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Home My WebLink AboutH2021-0723 - Permitsh„ City of Newport Beach - Building Division H2O21-0723 100 Civic Center Drive, Newport Beach, CA 92660 ` Permit Counter Phone (949)644-3288 a �CSY04�\ T Job Address: 1519 BAY AVE E BIdg:1 Floor: Suite: Description of Work: MECH (2) A/C UNITS *TAMPER PROOF CAP REQ* Sty IJJFCT TO FIELD INSPF.0 !'Op InspectorArea:1 Code Edit: 2019 E1'[F'A' kNDAPPROVAL Legal Description: BALBOA TR EAST SIDE ADD LOT 9 ELK 24 E1/2 -INC 31/2 ABAN ST ADJ ON Owner: LUMPKIN CHARLES KEITH Contractor: Address: 1519 BAY AVE E Address: NEWPORT BEACH, CA 92661 Phone: 949-300-4813 Phone: Con State Lic: Issued Date:12/23/2021 Lic Expire: Bus Lic: Processed By: Lic Exp Date: D L S HEATING & A/C 8542 LARTHORN DRIVE HUNTINGTON BEACH CA 92646 714-231-8002 584220 01/31/2022 BT98040420 12/31/2021 MECHANICAL Permit: H2O21-0723 Project No: 2393-2018 Inspection Requests Phone (949)644-3255 CTU Worker's Comp Insurance - Carrier: STATE FARM ' Policy No: 92GUV4642 Expire :01106/2022 - HVAC Items FEES FurnacesBoilers & Compressors Ventilation Other Up to 100K 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 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: $38.28 Up to 1M BTU/hr: 0 $0.00 up to 10K CFM: 0 $0.00 Repair/Alter/Add: 0 $0.00 Model: IN4A548GKCIssuance: $38.00 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: $52.00 TOTAL: $172.28 Plan Check Fee : $0.00 Fee Due at Permit Issuance: $172.28 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. 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 items) (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 Licerfse Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and w-: Professions Code) or that he or she is exempt from licensure and the bases 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 ($500). - I, as owner of the property, or my employees with wages as rifeir sole comp$nsatlon, MIND 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 th, »rpose 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 Ppp'y to an owner cf 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 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 sell a structures that , 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 Pro,,'essions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. Sigrature of Prope-h, Owner or Authorized Agent Date L ICENSED CONTRACTOR'S DECLARATION I hPr=Dy affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 00) o ivision 3 of the Business an P f Sion ICOde and ,y license full force and effect. Li;ensa Class License No Date Or � Contractor Signaturd/ / WORKERS' COMPENSATION DECLARATION �\ WARNINu: FAILUFE TJ S«:URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAN OLLARS ($100,000), IN ADDITION TO THE CJST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS 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 thI performance of the work for which this permit is issued. Policy No. 4have 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' compensatior nce carrier and policy number are: :arrier Policy Number Expiration Date lame of Agent Phone # I certify that, in the *ofedury work for w h this per it is issued, I shall not employ any person in any manner so as to become subject to the workers' co pensation laws of California, and agree Tat, if I should becomrs' com ati p visions Of Section 3700 of the Labor Code, I shall forthwith comply with those provisions./ signature of Applicant Date' )ECLARATION REGAC N LENDING AGENCY hereby affirm under pt re is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Ender's Name Lender's Address ly my signature below, I certify to each of the following: I am the property owner or authorized to act On the property rier's behalf. I have read this application and the information I have provi ed is correct. I agree to comply with all applicable city and coun4ord,esd state law relating to uiiding construction.�,{�/Ja/��I authorize representatives of this city or countyabo = e tified a spection purposes. /'YL ol( GnGn�N- ;ignature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name /.�'�, ACTION DATE BY 77 DECLARATION OF COMPLIANCE WITH CODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TIRE 40 AND AQMD RULE 1403. PERMIT EXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMITCANCELLED PERMfTEXTENDED ❑ ASBESTOS N077FICATIONIS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL 0 CERTIFICATEOF SIGNATURE: OCCUPANCYUSUED