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Home My WebLink AboutH2021-0260 - PermitsCity of Newport Belch - Building Division III 1111111111111111111111111111 IN 1111111111111 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 1 0 2 6 0 Permit Counter Phone (949)644-3288 Job Address: 1400 SAN MIGUEL DR Description of Work: MECHANST&ILLL1 Inspector Area:7 Legal Description: N TR 106 Owner: GALLARDO ADRU Address: 604 GORDON HIGI GLENDORA CA 91 Phone: 1 Floor: Suite MECHANICAL Permit: H2O21-0260 Project No: 0589-2017 Inspection Requests Phone (949)644-3255 UNIT 50d1B (CARRIER; WAS-24) ; i)uJEC'C TC FIFI.D INSPF,CT01?' s t-% INSPECTUH 2019 ' Z9Ji0 9 m.o Contractor: R D M S INC '- �f apItRj.,mp Insurance - 2 E KE T # 00 Carrier ER INS CO n 7 9 5 ❑ 8 ExpJire 057tl� f19kind •OmJEm Co at 1c: 8 Issued Date:04/15/2021 Lic Expire: 12131/2022 XtBE i TH i 0008726 Processed B . � A / zR%, BRED FOR FMCONNECTS ,nacesBoilers & Corn to 100K BTU/hr: 0 :r 100K BTU/hr: 0 ill/Floor Heaters: 0 A Pumps & Package to 100K BTU/hr: 0 :r 500K BTU/hr: 0 to 1M BTU/hr: 0 to 1.75M BTU/hr: 0 �r 1.75M BTU/hr: 0 FEES til U toqq��pp.��aa throom Fan QO Fire Dampers: 0 H97i P a' $ I aust Fan: $ Affic Fan:.Q ��;pY;1a5: 'n�T° 0 so >15 HP�pItQAjP:StCte`00 Down -Draft Fan: 0 q00 RecMee >30 HP al I o''5�fjf �Hpp 1 9, {. >50 HP: 0 $0.00 Residential Hood: 0 �Ilb? fAiiataot j DteAir Handling Units Comm. Hood: 0 $0.00 up to 10— K CFf�fV ---T1— -$0 e0�air/Altgr/Add: 0 $0.00 Model: N4A5241 CFM: 0 $0.00 TOTAL: $122.52 Plan Check Fee : $0.00 Insp. initial": CARRIER 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. 0 0 o m-m V L ..._6 i'�6MV tN �'•+.+1 APPLICATK. momoc .m m m.,,m moomor •roo Other $0.00 $0.00 Investigation: $0.00 Plan Check: $18.27 $37.00 Zoning PC: $46.25 $122.52 L,t-1A 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) 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 is 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 SegLon 7000) of Division 3 of the Business and 'rofessions 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 subfects the applicant to a civil penalty of of more than five hundred dollars ($500). 7 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, Iusiness 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 nprovements 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 n 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 ply 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 frermdicensure under the Contractors' State License Law for the following reason: ly my signature Wowl 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 legall, PJ6agtfucture (17Pj j, 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 Irofesslons Code, is available upon request when this application is submitted or at the following Web site:http://Ww .leginfo.ca.gov/calaw.html. gnature of Property dwner or Authorized Agent Date .IG661SED CONTRACTOR'S DECLARATION Iierelay affirm lj4t:04 9;.nalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Pr f sions Code d my license is in full force nt?glOct. icense Class +•• • License No y ��S" ` Contra to gnature l*tOQFRS' COMPENSATION DECLARATION FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO :OMPENSBTIO% pAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. affirm 6441 penalty of perjury one of the following declarations: DOLLARS ($100,000), IN ADDITION TO THE ands 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 of the work for which this permit is issued. Policy No. awill 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' compensal carrier and policy number are: Policy Number Date is of Agent I rnone 8 certify that, in the performan a of is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree if I should be `ome sub' t __ - orkers' mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those -provisions. C Iature of icant ale ARATIrI FOARrII -CAN TRIIr_TIr1N I PNr11Nr. A(-FNCV T hereby affirm under penalty of p6 6ry that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Ender's Name Lender's Address y 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 rovided is cor ct. I agree to comply with all applicable city and ccunty or finances and ate laws relating to building construction. I authorize representatives of this city or county to eI to the Dove-i anti giae y for inspection purposes. / I 6 / I ionature of Property Owner or Authorize d�prgent G Print Property Owner's or Authorized Agent's N e tSSV f 11 ACTION DA-d BY DECLARATION OF COMPLIANCE MTN CODE O FOR OFREE USE ONLY FEDERAL REGULATIONSPART 61 OF TITLE40AND AQMD RULE 1403.0 ISUBMITTEDASBESTOSNOTLFICATIONTO: ❑ EPA ❑ AQMD ASBESTOS NOTIRCATIONIS NOT APPLICABLE TO PROPOSEDDEMOLTTION. PERMITEXPIRED 4/-1'e2aLZ PERMIT CANCELLED PERMfTEXTENDED PERMITFINAL CERTIFICATEOF SIGNATURE: OCCUPANCYISSU€D { CL CL }\ . 72 ) !� to ca ` E-0 0 »■ _ $o m | m Eq § k E ) `#_§ R aB .. ; �� )0 \ o�u § k 2 ) } 7 z# o f£ / 22■0 § </mJ d1$ o z ƒ k co