HomeMy WebLinkAboutH2022-0092 - Permits0City of Newport Beach - Building Division 111111111111111111111111111111111111111111111111 MECHANICAL Permit: H2O22-0092
` d 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 2 0 0 9 2 Project No : 0978-2021
_F ` Permit Counter Phone (949)644-3288
Tayy.,���ac�' 0 0 Inspection Requests Phone (949)644-3255
Job Address: 1101 BERKSHIRE LN BIdg:1 Floor: Suite:
Description of Work: MECH -INSTALL 2 A/C CONDENSERS. TIMERS & TAMPER -RESISTANT CAPS REQUIRED
InspectorArea:3 Code Edit:
2019
Legal Description: N TR 3031 LOT 9
Owner: BOTSFORD SCOTT & BARBARA
Contractor:
Address: 1101 BERKSHIRE LN
Address:
NEWPORT BEACH, CA 92660
Phone:
Phone:
Con State Lie:
Issued Date:02/23/2022
Lie Expire:
Bus Lie:
Processed By:
Lie Exp Date:
D L S HEATING & A/C
8542 LARTHORN DRIVE
HUNTINGTON BEACH CA 92646
714-231-8002
584220
01/31/2024
BT98040420
12/31/2022 _
INS
Worker's Comp Insurance -
Carrier: STATE FARM
Policy No: 92GOK7865
Expire :01/06/2023
HVAC Items
FEES
Furnaces Boilers & Compressors
Ventilation
Other
Up to IOOK BTU/hr:
0
$0.00
Up to 3HP:
2 $44.00
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 IOOK 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:
$38.28
Up to 1 M BTU/hr:
0
$0.00
up to 1 OK CFM:
0 $0.00
Repair/Alter/Add:
0 $0.00
Model:
XL161 R4101ssuance:
$38.00
Up to 1.75M BTU/hr:
0
$0.00
Over 1 OK CFM:
0 $0.00
Supplemental Fee:
$0.00
Manufacturer:
Over 1.75M BTU/hr:
0
$0.00
VAV Box:
0 $0.00
Zoning PC:
$52.00
TOTAL:
$172.28
Plan Check Fee:
$172.28
Fee Due at Permit Issuance :
$0.00
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LASTY(1LLP `NSPECoTI01,V, o d a a a
Construction Hours: Monday - Friday 7:00 a.m.to 6:30 p.m.and Sat> tday, fromV:60 a^ to 60 P.n.1
e a r s a a a a e
e a % s
a e a e
a• a.® c a as a• aca
fNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the mason(s) 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, prior to 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 Law (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 Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
more than five hundred dollars ($500). 1
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions
lusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, throu
nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of cc
nproved for the purpose of sale).
1 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7C
pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contra
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 o
ell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors.
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.Ie
'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 Section 700
nd effect.
icense Class License No Date i
COMPENSATION DECLARATION
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).
e year prior to completion of the Improvements covered by this permit, I cannot
understand that a copy of the applicable law, Section 7044 of the Business and
of Division 3 of the Business and
is in full force
'ARNING: 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 1$100,000), IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
koa ad 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 the
rn e the work for which this permit is issued. Policy No.
and will maintain workers' compensation
carrier and policy number are:
of Agent
insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
_ Policy Number Expiration Date
Dh— ee
certify that, in the performance of the wor ;-for hich this permit is iptied, I shall not employ any person in any
if I should become subject to the wo rs' mpensation pro ns of Section 3700 of the Labor Code, I shall
lature of Applicant //"//''\
weby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for
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 the
I have read this application and the information I have provAed is orrect.
I agree to comply with all applicable city and county or ' ances nd weee laws relating to building construction.
I authorize representatives of this city or county to/ -Identified property for inspection purposes.
nature of Property Owner or AuthorizPrint Prooertv Owner's
ACTION DATE • • ... fl i • •
PERMIT EXPIRED
PERMIT CANCELLED • «'
PERMITEXTENDED
PERMIT FINAL .2
CERTIFICATEOF s • • o e
OCCUPANCYISSUED
so as to become subject to the workers' compensation laws of California, and agree
i comply with those provisions. ^ 1) 3 j 1
this permit is issued (Section 3097, Civil Code).
Name
• •FEDERAL REGULATIONSPART 61 OF TITLE40AND
• AQMD RULE 1403
:❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO:
` ❑ EPA
❑ AQMD
❑ ASBESTOS NOTIFICATION IS INOT APPLICABLE TO
PROPOSEDDEMOUTION.
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