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HomeMy WebLinkAboutH2020-0153 - Permitswrw City of Newport Beach - Building Division IIIIIIIIIIIIIIIII'IIIIIIIIIIIIIIIIIIIIIIII o. 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 0 0 1 5 3 Permit Counter Phone (949)644-3288 c�.tratitis�'`' Job Address: 915 TILLER WAY BIdg:1 Floor: Suite: Description of Work: MECH (2) NEW A/C UNITS *TAMPER PROOF CAP REQ* & (2) FURNACE C/O InspectorArea:4 Code Edit: 2016 Legal Description: N TR 6228 LOT 89 Owner: BEARD LESLIE & JAY Contractor: HOBSON'S J REMODELING Address: 915 TILLER WAY Address: 6462 ACACIA LN CORONA DEL MAR, CA 92625 YORBA LINDA CA 92886 Phone: 714-529-9495 Phone: 714-225-6365 Expire :06/14/2020 Con State Lic: 930528 Issued Date:02/2712020 Lic Expire: 10/31/2020 Bus Lic: BT30045866 Processed By: Lic Exp Date: 01/31/2021 MECHANICAL Permit: H2O20-0153 Project No: 1080-2019 Inspection Requests Phone (949)644-3255 Ii�I��L��®'m:o .. o o • ° m ..mmmm m ,• • m Worker's Comp Insurance - - . • m ° 0 Carrier: EVEREST mm 0 •• o Policy No: 7600017748181 a `e o ` • ° o m mmm m m °• o = °omoo om • m mmoco $40.00 Up to 3HP: m ° , • o 0 $0.00 Fire Dampers: mmmm •mmmoc ° m m mmmm mc000 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 : $0.00 Investigation: $0.00 Over 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $69.60 Up to 1 M BTU/hr: 0 $0.00 up to 1 O CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: ASX160371AIssuance: $35.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: AMANA Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $41.50 TOTAL: $226.10 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $226.10 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. INER-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) ction 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 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 fessions 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 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 L) portions of the work, and the structure is not intended or offered for sale (Section 7044, :iness 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 Irovements 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 roved 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 fly to an o V 11Er df 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 exernot9Poln licensure under the Contractors' State License Law for the following reason: mlHsignat ure bglblf 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) a Structure chat 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 �fessions Codb, is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.html. nature of Property pwner or Authorized Agent Date ;E,NSED 09NTIZ4CTOR'S DECLARATION :may affirms nderAenalty of perjury that I am licensed under provisions of Chapter 9 (commencing wit Section 7000) of Division 3 of the Business/andP ions Code,and my license is in full force I, (fect.Z: Z Contractor Sianse,Class ° • License No Date gnatur)RMRS'COMPENSATION DECLARATION ININ(P. FAILURE •r0 FEIRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONTHOUSAND DOLLARS ($100,000), IN ADDITION TO THE IT OFtOMPENSXNON, 19AMAGES AS PROVIDED FOR IN SECTION 9706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I'd affirm underpe�nalty of perjury one of the following declarations: T have and WMrill intain 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 the !r7nance of the work for which this permit is issued. Policy No. 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' compensation sante carrier and policy number are: Tier Policy Number Expiration Date ne of Agent Phone # certify that, in the perfo ante of th rk for which this permit is issued, I shall not employ any person in any manner so as to become subject to t e workers' compensation laws of California, and agree t, if I should become su ject to th ork rs' co per gaation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisi s. / nature of Applicant Date 7 A7 7 0 CLARATION REGAR ING CO TRUCTION LENDING AGENCY Ireby affirm under peally of perjury that there is a construction lending agency for the performance of the work for which this permit is issue (Section 3097, Civil Code). Ider's Name t 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 cou Ernances and state laws relating to building construction. I authorize representatives of this city or county obovB-identified property for inspection purposes. Z nature of PropertyOwner or Authorized Agent Print Property Owners or Authorized Agent's Name �" Da ACTION DATE BY DECLARATION OF COMPLIANCE IWTN CODE OF FOR t7FFICE USEONL FEDERAL REGULATIONS PART 61 OF TITLE40 AND PER.MITEXPIRED AQMDRULE1403. ❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO. PERMiTCANCELLED ❑ EPA PERMITEXTENDED ❑ AQMD ❑ ASBESTOS NOTLFICARONIS NOTAPPLICABL.ETO PERA41TFINAL / ^I " PROPOSED DEMOLITION. CERTWfCATEOF' OCCUPANCYISSUED SIGNATURE: