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HomeMy WebLinkAboutE2023-0031 - PermitsCity of Newport Beach �a6�'PO,QT O em Community Development Department- Building Division -. 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-3288 a« CqL FO ftN�P Inspection Requests Phone: (949) 6443255 newportbeachca.gov/inspections Electrical Permit Plan Check No : Work Class : Other Issued Date : 01/19/2023 Inspection Area : 3 E2023-0031 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 : 1706 GALAXY DR Description : ELEC A/C DISCONNECT Owner: STEINER MICHAEL A TR Address : 1560 SUPERIOR AVE STEA2 COSTA Phone: Applicant: REAL TIME BROS HEATING AND AIR CONDITIO Address: 11681 ANABEL AVE GARDEN GROVE, CA 92843 Phone : (714) 247-9928 Owner/Builder. - Address Phone: Code Edition : 2022 Type of Construction : Building Setbacks : Front: 20, Side: 6, Side: 6, Rear. 6 Flood Zone: X Use Zone : R-1-6000 - Single -Unit Residential PROCESSED BY: 69JX•1r_1S0101il101Y11 to] k'671 Desc : N TR 4224 BLK LOT 41 Contractor REAL TIME BROS HEATING AND AIR CONDITIONING Address : 11681 ANABEL AVE GARDEN GROVE, CA 92843 Phone: (714) 247-9928 Con State Lic : 10270B9 NING Lic Expire a 05/31/2023 Bus Lic: BT30078991 Bus Lic Expire:06/30/2023 Workers' Compensation Insurance Carrier : - STATE FARM GENERP Policy No: i 92J21_2560 W. C. Expire,:- 9/8/204]ZI Fire Hazard Zone : NO Occupancy,Groups: 3 indicates minimum lot area) •o 000 • • o• •• ••• a• o• oe e• a e 0 o e o® a vo • ®• 000 0 0 • • INSURANCE COMPANY OWNER -BUILDER DECLARATION I. hereby affirm under penalty of perjury.that I am exempt from the Contractors':State, License Law for the reason(s).Indio Iated 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 Ilcerisuro and the basis for the alleged'axemptfon, Any violation of Section 7031.5 by any applicant for a permit subjects the: applicant to a civil penalty of not more than fivehundred dollars (ssoq © I, as owner of the property, or my employees with wages as their sale compensation, will do (_) all of or L) Portions of t1 a 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 sate. If, however, the building or improvement is sold within one year of comp alien, the Owner -Builder will have the burden of proving that it was not built or rin roved for the purpose of sale), L.I 1, 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 5a ply to an owner of property who builds at improves thereon, and who contracts for the projects with a licensed Contreclarl•.pursuant to the Contractors' State License Law),.. I 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 foratleast one year prior to completion of the Improvements covered by this permit, I Cannot togall 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 copyof theapplicable. few, Section: 7044 of the Business and Professions Code, is available upon request when this application is submitted oral the. following Web site:htip:rfwww.ieginto.ca.govlcalaw,html. Signature of Property Owner or Authorized Agent Date: LICENSED CONTRACTOR'S DECLARATION I hereby all rn under penafty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section, Q).dfi.Divi 'on 3.of the Business and PON ions Code,:a Yty It sei full force and effect- License Class License No Date 2s' CvnUactor:Signatu WORKERS'COMPENSATION DECLARATION ARNING: FAILURE TO SECURE wOR%ER8' COMPENSATION COVERAGE IB UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ANO CIVIL PINES UP TOONE HUNDRED THOUSAND DOLLARS. 4s100:000), IN ADDITIONTO.THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST. AND ATTORNIFY SFEES; I hereby affirm under penalty; of perjury one: of the following deciarations: I have and will maintain a Certificate of consent to self -Insure for workers' compensation, Issued by.. the Director. Industrial Relations as provided for by Section 3700 of the Labor Code, for In( rmence of the work for which this permit Is issued. PolicyNo: I ve 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' Gompensatio insuran carrier and pollcy number. are: Carrier Policy Number. Expiretton Date. Name of Agent Phone 1 certify that, in the =thathere work for which this permit's: issued, I shall not employ any person in any manner so as to become subject to this work rs` mpensation laws of California, andagre. that, if I should becomrkers' ens comply With those provisions. Signature of Applicantp Provisions of Section of the. Later Cotle;1 shalt forthwith DECLARA71ON REGAON, DING AGENCY 1 hereby affirm under pat there is a construction lending agency for the performance of the work forwhicl, this perms f is issued (Section 3097, Civil Code)... Lender's Name Lender's Address By my signature below, I Certifyto each of the fallowing: I am the property Owner orauthorized toact on theproperty owners behalf, I have read this application and the infarmati Lnt.er provided is aorracL f;V% tW p I':aUthadze ro rasentativas o�this city orc@unhe abo ratified roe fa s ding construction- 0 1 t agree to comply with -all applicable N and ances and state jaws reletin to boil p ty tyecNan puryosas. Si nature of Pro a Owner @r Autnodzed A. rat• • • • • • • int Pro a Owner's Or AuthOnzed A aeht's Name AlvOl L� NF U i :Date'r4K,t ACTION. :DATE. BY V O£CIr1RAT40N OF •PMANCE:VJTjt CQQEOF FEDERAL, FOR OFFICEUSE ONLY RE4MTIOIPS•PARTr61 OT TITLE 40 ANU AQMD RULE 1403 PERMITEXPIRED 1SU694VTEDANES7275l1#}Ti TICT410 PERMtTCANCELLED PA • PERMIT EMNOED Qt'r<b PERMIT FINAL . �. ASBESTOS NOTIFICATION 15NOT APPLICABLE TO. CERTiFIEATEQF ((// ` PROPOSED DEMOLITION O=PANCY ISSUED SIGNATURE: