HomeMy WebLinkAboutH2022-0159 - PermitsCity of Newport Beach - Building Division H2O22--0159
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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MECHANICAL Permit: H2O22-0159
Project No: 0860-2020
Inspection Requests Phone (949)644-3255
Job Address: 1140 BAY AVE W BIdg:1 Floor: Suite:
Description of Work: MECH/INSTALL (2) ROOF MOUNTED A/C UNITS 43dB & 44dB (DAY& NIGHT; INH4A436AKA & INH4A448AKA)
Inspector Area:1 Code Edit: 2019
Legal Description: N TR 626 BLK 4 LOT 1
Owner: WELLS JOHN Contractor:
Address: 3239 COUNTRY CLUB DR Address:
GLENDALE, CA 91208
Phone: 818-415-2933 Phone:
Con State Lic:
Issued Date:03/23/2022 Lic Expire:
/ Bus Lic:
Processed By: y ` Y Lic 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
Worker's Comp Insurance -
Carrier : STATE FARM
Policy No: 92GOK7865
Expire :0110612023
CC
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HVAC Items
FEES
Furnaces Boilers & Compressors
Ventilation
Other
Up to 100K BTU/hr:
0
$0.00
Up to 3HP:
0 $0.00
Bathroom Fan:
0 $0.00
Fire Dampers:
0 $0.00
$0.00
Over 100K BTU/hr:
0
$0.00
> 3 HP to 15 HP:
2 $78.00
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 :
$65.25
Investigation:
$0.00
Over 500K BTU/hr:
0
$0.00
Air Handling Units
Comm. Hood:
0 $0.00
Plan Check:
$67.86
Up to 1M BTU/hr:
0
$0.00
up to 10K CFM:
0 $0.00
Repair/Alter/Add:
0 $0.00
Model:
Issuance:
$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:
$301.11
Plan Check Fee
: $0.00
Fee Due at Permit Issuance:
$301.11
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Construction Hours: Monday - F4oay 7:00 a.jn.to 6:LO p.rn.and Saturday from 8:00 a.m. to 6:00 p.m.
DWNER-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 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 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,
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 the purpose 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
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).
❑ 1 am exempt from Iicensure 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, 1 cannot lega111
sell a structure that I 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
Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 7000) of Division 3 of the Business and Profess ode, aW my license is in full force
and effect. n ) `l1
License Class License No Date Q' oz °, Contractor Signatur'C
WORKERS' COMPENSATION DECLARATION
NARNING: 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 ($100,0007, IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
❑ 1 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 th
oerformance of the work forwhich this permit is issued. Policy No.
have androkmaintain 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'
Date
Of
certify that, I�e performance of t\e w r or this permit is is dTl�l not employ any person in any manner so as to become subject to the workers' compensation laws Of California, and agre
t, if I should become sub ct to the wo airs' compens tion provis e 1 3700 of the Labor Code, I shall forthwith comply with those provisions,
nature of Applicant', Date(/���//
CLARATION REGA IN CON UC NDING CY
areby affirm under nalty 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).
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 t property owne ehalf.
I have read this application and the information I have pro�ed is corect.
I agree to comply withal] applicable city and county rdina es allate laws�relg to building construction.
I authorize representatives of this city or county t nter P e�b6ve-identified for inspection purposes. (�'� S n L7C a
nature of Prooertv Owner or Authorized AGED // / Print Property Owner's or Authorized Agent's Name Y DON, Q Da �
AC77ON
DATE
BY
DECLARA TION OF COMPLIANCE Al TH CODE OF
FOR OFFICE USE ONLY
FED6Z1, RE GOLAR6NS FAkT 61 Or TI TLc 40 AND
AQMD PULL -403.
PERMIT EXPIRED
❑ 1 iUF3M'TTEDASBEST9S NOT7FICATI'DN TO:
❑ EPA
❑ AQMD
PERMIT CANCELLED
PERMITEXTENDED
❑ ASBESTOS N077RCATION IS NOT APPLICABLE TO
PROPOSE) DLMOI IRON
PERMIT FINAL
CERTIFICA TE OF
SIGNATURE,
OCCUPANCYISSUED
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