ikp
.icense Class License No f 0/ ContraSignature
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 ($100,000), 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 following declarations:
7 I have and 411"ejjtain 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
ormapce of the work for which this permit is issued. Policy No.
e. 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' compensatiol
nie carrier 2ritilptolicy number are:
Policy Number
Date
is of Agent ' Phone #
certify that, in�lhe performance of t work fo Is permit is issued, I shall not employ any person in any manner so as to become subject o the workers' compensation laws of California, and agre
'if Mshould tsecomebubject to th compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prov Ions.
o.. /p
Ialu're of1� (cant D
XORAR NG CON RUCTION LENDING AGENCY
rebyaffinn LMg1,^pc a erjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
90s -Name Lender's Address
my zlgnature be dw', J certify to each of the following:
I am the properfty` owner or authorized to act on the property owner's behalf.
I have read this application and the information I h ed is correct.
I agree to comply with all applicable city and codmy o inaXces an tate laws relating to building construction. nt'dbd.144;��Z
I authorize representatives of this cityze0y4g# or count to en a ove-identified property for inspection purposes.` AIature of Property Owner or AuthoriPrint Property Owner's or Authorized,s Name((V// .f�(/ \ e 1.
ACTION
DATE BY
DECLARATION OF COMPLIANCE WITH CaDEOF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TIILE40AND
AQMDRULE 1403.
P€RMITEXPIRED
I SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
PERMITCANCELLED
❑ AQMD
PERMITEXTENDED
❑ ASBESTOS NOTIFICATIONIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMITFINAL
SO
CERTIFLCATEOF
SIGNATURE:
OCCUPANCYISSUED
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