HomeMy WebLinkAboutH2016-0774 - Permits0�$ r% City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II MECHANICAL Permit: H2O16-0774
e� 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 6 0 7 7 4 Project NO
t. Permit Counter Phone (949)644-3288
fep%�Ayn - ' ` Inspection Requests Phone (949)644-3255
Job Address: 1964 VISTA CAUDAL BIdg:1 Floor: Suite:
Description of Work: MFR/INSTALL AIC UNIT 46dB (RHEEM; RCQ3621-36) W/DUCT WORK
InspectorArea:8 Code Edit: 2013 �a
Legal Description: T
Owner: FABER MICAEgY TJ SA /1 t jac�r: OWNER/BLDR If applicabl'�.rker's Comp Insuranc -
Address: 1964 VISTA; AU is``a Carrier:
Phone: NEWPORT 4 396 08 EACH, CA 92660 G ❑ 80% or Pi e0% refund
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NCELM Yy
Issued Date:11/03/2016 t0 whom: u
Processed By: Lic Exp Date:PYPIRED
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HVAC Items
FurnacesBoilers & Con pressors Ventilation Other
Up to 100K BTU/hr: 0 _ $0.00 Up to 3HP: 1 $18.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 $0.00
Over 100K BTU/hr: 0 $ HP to 15 HP: 0 $0.00 Exhaust • tic F 0.$e(4
s e: $0.00 $0.00
Wall/Floor Heaters: 0 $ .00 �": Down -D q 0.0 f{ecor IMe� $0.00
aH
Heat Pumps & PackageUni ���888��a Plf° 00
Up to 100K BTU/hr: 0 $0.00 >!Q„}{P,Pk �tar}��\ $0.00 Residential Hood: (rM vft* gj:, Wr )I Fee : $37.50 Investigation: $0.00
Over 500K BTU/hr: 0 $0.00 Ai} an l ng m J Comm. Hood: 0 $0.00 Plan Check: $15.66
Up to 1M BTU/hr: 0 $0.00 up to 1OK CFM: 0 $0:00 Repair/Alter/Add: 0 $0.00 Model: Issuance: $33.00
Up to 1.75M BTU/hr: 0 , pa_ Over 1 OK CFM 0 $0.00 Supplemental Fee, SD.Oo ream fart rr r
Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 %�/ �
Insp. initials: !
TOTAL : Plan Check Fee : _$0,00 Fee Due dVermit Iss ante : $104.16
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
ae• •o• • • mem m
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•O O® •O. 600 O( DEf
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OWNER -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(a)
(Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair apy,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 ore than five hundred dollars ($500).
owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business a 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, 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).
❑ I am exempt from licensure under the Contractors' State License Law for the following reason:
By my signature below ack t`61BE9faYfret�exGepA9¢rssa - - ust have resided for at least one year prior to completion of the Improvements covered by this permit, I cannot legal
sell a structure that I have b It as an owner builder if it has n e nstruct s erifirety by GceHl3e3`cT)fi'ffS r§` I Rderstand,tha4a;,GRF,YzfJJ thg_applicable law, Section 7044 o the Bu iness and
Professions Code, Is availab up ,g ps�tyvhen i p c s subs or at the followin ' e:http://wsnv.leginfo.ca.gov/ca[aw.html. /% ,�
Signature of Property Owne r AM fff� ��``Ag 2
I hereby affirm under
and effect.
License Class
rARNING: FAILURE TO SECURE RKERS-M
'OST OF COMPENSATION, DAMA
SASPROVI[
hereby affirm under penal t
of pe
I have and will maintai
a ce fi
erformance of the work for
hich p
71 have and will maintain
orkers
Isurance carrier and policy
umber are:
is of Agent
certify that, in the p
cif I should become
of
i licens fLnder p vis'%ns of Chapter 9 commencing with Section 7000) of Division 3 of the Business and
„e. ( ' ^ ❑ 80% or L1.1.ilra���.r•. Ff::
Lice a Na e
TIO ,» - " ,'
'ION COVERAGE IS UNLA L, ND LLS T A
URY
kM
IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S
as Milifed by
Policy Number
not
3700
PI"*PANO CIVIL FINES UP TO ONE HUNDRED
Director of Industrial Relations as provided
for the performance of the work for which
Date
�l
pions Code, and my license is in full force
DOLLARS ($100,000(, IN ADDITION TO THE
Section 3700 of the Labor Code, for
is issued. My workers'
compensation laws of California, and
DECLARATION REC{ARVI CONSTRUCTION LENDING AGENCY ' j
I hereby affirm under enal oAnrdi ,p)tthat there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Name itlll G' Lender's Address
By my signature below, I c ify to each of the following:
I am the property own e or .z d to act on the property owner's. behalf. ,
I have read this applic nd the information I have prow I corr Insp. initials;
I agree to comply with all applicable city an coun y o rst9wssrshatia4d
I authorize representatives of this city or county o 0 -i ified roperty for inspection purposes.
Sianature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Da
ACTION DATE
BY •
••SIECLAIJATIO(d OF C. EMTHCODEOF
FOR OFFICE USE ONLY _
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PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL �/J. �9
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CERTIFICATE OF
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OCCUPANCYISSUED
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