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HomeMy WebLinkAboutH2021-0519 - Permits (3)� Lrk City of Newport Beach - Building Division III 1111111111111111111111111111111111111111111111 MECHANICAL Permit: H2O21-0519 a 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 1 0 5 1 9 p Project No : 1624-2021 E, ,' �, Permit Counter Phone (949)644-3268 " � fi cry: �:+Vr��u P`. Inspection Requests Phone (949)644-3255 Job Address: 2001 CENTELLA PL BIdg:1 Floor: Suite: Description of Work: MECH* REVISED 04/16/2022 (3) A/C UNITS 46.5clB, 43.2clB & 36.7dB (CARRIER;24AHA424:24 & 60) 01 Inspector Area:3 Code Edit: 2019 Legal Description: N TR 3379 LOT 1 III Owner: SACKMAN PAUL Contractor: TRUE HOME HEATING AIC Worker's Comp Insurance - Address: 204ONYX AVE NEWPORT BEACH CA 92663 Address: 4 FARADAY Carrier: CYPRESS INS IRVINE CA 92618 Policy No: TRWC122609 Phone: Phone: 949-382-6337 Expire :12/0112021 0 Con State Lic: 1025397 Issued Date:09103/2021 Lic Expire: 04/3012023 Bus Lic: BT30064629 Processed By: Lic Exp Date: 10/3112021 nc items FEES nacesBoilers & Compressors Ventilation Other 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 :r 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 II/Floor Heaters: 0 $0.00 >15 HP to 30 HP: 0 $0.00 Attic Fan: 0 $0.00 Metal Fireplace: 0 $0.00 it Pumps & Package Units >30 HP to 50 HP 0 $0.00 Down -Draft Fan: 0 $0.00 Record Mgt Fee: $0.00 to 100K BTU/hr: 0 $0.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee : $106.42 Investigation: $0.00 :r 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $57.42 to 1 M BTU/hr: 0 $0.00 up to 10K CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: 24AHA4601ssuance: $38.00 to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: CARRIER �r 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $52.00 TOTAL: $319.84 Plan Check Fee : $213.42 Fee Due at Permit Issuance : $106.42 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 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 U 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-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.htmi. 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 J 0) I Division 3 of the Business and Professions my license is In full force and effect. _l 6 ��Contractor Si License Class License No Date gnat 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 37US OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: ❑ 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 thr Vnce of the work for which this permit is issued. Policy No. and will_w ktain worke5Ls%npensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatior Date ame of Agent V r 11 certify that, in t performance of t work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workensation laws of California, and agree tat, if I should become subject to the rkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pro islo ignature of Applicants Y D& DECLARATION REGARD G CONSTRUCTION LENDING AGENCY hereby 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). ender's Name Lender's Address - y 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 to ter the abov = ntifie y or inspection purposes. ignature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 51 OF TITLE 40 AND AQMD RULE 1403. ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMIT EXPIRED PERMITCANCELLED PERMIT EXTENDED ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: PERMIT FINAL CE,RTIRCATEOF OCCUPANCYISSUED