HomeMy WebLinkAboutH2022-0450 - Permitsa�WPoRT City of Newport Beach III I I I II I II I II II III I II II
Community Development Department- Building Division
i y 100 Civic Center Drive, Newport Beach, CA 92660
? Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
°94FonN�r newportbeachca.gov/inspections
Mechanical Permit : H2O22,-0450
Plan Check No: 1591-2020
Work Class : Other
Issued Date : 0812912022
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 : 1814 PORT CHARLES PL Legal Desc : N TR 6622 BLK LOT
Description: MECH (2) NEW A/C UNITS *TAMPER PROOF CAP REQ'.
Owner: BLACKBURN TIMOTHY M TR
Contractor:
RANCHO-VIEJO A/C & HEATING
Address : 1814 PORT CHARLES PL NEWPORT BEACH, CA 92660
Address : -
'22596 COTTONWOOD CIR LAKE FOREST, CA 92630
Phone :
Phone : ;.
(949) 2.12-4870
Con State Lie
: 745018
Applicant: RANCHO VIEJO A/C & HEATING
Lie Expire :.
11/30/2023
Address : 22596 COTTONWOOD CIR LAKE FOREST, CA"92630
Bus Lie:
BT30031040
Phone: (949) 212-4870
Bus Lie Expire:03/31/2023
Workers' Compensation
Insurance
Owner/Builder:
Carrier:
ACCREDITED+SURETY+AND+CASUALTY+COMPANY+INC
Address :
Policy No:
1AUICA160129868000
Phone:
W. C. Expire.::
3/15/2023
Code Edition : 2019 Fire Hazard Zone : N
Manufacturer: BRYANT
Type of Construction :
Model# : 124ANS
Occupancy Groups:
Building Setbacks : Front: 20, Side: 5, Side: 5, Rear: 10 ,
Flood Zone: X
Use Zone : PC - Harbor View Hills
TIMER REQUIRED ON EQUIPMENT ,
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PROCESSED BY: SHUT OFF BETWEEN 10 P.M.
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I hereby affirm under penalty of perjury that; am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable Ramos
!Coon 7031.5, Business and Professions Code: Any city or county that requires apermit to construct, alter, improve, demolish, or repair any structure, prior to Its Issuance; also requires the applicant for
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 3of the Business and
-fessions Code) or that he or she is exemptfrom lioensure 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
more than five hundred dollars ($500).
1, as owner of the property, or my employees with wages as their sole compensation„ wilt do f_.) all of or U porttonslof the work, and the structure Is not intended or offered for sale ''(Sect,6 7044,
;iness and Professions Code: The Contractors' State License Law does not apply town owner of property who, through,employees' or personal effort, builds or improves the property, provided that the
-
Irovements 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
iroved for the purposeof sale).. I
I, as owner of the property. am exclusivelycontracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
ily to an owner of property who builds or improvesthereon, and%,no Contracts for the projects with a licensed Contractor pursuant to the Contract=' State License Law).
I am exempt from lioensure Under the Contractors'. State License Law for the following reason:
my signature below I acknowledge that, exceptfor my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by t ` permit, I.cannot legally
a Structure that I have built as an owner -builder if it has not been constructed in its Entirely by licensed contractors. I understand that a copy of the applicable law, Section 7044. f t e Business and
fesslons Code, is available upon request when this. application' is submitted or at the following Web sita:http:IAw w,€eginro.ca.govfcalaw.html.
nature of Property Owner or AuthorizedAgentDate
TENSED CONTRACTOR'S DECLARATION
>isby affirmunder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 00) o Of ision 3 of the Business and Pr ions Code, d license is In full force
I effect. License Class License No Date L LL Contractor Signature
)RKERS' COMPENSATION DECLARATION
INING: FAILURE TO SECURE WORKERS` COMPENSATION COVERAGE IS UNLAWFUL, AND. SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE4ALTIES AND Clwl FINES UP TO, ONE HUNDRED THOU AND JARS (SiDeeOel, IN ADDITION TO THE
n OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES,
ireby 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, issuedby the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the
fommnce of the work for which this permit is issued. Policy No..
- have 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
trance carrier and policy number are:
Policy. Number Expiration Date
Agent A Phone #
ythat, in the performance of the work ich this permit is issued, I shall not employ any person in any manner so. as to become subject to the workers' compensalion laws of California, and agree
should beco su ect to the workers ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
a of Applica t D I -Al '
1. (tl 7
JtTIQN RE DING CDNSTRUCTI N LENDING AGENCY a9�FJi`� --I
affirm under penalty of perjury that th re is a Construction lending agency for the performance of the work for w ich this permit is., issued (Section 3Q97, Civil Code).
Name Lenders Address
mysignature below, I Gently to Each of ma TDIICWi
I am the property owner or authorized to act on
I have read this application and the information I
I agree to oOWWwith, all applicable City and cou
I authorize teprasentaBves of this city or county
• • • I DATE I By
c
once e
rs relating to building Construction,
property for inspection purposes.
OF
• ��/(�. /( /,/� LIASBESTOS NOTIFICATION IS NOT APPLICABLE TO
• • • �( f�% PROPOSED DEMOLITION
1SIGNATURE:
USE
All required alarms, latches gates and fences which serve as part of a pool/spa barrier, shall
be in place prior to approval to fill pool/spa & shall remain in place & bemaintained for the
life of the pool.