HomeMy WebLinkAboutH2021-0353 - Permitswta�A City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
;, •, ';Y .y. �, Permit Counter Phone (949)644-3288
i
r'�LJXC11��{�
III IIII IIIII IIIII IIIII IIII (IIIII IIIII IIIII IIIII III
Job Address: 41 ROYAL SAINT GEORGE RD BIdg:1 Floor: Suite:
Description of Work: MECH -3 A/C CONDENSERS. TAMPER -RESISTANT CAPS REQUIRED
Inspector Area:4 Code Edit:
2019
Legal Description: N TR 7223 LOT 71
Owner: CHRISTIAN HENDERSON
Contractor:
SOLSTICE HEATING & A/C
Address: 610 NEWPORT CENTER DR
Address:
A A IOTA
NEWPORT BEACH, CA 92660
SAN CLEMEN 92672
Phone:
949-573-3607
Phone:
Con State Lic:
938888
Issued Date:06
Lic Expire:
10/3112021
Bus Lic:
BT30041721
Processed By:10312021
Lic Exp Date:
02/28/2022
MECHANICAL Permit: H2O21-0353
Project No : 2885-2018
Inspection Requests Phone (949)644-3255
10511 �p,A 00"',
�A`
FEES
4C Items
nacesBoilers & Compressors
Ventilation
Up to 3HP:
1
$21.00
Bathroom Fan:
0 $0.00
to 100K BTU/hr:
100K BTU/hr:
0
0
$0.00
$0.00
> 3 HP to 15 HP:
2
$76.00
Exhaust Fan:
0 $0.00
:r
II/Floor Heaters:
0
$0.00
>15 HP to 30 HP:
0
$0.00
$0.00
Attic Fan:
Down -Draft Fan:
0 $0.00
0 $0.00
at Pumps & Package
Units
>30 HP to 50 HP
0
0
$0.00
Residential Hood:
0 $0.00
to 100K BTU/hr:
0
0
$0.00
$0.00
>50 HP:
Air Handling Units
Comm. Hood:
0 $0.00
ar 500K BTU/hr:
to 1 M BTU/hr:
0
$0.00
up to 1 OK CFM:
0
$0.00
Repair/Alter/Add:
0 $0.00
to 1.75M BTU/hr:
0
$0.00
Over 10K CFM:
0
$0.00
Supplemental Fee:
$0.00
er 1.75M BTU/hr:
0
$0.00
VAV Box:
0
$0.00
TOTAL:
$264.64
Plan Check Fee
: $0.00
Worker's Comp Insurance -
Carrier : SECURITY NATIONAL INS CO
Policy No: SWC1328473
Expire :03/1912022
Fire Dampers:
Gas Line:
Metal Fireplace:
Record Mgt Fee:
Additional Fee:
Other
$0.00
$0.00
$0.00
$0.00
$0.00 Investigation:
Plan Check:
Model: AULD36W21AIssuance:
Manufacturer: AC PRO
Zoning PC:
Fee Due at Permit Issuance: $264.64
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday- Friday7:00 a.m. to 3:30 d,m.and Saturday FrOm 8:00 a.m. to 6:00 p.m.
$0.00
$0.00
$0.00
$84.39
$37.00
$46.25
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 Iicensure 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).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) 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
ffim roved 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 Iicensure 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 legall,
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
LICENSED CONTRACTOR'S DECLARATION Date
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 of i s Code, and my license is in full force
and effect. s
License Class License No Date PP 3 Contractor Signatu
WORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE H RED THOUSAND DOLLARS ($100,"" IN ADDITION TO THE
COST 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:
1 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(
3edormance of the work for which this permit is issued. Policy No.
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:
of Agent
certify that, in the performannce of
if I should become subienan fhA
of
Policy Number
Date
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
compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
.JN LENDING AGENCY Date v �
:reby affirm under penalt perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097
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 and state laws relating to building construction.
I authorize representatives of this city or county to e r b J roperty for inspection purposes.
nature of Property Owner or Authorized A en Print ProDertv Owner's or A, AhnrivcH A,...w� nl.,..,,, IZ -Tsr
ACTION I DATE I' V BY
EXPIRED
PERMIT
PERMIT FINAL 77 3 23
CFR7IFICATEOF
OCCUPANCYISSUED
rru,t LHLAiDLA I:ULT PART 59 OF TITLE40AND
AC'ML'R)JLF 1403,
L7. I SU8JWREDASBFSTOS NOTIFICATIONTO:.
❑ ZPA
❑ AQMD
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROFOSEL DE`4J:JTICN.
SIGMA r URf-:
Civil Code).
FOR