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HomeMy WebLinkAboutH2019-0689 - PermitsCity of Newport Beach - Building Division III 111111111111111111111111111111111111111111111 MECHANICAL Permit: H2O19-0689 a 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 1 9 0 6 8 9 Project No '., Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 1019 MUIRFIELD BIdg:1 Floor: Suite: Description of Work: MECH C/O A/C UNIT (1) *TAMPER PROOF CAP REQ* AND FURNACE C/O W/ DUCT WORK t° �' lu Inspector Area:4 Code Edit: 2016 Legal Description: TRACT 12105 LOT 1 OF PROJECT 931-79 LOCATED ON AP 442-033-04 Owner: OLSON D MICHAEL Contractor: Address: 1019 MUIR BEACH CIR Address: NEWPORT BEACH, CA 92660 Phone: Phone: Con State Lic: Issued Date:11101/2019 Lic Expire: Bus Lic: Processed By: Lic Exp Date: ALISO AIR INC 29736 AVE DE LAS BANDERAS RSM CA 92688 949-589-2021 526420 03/31/2020 BT30019236 02/28/2020 Worker's Comp Insurance - • • y Carrier: LIBERTY MUTUAL Policy No: WC2Z61036218098 > • > Expire :07101/2020 a' as aaa aaaeap a P HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 1 $20.00 Up to 3HP: 1 $20.00 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 1 OOK BTU/hr: 0 $01,00 >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: $52.20 Up to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 1 $20.00 Model: EL1806HO60NE36A Issuance: $35.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: LENNOX Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $41.50 TOTAL: $188.70 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $188.70 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. VNER-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) Iction 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 th'i applicant for 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 Ifessions 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 more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, siness 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 )rovements 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 )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 )ly 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). J I am exempt from licensure under the Contractors' State License Law for the following reason: ly 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 legally ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. 1 understand that a copy of the applicable law, Section 7044 of the Business and 'rofessions Code is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm]. signature of Property Owner or Authorized Agent Date .11--21%SED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with ecti 70 0) of Division 3 of the Busi 7!5od7e,and my license is in full force ib effect 6 ( ) Contraclor3 gnatur icense Class License No Date V7RKERS' COMPENSATION DECLARATION ARNIN'G: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLO(R TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($1D0,000), IN ADDITION TO THE CS.-J. JOMPENSPT!Z%, rA`6AGES AS PRONGED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ha:cty affirm under penalty of perjury one of the following declarations: I ;nave 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 forrnance of the e:cr:.'or 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' compensa Smahce carrier and ool,cy number are: Policy Number Expiration Date Tie of Agent _ Phone # certify that, in the work for which this e , shall not employ any person in any manner so as to become subject to the workers' co pensation laws of California, and agreE I, if I should become c tot rke sation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provis ns. natureof Ap ca Date l CLARATION REGA RUCTION LENDING AGENCY ereby affirm under p alty of perjury that there is a construction lending agency for the performance of the work for which this permit is issue (Section 3097, Civil Code). 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' I agree to comply with all applicable city,�Ld-ee es and state laws relating to building construction. t I authorize representatives of this city or c o entfi' above id inspection nature of Property Owner or Authorize an p Print roperty Owners or Authorized Agent's Name/ Date ACnoN DATE DECLARATION OF COMPLIANCE fMTN CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OFTITLE40AND A4A0 RULE 1403. PERMIT EXPIRED ❑ I SUBAITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMIT CANCELLED PER,MITEXTENDED ❑ ASBESTOS NOTIFICARONIS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL .2 GOa77 CERTIFICATE OF OCCOPANCY;SSUED SIGNATURE: