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Home My WebLink AboutH2022-0097 - PermitsCity of Newport Beach - Building Division IIIIIII111111111111111111111111111111111111111111 MECHANICAL Permit: H2O22-0097 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 2 0 0 9 7 Project No: 2795-2019 (9) Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 4515 ORRINGTON RD BIdg:1 Floor: Suite: Description of Work: MECH (4) NEW A/C UNITS *TAMPER PROOF CAP REQ* Inspector Area:5 Code Edit: 2019 Legal Description: N TR 3357 LOT 76 Owner: ZIEMBA FAMILY TRUST Contractor: FOLGER HEATING & AIR INC Worker's Comp Insurance - • - -• • - Address: 520 FIINTDALE RD Address: 8842 LUSS DR Carrier: CLEAR SPRING PROPERTY• HOUSTON, TX 77024 HUNTINGTON BCH CA 92646 Policy No: CWC00194500 Phone: Phone: 714.334-4433 Expire :10101/2022 - - Con State Lic: 763312 Issued Date:02/2412022 /'� Lic Expire: 04/30/2022 Bus Lic: BT30047641 Processed By: l J0V Lic Exp Date: 0613012022 HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 0 $0.00 Up to 3HP: 4 $88.00 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: $76.56 Up to 1M BTU/hr: 0 $0.00 up to 1OK CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: AULD60WIssuance: $38.00 Up to 1.75M BTU/hr: 0 $0.00 Over 1 OK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: AC PRO Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $52.00 TOTAL: $254.56 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $254.56 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. 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 L) all of or L) 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 the Contractors' State License Law for the following reason: By my signature. beiuW 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 th.:t 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 Pn1e3rinns Code, is Fvailable upon request when this application is submitted or at the fallowing Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date I ICENFED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing wi Section 7000) of Division 3 of the Business and Profes 'ons Code, and my license is in full force arA effect. / I icers= Class License NO Date Z` Z _ Z''Gontractor Signature I� \Y=FIY.ERS' COMOENSATION DECLARATION rr RN'N3: 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 I$100,0001, IN ADDITION TO THE COST OF COMPENSATI3N, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under Fcnalty of perjury one of the following declarations: ' h3"e 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 th e orrwOen of the wurj` for which this permit is issued. Policy No. hale and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, far the performance of the work for which this permit is issued. My workers' compensatio in ce carrier and policy number are: - arner Policy Number Expiration Date Name of Agent Phone # I certify that, in the perfor ance 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 agre that, if should becomes b ect to-thD-w ers' compe s i n provisions of Section 3700 of the Labor Code, shall forthwith comply with those pro/y/dons. Signature of Applicant, i Datd' I�— DECLARATION REGARQfNG CONSTRUCTION LENDING AGENCY ix I 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). Lender's Name Lender's Address By 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 coung ordinances and state laws relating to building construction.�- I authorize representatives of this city or county entsQhe above-i,: lifted property for inspection purposes. Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Na" D ACTION DATE BY DECLARATION OFCOMPLIANCE INlTN CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE'l403. PERMITEXPIRED ❑ !SUBMITTED ASBESTOS N017FlCATlON TO: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMITEXTENDED El ASBESTOS NOAFICARON IS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL g 3O —24�1 M CE,4TlF7CATEOF SIGNATURE: OCCUPANCYlSSUED