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Home My WebLink AboutH2023-0520 - Permits0E o_r City of Newport Beach D t Community Development Department- Building Division uF a. y 100 Civic Center Drive, Newport Beach, CA 92660 S Permit Counter Phone! 949) 718-1688 newportbeachca.gov/civic II II Mechanical Permit : H2O23-0520 Plan Check No : 0170-2022 Work Class : Other Issued Date : 08/18/2023 Inspection Area : 2 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 : 110 APOLENA AVE Legal Desc : A TR BALBOA ISLAND SEC 3 BLK 6 LOT 25 `� e _ f--,g rf'?, � Description: MECH INSTL (2) HEAT PUMPS, (1) @ THE MECH WELL AND (1) @ THE ROOF DECK, TAMPER RESISTANT CAPS REQ �' i"" '�� tl U a'—>l Owner: CLINT BURNS Address : PO Box 5917 Balboa Island, CA 92662 Phone: (714)366-2273 Applicant : SKY HEATING & COOLING INC Address : 769 N GLASSELL ST ORANGE, CA 92867 Phone : (714) 883-D623 Owner/Builder : Address Phone : Code Edition : 2022 Type of Construction Occupancy Groups: Fire Hazard Zone : NO Building Setbacks : Front: 5, Side: 3, Side: 3, Rear: 5 Flood Zone: X Use Zone: R-BI - Two -Unit Residential, Balboa Island PROCESSED Bg,,,�5 SPECIAL CONDITIONS: Contractor : SKY HEATING & COOLING INC Address : 769 N GLASSELL ST ORANGE, CA 92867 Phone: (714)883-0623 Con State Lic : 1045281 Lic Expire : 12/31 /2023 Bus Lic: BT30065983 Bus Lic Expire:02/28/2024 Workers' Compensation Insurance Carrier : NORGUARD INSURANCE COMPANY Policy No : SKWC473964 W. C. Expire : 2/1/2024 Manufacturer: Model#: ,- 11MERS PROHIBITED ON HEAT PUMPS OWNER -BUILDER DECLARATION I hereby afT 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) fim 'Section 7031.5. Business and Professions Code: Any city or county trial requires a permit to consilmot, alter. improve. demolish, or repair any structure, prior to Its issuance, also requires the applicant for .he permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' Stale License Law (Chapter 9 (commencing with Section 7000) of Division 3 of tho Business and �rofesslons 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 lot more than five hundred dollars {$500). 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions of the work, and the structure Is notintended or offered for sale (Section 7044, Business and Professions Code. The ContractorsState 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 R was not built or Improved for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed Contractors to Construct the project (Section 7044, Business and Professions Gode: 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). ❑ pI am exempt from licensure under the Contractors' Slate License Law for the following reason _. By I,y signalurD belay I acknowledge that, except far sly personal residence in Which I must have resided for at least one year prior to completion of the Improvements covered by this pennrt I cannot legally self a structure that I have built as an owner -builder if it has not peen constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Businoss and Professions Code, is available upon request when this application is submitted or at the following Web site:http:/i"ro .leginfo.ca..govlcalaw,html. jl-�and Siynatura of Property Owner or Authorized Agent ._....___._.......__.._..,____.._...._._..____..._-�.--------m_._____.�_—.�..��-�---.----- LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 f Di)+}si 3 of the Business a Profe my license Is in full force and effect. Llcensa Class License No to (' G Contractor nature IrIll WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION cov ERAGE IS UNLAWFUL, AND SHALL Suaj5el AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL pli UP TO ONE HUNDRED THOUSAND DOLLARS 15300,606), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORN€Y'S PEES. I hereby affirm under penalty of perjury one of the following declarations: I have and WE 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. fcr IT Ias rmance of the work for which this permit is issued, Pollcy No. hhove 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' compensaiiol ranee carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # 01 certify that. in the pe,anc a work for which this permit is Issued I shall not employ any person in any manner so as to become subject to the ID pe anon law of California, and ayre that, If I shout sea subject t Ot compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.4A— DECLARATONSiynature of A s f. . GARDEN off' LENDING AGENCY I hereby affirm on der p�nal'y pa,ruq LTat there is a construction lending agency for the performance of the work for which this permit is issued (Section odej. Lender's Name _ _ _ Lender's Address _,_By my signature below, I certify to each of the following: I am the property ov'rie• or a401orizLd to act on the property Owner's behalf. I have read this application and the information I have provided is correct. I agree to compy with nl1 apt iiaatrie city and county noes state laws relating to building construction. I authorize representatives of I, Ii,, ail r count en v - entitled property for inspection purposes. ^ SI nature of PropertyOwner or Authorized t Print Pro art Owner's or Authorized A e t' me �\ i,ii ACTION DATE BY 3 DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY i RFGl/1.ATIONS PART 51 OF TITLE 40 AND ACMD RULE !' EXPIRED PFAMIT FINAI ASBESTOS NUl'I FICATION IS NOT APPLICABLE TO CERTIFICATE OF CZ/t�'I Y�'�I PROPOSED DEMOLITION OCCllPANCY lSSlIEO -;_, 51GNATURE,.._ . ___... .. __.— .._...------- --