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Home My WebLink AboutH2021-0012 - Permits,w City of Newport Beach - Building Division H2O21-0012 A� 100 Civic Center Drive, Newport Beach, CA 92660 -" Permit Counter Phone (949)644-3288 r''3ra �a .- MECHANICAL Permit: H2O21-0012 Project No: 0880-2020 Inspection Requests Phone (949)644-3255 0o0on 00000 Job Address: 3805 SANDUNE LN BIdg:1 Floor: Suite: ° o 000000 o0n„ Description of Work: MECH INSTALL (2) A/C UNITS @ THE SIDE YARD "TAMPER RESISTANT CAP REQ" Inspector Area:6 Code Edit: 2019 �Q o "" Legal Description: N TR 6425 LOT 68 Ventilation :: ii o " Owner: WILLIAMS HOLLY & TIM Contractor: DPL AIR CONDITIONING INC Worker's Comp Insurance - " Address: 3805 SANDUNE LN Address: 4540 VIA BELLA VISTA Carrier: NORGUARD INS CORONA DEL MAR, CA 92625 YORBA LINDA CA 92886 Policy No: DPWC177015 Phone: Phone: 714-609-9795 Expire :07120/2021 „ o" Con State Lia 801191 wfTI3JEC1' TO F IELDINSPF,(:7Y)It',; Issued Date:01/0712021 Lic Expire: 01/31/2022 I�}Xfr�✓-�NDAPPitOVAL Bus Lic: BT30056884 0 $0.00 Processed By: Lic Exp Date: 10/31/2021 HVAC Items FEES Furnaces Boilers & 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 100K BTU/hr: 2 $42.00 >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: $62.64 Up to 1M BTU/hr: 0 $0.00 up to 10K CFM: 2 $30.00 Repair/Alter/Add: 0 $0.00 Model: 36LAMS1lssuance: $37.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: FUJITSU Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $46.25 TOTAL: $217.89 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $217.89 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. e MER -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) ction 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 permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' Slate License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the business and �fessions 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 anvil penalty of more t ar(,fjve hundred dollars ($500). I, as PPI *. Jthe 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 sate (Section 7044, Areas 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 frovernSuits ere 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 Proved 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 fly to an &g sof property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ►am exempt frop licensure under the Contractors' State License Law for the following reason: My signa2urebSlow 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, -a,structuve 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 Sessions Coale, is available upon request when this application is submitted or at the following Web site:http://Www,leginfo.ca.gov/calaw.html. nature of Prpperl Owner or Authorized Agent Date TENSED CO&AACTOR'S DECLARATION leffebtfrm tinder Renalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Bus' as and Profga ' ns Code, and my license is in full force �— Class License No Da % Z Contracto nature VORKERS' COMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUND DT SAND DOLLARS ($100,0001, IN ADDITION TO THE :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 orRancg pf the work for which this permit is issued. Policy No. fn,dwill 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' carrier and policy number are: is of Agent certify that, in the performan the work for , if I should become sub} a workers' co Policy Number Date is issued, I shall not employ any person in any manner so as to become subject to workers' co tion laws of California, and jons of Section 3700 of the Labor Code, I shall forthwith comply with those provis' s. � , rreby affirm under penalclrjury that ere is a construdlPignJenaing agency for the performance of the work for which this permit is Issued (Section 3097, Civil Cgde) Ider's Name _ Lender's Address / my signature below, I certif toe cf 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 able city and county ordin and state laws relating to building construction. I authorize representatives city or county toe a ove-identifie operty for inspection purposes. a, ,.�; ' nature of Property Owner Authorized Agent �� Print Property Owner's or Authorized 7rFnc s NameZ& ACTION DATE Y DECLAR4TIOMOFCOMPLIAPICE WITHCODEOF1 USEONLV FEDERAL REGULATIONS PART 87 OF TITL.E40 AND' 1014D RULE 9403. PERMIT EXPIRED I SUBMITTEDASDESTOS NOTIFICATION TO:. ❑ EPA ❑ AQMD PERMIT CANCELLED PERMIT EXTENDED ASBESTOSNOTIFICATIONISNOTAPPLICABLETO PROPOSEDDEMOOTION PERMIT FINAL —' 2 Z jam_ , CERTIFICATE OF SIGNATURE: OCCUPANCYI'SSUED