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HomeMy WebLinkAboutH2021-0570 - Permitsr'�* City of Newport Beach - Building Division 1111111111111111111111111111111 IN 1111111111111 MECHANIC Permit : H2O21-0570 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 1 0 5 7 0 6 Project No: 06 - 020 � Permit Counter Phone (949)44-3288 r''iirxou�*� 01 Inspection Requests Ph9v$y(949)644-3255 Job Address: 320 ALVARADO PL Bldg:1 Floor: Suite: Description of Work: MECH -INSTALL A/C CONDENSER. TIMER & TAMPER -RESISTANT CAP REQUIRED Inspector Area:1 Code Edit : 2019 Legal Description: NEWPORT BAY TR SUB OF BILK C LOT 49 �®® Owner: STEWART GINA Contractor: CATHERWOOD GLEN A Worker's Comp Insurance - s9 Address: 320 ALVARADO PL NEWPORT BEACH CA 92661 Address: 15120 WASHINGTON ST Carrier: WC EXEMPT !® t� RIVERSIDE CA 92506 Policy No: (NO EMPLOYEES) Phone: Phone: 909-789-2600 Expire Con State Lic: 789094 Issued Date:10/01/2021 Lic Expire: 1213112022 Bus Lic: BT30073791 Processed By: Lic Exp Date: 12131/2021 Pr HVAC Items FEES Is Furnaces Boilers & Compressors Ventilation Other Up to 1OOK BTU/hr: 0 $0.00 Up to 3HP: 1 $22.00 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 1 OOK 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: $19.14 Up to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: N4A61ssuance: $38.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: CARRIER Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $52.00 IlTOTAL: $131.14 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $131.14 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Corkstruct on HcVrss Rondae ®FfiLlay 7.00 a.m. to 6:30 p.m.and Saturday from 8:00 a.m. to 6:00 p.m. ow s q Ub 6f.N tl 6 tltl 'd se atltl tltl• DWNER-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 not 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, 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). LJ 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 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 7i 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 Prof Sion C e a and effect. License No COMPENSATION DECLARATION Date �Contractor :his permit, I cannot of the Business and my liceyse is in full ARNING: 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 (S100,000), IN ADDITION TO THE DST 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: 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 )rmance 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' compensa rance carrier and policy number are: Policy Number of Agent Date certify that, in the performance of the work f rWhich this permit is issued, I shall not emp y any person in any manner so as to become subject to the workers' compensation laws of California, and agre( if I should become subjec to the w ers' o n provisio f Section 3700 90fie Labor Code, I shall forthwith comply with those provisions. nature of Applicant Date CLARATION REGAR CONSTRUCTI N NDING AGENCY areby affirm under penalty of perjury that ere is a on 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 o ner's behalf. I have read this application and the information I have provid is correct. I agree to comply with all applicable city and county or inane and state law relating to b ing construction. I authorize representatives of this city or county to to the 'fie ro y for ection purposes. nature of Property Owner or Authorized Agent _ Print Property Owners or Authorized Agent's Name ° ✓�[ ate®fT19 ACTION DATE - BY ANCE CODE OF FEDERALTRE FQ11R OFFICE U5EONLY ULATIONSPOF ART 6 �Tt71.E40AMJ ..• ... ... AQMDRULE1403. • : +WITH •.• ttces PERMITEXPIAED ❑ ISUBMITTED 'ASBESTOS NOTACAThk TES:• .: ❑ EPA ❑ AOMD •• PRASBESTOS OPOSED DEMOLITION.IFIC BON IS NOT APPLICABLE TO • e ••• • • i e ° . . ,• 'lM.t{ / I 1 i •� . • Q'tr� ��,fi lr PERMIT CANCELLED PERMtTEXTENDED PERMIT FINAL CERTIFICATEOF SIGNATURE: o e QCCUPANCYISSUED