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Home My WebLink AboutH2020-0634 - Permits (2)w City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIII 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 0 0 6 3 4 Permit Counter Phone (949)644-3288 Job Address: 4916 SEASHORE DR BIdg:1 Floor: Suite: Description of Work: MECH (2) A/C UNITS *TAMPER PROOF CAP REQ* Inspector Area:1 Code Edit: 2019 Legal Description: N TR 3813 LOT 80 Owner: ALEJO PS89 LLC Address: 73-145 FIDDLENECK LN PALM DESERT CA 92663 Phone: Issued Date:10/28/2020 Processed Bv: Contractor: D L S HEATING & A/C Address: 8542 LARTHORN DRIVE HUNTINGTON BEACH CA 92646 Phone: 714-231-8002 Con State Lic: 584220 Lic Expire: 01/31/2022 Bus Lic: BT98040420 Lic Exp Date: 12131/2021 MECHANICAL Permit: H2O20-0634 Project No : 2399-2019 Inspection Requests Phone (949)644-3255 Worker's Comp Insurance - Carrier : STATE FARM Policy No: 92GUV4642 Expire :01/06/2022 HVAC Items FEES Furnaces Boilers & Compressors Ventilation Other Up to 100K BTU/hr: 0 $0.00 Up to 3HP: 2 $42.00 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 100K BTU/hr: 0 $0.00 >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: $36.54 Up to 1M BTU/hr: 0 $0.00 up to 1 O CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: N4A524/548GKC Issuance: $37.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: SEER Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $46.25 TOTAL: $161.79 Plan Check Fee: $161.79 Fee Due at Permit Issuance : $0.00 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Porrstructicn Hour,: Monday - Friday 7:00 a.m.to 6:30 p.m.and Saturday from 8:00 a.m. to 6:00 p.m. P � A O C cu t c` u cc goo . d �o aac oa• 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 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 not 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, 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 improved 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 licensure 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 legal 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:htlp://www.leginfo.ca.gov/colaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION 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 Professions Code, and my license is in full force and effect. License Class License No Date Contractor Signature COMPENSATION DECLARATION rARNING: 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 T OST 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: 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 erformance of the work for 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' rance carrier and policy number are: ler Policy Number - Expiration Date of Agent certify that, in the performance of the work 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 if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant Dale CLARATION REGARDING CONSTRUCTION LENDING AGENCY weby 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). Idler'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 ordinances and state laws relating to building construction. I authorize representatives of this city or county to enter the above -identified property for inspection purposes. nature of Pmnerty Owner or Authorized Anent Print Prooertv Owner's or Authorized Agent's Name Date ACTION DATE BY ucr.Lsr IIvn ur UVRUr "Aff�c xef rn wvc yr run rrrrl� we u1r.r FEOER4LREGULATRNSPART61OFTiRE40AND • '••` `•' AQMD RULE 1403: • • • ' PERMITEXPIRED ❑ ISUBARTTEDASBESTOSNOTIFICATIONTO: ❑ EFA ❑ AQMD •: • ' + • ' PERMIT CANCELLED P€RMfTEXTENDED ❑ ASBESTOS NORRCAIIONISNOT APPLICABLE TO PROPOSEDBEMOLITION. . • . • • • • • ' • + PERMIT FINAL 'j.6 `• CERTWICATEOF SIGNATURE: • • ` OCCUPANCYISSUED