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Home My WebLink AboutH2022-0195 - Permitsa City of Newport Beach - Building Division1111111111111111111111111MECHANICAL Permit: H2O22-0195 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 2 0 1 9 5 Project No: 2840-2019 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 322 AMETHYST AVE BIdg:1 Floor: Suite: Description of Work: MECH (2) NEW HEAT PUMPS *TAMPER PROOF CAP REQ* a InspectorArea:2 Code Edit: 2019 �_ Legal Description: BALBOA ISLAND SEC 3 BLK 18 LOT 12 Owner: PENCE MELISA Contractor: OWNER/BLDR Worker's Comp Insurance- °°•a•• Address: 322 AMETHYST AVE Address: Carrier : .... NEWPORT BEACH, CA 92662 Polley No: °••• 4B�•®� Phone: 949-370-6037 Phone: Expire: 8890 ° Con State Lie: O/B _° ••• Issued Date:04/15/2022 Lie Expire: $°°.a° a° Bus Lie: •° `°• Processed By: Lie Exp Date: °• d-® ° ° °° 0°E®J• • Yi i BBilO ]° R G HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other :°• °. °.®°•` Up to 100K BTU/hr: 0 $0.00 Up to 3HP: 0 $0.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 ° • $0.00 Over 1 OOK 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 1OOK BTU/hr: 2 $44.00 >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: 18RLxFZlssuance: $38.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: FUJITSU 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. ✓NER-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) !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 ifessions 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 fly 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 f Ilowing reason: my signature below I acknowledge that, except for my personal reside in ich I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall a structure that I have built as an owner -builder if it has not b en on ru to in it entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of t e Business and Ifessions Code, sevailable upon request v the appli to Is I itt�d at Ilowing Web site:http://www.leginfo.ca.gov/calaw.htmi. nature of Propa;ty Owner or Authorized Agen Date 77 dEMSED CON.TRACTOR'S DECLARATI ereby%ffirm undi;CWalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, nd my license is in full force i Bfft°ct. env@ glass License No Date Contractor Signature ).RKE RS' CdiiPEjJSATION DECLARATION 11,11i 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 I$100,000), IN ADDITION TO THE iT QF%COMPEN*'re)N,%AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. ILeDylaffirm Ader*ftnalty of perjury one of the following declarations: ••l.kave and will -maintain a certificate of consent to self -insure for workers' compensation, issued by the performance of the w®rkfor which this permit is issued. Policy No. :I t2%and wil;maip;m workers' compensation insurance, as required by Section 3700 of the Labor Code, insurance carriesandrpolicy number are: Carrier Policy Number of Agent Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for for the performance of the work for which this permit is issued. My workers' Date I certify that, in the pert mance of he wor for which 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 agree It, if I should becom5,',j�Ao`','rject th wo a co�ns`a>-ti-o-n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provi ns. Inature of ATIONpIlicant REG D STRUCT ON L NDING AGENCY Date Z�22 ereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Secti n 3097, Civil Code). rider'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 ordina ces and st a law///s elating to building construction. I authorize representatives of this city or coVto enter th abgve-id nt fied/ ope for inspection purposes. n r �Llc A 'tJ a 1\\ A / D...a D., —. - n,.,..e. � — n„H,.. s—ri a.,o„v� nh..,o ;)n L.lil .r n ACTION DATE BY DECLARATION OF COMPLIANCE IMTH CODE OF - FOR OFFICE USE ONLY FEDERAL REGU€ATIONSPART 51 OF T17L.E40 AND AOMD RULE 1403. PERMIT EXPIRED ❑ ISUBMITTED ASBESTOS N077FICATIONTO:. ❑ EPA ❑ AQMD PERMIT CANCELLED PERMlTEXTENDED ❑ ASBESTOS N077FICAA770N IS NOT APPLICABLE TO PROPOSEDDEMOLITION. PERMiTFINAL CERTIFICATEOF SIGNATURE., OCCUPANCYISSUED