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Home My WebLink AboutP2021-0510 - PermitsCity of Newport Beach - Building Division '.� 100 Civic Center Drive, Newport Beach, CA 92660 . Permit Counter Phone (949)644-3288 si IIIIIIIIIIIII0 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II Job Address: 1100 AVOCADO AVE Bldg: 1 Floor: Suite: Description of Work: COMM PLUM BOILERR REPLACEMENT "NEWPORT BEACH LIBRARY" Inspector Area: 7 Code Edit 2019 Legal Description: Owner: CITY OF NEWPORT BEACH Address: 100 CIVIC CENTER NEWPORT BEACH CA 92660 Phone: 949/644-3311 Contractor: THOMAS F M AIR CONDITIONING INC Address: 231 GEMINI AVE BREA CA Phone: Con State Lic:313574 Issued Date:05/09/2022 Lic Expire: 02/2812023 Bus Lic: BT30078664 Processed By: W Lic Exp Date: 05/31/2023 PLUMBING Permit: P2021-0510 Project No : 2515-2021 Inspection Requests Phone (949)644-3255 Worker's Compensation Insurance - Carrier : INS CO OF WEST Policy NowSD505268302 Expire : 01101 /2023 ° °JO ° J J ° J JU ®° OOJO° i J 00000 J J FEES Bathroom Fixtures Kitchen Fixtures Misc. Misc. Other UJ°J°° Toilet: 0 $0.00 Kitchen Sink: 0 $0.00 Water Piping: 10 $80.00 Roof Drain: 0 $0.00 $0.00 Bidet 0 $0.00 Garbage Disp: 0 $0.00 Water Softener: 0 $0.00 Grease Trap: 0 $0.00 $0.00 Urinal 0 $0.00 Bar Sink: 0 $0.00 Water Heater: 0 $0.00 Grease Interceptor:0 $0.00 Bath Tub: 0 $0.00 Vegetable Sink: 0 $0.00 Gas up to 4 outlets: 0 $0.00 P-Trap: 0 $0.00 Record Mgmt Fee: $0.00 Shower Stall: 0 $0.00 Ice Maker: 0 $0.00 Gas over outlets: 0 $0.00 Sewer Investigation: $0.00 Wash Basin: 0 $0.00 Dishwasher: 0 $0.00 Backflow up to 2": 0 $0.00 Sewer: 0 $0.00 Plan Check: $69.60 Hydro -Mass Tub:0 $0.00 Lndry[Trap: 0 $0.00 Backflow over 2": 0 $0.00 Sewer Alter/Repair:0 $0.00 Issuance: $38.00 Floor Sink: 0 $0.00 Regulator: 0 $0.00 Hose Bibb: 0 $0.00 Sewer Abandon: 0 $0.00 Supplemental Fee: $0.00 Floor Drain: 0 $0.00 Lawn Sprinkler: 0 $0.00 Drinking Fountain: 0 $0.00 Additional Fee : ($187.60) TOTAL: $0.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $0.00 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. OWNER -BUILDER 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 iot 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). 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 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). I 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 lega1l. sell a structylTu#fh%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 EOaB, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. ,5 gWa!Lre of Rroperty Owner or Authorized Agent Date .• LICENSED CONTRACTOR'S DECLARATION t Pettily affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing )h Section 7000) of Division 3 of the Business an -Profe n21 s Co e, and my license is in full force and effect. LlcenceClass.••••• License No Dat S��_Z'2' ContractorSignatum WRARS' COFFkINSATION DECLARATION i YARNWIR: FAILURE TO 8%CtIRE 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 _OST-OFCOMPENSA%TN, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ."byaffirm under penalty of perjury one of the following declarations: T have and 411 maintain a certificate of consent to self -insure for workers' fprrp3nce of the worK for which this permit is issued. Policy No. 4mve and v l•gl9injhin 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' trance carrier and policy number are: Policy Number compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for me of Agent Phone I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become sL IL if I should becomesub(ect to the worlea' compAnsationprovisions of Section 3700 of the Labor Code, I shall forthwith comply with those Date to the workers' compensation laws of California, and Signature of Applicant' /I D � 0%-Z2 DECLARATION REG - DING STRU 10 L DING AGENCY I hereby 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). Lender's Name Lender's Address By my signature below, I certify to each of the following: 1 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 ordi nces an state laws relating to building construction. n r I authorize representatives of this city or y to et e abov operty for inspection purposes. r. 1 Signature of Property Owner or Authorized Age u tPrint Property Owners or Authorized Agent's Na C _rvyt TVOewe D t ✓ �{{ "7-2Z ACTION HATE V BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART fit OF TITLE40 AND AQMD RULE 1401 PERMfT:EXPtRED ❑ I SUBMITTEDASBESTOS NOTIFICATION TO:. ❑ EPA ❑ AQMD ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMITCANCELLED PERM7TEXTENDED PERMfTFIJYAL b -( CERTIFICATEOF SIGNATURE. OCCUPANCYISSUED