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HomeMy WebLinkAboutH2017-0609 - Permits'tea City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIII MECHANICAL Permit: H2O17-0609 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 7 0 6 0 9 Project No r: Permit Counter Phone (949)644-3288 �' H2u�'1 ­06V9�ae�n�,P� -1; Mo U vi v V e ` l- (IC Inspection Requests Phone (949)644-3255 Job Address: 73 MONTEREY PINE BIdg:1 Floor: Suite: Description of Work: MECH/FAU C/O Inspector Area:6 Code Edit: 2016"& c � a Legal Description: 14103 LOT 13 OF PROJECT 935-90 LOCATED ON AP 473-021-65 Owner: RIELLY THOMAS J Contractor: SERVICE CHAMPIONS HTG Worker's Camp Insurance - ;...:. Address: 73 MONTEREY PINE Address: 3150 E BIRCH Carrier: PACIFIC COMP ° CA 92657 BREA CA 92821 Policy N0: WA000607 e o .E,WPCOAST, Phone: 49-922-2 2 Phone: 714-777-7777 Expire :03/22/2018 °°°° Con State Lic: 799170 Issue Date:10/25/201 Lic Expire: 09/30/2019 Bus Lic: BT01080105 Pro essed By: Lic Exp Date: 07/31/2018 m s mmmmn° HVAC Items FEES mm.e°m FurnacesBoil & Compressors Ventilation Other Up to 100K B /hr: 1 $18.00 Up to 3HP: 0 $0.00 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: $0.00 Up to 1M BTU/hr: 0 $0.00 up to 1 O CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: Issuance: $33.00 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 PC: $0.00 TOTAL: $51.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $51.00 PERMITS EXPIRE 980 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. 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) Iction 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 Ifessions 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 ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, >iness and Professions Cade: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the movements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or roved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not ily to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I am exempt from licensure under the Contractors' State License Law for the following reason: my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot Iega11, I a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Ifessions Code, 1%gtailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. nature of Property Owner or Authorized Agent Date ZN$ED COAZRACTOR'S DECLARATION ;reby'affirm 11njJpcpenalty of perjury that tII,am licensed under �p'roovissiionnss of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force Ass y� P License No d < `I 70 Date 1® -V5 ^ f Contractor Signature`' ` )RKERS' CCNP+EVSATION DECLARATION l c$T iNINe: FAILURE TOyySE URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLO R TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE )T F�COMPEN� CS N, 4MAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. Irppl 8ffirm uhder*p*enalty of perjury one of the following declarations: 4have and will .maigtain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th fdrma$ce of tke wa"for which this permit is issued. Policy No. i1d sand wiy maj itpin 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' compensatia .ver ra a carr. ang1d policy number are: ,rL r E°c `t` 1 ti Policy Number W P -f 0Ur% � ©% � Uzi Expiration Date __3 Z,_ ne of Agent Phone # 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 th IS compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provi.Sig S. nature of ApplicantA�IDI G CN�� Datey:-2 ) �7 % CLARATION REG TIDING CONSTRUCTION LENDING AGENCY Ireby affirm under p natty 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). Idler'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. Ihave read this application and the information I have provided is correct. /�-ftYGy✓i 1 agree to comply with all applicable city and county ordinances and state laws relating to building construction. 1 authorize representatives of this city or county to�epter &-etrpve-identified property for inspection purposes. AC77ON PERMITEXPIRED PERMITFINAL CERTIFICATEOF OCCUPANCYISSUED DATE 1 BY ❑ I SUBMfTTEDASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD ❑ ASBESTOS NOTIFICATION/S NOT APPLICABLE TO A.IL Cb*% C U I PROPOSED DEMOLITION. SIGNATURE.