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Home My WebLink AboutH2022-0198 - Permits0# City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIII�II IIIDIIIIIIIIIIIII MECHANICAL Permit: H2O22-0198 D 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 2 0 1 9 e Project No Permit Counter Phone (949)644-3288 Y"�ttrta4'n Inspection Requests Phone (949)644-3255 Job Address: 405 JASMINE AVE BIdg:1 Floor: 1/2 Suite: Description of Work: MECH -INSTALL NEW A/C CONDENSER. TAMPER -RESISTANT CAP REQUIREDInspe�� Legal for crea:' 7 Code Edit: 5 OF > ® (Dk U0 A 4��@ Legal Description: DEL MAR BLK. 336 LOT 5 OF PROJECT 938-0 tc� Owner: MELLO DAVID Contractor: KLONDIKE AIR INC Worker's Comp Insurance - Address: 405.5 JASMINE CDM CA 92625 AV Address: 1308 COSTA MANSTE Er/�� PolicyCarrierNo: FLAG 095 4IRE &CASUAL Phone: Phone: 714.97 O1 e a`� Expire :0110112023 Con State Lic: 754456 Issued Date:04120/2022 Lic Expire: 09/30/2022 Bus Lic: BT30060482 Processed By: Lic Exp Date: 09/30/2022 71 vAt, nems FEES - urnacesBoilers & Compressors Ventilation - Other p to 100K BTU/hr: 0 $0.00 Up to 3HP: 1 $22.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 $0.00 aver 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 Jall/Floor Heaters: 0 $0.00 >15 HP to 30 HP: 0 $0.00 Attic 'Fan: 0 $0.00 Metal Fireplace: 0 $0.00 eat Pumps & Package Units >30 HP to 50 HP 0 $0.00 Down -Draft Fan: 0 $0.00 Record Mgt Fee: $0.00 p to 100K BTU/hr: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee : $0.00 Investigation: $0.00 aver 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $19.14 p to 1 M BTU/hr: 0 $0.00 up to 10K CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: AULD36WC/Alssuance: $38.00 p to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: AC PRO aver 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 - Zoning PC: $52.00 TOTAL: $131.14 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $131.14 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Ob"Ityuctior. Hours: Monday - Friday 7:00 a.m.to 6:30 p.m.and Saturday from 8:00 a.m. to 6:00 p.m. � � e a c® +ee s � •�� eee e s e°o INER-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 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 J I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portic 'usiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, thi nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year o nproved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Con 7 I am exempt from licensure under the Contractors' State License Law for the following reason: ly my signature below I acknowledge that, except for my personal residence in which I must have resided for at leas ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractor 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://w signature of Property Owner or Authorized Agent .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 nd effect. -LZ icense Class License No Date Contractor Signature „ / AAI' PORKORK ERS' COMPENSATION DECLARATION (y`. IARNING: 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$100,0001, IN ADDITION TO THE OST 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: 1 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 th erformance 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' compensatiol )S, ranee carrier and policy number are: ier Policy Number ' Expiration Date of Agent certify that, in the performance of the work for w ch this permit is issued, I shall not employ any person in any , if I should become subject to the workers' com*ns^tion provisions of Section 3700 of the Labor Code, I shall lignature of Applicant I V IECLARATION REGAR PhG CONSTRUCTION LENDING AGENCY hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work t Ender's Name Lender's Address ly 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 a coo re I agree to comply with all applicable city and county ordinances and fate laws relating to building construction. I authorize representatives of this city or county to enter the above-i Ifie property for inspection purposes. >ignature of Property Owner or Authorized Agent (� Print Property Owner of the work, and the structure is not intended or offered for sale (Section 7044, gh employees' or personal effort, builds or improves the property, provided that the )mpletion, the Owner -Builder will have the burden of proving that it was not built or Business and Professions Code: The Contractors' State License Law does not pursuant to the Contractors' State License Law). one year prior to completion of the Improvements covered by this permit, I cannot . I understand that a copy of the applicable law, Section 7044 of the Business and Date of Division 3 of the Business and Professions Code, and my license is in full force so as to become subject to the workers' compensation laws of California, and i comply with those provisions. Date which this permit is issued (Section 3097, Civil Code). n�ro ACTION DAATE BY DECLARATION OF COMPLIANCE MTH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40 AND AQMD RULE 1403 , •.• • •, PE,RMITEKPIRED ❑ I SUBMI TTED AS BES TOS NORftCAX%N TO! ❑ EPA ; . : • • , ❑ AQMO ••, , • • • , PERMIT CANCELLED PERMITEXTENDED ❑ ASBESTOS NORACA RON IS NOT APPLICABLE TO PROPOSED DEMOLITION. •.• ••• • e u s PERMIT FINAL CERTIFICATE OF ,�• SIGNATURE. OCCUPANCYiSSUED