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Home My WebLink AboutH2020-0027 - Permits&City of Newport Beach - Building Division KU 100 Civic Center Drive.Newport Beach, CA 92660 H 2 0 2 0 0 0 2 7 Permit Counter Phone (949)644-3288 Job Address: 4515 SURREY DR Bldg:1 Floor: Suite: Description of Work: MECH - R/R A/C CONDENSOR & FAU. TAMPER -RESISTANT CAP & TIMER REQUIRED Inspector Area:5 Code Edit: 2019 Legal Description: N TR 3519 LOT 73 Owner: SMITH JEREMY Contractor: DPL AIR CONDITIONING INC Address: 4515 SURREY DR Address: 2536 FENDER AV STE E CORONA DEL MAR, CA 92625 FULLERTON CA 92831 Phone: Phone: 714-609-9795 Con State Lic: 801191 Issued Date:01/13/2020 Lic Expire: 0113112020 Bus Lic: BT30056884 Processed Bv: o Lic Exp Date: 10/31/2020 MECHANICAL Permit: H2O20-0027 Project No : Inspection Requests Phone (949)644-3255 HERS VERIFICATION REQ Worker's Comp Insurance - Carrier : NORGUARD INS Policy No: DPWC063251 Expire :07/20/2020 ®R HVAC Items FEES Furnaces Boilers & Compressors Ventilation 0 $0.00 Other $0.00 Up to 100K BTU/hr: 1 $20.00 Up to 3HP: 1 $20.00 Bathroom Fan: 0 $0.00 Fire Dampers: 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 : $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 1M BTU/hr: 0 $0.00 up to 10K CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: A,SAW DlmD f Issuance: $35.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: AMANA 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 Hours: Monday Friday 7.00 a.m.to 6:30 p.m.and Saturday from 8:00 a.m. to 6:00 p.m. I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) 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, priorto 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' State License aw (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 Sec ion 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of more than five hundred dollars ($500). J I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of lusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of com n roved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044 pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contracts I am exempt from licensure under the Contractors' State License Law for the following reason: ly my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I u. 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.legil signature of Property Owner or Authorized Agent .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Be son 7 00) I nd effect. icense Class License No �"rl�� ) 1 Date VORKERS' COMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAI 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: work, and the structure is not intended or offered for sale (Section 7044, oloyees' or personal effort, builds or improves the property, provided that the on, the Owner -Builder will have the burden of proving that it was not built or Business and Professions Code: The Contractors' State License Law does not pursuant to the Contractors' State License Law). that a copy of the applicable law, Section 7044 of the Business and Date Division 3 of the Busines aProfess,o a dCmy license is in full force Contractor Sign t r AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE 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, forth a- rmance of the work for which this permit is issued. Policy No. I Aper71 riveand will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this t isyissued. My workers' compensatioIsura c arr r policy number are:Policy Number Expiration Datewit lame of Agent ,. A I Phone # certify that, in the pe�r(ormance)of t tors, for which this permit is issued, I shall not employ any person in any if I should becom subject to he rs' compensation provisions of Section 3700 of the Labor Code, I shall ignature of Applicah IECLARATION RE D G CONSTRUCTION LENDING AGENCY hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for ender's Name Lender's Address y my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner' ehalf. I have read this application and the information I have provided 1 rrect. 1 agree to comply with all applicable city and c y or 'nances state laws relating to building construction I authorize representatives of this city or co ty to enter the ab e-identified property for inspection purposes. o as to become subject to the workers' c pensation laws of California, and agre comply with those provisions. Date ! / 1 3 �if this permit is issued (Section 3097, Civil Code). Signature of Property Owner or Authorized A nt Print Property Owner's or Authorized Agent's Name^ 1 Oproto //[ Date 1113ld6 11 ACTION BY DECLARATION OF COMPLIANCE W/WHCODE OF \ FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 610 AQMD RULE 1403. TITLE40AND PERMITEXP'REO ❑ I SUB&I,TEDAtiBEETCS NO,7Ff [3 EPA ❑ hQMD TION TO: PERMITCA,NCELLED PDATE PERMITEXTENDED ❑ ASBES FOS NO'RFICATIONISN PROPOSED DEMOLITION, TAPPLICABLE TO PERMIT FINAL CERTIFICATE OF SIGNATURE. OCCUPANCYISSUEO