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HomeMy WebLinkAboutH2021-0727 - Permits0City of Newport Beach - Building Division 11111111111111111111111111111111111111111111111 MECHANICAL Permit: H2O21-0727 u' �' od 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 1 0 7 2 7 Project No : 0777-2020 `-�- Permit Counter Phone (949)644-3288 ��>~�� Inspection Requests Phone (949)644-3255 Job Address: 114 19TH ST BIdg:1 Floor: Suite: Description of Work: MECH -*UNIT B* INSTALL ROOFTOP HEAT PUMP. TAMPER -RESISTANT CAP REQUIRED Inspector Area:1 Code Edit:2019 Legal Description: NEWPORT BEACH SEC B BILK 18 LOT 15 Owner: HOBERG ROBERT Contractor: Address: PO BOX 2466 Address: CHINO CA 91708 Phone: Phone: Con State Lic: Issued Date:12/23/2021 Lic Expire: Bus Lic: Processed By: Lic Exp Date: BUENA VIDA ASSET MANAGEMENT 314 IRIS AVE CORONA DEL MAR, CA 92625 949-922-1669 968985 03/31/2023 BT30076165 08/31/2022 Worker's Comp Insurance - Carrier : NO EMPLOYEES Policy No: Expire : HVAC Items FEES FurnacesBoilers & Compressors Ventilation C�k}ier Up to 100K BTU/hr: 0 $0.00 Up to 3HP: 0 $0.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 m $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: 1 $22.00 >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: $19.14 Up to 1M BTU/hr: 0 $0.00 up to 1OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: A47A4060Llssuance: $38.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: AMERICAN STD Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $52.00 TOTAL: $131.14 No rnh ,... Plan Check Fee : $0.00 Fee Due at Permit Issuance : $131.14 - I U Uuw N0186 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Construction o n a - Friday 7:00 a.m.to 6:30 p.m.and Saturday frofta:09sam. to,6:00 nrm. ay{yt/Qpp� o ° ° ° o 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 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 U 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). ❑ 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 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' State 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 legall, 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.html. Signature of Property Owner or Authorized Agent - Date 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 Pr Sio Cod nd my license is in full force and effect. [ q License Class 13 License No t7 _ / Date 2.( Contractor Sign'll e WORKERS' COMPENSATION DECLARATION V NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLgR5187U0,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: ZI 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 th Derformance 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' rance carrier and policy number are: Policy Number _ Expiration Date of Agent ertify that, in the performance of the work for whit 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 if I should become subject to th rs' om ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pr visions. r nature of Applicant i ^ CLARATION REGARDIN ONS ON LENDING AGENCY Ireby affirm under penalty%pfpgrjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Ider'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 owners behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and sate laws relating to building construction. I authorize representatives of this city or county//o e r bo entified property for inspection purposes. —7-y nature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Nar� /��� Date ACTION DATE BY DECLARATION OF COMPLIANCE MTH CODE OF FOR OFFICE USE ONLY „ FEDERAL REGULAT/ONSPART 51 OF T17LE40 AND AQMDROLE1403. PERMITEXP[RED .•. • •• .. . ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD.. PERMIT CANCELLED . , , ,• PERMITEXTENDED • ❑ ASBESTOS NOURCATION IS NOT APPLICABLE TO PROPOSEDDEMOLITION PERMIT FINAL -' L .. CERTIFICATE OF e o o• o OCCUPANCYISSUED e e• e o 0 e o e 0 o c oo c c 0 SIGNATURE:.