HomeMy WebLinkAboutH2021-0088 - PermitsCity of Newport Beach - Building Division MECHANICAL Permit: H2O21-0088
;4a 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 1 0 0 8 a Project No : 1172-2020
Permit Counter Phone (949)644-3288
V.
Inspection Requests Phone (949)644-3255
Job Address: 523 SIGNAL RD
BIdg:1 Floor: Suite:
✓I �. ��®
Description of Work: MECH (2) NEW A/C UNITS *TAMPER PROOF CAP REQ*
LETTER & TIMER
REQ
Inspector Area:3
Code Edit: 2019
Legal Description:
....
Owner: VALENTINE ANTHONY Contractor:
D L S HEATING & A/C
Worker's Comp Insurance -
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°•
;
Address: 523 SIGNAL RD
Address:
8542 LARTHORN DRIVE
Carrier: STATE FARM
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NEWPORT BEACH CA 92663
HUNTINGTON BEACH CA 92646
Policy No: 92GUV4642
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• °
Phone: 949-584-9594
Phone:
714-231-8002
Expire:01/06/2022
6°
Con State
Lic: 584220
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Issued Date:02/09/2021
Lic Expire:
01/31/2022
•°
Bus Lic:
ST98040420
6 G °
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Processed By:
Lic Exp Date: 12/31/2021
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HVAC Items
FEES
Z. °
FurnacesBoilers & 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 10oK 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 10K CFM: 0
$0.00 Repair/Alter/Add:
0 $0.00
Model: N4ASIssuance:
$37.00
Up to 1.75M BTU/hr: 0 $0.00
Over 10K CFM: 0
$0.00 Supplemental Fee:
$0.00
Manufacturer: DAY & NIGHT
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
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.
TIMER REQUIRED ON EQUIPMENT
TO SHUT OFF BETWEEN 10 P.M. AND 7 A.M.
)WNER-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 jjem(a)
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
ie 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
'rofessions 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
of more than five hundred dollars ($500).
1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
nprovements 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
n roved for the purpose of sale).
1, 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
only 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:
ly 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 legally
ell a structure AmI.I.Mve 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
:rpWIi Code, is mailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
)ignatum, of PrdipegY Q%ner or Authorized Agent to
ICEN'SED CONJRACTOR'S DECLARATION
erralby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing w' ''action 7000) of Division 3 of the BusinessWEDTHOUSAND
e, and my license is in full force
M effect. s ] (
Icanig Class • • •' License No Date " 1 Contractor Signatur
YPPAERS' COMPEtISATION DECLARATION
(V2UIgg:*FAILURE lU•SMURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYE TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONOLLARS (E100,000), INADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
•• ♦•
$ere6y affirm unAerpeRalty of perjury one of the following declarations:
1,4q'E and will9naidtain 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 IN
rforma/nc of tH yapNfor which this permit is issued. Policy No.
• ill 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' compensatior
Is ce carrier and policy number are:
Policy Number
Date
TIE of Agent Alone n
certify that, in the performanc of the work for w ' this permit is issued, I shall not emplo an erson in any manner so as to become subje to the workers' compensation laws of California, and agree
t, if I should become bjec o the rkers' mpensation provisions of S o e Labor Code, I shall forthwith comply with those o isions. G
nature of Applicant Dat � I � I
CLARATION REGA STRUCTION L ING AGENCY
ersby affirm under pe alty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued JSe\ct1on 3097, Civil Code).
Ider'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 theWtheove-identifil
behalf.
I have read this application and the information I hTact.
I agree to comply with all applicable city and D mtate laws relating to bu' onstruclion.
I authorize representatives of this city I cou t toed pro r inspection purposes. -, ( � -`J D
nature of PropertyOwner or Authorized Agent Print Property Owner's or Authorized Agent's Name j /V J 4�
ACTION I DATE
PERMIT CANCELLED
P€RA41TEXTEOVDED
OCCUPANCYISSUED
BY urc.Lf1rw111s1r yr I.,", 1�.� yr - run urn.. we ..a,�,.•
FEDERAL REGULATIONS PART 64 OF T17LE40AND
AQMD RULE 1403,
❑ f SUBMITTEDASBESTOS MOnFICATION TO:
❑ EPA
AQMD
ASBESTOS M07117CAIIOMIS NOT APPLICABLE TO
PROPOSED DEMOLITION. _.,.
SIGNATURE:
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