HomeMy WebLinkAboutH2022-0211 - PermitsCity of Newport Beach - Building Division III 11111111111111111111111111111111111111111111
�'t M 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 2 0 2 1 1
W Permit Counter Phone (949)644-3288
cM tirinl>'�h
Job Address: 217 35TH ST BIdg:1 Floor: Suite:
Description of Work: MECH C/O HEAT PUMP *TAMPER PROOF CAP REQ`
InspectorArea:1 Code Edit: 2019
Legal Description: LAKE TR BILK 135 LOT 16
Owner: FREEMAN JACKIE
Contractor:
Address: 217 35TH ST
Address:
NEWPORT BEACH, CA 92663
Phone:
Phone:
Con State Lie:
Issued Date:04/25/2022
Lic Expire:
Bus Lic:
Processed By: V
.Lic Exp Date:
ASSOCIATED HEATING & AIR INC
1320 #B N HANCOCK STREET
ANAHEIM CA 92807
714-777.8833
608210
12/3112022
BT30078570
04/30/2023
4G Items
FEES
nacesBoilers & Compressors
Ventilation
to 100K BTU/hr:
0
$0.00
Up to 3HP:
0 $0.00
Bathroom Fan:
0 $0.00
:r 100K BTU/hr:
0
$0.00
> 3 HP to 15 HP:
0 $0.00
Exhaust Fan:
0 $0.00
II/Floor Heaters:
0
$0.00
>15 HP to 30 HP:
0 $0.00
Attic Fan:
0 $0.00
it Pumps & Package
Units
>30 HP to 50 HP
0 $0.00
Down -Draft Fan:
0 $0.00
to 100K BTU/hr:
1
$22.00
>50 HP:
0 $0.00
Residential Hood:
0 $0.00
:r 500K BTU/hr:
0
$0.00
Air Handling Units
Comm. Hood:
0 $0.00
to 1 M BTU/hr:
0
$0.00
up to 10K CFM:
0 $0.00
Repair/Alter/Add:
0 $0.00
to 1.75M BTU/hr:
0
$0.00
Over 1 OK CFM:
0 $0.00
Supplemental Fee:
$0.00
�r 1.75M BTU/hr:
0
$0.00
VAV Box:
0 $0.00
TOTAL: $131.14
Plan Check Fee: $0.00
MECHANICAL Permit: H2022-0211
Project No :
Inspection Requests Phone (949)644-3255
C -.-
1=
Worker's Comp Insurance -
Carrier: TRANSVERSE
Policy No: FORWC000000249_
c-
Expire :02/0112023
,max s°
Other
Fire Dampers:
0 $0.00
Gas Line:
0 $0.00
Metal Fireplace:
0 $0.00
Record Mgt Fee:
$0.00
Additional Fee :
$0.00
Investigation:
Plan Check:
Model:
MPB01BS4MIssuance:
Manufacturer:
LENNOX
Zoning PC:
Fee Due at Permit Issuance :
$131.14
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.
IIE ''OHIBITED
HIV HEAT �UIVII V
$0.00
$0.00
$0.00
$19.14
$38.00
$52.00
3WNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law far the reasori 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
:he 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
Drofessions 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
lot 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 L) 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 -Builder will 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 oamer 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 exer^.rt from licensure under the Contractors' State License Law for the following reason:
By my signature helow 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 z 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.
Cign&ture of Property Owner or Authorized Agent Date
LICENSED CON TRACTOR'S DECLARATION
I hereby affirm eider penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sect n 7000) of Division 3 of the Business and Professions Code d my license is in full force
anu effect. e (
s.:,se Class License No Date �� L� Contractor SignatuV� //`�/
.NGRKERS' COMPENSATION DECLARATION
, I�RN.NG: FAILURr TO r-L .URE WORKERS' COMPENSATION COVERAGE 15 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 O' COMPE.JSATiON DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hgr=hy affirm under penalty of perjury one of the following declarations:
I i.ave and Wl'I 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.
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' compensatior
u e carrier and policy number are:
Policy Number
Date
me of Agent rnone x
I certify that, in the peformance of ll work forwhi is 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 agree
It, if I should become sub' ct to er ' c ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prove i (Is.
)nature of Applicant DateZ-Z-
:CLARATION REGARONb<Jl&STRUCTION 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 (Secti 3097, Civil Code).
rider'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. L _l
I have read this application and the information I have provided is correct. � L�L4
I agree to comply with all applicable city and cou���� ordina a nd state laws relating to building construction.
I authorize representatives of this city or county I ante -iden foperty for inspection purposes.
]nature of Property Owner or Authorized Agent ���� Print Property Owner's or Authorze'
ACTION
DATE
BY
DECLARATION OF COMPLIANCE WITHCODEOF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TITLE40 AND
AQMD RULE 1403.
❑ I SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
[I AQMD
PERMIT EXPIRED
P
PERMIT CANCELLED
PFRA^lIT LXTEPfDED
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE:
PERMIT FINAL
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