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HomeMy WebLinkAboutH2023-0652 - PermitsEWP'o,?r City of Newport Beach nt-Building Division Mechanical Permit :H2O23�OVIII I I I III III II IIIIII I I II c52 Communt Development Depart me 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: 'n Permit Counter Phone: (949) 718-1888 Work Class : Other u ' newportbeachca.gov/civic Issued Date : 1010912023 CgGiFOr�N`p Inspection Area : 4 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS Job Address : 83 HILLSDALE DR Legal Desc : N TR 11785 BLK LOT 5 UN 41 TR 11785 LOT 5 UNIT 41 Description: MECH - R/R HEAT PUMP & AIR HANDLER. TAMPER -RESISTANT CAP REQ-D Owner: ROSENBAUM DANIEL I TR Contractor : JUST RIGHT SERVICES PLUMBING HEATING & & A/C Address : 83 HILLSDALE DR #50 NEWPORT BEACH, CA 92660 Address : 23482 PERALTA DR LAGUNA HILLS, CA 92653 Phone : Phone : (949) 228-2108 Con State Lie : 970383 Applicant: BEN MEDINA Address: 31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362 Phone: (818)735-7876 Owner/Builder : Address Phone : Code Edition : 2022 Fire Hazard Zone Type of Construction occupancy Groups: Building Setbacks : Flood Zone : X ID Use Zone: PC - Aeronutronic Ford Rol PROCESSED BY: SPECIAL CONDITIONS: Q Lie Expire : 04/30/2024 Bus Lie : BT30066798 Bus Lie Expire:04/30/2024 Workers' Compensation Insurance Carrier : SECURITY NATIONAL Policy No: SWC1452087 W. C. Expire : 7/15/2024 NO Manufacturer: AMERICAN STANDARD Model# : 4ABL5048 OWNER -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 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 )a permit to fle 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 'rofessions 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 fora permit subjects the applicant to a civil penalty of at more than five hundred dollars ($500). 7 i, as owner of the property, 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 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 nprovements 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 uproved for the purpose Of sale). -1 1, as owner of the property, am exclusively contracling With licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale License Law does not pply 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 I am exempt from licensure under the Contractors' State License Law for the fol1mving reason. ,y 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 legall, ell 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http:l/www.leginfo.ca.gov/calaw.html. ignanne of Property Owner or Authorized Agent _ _ _ Date .10ENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sao 7000� n 3 of the Business and Prate sIons, Codjaoom my license is in full force rid effect License Class License. No d�`tvra',1]��\\` 11 Contractor Signatur JORKERS' COMPENSATION DECLARATION ARNING:: FAILURE TO SECURE WORMERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THDOLLARS I$100A00), IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES, hereby affirm under penalty of perjury one of the following declarations 7 I have and will maintain a certificate of consent 10 self -insure for workers' compensation, issued by the Director or Industrial Relations as provided for by Section 3700 of the Labor Code, for th Ell ormance of the work for which this permit is issued. Policy No, 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' Carrier and policy number are: Policy Number Expiration Date of Agent I certify that. in the performance of ft or which this permit is issued, I shall not employ any person in any manner so as t0 become subject to the workers' compensation laws of California, and ogre t, if I should become sub' cl tot rue ompensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant D.ytk l CLARATION REOA i CONry UCTION LENDING AGENCY�T Jc—"' `"-'� areby affirm under papa that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Iders Name _ _ _ Lenders Address my signature below, I certify to each of the following: I Bill the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided' ct. I agree to comply with, all applicable city and county ardi ces and state laws relating to b Ing construction. I authorize representatives of this city orcountyant above-identi er y for inspection purposes. I 1 �a�A7lG nata D �4 nature of Property Owner or Authorized Ai en Print Property Owner's or Authorized AaenCs Nan IAI� PERMIT EXPIRED PERMIT CANCELL PERMIT FINAL CERTIFICATE OF OCCUPANCY ISSUED OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY PART fit OF TITLE 40 AND AO,MD RULE Lt I suBMITTF.D ASBESTOS NOTI FICATION TO GASBESI 05 NOTIFICATION IS NOT APPLICABLE TO fff--- PROPOSED DEMOLITION SIGNATURE: