HomeMy WebLinkAboutH2020-0711 - Permits0�wrti� City of Newport Beach - Building Division III III IIIIIpIII11111p11111111p1111p111p1111 MECHANICAL Permit: H2O20-0711
.'� 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 0 0 7 1 1 Project No : 1303-2018
H Permit Counter Phone (949)644-3288
e''ur,�n+{4 Inspection Requests Phone (949)644-3255
Job Address: 219 EVENING STAR LN BIdg:1 Floor: Suite:
Description of Work: MECH/A/C/HEAT PUMP ON ROOF (4) "TAMPER RESISTANT CAP REO"
Inspector Area:3 Code Edit: 2019
Legal Description: N TR 4224 LOT 139
Owner: JONES JR. CLIFTON S
Contractor: OWNER/BLDR
Address: 219 EVENING STAR LN
Address: CLIFTON JONES
NEWPORT BEACH CA 92660
Phone:
Phone:
Con State Lie: O/B
Issued Date:12/10/2020
Lie Expire:
Bus Lie:
Processed By: Lie Exp Date
ON HEAT PUMPS
Worker's Comp Insurance -
Carrier
Policy No:
Expire
INSPECTOR,
HVAC Items
FEES
FurnacesBotlers & Compressors
Ventilation
Other
Up to 100K BTU/hr:
0
$0.00
Up to 3HP:
0 $0.00
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:
4
$84.00
>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:
$73.08
Up to 1 M BTU/hr:
0
$0.00
up to 1 OK CFM:
0 $0.00
Repair/Alter/Add:
0 $0.00
Model:
SEE PLANlssuance:
$0.00
Up to 1.75M BTU/hr:
0
$0.00
Over 1OK CFM:
0 $0.00
Supplemental Fee:
$12.00
Manufacturer:
MITZSUBISHI
Over 1.75M BTU/hr:
0
$0.00
VAV Box:
0 $0.00
Zoning PC:
$46.25
TOTAL:
$215.33
Plan Check Fee:
$0.00
Fee Due at Permit Issuance :
$215.33
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.
ILDER 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 items)
(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
Krofessions Cade) 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
than five hundred dollars ($500).
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,
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
�rrim roved for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contr ct rs 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, an w c trac for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
❑ I am exempt from licensure under the Contractors' State c se L e ollowing reason:
'By my signature below I acknowledge that, except for y p rs al re en in hich I must have resided for at least one year prior to completion of the improvements covered y this permit, I cannot legallt
(sell a structure that I have built as an owner -build r It h n b cons m its entirety by licensed contractors. I understand that a copy of the applicable law, Section 44 of the Business and
Professions Code, is available upon request whe Is p' ati is su a following Web site:http://www.leginfo.ca.gov/calaw.html.
'Signature of Prcpe-t,, ^caner or Authorized Agent D
,LICENSED CONTRACTOR'S DECLARATI'
I hereby affirm I-nde, penalty of perjury that I am II arm under pr visions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
.and effect.
Liccnse lass License No Date Contractor Signature
COMPENSATION DECLARATION
6.ARMNG. FAILURE TO BEMIRE 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 COMPENSAPON, 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 wit: 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
performonce of the wcrl' for which this permit is issued. Policy No.
have and wil, nain,ain workers' compensation
ranca carrier a.l(. policy number are: /
of Agent
as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
Number
Date
I certify that, in the a orm ce rk for ' h t ' nnit is issued, I shall not employ any person in any manner so as to become subjec 'he workers' compensation laws of California, and agre
that, if I should becom ubj t t ers' c e visions of Section 3700 of the Labor Code, I shall forthwith comply with those proyl ns.
Signature of Applican Date lU
DECLARATION REG I C ON LEND NCY
1 hereby affirm under n f perjury th there is a construction lending agency for the performance of the work for which this permit is issued (Sec ion 3097, Civil Code).
Lenders 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 prope n s behalf.
I have read this application and the information I have ov' I correct.
I agree to comply with all applicable city and county rdi n I ws a ling to building construction.
I authorize representatives of this city or cou o n th e-ident' y for inspection purposes.
Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name (.✓-'% I' �L 5 Date O
ACTION
DATE
BY
DECLARATION OF COMPLIANCE Vi CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TITLE40 AND
AQMD RULE 3403.
PERMIT EXPIRED
❑ 1 SUBM7TTEDASBESTOS N077FICARON TO:
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❑ AQMU
PERMIT CANCELLED
PERMIT EXTENDED
❑ ASBESTOS NOTIRCA nom is NOT APPL/CABL€ TO
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PERMIT FINAL
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