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Home My WebLink AboutH2022-0170 - PermitsCity of Newport Beach - Building Division III 1111111111111111111111111111111111111111111111 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 2 0 1 7 0 Permit Counter Phone (949)644-3288 r'at �rrix�� Job Address: 500 FULLERTON AVE BIdg:1 Floor: Suite: Description of Work: MECH NEW A/C UNIT *TAMPER PROOF CAP REQ* Inspector Area:3 Code Edit: 2019 Legal Description: FIRST ADD TO Owner: DOJA PROPERTIES LL��, Address: 5050 W MISSION RD ONTARIO CA 91762 Phone: 626-340-5461 Issued Date:03/29/2022 Processed nacesBoilers & Compressors to 100K BTU/hr: 0 $0.00 3r 100K BTU/hr: 0 $0.00 II/Floor Heaters: 0 $0.00 it Pumps & Package Units to 100K BTU/hr: 0 $0.00 3r 500K BTU/hr: 0 $0.00 to I BTU/hr: 0 $0.00 to 1.75M BTU/hr: 0 $0.00 3r 1.75M BTU/hr: 0 $0.00 TOTAL:$1 Ventilation 4�Krc'�B=L '24*�-=-2700 c Exp Date. 06/30/2022 MECHANICAL Permit: H2O22-01 Project No : 1131-2021 Inspectipn Requests Phone (949)644-3255 i 01EC 10R ontr� 6 NE�G�N A/C INC - jfr1erl�EFUBLIC N ALurance LEY-ST STE K GEN INS CC ANAHIEM CA 92801 PQQI}}'�� o: Al,sy 2 hone. 657-20i3-1987 �ESf(b1piii(��o refund on State Lic. 1011173 c Expire: 02/29/2024 l II t0 whom: us Lic: BT30055503"` Up to:1)j3HF; 1 $22.00 Bathroom Fan: 15 0 $0.00 xhaust��Fan: 00 >3 5 g .p00 Br r r6ft Fan: >�50 HP: /tA1�Pk Slpai�C�dntial Hood: Air Handling Lhiils Minn.oHood: up to 10K CFM: 0 $0.00 Repair/Alter/Add: (NStL6K CFM: 0 $0.00 Supplemental Fee: VAV Box: 0 $0.00 0 $0.00 Fire Dampers: 0 $0.00 LJO Gas Line: 0 $0.00 .0 Rer I` � l 0 0 $0.00 nd K"rkl tdrted) $0.00 0 $0.00 0 $0.00 Model: FDMQ24RVJU Insp. initials: 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. stigation: $0.00 Check: $19,14 3nce: $38.00 ng PC: $52.0( 14 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). I am exempt from licensure under ly my signature below I acknowledge ell a structure that I have built as an 1 'rofessions Coda, .a available upon BE 'ignature of Prop^r`.y Owner or Author !�IE4SED CONTRACTOR'S DE hereby affirm under penalty of perjun ad elect. ice its Class 70RKERS' COMPENSATION DI 'ARi.I..G: FAILURE TO SECURE WORKERS' C OST C E COMPENSA rin N, DAMAGES AS PRO hPmhy affirm uuuer penalty of perjun I Lcve and will maintain a certific erformante of the rvo:k for which this 4 rr @e and will maintain workers' c plice carrier and policy number al except for my p� r-"Idet if it has Agent by licensed contractors. I understand that a copy of the applicable law, Secti�IT 7044 of the Business and ig Web site:http://www.leginfq.FBAPvi.PWanJ tit L. I he "tl under` provisions of Chapter 9 (co'mmencrng wilb Secti ( 00 of Di i"!y6f �-�su irn o- ' License No Date 2z-Contractna 1RATION _.. :N t0 Wi1on _ VSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO FOR IN SECLigN 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES of the folloslfjng declarations. for workers' compensation, issued by the Director of Industrial Relations as provided for by insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit Number me of Agent I certify that, in the performance of It. if I should becolhe shbiect to the nature of Applicanq CLARATION REG DII R TI ND areby affirm under penalty of perju 8is a a Ider's Name my signature below, I certify to as of the following: I am the property owner or author ed to ac— t onTFe I have read this application and t I agree to comply with all applicable city and county ordinances and I authorize representatives of this city or countXt9 enter t and my license is in full force ($100,000), IN ADDITION TO 3700 of the Labor Code, for My workers' Expiration Date 4211 P )gne i r t n pl_oy any pers . in any manner so as to become subject to the workers' comps sation laws of California, and R&I 13700 of the Labor Code, I shall forthwith comply with those pr visions for the performance of the work for which this permit is issued ec on 3097, Civil Code Insp. Initials: is-reFating to building construction. --" property for inspection purposes. Print Property Owner's or Authorized Agent's Name ACTION DATE- y DECLARATION OFCOMPLIANCENRTN CODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40AND AQMD RULE 1403. 1 SG C t•Dt 1,J4Ct PERMIT EXPIRED ❑ ISUBMITTED ASBESTOS NOTIFICATION'TO., ❑ ❑ EPA El f 1" N 2023 - 0 6b PERMIT CAN CELLED f t 6 2 PERMIT EXTENDED PROPOSED DEMOLIT OCASBESTOS NO R 'RON IS NOT APPLICABLE TO PERMIT FINAL CERTIFICA.TEOF OCCUPANCYISSUED SIGNATURE: