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HomeMy WebLinkAboutH2021-0192 - Permits0 City of Newport Beach - Builtlingbivision H2O21-0192 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 2501 HOLLY LN BIdgA Floor: Suite: Description of Work: MECH REPLACE FURNACE Inspector Area:3 Code Edit: 2019 Legal Description: N TR 1702 LOT 5 Owner: GLASGOW PATRICK W Contractor: Address: 2501 HOLLY LN Address: NEWPORT BEACH, CA 92663 Phone: Phone: Con State Lie: Issued Date:03/12/2021 Lie Expire: Bus Lie: Processed By: � Lie Exp Date: GREENSTAR HOME SERVICES 965 RIDGE LAKE BLVD #201 MEMPHIS TN 38120 949-885-0102 795556 02/28/2022 BT30056111 08/3112021 MECHANICAL Permit: H2O21-0192 Project No: Inspection Requests Phone (949)644-3255 INSHICUT019, Worker's Comp Insurance - Carrier : LIBERTY INS Policy No: WA763D508631010 Expire :1010112021 • "• a a Aa9.o° ° ° . ° . 9 s . ABB9i• 0 0 O ]O' O �0 tViJJO 0 ®0 A HVAC Items FEES I... FumacesBoilers & Compressors Ventilation Other ° n ° Up to 100K BTU/hr: 1 $21.00 Up to 3HP: 0 $0.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 ° ° $0.G4 . .. 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 `9 $04M . a 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 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: $0.00 Up to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: Issuance: $37.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: Over 1.75M BTU/hr. 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $0.00 TOTAL: $58.00 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $58.00 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. INER-BUILDER DECLARATION 1 hereby affirm under penalty of perjury that 1 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). 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) 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). 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 704 , Business and Professions Code: The Contractors' State License Law does not ly 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: I 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 legall, I 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 7044 of the Business and Aessions Code, is available upon request when this application is submitted or at the following Web site:http://Www.leginfb.ca.gov/calaw.htmi. Inature of Property Owner or Authorized Agent _ Date TENSED CONTRACTOR'S DECLARATION —ll :reby affirm undec panalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectioq 7000)'of Division 3 of the Busine 4nd Professio 6 Code, and my license is in full force • • License No COMPENSATION DECLARATION JARNIhV FAILURE TQ SECUPE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN :OS,T OFCOMPEN54T4C" "NIAGES As PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby ai6ml under penalty of perjury one of the following declarations: 3 vn% and 10 g%irl;ain a certificate of consent to self -insure for workers' compensation, issued by the Director ��// ��rryysnce of the work for which this permit is issued. Policy No. �ry,ve:and will jnaigt2in workers' compensation insurance, as required by Section 3700 of the Labor Code, for the 1 ncd` rmer-VII po)tcy number are: :'¢RAP •: Policy Number lar11ebtAgent •• Contractor Si atu ` !ES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO THE Industrial Relations as provided for by Section 3700 of the Labor Code, for of the work for which this permit is issued. My workers' Date certify that, in the performance gAhe work for which this permit is issued, I shall not employ any person in any manner so as to become subjectyto the workers' compensation laws of California, and agrer f, if I should b come subject t e workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with tho e prg asions.�� e nature of Applic CLARATION RE A NG C UCTION 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 (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 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 coup ordi nces and state laws relating to building construction. 9 PY PP Y county 9� 9 9 �� I authorize representatives of this city or,Eount�trren the above -identified oroperty for inspection purposes. �'•.-r � T � An /) ACTION DATE BY DECLARATION OF COMPLIANCE VATN CODE OF FOR OFFICE OAV FEDERAL REGULA TIONS PART 61 OFTIILE40AND AQMD RULE 1403. PERMITEXPIRED ❑ 15UBMfTTEDASBESTOS NOI FICATION TO: ❑ EPA j ❑ AQMD _ PERMITCANCELLED PERMITEXTENDED 0 ASBESTOS RON IS NOT APPLICABLE TO PROPOSEDDEMOLITION. PERMIT FINAL Q/ CERTIFICATE OF Ile SIGNATURE: OCCUPANCYISSUED