HomeMy WebLinkAboutH2021-0408 - PermitsCity of Newport Beach - Building Division H2O21-0408
a
�., 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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Job Address: 912 OCEAN FRONT E BIdg:1 Floor: Suite:
Description of Work: MECH (3) NEW HEAT PUMPS ON 3RD FLOOR DECK *TAMPER PROOF CAP REQ*
Inspector Area:1 Code Edit : 2019
Legal Description: BALBOA TR BILK 14 LOT 21
Owner: KHALIL MORCOS FAMILY TRUST
Contractor:
OWNER/BLDR
Address: 2791 E LINCOLN AV
Address:
MORCOS KHALIL
ANAHEIM CA 92806
Phone: 714-393-6626
Phone:
714-393-6626
Con State Lic:
O/B
Issued Date:07/07/2021
Lic Expire:
Bus Lic:
Processed By: IS
Lic Exp Date:
MECHANICAL Permit: H2O21-0408
Project No : 0620-2020
Inspection Requests Phone (949)644-3255
ON HEAT PUMPS
Worker's Comp Insurance - '
Carrier :
Policy No:
Expire
INSPECTOR
HVAC Items
FEES
FurnacesBoilers & 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 1 OOK BTU/hr:
3
$66.00
>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:
$57.42
Up to 1 M BTU/hr:
0
$0.00
up to 1 OK CFM:
0 $0.00
Repair/Alter/Add:
0 $0.00
Model:
MXZ-4C36NA2-u1
Issuance:
$38.00
Up to 1.75M BTU/hr:
0
$0.00
Over 1OK CFM:
0 $0.00
Supplemental Fee:
$0.00
Manufacturer:
MITSUBISHI
Over 1.75M BTU/hr:
0
$0.00
VAV Box:
0 $0.00
Zoning PC:
$52.00
TOTAL:
$213.42
Plan Check Fee
: $0.00
Fee Due at Permit Issuance :
$213.42
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.
)WNER-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
: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
'rofessions 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).
I, as 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,
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-Builderwill 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 ct the project (Section 7044, Business and Professions Code: The Contractors' State License Lew does not
apply to an owner of property who builds or improves thereon, and who contracts a pro' cts with a licensed Contractor pursuant to the Contractors' State License Law). /^/
I am exempt from Iicensure under the Contractors' State License Law
y my signature baiow I acknowledge that, except for Fly personal reside)
?II ^',tructur3 that; ,lave built as an owner -build) as not bee co
rofessions C: c,* is available upon request when a n
ignature of Property Owner or Authorized Agent
.ICENSED CONTRACTOR'S DECLARATI
hereby affirm. under penalty of perjury that I am license under pro Ision
❑d efrect.
icense Class, License No
have resided for at least one year prior to completion of the improvements coverea oy rnl.
y by licensed contractors. I understand that a copy of the applicable law, Section-7
044 of
ving Web site:http://www.leginfo.ca.gov/calaw.html. I/1,
of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,
Date
Contractor Signature
VORKERS' COMPENSATION DECLARATION
IARNIN .: FAILURE TO SECURE 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
'AST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm ua�er penalty of perjury one of the following declarations:
I have and, v'01 rrl intain 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 wotK for which this permit is issued. Policy No.
I 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' compensatiol
lsurance carrier and policy number are: Z2
Expiration Date
of Agent
I certify that, in the performance of
it. if I should becomAgbject to the
of
permit is issued, I shall not employ any person in any manner so as to become subject to the
I provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provis' .
Date
ULAKAI IUN MMV'VIuI y �+��
:reby affirm under penal of p ry a ere is a construction lending agency for the performance of the work for which this permit is issue
d ' N Lender's Address
I ers ame
my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owners
I have read this application and the information I have provided is C
I agree to comply with all applicable city and county ordma ar}d
1 authorize representatives of this city or COCO to enter
of
PERMIT
PERMIT
PERMfT
Authorized
ACTION I DATE 'I ' BY
is relating to building construction.
property for inspection purposes.
Print Prcoertv Owners or Authorized Agent's Name
DECLARATION OF COMPLIANCE MTH CODE OF
FEDERAL REGULATIONS PART 61 OF TITLE40 AND
AQMD RULE 1403,
❑ 1 SUBM1TTED ASBESTOS NOTIFICATION TO:.
❑ EPA
❑ AQMD
❑ ASBESTOS NO nFICA'80N IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
CERI7 FICA t �Ul- I I SIGNATURE:.
OCCUPANCYfSSUEO
3097, Civil
FOR
and