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HomeMy WebLinkAboutH2021-0431 - PermitsCity of Newport Beach - Building Division H2O21-0431 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 u. Job Address: 2626 BASSWOOD ST BIdg:1 Floor: Suite: Description of Work: MECH (2) NEW A/C UNITS *TAMPER PROOF CAP REQ* Inspector Area:4 Code Edit: 2019 Legal Description: N TR 4893 LOT 7 Owner: PAT[ FAMILY TRUST Contractor: OWNER/BLDR Address: 68 PORTUGUESE BEND ROAD Address: AUTH AGENT: NEWPORT BEACH, CA 90274 GANGAPURAM Phone: Phone: 310-483-7789 Con State Lic: O/B Issued Date:07/22/2021 Lic Expire: Bus Lic: ,Processed By: � Lic Exp Date: MECHANICAL Permit. H2O21-0431 Project No: 0271-2019 Inspection Requests Phone (949)644-3255 9999 ♦ 'sG�9 G - 99C 9 cta,. a C G GC Worker's Comp Insurance - a' Carrier : I A4 • Policy No: • • O G9 O� Expire: 90 • a99 a a� 9N 9 8V G 8 ! 9 ♦ G9 9 HVAC Items FEES FurnacesBoilers 8. Compressors Ventilation Other Up to 100K BTU/hr: 0 $0.00 Up to 3HP: 2 $44.00 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 i�15 HP to 30 HP: 0 $0.00 Attic Fan: 0 $0.00 Metal Fireplace: 0 $0.00 Heat Pumps 8. 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: $38.28 Up to 1 M BTU/hr: 0 $0.00 up to 10K CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: Issuance: $38.00 Up to 1.75M BTU/hr: 0 $0.00 j Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: AC PRO Over 1.75M BTU/hr: 0 $0.00! VAV Box: 0 $0.00 Zoning PC: $52.00 TOTAL: $172.28 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $172.28 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. DECLARATION asa• eess esas 3aaa rsea• eaa 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) !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 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 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 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 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 )rovements 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"wner 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 artT t'>tttnpt from licensure under the Contractors' State License Law for the following reason: myasigrlesulre 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 y this permit, I cannot legal a s•tw cture that I have built as an owner-buil er iff has not been ducted in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 44 of the Business an ifessiors Code, is available upon request whe t applicatio to rat the folio is eb site:http://www.leginfo.ca.gov/calaw.html. 2 2 2 nature of Property Owner or Authorized Agent' Date mn 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 ss License No Date Contractor Signature COMPENSATION DECLARATION 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 4TION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirrp under penalty of perjury one of the following declarations: s••sss I have arfd will maintain a certificate of consent to self -insure for workers' compensation, erformance of the work for which this permit is issued. Policy No. issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for I 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' urance carrier and policy number are: me of Agent I certify that, in the performance of the It. if I should become su4iecKo the wo Policy Number Date this permit is issued, I shall not employ any person in any manner so as to become subject to ation provisions of Sec ion 3700 of the Labor Code, I shall forthwith comply with those provi�'e nature of Applicant uate CLARATION REGA / C CTIO 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 (; 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 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 county ordinances and state laws relating to building construction. I authorize representatives of this city or court' �b enter the a de ifie pnspection purposes. .,.,f1— „f o.,..,on., n—�o..,. A„fhnr;�orl Anon �[ Print Prooertv Owner's or Authorized ADent's Name ACTION DATE BY FEDERAL REGULATIONSPARTbf OFTITLE40AND AQMDRULE1403. PERMITEXPIRED ❑ I SUBMRFEDASBESTOS N077FICATIOM TO: ❑ EPA ❑ AQMD PERMITCANCELLED PERMITEXT€AIDED ❑ ASBESTOS NOT/ACAT}©NISNOT APPLICABLE TO PROPOSEDDEMOLITION. PERMIT FINAL ?i$' CER77FICATEOF SIGNATURE: OCCUPANCYISSUED workers' compensation laws of California, and �%Z9-�2"Z sp97, Civil Code). W,UllU,ov�i�