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Home My WebLink AboutH2021-0715 - Permits�x.,3,„�. City of Newport Beach :Building Division 111111111111p11111p11111111111I 111111111111 MECHANICAL Permit(��H2O21-0715 ' ` % 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 1 0 7 1 5 Project No : 1158-Z Permit Counter Phone (949)644-3288\ ' y n.. ue`a Inspe�ests Phone (949)644-3255 - 021% %n Job Address: 1116 OCEAN FRONT W BIdg:1 Floor: Suite: `D Description of Work: MECH - RELOCATE & REPLACE 3 AC CONDENSERS. (ROOFTOP DECK) TAMPER -RESISTANT CAPS RE®lj(� ` `vv InspectorArea:1 Code Edit: 2019 Legal Description: N TR 234 BLK 11 LOT 5 Owner: 1116 W OCEANFRONT LLC Contractor: MOELKE BRYAN & COMPANY Worker's Comp Insurance - Address: 10717 E PIERCE LN Address: 10 PAMPANA ST Carrier: EXEMPT I SPOKANE WA 99206 RANCHO MISSION VIEJO CA 92694 Policy No: \ SO Phone: Phone: 949-324-7440 Expire : Issued Date:12/1612021 Con State Lie Expire: Lie: 932557 01/31/2022 ?,�L®op Ca6 Bus Lie: BT3 e Processed By: -Lie Exp Date: 0113112022 1/2022 -Vol! �0� 0lfat�0��'_ HVAC Items FEES Furnaces Boilers & Compressors Ventilation Other Up to 100K BTU/hr: 0 $0.00 Up to 3HP: 3 $66.00 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 10oK BTU/hr: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee : $0.00 Investigation: $0.00 500K BTU/hr: 0 $0,00 Air Handling Units Comm. Hood: 0 $0,00 Plan Check: $57.42 Up to 1 M BTU/hr: 0 $0.00 up to 10K CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: 10ANAlssuance: $38.00 ,Over Up to 1.75M BTU/hr: 0 $0.00 Over 1 OK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: PURON Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $52.00 TOTAL: $213.42 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $213.42 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. OWNER -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 far 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 L) 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. Jf,.however, the building or improvement is sold within one year of completion, the Owner-Builderwill 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). ❑ 1 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 by this permit, I cannot legal) 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 7044 of the Business and 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 Profess a a license is in full force and effect. / �� License Class License No Date 17 ' ( 2 Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING: 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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: El I 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 performance of the work for which this permit is issued. Policy No. ❑I 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' compensatio insurance carrier and policy number are: Carrier Policy Number Expiration Date Na a of Agent Phone # c rtify that, in the performance of the work 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 agre i I should become subject to the workers' oensation_ oro isi=Section 3700 of the Labor Code, I shall forthwith comply with those provisions. lure of Applicant �� Date DECLARATION REGARDIN C LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency forthe performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name Lender's Address By 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 t 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 county to enter t - d Uned property for inspection purposes. Signature of Property Owner or Authorized Agen Print Property Owner's or Authorized Agent's Name --� Date ACTION DATE BY DECLARATION OF COMPLIANCE N7TH CODE OF � FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 51 OF TITLE 40 ANB AQMO RULE 1403. HERMIT EXPIRED ❑ 1SU&MtiTED ASBESTOS NOTIFICATION TO: ❑ EPA PERMITCANCELLED ❑ AQMD PERMIT EXTENDED ❑ ASBESTOS NORFiCAROM t5 NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL ' CER7fFfCA7EOF SIGNATURE: OCCUPANCYlSSUED