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Home My WebLink AboutH2021-0348 - PermitsCity of Newport Beach - Building Division H2O21-0348 b 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 spa: �ttaa74+ TIMERS PROHIBITED Job Address: 2701 CIRCLE DR BIdgA Floor: Suite: ON HEE Description of Work: MECH (4) NEW A/C UNITS *TAMPER PROOF CAP REQ* Inspector Area:2 Code Edit: 2019 Legal Description: N TR 1102 LOT 27 Owner: LISENBEE GARY Contractor: COMFORT HEATING & A/C Address: 2581 CIRCLE DR Address: 21962 COSALA NEWPORT BEACH CA 92663 MISSION VIEJO CA 92691 Phone: Phone: 714-335-7055 Con State Lic: 632774 Issued Date:06/01/2021 Lic Expire: 12/31/2021 C (� Bus Lic: BT30005700 Processed By: 0 ` Lic Exp Date: 08/31/2021 MECHANICAL Permit: H2O21-0348 Project No : 2733-2019 Inspection Requests Phone (949)644-3255 ayya ° dQaa QcocO� ° a a aaJ . c°oa ma°• a ° Worker's Comp Insurance - a o aooa°a owav Carrier: WIC EXEMPT aaoa• Policy No: (NO EMPLOYEES) aaoaaa O O O a Expire � a m° a HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K BTU/hr: 0 $0.00 Up to 3HP: 4 $84.00 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: $73.08 Up to 1 M BTU/hr: 0 $0.00 up to 10K CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: AM060MXMDCHIAA Issuance: $37.00 Up to 1.75M BTU/hr: 0 $0.00 Over 10K CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: SAMSUNG Over 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $46.25 TOTAL: $240.33 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $240.33 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 s , . 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 "roperty, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and F%feiSidns 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 hprpye}nents arp.%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 4nprovad for the pa.MDee of sale). •. 1,'ag owner of1he 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 ATp exem%%oficensure under the Contractors' State License Law for the following reason: y rnysignature 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 legal) 9 actmcture t6at,14° ve 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 ,rpfegs•Ions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. $i94at ire of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereb. affirm ruder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70000)) of Division 3 of the Business nd Professions e, and my license I I ull force ntl a at. , G" I Contractor Si '9 LicCMe Class • • • • • • License No Dat Signature WORKERS' COMPENSATION DECLARATION WARNING: 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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I 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 IN performance of the work for which this permit is issued. Policy No. I have and will 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' compensatio insurance carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # I certify that, in the performance of the work which this permit is issued, I shall not employ any person in any manner so as to become subject to he workers' compensation laws of California, and agre tha , certify should become'_s�u/h�ectlip�th�e w_orke ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those pro Elis. n Signature of Applicant 1 4e /� //!'/ �% 1 Date DECLARATION REGAWAZI4,019STRUCTION LEMbINU AGENCY 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 county ordinances and ate laws relating to building construction. G. / I authorize representatives of this city or county ente he abpv entif d property for inspection purposes. Signature of Property Owner or Authorized Agent // L Print Property Owner's or Authorized Agent's Nam �f' / �y Data AC77ON DATE BY DECLARATION OF COMPLIANCE i47TN CODE OF FOR OFFICE USE ONLY FEDERAL REGUtATiDNSPARP 6f OF TtTLE40AND AQMD RULE 1407 PERM1TEXP1RE0 ❑ 1 SUBMITTED ASBESTOS NOTfFiCAFfON TO: ❑ EPA ❑ QQMD' ❑ ASBESTOS N073RCA7fONfSNOT APPLICABLE TO PROPOSED DEMOLITION. PERM/TCANCELCEO P€RM7FEXTENDED PERMIT FtNAt C€R77ACA7EOF SIGNATURE. OCCUPANCYISSUED