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HomeMy WebLinkAboutH2020-0539 - Permits. City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIiIII MECHANICAL Permit: H2O20-0539 c� 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 0 0 5 3 9 Project No : 2704-2019 t~ i Permit Counter Phone (949)644-3288 94r "zrr. ��Sr Inspection Requests Phone (949)644-3255 Job Address: 1975 PORT BRISTOL CIR BIdg:1 Floor: Suite: Description of Work: MECH - (2) A/C CON DENSORS. TAMPER-RESISTANT CAPS REQUIRED Inspector Area:4 Code Edit: 2019 Legal Description: N TR 6623 LOT 79 Owner: GRISSINGER JEREMY Contractor: Address: 1863 PORT RENWICK PL Address: 670 NEWPORT BEACH, CA 92660 745018 Phone: 949-922-6755 Phone: 03/31/2021 Ventilation Con State Lic: Issued Date:"I ! Lic Expire: �j Bus Lic: Processed By:Lic Exp Date: RANCHO VIEJO A/C & HEATING Worker's Comp Insurance - 22596 COTTONWOOD CIR Carrier: NORGUARD INSURANCE LAKE FOREST CA 92630 Policy No: LAWC000721 670 'e .Expire 01/2021 745018 O 111130/20211^ BT30031040 � 03/31/2021 Ventilation HVAC Items FEES O � Furnaces Boilers & Compressors Ventilation Other Up to 100K BTU/hr: 0 $0.00 Up to 3HP: 0 $0.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 O $0.00 Over 100K BTU/hr: 0 $0.00 > 3 HP to 15 HP: 2 $76.00 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 1o0K 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: $66.12 Up to 1M BTU/hr: 0 $0.00 up to 10K CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: 126CNA060Issuance: $37.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: BRYANT Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $46.25 TOTAL: $225.37 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $225.37 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction Hours: Mondey - Friday 7:00 a.m.to 6:30 p.m.and Saturday from 8:00 a.m. to 6:00 p.m. ° • `VL U LG � O � O O • �� ` p0 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate 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 U all of or (_) 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, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale 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' Slate 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 legal) 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. Signature of Property Owner or Authorized Agent Dat LICENSED CONTRACTOR'S DECLARATION I 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 Professions e, and my license is in full force and effect. License Class License No Da Ct J� Contractor Signalur 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 H NDRED THOUSAND DOLLARS 1$100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 7706 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 t WRInnance of the work for which this permit is issued. Policy No. h 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' compensatio insura a carrier and policy number are: arr' Policy Number Expiration Date Name of Agent Phone # I certify that, in the performance of the rk r 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 that, if I should become subject to thew mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prow ions. Signature of Applicant' aaJ�'/¢ 9 'T L—z DECLARATION REG NG CON RUCTION LENDING AGENCY (/� �� I hereby affirm under pena y of perjury that there is a construction lending agency for the performance of the work for which this permit is issued ection 3097, Civil Code). Lender's Name Lender's Address By my signature below, I certify to each of the following: 1 am the property owner or authorized to act on the property owners be(ed I have read this application and the information I have provided is c I agree to comply with all applicable city and county ordinances an s relating to building construction. I authorize representatives of this city or county: o niter the a _ roperty for inspection purposes. Signature of Property Owner or Authorized Agent 1I Print Property Owners or Authorized Agent's Name �fAi1VV1 Date ACTION DATE BY DECLARATION OF CO. A CEtMT CODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TlTLE40ANO PERMtTEXPLREQ - AQMD.RULE1403. °° •• ❑ f SUBMITTED ASBESTOS NOTIFICATION t0: PERMIF. T CANCELLED EFA : ; ••: , • ••• ;•• PERMITEXTENDED ❑ AfTNfD • •• ° • • • ° � • e • ❑ ASBESTOS N017RCA770NT5 NOT APPLICABLE TO • ..; • ; • .° PERMIT RNAL PROPOSED DEMOLITION. • • •, CERTtFtCATE 6F OCCUPANCVLSSUED SIGNATURE: ; • �� � • • e ••. s•