HomeMy WebLinkAboutH2020-0417 - PermitsCity of Newport Beach - Building Division III 1111111111111111111111111111111111111111111111
100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 0 0 4 1 7
Permit Counter Phone (949)544-3288
Job Address: 4601 JAMBOREE RD BIdgA Floor: Suite:
Description of Work: COMM CHANGE OUT 2-TON UNIT (LIKE FOR LIKE) UNIT ONLY
MECHANICAL Permit: H2O2O-04'
Project No : 1323-2020
Inspection Requests Phone (949)644-3255
Inspector Area:7 Code Edit :
2019
Legal Description: IRVINE SUB LOT 138 BLK
50 POR OF LOT
Owner: COUNTY OF ORANGE
Contractor:
THERMA LLC
Worker's Comp Insurance -
Address: 4601 JAMBOREE RD
Address:
1601 LAS PLUMAS AVE
Carrier: ZURICH AMERICAN CO
NEWPORT BEACH, CA 92660
SAN JOSE CA 95133
Policy No: GLO058822901
Phone:
Phone:
408-347-3400
Expire :06/20/2021
Con State Lic:
1027316
Issued Date:0712912020
Lic Expire:
05/31/2021
Bus Lic:
BT30062177
Processed By: .JA
Lic Exp Date:
02/28/2021
AC Items
FEES
_
nacesBoilers & Compressors
Ventilation
Other
to 100K BTU/hr:
0
$0.00
Up to 3HP:
1 $20.00
Bathroom Fan:
0 $0.00
Fire Dampers:
0 $0.00
$0.00
3r 100K BTU/hr:
0
$0.00
> 3 HP to 15 HP:
0 $0.00
Exhaust Fan:
0 $0.00
Gas Line:
0 $0.00
$O.QO
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 :
$62.00
Investigation:
$0.00
3r 500K BTU/hr:
0
$0.00
Air Handling Units
Comm. Hood:
0 $0.00
Plan Check:
$0.00
to 1 M BTU/hr:
0
$0.00
up to 10K CFM:
1 $14.00
Repair/Alter/Add:
0 $0.00
Model:
Issuance:
$35.00
to 1.75M BTU/hr:
0
$0.00
Over 10K CFM:
0 $0.00
Supplemental Fee:
$0.00
Manufacturer:
3r 1.75M BTU/hr:
0
$0.00
VAV Box:
0 $0.00
Zoning PC:
$41.51
TOTAL: $172.50 Plan Check Fee : $172.50 Fee Due at Permit Issuance : $0.00
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 hom 8:uu a.m to 6:00 p.m.
�AV
7
I hereby affirm under penalty of perjury that I am exenpl from the Contractors' State License Law for the reasons) indicated below by the checkmad•.(s) I have placed next to the applicable tem(s)
(Section 7031.5, Business and Professions Code: Any cry or coinl• that requires a permi to construct, after, improve, demolish, or repair any shuctire, prior tc is issuance, also requires the applicant for
Lt. pemiil lu Ole a syred slalemenl that he UI she is liceuseJ pursuart to l'le pruvisio is ul the Cuuuaclurs Slade Lcense Law lChaprer a (u.•nmreucfug with SouLiun 7000) of Div siuu 3 u1 the Business a, d
Professions Code) cr that he of she is exempt from licensure and the basis forthe alleged exemption Any volahon of Section 7031.5 by any applicail for a permit subjects the applicant to a civil penalty of
not more thai five hundred dollars ($500).
I, as owner of the property, or my employees :with wages as their sole compensation, Will do I ) 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 Contactors' Slate icense Law does not apply to an ownerof property who, thrOLgh amploVaes' or personal effort, builds or improves tha property, provided that tie
improvements ace n•. ' landed or offered for sate. If, however, the building or,mWovement is sod within one year of completion, the Owner-3uilder will have tie burden or pnvirg that it was not built or
impraledr(N a of sale).
I, as o:::F property, am exclusively contranng with licensed Contractors to construct the prolact ISectfon 7144, Business and Professions Code I ha ContractorsState License Law does IIOt
to an owner of prcperty who builds Or improves thereon, and who contracts for the projects wffh a licensed Contractoi pursuant 0 the Contractors' Stare License Law).
am exempt from licensure under the Contractors' State License Law for the following reason:
WLMy signature below I acknowledge that, except for my personal residence it which I must have resider) fcr at least one pear prior tic completion of the improvements covered by this permt, I . nnot legally)
cell a simchra :hat I have tafilt as an r. nor-inildar if it has n t Man rnnsiviii in its enfirRry by Iir.FncFrt rnntractom I undRrfand that a rnpy of the applicahtn lax, Sadon 7044 of the Rimmoms and
Professions Code, is available upon request when this appli a' is sub i at t wing Web site:tttp:rvwww.le-ginfo.ca.govicalaw.html.
Signature of Property Owner or Au:horeed Agent e 7--,�(` y-aQ
LICENSED CONTRACTORS DECLARATI
I hereby affirm uider penalty of perjury that I am I cers nder provisions Df Chapter 9 (commencing with Section 700)) of Division 3 of the Business and Profassion ode, an Rfy lic se is n full fcrce
and effect. License Class L - 2c, _icense No / 0.2 7.31 G Date '? -.2 H - R o Contractor Signature /
NORKERS' COMPENSATION DECLARATION
YARNING: FAILJRETO SECURE WORKERS' COMPENSATIOV COVEFAGE IS UNLAWFUL AND SILL SUBJECT AN EMPLOYER TOCRIrNNAL PENALTIESANO CIVIL FIVES UP TO ONE HUNDRED 74SAND DOLLARS tsrogon), IN ADDITION 10 THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION3701 OFTNE LAEOR COD= INTEREST. ANDATTORNETS FEES.
hereby affirm under peiatty of perjury one of the following declarations:
J I have end will maintain a cedificate of consent to sell -insure for wo kefs' compensation, issued by the Directcr of Industrial Relations as provided far by Section 270C of the Labor Code. for the
oerforrnanre of the work for which this permit s issued. Policy No_
have and will maintain walkers' compensaticn insurance, Es requred by Section 37DO of the Labor Code, fo• the performance of the work far which this perm:•t is issued fully workers'
,...nca carrier and pdiry numhar ara-,
of A9f �rwtr`,N�
rtify that, in the performance of tie wort'.
I siould become suljectt D e workers'
ire of Applica.
Policy Number LtJG-0 7A 1 -7 (0 8 - 0 / Expiration Date Co - a c
this permit is issued, I shall not employ any person if any maniar so as to become subject to the workers' compensation laws of California, and
oif n or.,
of Sector 3700 of the Labor Cede, I shall forth with comply with those pnvisions.
DatPX- 7 -.,29 -20
I hereby affirm under penalt ijury that there s aconstruction lending agency -or the performance of the work for which this permit is ssued ;Section 3C97, Civil Code,.
Lender's Name Lenders Address
By my sicnature below, I ce ity to each of the followirg:
I am he property owner or authorized to act on the property owner's behalf.
I have read this application and the information I have proviced Is correct.
I agree to comply with FJI applicable city and county ordffnances andsleire laws relatinc to pudding constriction.
I authorize iepresematNas of this city of coun to era r abov denlf eny for inspection purpases.
Signature of Property Owner orAuthor¢ed AgentPrint Property Owier's crAuhodzed Agent's Nafie` e 'Xc mDar€r
ACTION DATE BY it"TION OF COMPLIANCE K•rrii CODE OF FEDERAL FOR OFFICE USE ONLY
rP 6ULAT13)N5 PART 61 Or TITLE 40 AND A( RULE
1403
E:FVPED I I I❑15UBMITTED ASBESTOS NOTIFICAMONTO
PERNJTPNAL a ❑A56PSTO�N(-TIFICATION 15 NOT APPLICABLE TO
CERTF)CA EDF �ya ,/ Pr,JPOSEJ D:MJUTION
OCCUPANCY 65UED ( c,..uer tec.