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HomeMy WebLinkAboutH2019-0284 - Permits. City of Newport Beach - Building Division 1111�IIIIIflillllllllllllllllllllllllllllllllllll 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 9 0 2 8 4 x Permit Counter Phone (949)644-3288 Job Address: 128 45TH ST BIdg:1 Floor: Suite: Description of Work: MECH ROOF MOUNTED A/C UNIT *TAMPER PROOF CAP REQ' & FURNACE C/O (STOP WORK) C2019-0088 InspectorArea:1 Code Edit: 2016 Legal Description: RIVER SECTION BILK 44 LOT 13 MECHANICAL Permit: H2O19-0284 Project No : Owner: BOWMAN BRADFORD S Contractor: GOETTL AIR CONDITIONING Worker's Comp Insurance - Addressi 128 45TH ST Address: 532 MALLOY CT Carrier: GEMINI INS CO NEWPORT BEACH, CA 92663 Up to 100K BTU/hr: CORONA CA 92880 Policy No: VGGP003726 Phone: 818-341-5210 Phone: 714-336-6159 Expire :12/01/2019 0 $0.00 Con State Lie: 1047781 Exhaust Fan`. Issued Date: Wall/Floor Heaters: Lie Expire: 12/31/2020 >15 HP to 30 HP: 0 $0.00 Attic Fan: Bus Lie: BT30062269 Units Processed By: 1 Lie Exp Date: 02/28/2020 0 $0.00 HVA(; nems 0.%.6e.mm Other Fire Dampers: rtes FurnacesBoilers & Compressors Ventilation 0 $0.00 $0.00 Up to 100K BTU/hr: 1 $19.00 Up to 3HP: 1 $19.00 Bathroom Fan: 0 $0.00 Over 100K BTU/hr: 0 $0.00 > 3 HP to 15 HP: 0 $0.00 Exhaust Fan`. 0 $0.00 Wall/Floor Heaters: 0 $0.00 >15 HP to 30 HP: 0 $0.00 Attic Fan: 0 $0.00 Heat Pumps & Package Units >30 HP to 50 HP 0 $0.00 Down -Draft Fan: 0 $0.00 Up to 100K BTU/hr: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Over 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Up to 1M BTU/hr: 0 $0.00 up to 10K CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Up to 1.75MBTU/hr: 0 $0.00 Over 1 O CFM: 0 $0.00 Supplemental Fee: $0.00 Over 1.75M BTU/hr. 0 $0.00 VAV Box: 0 $0.00 TOTAL: $184.06 Plan Check Fee : $0.00 emm• m eoe •o 0 e c e oo¢oem oom o . a eo m 0 m•em00 e n oee•oc e c s • o ee r. e o o • c om o 00000 0 mmme)O OOebOn 0 O t� Fee Due at Permit Issuance: $184.06 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. - Construction Hours: Monday - Friday 7:00 a.nl.to 6:30 p.m.and Saturday from 8:00 a.m. to 6:00 p.m. 0.%.6e.mm Other Fire Dampers: 0 $0.00 $0.00 Gas Line: 0 $0.00 $0.00 Metal Fireplace: 0 $0.00 Record Mgt Fee: $0.00 Additional Fee: $0.00 Investigation: $38.00 Plan Check: $33.06 Model GSX140371KIssuance: $35.00 Manufacturer: GOODMAN Zoning PC: $40.00 Fee Due at Permit Issuance: $184.06 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. - Construction Hours: Monday - Friday 7:00 a.nl.to 6:30 p.m.and Saturday from 8:00 a.m. to 6:00 p.m. 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 items) 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 applicar\t 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 cjvt'rpenalty 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 (_) 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 iroved 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 fly 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 legally a structure Ur9t'NRaye built as an owner -builder if it has not been constructed in its entirety by licensed contractors. 1 understand that a copy of the applicable law, Section 7044 of the Business and fessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.govlcalaw.htmi. saturp of Propeity Owner or Authorized Agent Date TENSED C©WrRACTOR'S DECLARATION ;feUv affirm undgr penalty of perjury that I am licensed under provisions of Chapter 9 (commencing witaction 7000) of Division 3 of the Business and Pro ssions Code, a P cense is in full rce I effect. 11 mse Class .: • • •: License No Date 5-1�1 ( Contractor Signature )RKERS' COMPENSATION DECLARATION MING: FAILURBTOSECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND 0 $100,0001, IN ADDITION TO THE SDE t:OMPENSRnON, DAMAGES AS PROVIDED FOR IN SECTION 370$ OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. jeiby aiFrm under penalty of perjury one of the following declarations: 1 have and owlMmal'ntain 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 IN pypance of the worn for which this permit is issued. Policy No. 4ra$a and will gZain 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' compensatior lance carrier and policy number are: rier Policy Number Expiration Date ne of Agent Phone # I certify that, in the pert rmance of the work for which this permit is 4'sued, shall not employ any person in any manner so as to become subject to he workers' compensation laws of California, and agre that, if I should become s bject to the workers' compensation vfsl s of S ction 3700 of the Labor Code, I shall forthwith comply with those provis' ns. Signature of Applicant Date DECLARATION REGA DING CONSTRUCTION LENDI G A CY I hereby affirm under, ally 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). Lender's Name Lender's Address By 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 c unty ordinances and state �relating t building construction. I authorize representatives of this city or coun to enter the above -id 'fied�prope or inspection purposes. .� // Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Na �lL 1n��CA-"eaA�r�" Datgr —1 — ll� ACTION DATE BY DECLARATIONOFCOMPLIANCEf4RTHCODEOF FOR OFFICE US€ONLY FEDERAL REGULAE_ TIONS PART 61 OFTITLE40AND AQMDRULE1403. PERMITEXPIRED I SUBMfTTEDASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMITCANCELLED PERMITEXTENDED ASBESTOS M017RCAJIGNIS NOT APPLfCABLE TO PROPOSEDDEMOLITION. PERMITFINAL CERTIFICATEOF OCCUPANCYISSUED SIGNATURE: