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Home My WebLink AboutH2020-0606 - PermitsCity of Newport Beach - Building Division III 1I111p1ps111p111111111I pNINIII 100 Civic Center Drive, Newport Beach, CA 92660 H 2 0 2 0 0 6 0 6 y Permit "ounter Phone (949)644-3288 z aw+crpniF��. Job Address: 2200 HEATHER LN BldgA Floor: Suite: Description of Work: MECH/ C/O FAU TO A/C IN ATTIC, ADD HEAT PUMP & DUCTING *TAMPER RESISTANT CAP REQ* Inspector Area:3 Code Edit: 2019 Legal Description: N TR 3138 LOT 1 Owner: JAM Address: 200 HEATHE LN NEWPORT BE CH, CA 92660 Phone: 949-400-7353 Issued Processed Contractor: Address: Phone: Con State Lic: Lic Expire: Bus Lic: Lic Exp Date: FOLGER HEATING & AIR INC 8842 LUSS DR HUNTINGTON BCH CA 92646 714-334-4433 763312 04/30/2022 BT30047641 06/30/2021 MECHANICAL Permit: H2O20-0606 Project No : Inspection Requests Phone (949)644-3255 Worker's Comp Insurance - Carrier : NORGUARD INS CO Policy No: FOWC018285 Expire :10101/2020 IN S P EC TOM 30PJS° SSIJBJECTTO FIELD INSPECTOR'° REVIEW AND APPROV A-L 4C Items FEES nacesBoilers & Compressors Ventilation Other to 100K BTU/hr: 0 $0.00 Up to 3HP: 1 $21.00 Bathroom Fan: 0 $0.00 Fire Dampers: 0 $0.00 $0.00 :r 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 II/Floor Heaters: 0 $0.00 >15 HP to 30 HP: 0 $0.00 Attic Fan: 0 $0.00 Metal Fireplace: 0 $0.00 it Pumps & Package Units >30 HP to 50 HP 0 $0.00 Down -Draft Fan: 0 $0.00 Record Mgt Fee: $0.00 to 100K BTU/hr: 1 $21.00 >50 HP: 0 $0.00 Residential Hood: 0 $0.00 Additional Fee: $18.27 Investigation: $0.00 -r 500K BTU/hr: 0 $0.00 Air Handling Units Comm. Hood: 0 $0.00 Plan Check: $0.00 to 1 M BTU/hr: 0 $0.00 up to 1 OK CFM: 0 $0.00 Repair/Alter/Add: 1 $21.00 Model: 4SHP20LX160P Issuance: $37.00 to 1.75M BTU/hr: 0 $0.00 Over 1OK CFM: 0 $0.00 Supplemental Fee: $0.00 Manufacturer: AC PRO -r 1.75M BTU/hr: 0 $0.00 VAV Box: 0 $0.00 Zoning PC: $46.25 TOTAL: $164.52 Plan Check Fee: $0.00 Fee Due at Permit Issuance: $164.52 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. r111MR-DUILUCR UCI.WKNIIVN -- 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) lion 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, alsolmt Nirwthe 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). I, as ownerof the, property, or my employees with wages as their sole compensation, will do (_) all of or U portions of tl iness and-Riefassions Code: The Contractors' State License Law does not apply to an owner of property who, through e royements are not intended or offered for sale. If, however, the building or improvement is sold within one year of comp) Ieved for T?3`pTlfpose of sale). I. as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, I:tO an ownef of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor I jam exerTO from:ficensure under the Contractors' State License Law for the following reason: 4snature ®eloh I acknowledge that, except for my personal residence in which I must have resided for at least one yi structure ttrat �ifave built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I unc LA%ions Code, Is available upon request when this application is submitted or at the following Web site:hftp://www.leginf rature of Property Owner or Authorized Agent EMED CQNTRACTOR'S DECLARATION reb; affirm Vn der pl3nalty of perjury that I am licensed under provisions of Chapter 9 (commencinkwith Action 7000) of .... License No c6VTPENSATION DECLARATION ®- iiy�� 'ARNING FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALI 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: have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of rfn -rice of the work for which this ennfl' IS i d P I N k, and the structure is not intended or offered for sale (Section 7044, ees' or personal effort, builds or improves the property, provided that the the Owner -Builder will have the burden of proving that it was not built or and Professions Code: The Contractors' State License Law does not to the Contractors' State License Law). u1 cornplenon or me Improvements covered by this permit, I cannot that a copy of the applicable law, Section 7044 of the Business and Date rision 3 of the Business an ssions Code nd my license is in full force _ Contractor SignatureCIVILT" AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS t$100,0001, IN ADDITION TO THE Relations as provided for by Section 3700 of the Labor Code, for p ssue . ocy o. and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the perforrmance of the work for which this permit is issued. My workers' carder and policy number are: Policy Number of Agent Date certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so es to become subject to the workers' compensation laws of California, and ogre t, if I should becom@@ ssuu�ub''eecct to the Workers' compe Ion provisions of Section 3700 of the Labor Code, I shall forthwith cdmply with those provisions. nature of Applicant i:: —�� mil— _ Date CLARATION REG DING NSTRUCTION LENDING AGENCY ereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issu€d (Section 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 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 state laws relating to building construction. k- -Z-t I authorize representatives of this city or county o the above= ntfied property for inspection purposes. 11 Da nature of Property Owner or Authorized Agen Print Property Owner's or Authorized Agent's Named AC7ON DATE l BY DECLARATION OF COMPLIANCEWITHCODEOF FEDERAL REGUL4TIONSPART 61 OF TITLE40AND AQMDRULE 1403. ❑ I SOBMITTEDASBESTOS NOTfF[CATRM TO: ❑ EPA ❑ AQMD [3ASBESTOS NOTfFICAPONIS NOT APPLICABLE To PROPOSEDDEMOIITION. SIGNATURE. fOR DFFICE tiSEONLyI PLRAMTFXP/REO PERMITCANCELLED PERMIT EXTENDED PERMIT FINAL - CERTiFICATEOF OCCUPANCYISSUED