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Home My WebLink Abouth2022-0116 - Permitsw ,�� City of Newport Beach - Building Division H2O22-0116 MECHANICAL Permit: H2O22-0116 d,A 100 Civic Center Drive, Newport Beach, CA 92660 Project No: 0664-2022 + Permit Counter Phone (949)644-3288 9v, rr .�iWP9A"� Inspection Requests Phone (949)644-3255 Job Address: 514 JASMINE AVE BIdg:1 Floor: Suite: ° °°®. . Description of Work: MECH -REPLACE (2) HEATERS *STOP WORK 122-0346* ° Z. °°�� InspectorArea:6 Code Edit: 2019 °=•° Legal Description: CORONA DEL MAR BILK 537 LOT 16 Owner: AMELI BARBARA Contractor: OWNER/BLDR Worker's Comp Insurance - °. Address: 34MANDALAY Address: AMELIBARBARA Carrier: °oP °•• LAGUNA NIGUEL, CA 92677 O/B FORM ATTACHED Policy No: M Phone: 949-212-4964 Phone: 949-212-4964 Expire: Issued Con State Lic: O/B a ° Date:03/03/2022 Lic Expire: Bus Lic: o �•• Processed By: k7 Lic Exp Date: HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 2 $44.00 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: $44.00 Over 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $0.00 Up to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: Issuance: $38.00 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: $126.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $126.00 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. 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 L) 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 l6 MNntended 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 i,9rovpd for thept"ose of sale). L1,•q4 owns: otthE 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 M-property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). f lafn exempt from licensure under the Contractors' State License Law for the following reason: By mY signature,L@lmv I acknowledge that, except for my personal re id a in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally sell a structure thatl.have built as an owner -builder if it has not n co cte n its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Profe%sions Cpde, i%available upon request when this s�applic n is itte r at the following Web site:http://www.leginfo.ca.gov/calaw.html. V- -J _ 9igAature of Ptope� YOwner or Authorized Agent �> �/ Date .!� hPD94SED CONTRACTOR'S DECLARATION - Pheraby 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 Professions Code, and my license is in full force an'd effect. l ipe,V.e Class • • • • • License No Date Contractor Signature WaF..XERS',COVMNSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: 111 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 thl performance 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 compensatior uance carrier and policy number are: - Tier Policy Number Expiration Date Tie of Agent Phone # certify that, in the performance of the wor for whi this permit i issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agref t, if I should become subject to the wor rs' co a ation pro Ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant K %� -� Date X C5 _C5 CLARATION REGARDING CONSTRUCTION LENDING AGENCY �reby affirm under penalty 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). )der'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. 1 have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances state ws relating to building construction. I authorize representatives of this city or county to enter e" ed property for inspection purposes. v J X mature of Prooertv Owner or Authorized Agent i Print Property Owner's or Authorized Agent's Name Kri��L✓ �%12� // Date ij'� ACTION DATE By DECLARATION OF COMPLIANCE MTH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE 40AND AQMD RULE 1403: PERMITEXPIRED ❑ ISUBMITTEDASBESTOSNOTTFICATIONTO:. ❑ EPA ❑ AOMD PERMIT CANCELLED PERMfTEXTENDED ❑ ASBESTOS NOTIFTCARONIS NOT APPLICABLE TO PROPOSEDDEMOIJTION. PERMIT FINAL Z'4_ pti/`_ CERPTICATEOF SIGNATURE: OCCUPANCYISSUED