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Home My WebLink AboutH2021-0568 - Permitsp City of Newport Beach - Building Division IIIIIII II�p p ��III IIpI 111111111111111111111111111 MECHANICAL Permit: H2O21-0568 0'1 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 1 0 5 6 6 Project No : 1873-2021 %v ', -`, � Permit Counter Phone (949)644-3288 6er{�7q$1� i Inspection Requests Phone (949)644-3255 Job Address: 2315 HEATHER LN BIdg:0 Floor: Suite: Description of Work: MECH - INSTIL A/C CONDENSER (BACKYARD). TAMPER -RESISTANT CAP REQUIRED InspectorArea:3 Code Edit: 0 Legal Description: N TR 3138 LOT 35 Owner: WELLS CORINNE & MICHAEL Contractor: GOLDBAUM'S AIR/HEATING Worker's Comp Insurance - Address: 2315 HEATHER LN Address: 1072 B WEST 9TH ST Carrier: FALLS LAKE FIRE NEWPORT BEACH, CA 92660 UPLAND, CA 91786 Policy No: FLA006238 Phone: Phone: 909-984-2406 Expire :06/30/2022 Con State Lic: 832367 Issued Date: Lic Expire: 02/28/2022 Bus Lic: BT30053286 Processed By: �TlLic Exp Date: 1113012021 HVAC Items FEES �q FurnacesBoilers & Compressors Ventilation IV Other Up 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 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 $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 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: $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: 124ANSIssuance: $38.00 Up to 1.75M BTU/hr: 0 $0.00 Over 1 OK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: BRYANT Over 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 struction°lours: Monday-x:Tday 7:00 a.m.to 6:30 p.m.and Saturday from 8:00 a.m. to 6:00 p.m. M d f°Ji B fi C U U ° • A •• •Ni DECLARATION I hereby affirm under penalty of perjury that I am exemptfrom 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, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portion: Iusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, throe nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of t nproved for the purpose of sale). 1 I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7 pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Comm; I am exempt from licensure under the Contractors' State License Law for the following reason: Iy my signature below I acknowledge that, except for my personal residence in which I must have resided for at least t ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. 'rofessions Code, is available upon request when this application is submitted or at the following Web site:httpPwww.l 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 70( nd effect. icense Class License No Date\\\ COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL 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: 7 I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Direi 6(formance of the work for which this permit is issued. Policy No. the work, and the structure is not intended or offered for sale (Section 7044, employees' or personal effort, builds or improves the property, provided that the pletion, 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). e year prior to compleuon Or me Improvements coverea Dy mIs permit, I cannot understand that a copy of the applicable law, Section 7044 of the Business and Date of Division 3 of the Business andProfessionsCode, and my license is in full force >,_ Contractor Signature c CITES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1$100,0001, IN ADDITION TO THE of Industrial Relations as provided for by Section 3700 of the Labor Code, for 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' carrier and policy number are: Policy Number of Agent Date certify that, in the performance of the work forwhich 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 agre, t, if I should become suulect to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant X�_ i Date - / \\�� CLARATION REGARDJN(a,CONSTRUCTION LENDING AGENCY 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 (Sec Ion 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 county ordinances and state laws relating to building construction. I authorize representatives of this city or count�7y�a�e�ter the above -identified property for inspection purposes. nature of Property Owner or Authorized Agent / V�.� Print Property Owner's or Authorized Agent's Narge Date AC77ON DATE BY DECLARATION OFCOMPUANCE KITH CODE OF FOR OFFICE USEONLY FEDERAL REGULATIONS PART 61 O)iWLE§OAND AQMD RULE 1463 • • • ❑ 1 SUBA41TTEDASBESTOS NOTIF1 94TiON ;0:, ❑ EPA • [I AQMD • �.. ..• •• PERMITEXPIRED PERMIT CANCELLED PERM1TEX7ENDE0 ❑ ASBESTOS NOTIFICATION rsjNOT APPLICABLE ro PROPOSEDDEMOUTION. ••• . a n'o voe �o PERMIT FINAL CERTIFICATE OF SIGNATURE. o OCCUPANCYISSUED o. o i