HomeMy WebLinkAboutE2022-0685 - Permits:E2022-0685
City of Newport Beach
Community Development Department - Building. Division
pElectrical lan Check Normlt
100 Civic Center Drive, Newport Beach, CA 92660
Work Class : Other
Permit Counter Phone: (949) 644-3288Inspection Requests Phone: (949) 644-3255 tr
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Issued Date: 09/29/2022
Inspection Area : 2
newportbeachca.gov(nspections
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PERMITS EXPIRE 190 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE
NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS
NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN
HIGH DENSITY AREAS AND
Job Address : 815 VIA LIDO SOUD Legal Desc : N TR
907 BLK LOT 303
Description: ELEC: INSTALL ELECTRICAL FOR HEAT PUMP REPLACEMENT (H2O22-0527)
Contractor : 20TH CENTURY AIR INC
Owner: BROOKE COLDREN
Address : 4061 E LA PALMA AVE #A ANAHEIM, CA 92807
Address : 815 VIA LIDO SOLD NEWPORT BEACH, CA 92663
Phone: (714).:514 9426
Phone : (714) 606-8449
Con State Lic : 511598
Applicant : 20TH CENTURY AIR INC
Lic Expire : 06/30/2023
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Bus Lic:BT30054933Bus
Address : 4061 E LA PALMA AVE #A ANAHEIM, CA 92807
Lic Expire:05/3112023
Phone: (714) 514-9426
Workers' Compensation Insurance
Carrier: INSURANCE COMPANY OF THE WEST
Owner/Builder:
Policy. No: :WSA55038606 :.
Address :
W. C. Expire: 12/18/2022
Phone:
2019
: Fire Hazard Zone : NO
Code Edition :
Occupancy Groups : R3/U
Type of Construction :
Building Setbacks : Front:4, Front: 10, Side: 3, Side: 3
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Flood Zone: AE,8FT; X
Use Zone: R-1 - Single -Unit Residential
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SPECIAL CONDITIONS: STOPWORK 122-2705
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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 applicableltem(s)
(Section 7031.5,. Business and Professions Code; Any city or county that requires a permit to construct, after, improve, demolish, or repair any structure, prior to its Issuance, also requires the applicant for
the parmft to fife a signed statement that he or she is licensed pursuant to the pmvisions 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 17031.5 by any applicant for a permit subjects the applicant to a civil penalty of
'not more than two hundred dollars($500).
111 as owner of the ro 0
rkins Of the
Business and Professions Code: The Contractors, s, State oyees with aLicen a Law ges as their sole compensation, f does not apply to an ona of pmperty who, through em
Improvements are not intended or offered for sale, if, however, the building or improvement Is sold within one year of complet
II roved for the purpose of sale).
Li I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Su
apply to an owner of property who builds or improves thereon, and %he contracts for the projects with a licensed Contractor pi, ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason:
By my signature below I acknowledge that, except for my personal residence in which I must have resided ieast one yea.
for at .
sell a stnrclure, that I have built as an oner-bupdar if it has not been constructed in its entirely by licensed contractors. I under
professions Code, is avaffable upon request when this application is submitted or at the following Web slte:http.1AVww.leginfo.c
'signature of Property Owner or Authorized Agent
'JCENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter g (commencing with Section 7 ) D
and effect. License Class License No �j
YORKERS' COMPENSATION DECLARATION Date!M11
fARNING FAILURE To SECURE woe"EM" COMPENSATNN,N COVERAGE IS UNLAWFUL, AND SHALL SUEJECT AN EMPLOYER TO CRIMINAL PENALTIES
:DST OF COMPENSATION, DAMAGESAS PROVIDED FORM SECTION a700 OF THE LABOR CODE, INTEREST, ANO ATTORNEY'$ FEES.
hereby affirm under penalty of perjury one of the following declarations:
I
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
ss and Professions Code: The Contractors' State License Law does not
Int to the Contractors' State License Law),
to completion of the €mpmvemerds Coven
that a. copy of the applicable law, Section
and
Dale
the Business and Professions C my license is i�—tlrll
Contractor Signature
Ci FINES UP TO ONE HUNDRED THOUSAND DOLLARS [$1W000),. IN
have and will maintain a certificate of Consent to self -insure for workes' compensation, issued by the Director of mdLs
Imanee of the work for which this permit is issued. Policy No. Relations as Provided for by Section 3700 of the Labor Code, for
ave and will maintain workers' Compensation insurance, as required by Section 3700 or the Labor Code, for the
Inca canter and policy number are: Performancethe of work for which this permit is issued. My workers` Compensal
of Agent
Policy Number
certify that, In the performan h Ork for which this permit is issued I shall not employ any person in any manner so
, if I should become subject t € kern' compensation provisions of Section 3700 of the Labor Code, I shall forthwith a
udure of ADDlican
d.--"..v nvoxtrr _..
hereby affirm under penalty of pegury that there rs
.antlers NysfiQa construction lending agency for the performance of the work for which this
• • Lenders Address
3yg y signak"VIOw, I certify to each of the following:
• I am �e.pr PEIRy owner or authorized to act on the property Owls behalf.
• • I have r�dtgis application and the information I have provide I Correct.
• • I agree toFamply with all applicable city and Counby ordi n s_ ntl state laws relating to building construction.
• I authorize reWsentatives of this city or county to enfer t ve-klentified property for inspection purposes.
3anafure Rf PrRna rl a.... n..
'��'�^ •• • I DATE E By (DEC(AAATION OF COMPEIANCE WITH COOEoFFEDFRAL FOR OFFICE USE
s
• • • • • • REGULATIONS PART 51 OF TfTLE 4DANDAQMD RULE
ZZTIFI FIM • •jjV ZBE5y,J TOS NOTIFICATION iS NOT TiPPLfCABLE 70 COCCUPANCYISS • � '�I� PROPOSED DEMOLITION
OCCDPANCYlSSUED
Date
to become subject to the workers' Compensation laws or Caliiom'ra, and age
with those provisions.Date
is issued (Section 3(107, Civil Code).