HomeMy WebLinkAboutH2020-0397 - Permitssrl ofcenter NewDport Bulazssog Division I II�III�I'IIIII�IIIII IIIII�III�I IIIIII
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MECHANICAL Permit: H2O20-0397
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Project No
Permit Counter Phone (949)644-3288
FurnacesBoilers & Compressors
Ventilation
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Inspection Requests Phone (949)644-3255
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Job Address: 118 SAPPHIRE AVE BIdg:1 Floor: Suite:
Other
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Description of Work: MECH/CHANGE OUT (E) F.A.0 & (E) A/C UNIT 45.5dB (LENNOX; 16ACX-060) @ ROOF DECK
49J
HIGH DENISTY
Up to 3HP:
1
$20.00
InspectorArea:2 Code Edit: 2019
0 $0.00
Fire Dampers:
Int t
Legal Description: BALBOA ISLAND SEC 2 BILK 4 LOT 21
$0.00
Over 100K BTU/hr:
'M� 1
Owner: LEONARD LUANNE Contractor:
DYNAMIC AIR SERVICES INC
Worker's Comp Insurance -
$0.00
Address: 36560 SAQUARO CT Address:
21088 BAKE PKWY #104
Carrier: INS CO OF THE WEST
0 $0.00
RANCHO MIRAGE CA 92270
LAKE FOREST CA 92630
Policy No: WSD505412400
0
Phone: Phone:
949-340-3917
Expire :03101/2021
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Con State Lic:
753286
Metal Fireplace:
.hJ
Issued Date:07/14/2020 Lic Expire:
02/28/2021
Heat Pumps & Package
Units
f
Bus Lic:
BT30064634
$0.00
Down -Draft Fan:
Processed By: -^ ' " Lic Exp Date:
10/31/2020
$0.00
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 IOOK BTU/hr:
0
$0.00
>50 HP:
0
$0.00
Residential Hood:
0 $0.00
Additional Fee :
$17.40
Investigation:
$0.00
Over 500K BTU/hr:
0
$0.00
Air Handling Units
Comm. Hood:
0 $0.00
Plan Check:
$0.00
Up to 1 M BTU/hr:
0
$0.00
up to 10K CFM:
0
$0.00
Repair/Alter/Add:
0 $0.00
Model:
Issuance:
$35.00
Up to 1.75M BTU/hr:
0
$0.00
Over 10K CFM:
0
$0.00
Supplemental Fee:
$0.00
Manufacturer:
Over 1.75M BTU/hr:
0
$0.00
VAV Box:
0
$0.00
Zoning PC:
$41.50
TOTAL:
$133.90
Plan Check Fee:
$0.00
Fee Due at Permit Issuance:
$133.90
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hous.,. pnday-•PtfdV7:00 a.m.tq •6:30 p.m.and Saturday from 8:00 a.m. to 6:00 p.m
4 & C € C &
••• •• •• • • ••• ••
)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
Irofessions 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
lot 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 `) portions of the work, and the structure is not intended or offered for sale (Section 7044,
3usiness 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
mprovements 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
mproved 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
Ipply 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 licensure under the Contractors' State License Law for the following reason:
3y 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
yell 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
rrofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.hlml.
Signature of Property Owner or Authorized Agent Date
-ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 7000 of Division 3 of the Business and Profess' Code and my license is in full force
Ind effect.
.icense Class License No Date r::_ : - - - Contractor Signatur =.�->= --- -.:-- -- _ -
VORKERS' COMPENSATION DECLARATION
/ARMING: 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 ($700,000), IN ADDITION TO THE
:OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3703 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
I 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 tt
elformance of the work for which this permit is issued. Policy No.
have and willpp��aintain 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'
ier andaD
rance carrolicY numbewe:
of Agent
Number Expiration Date
Phone #
A certify that, in the performance orrfi-e wo or 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 agree
iat, if I should become s bject to the works ' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
signature of Applicant t __ _.:. - ? DatelU /�-
IECLARATION REGARDING C G AGENCY -- - -
hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
ender's Name Lender's Address
ly 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 p Ided is correct.
I agree to comply with all applicable city and county ordin ces and state laws relating to building construction. �
1 authorize representatives of this city or county ty,Pnta. �perty for inspection pyronces.-- // A,/l,,,,,�'�
ACTION
DATE _-J_ v BY
PERMITEXPIRED AQMORULE I40a% • •: .0. •: • : .0.
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PERMITCANCELLED ❑ EPA • • • • ••• ••
PERMlT EXTENDED
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CERTIFICATEOF
OCCUPANCYISSUED SIGNATURE: : : •: : e