HomeMy WebLinkAboutH2023-0206 - PermitsEwro�r • City of Newport Beach III I I I 1111111 II II I I II II II Mechanical Permit : H2023-0206
D4 Community Development Department- Building Division
Fy' 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No
r n
Permit Counter Phone: (949) 644-3288 Work Class : Other
u
Inspection Requests Phone: (949) 644-3255 Issued Date : 03/27/2023
UC4G/FO PN�p newportbeachca.gov/inspections Inspection Area :1
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 : 200 07TH ST, A
Legal Desc : A TR EAST NEWPORT BLK 4 LOT 18
Description : MECH FAU CHANGE OUT
Owner: PETER GORMAN
Contractor : SERVICE CHAMPIONS HTG
3150 BIRCH BREA, CA 92821
Address : 30210 AIRFLIGHT DR VALLEY CENTER, CA 92082
Phones .
E
Phone :
Con State Lie : 799170 "
Applicant: SERVICE CHAMPIONS HTG
Lie Expire : 10/31/2023
Bus Lie: RM8WC00054221
Address : 3150 E BIRCH BREA, CA 92821
,
Bus Lie Expire: 04101/2023 ,
Phone : (714) 777-7777
Workers' Compensation Insurance
Carrier : EVEREST PREMIER INS CO
owner/Builder:
Policy No: RMBWC00054221
Address :
W. C. Expire : 4/1/2023
Phone:
Code Edition : 2022
Fire Hazard Zone : NO
Manufacturer : • • :. ,
Model# :
Type of Construction
Occupancy Groups :
Building Setbacks : Front: 9, Side: 3, Side: 3, Rear: 5
Flood Zone : X
Use Zone : R-1 -Single-Unit Residential
_
NO CONSTRUCTION
NOISE
PROCESSED BY: CY
r e to �'". ". "'�' "
SPECIAL CONDITIONS:
[
q+'e'�`` °p
ON THE WEEKEND
OWNER -BUILDER DECLARATION --
I hereby affirm under penally 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 applicableitem(s)
'Section 7031.5. Business one 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
he 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 or the Business and
?rofesslons Code) cr that he or she is exempt from hoensure and the basis for the alleged exemption. Any vlolatlon of Section 7031.5 by anyapplicant fora permit subjects the applicant to a civil penalty of
io€ more than five hundred dollars ($500).
I, as owner of the property., or my employees with wages as their sole compensation, will do U all of or U portions of the work.; and the: structure is not intended or offered for sale (Section 7044,
3usiness 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
mprovements 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
mproved for the purpose of sale).
I, 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
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).
3 1 am exempt from ficensure under the Contractors' Slate License Law for the following reason:
3y 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 legal,
tell 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 copy of the applicable law, Section 7044 of the Business and
'recessions Code, is available upon request whenthis application Is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw,htmi.
Signature of Property Owner or Authorized Agent. Date
_ICENSED CONTRACTOR'S DECLARATION
hereby al'i under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section coo f the Business and Prof Seta my license is In full force
Ind effect. License Class License No Dote Contractor Signature
PORKERS' COMPENSATION DECLARATION
DARNING: FAILURE TO 6=CURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED TWi DOLLARS ($100,000), IN ADDITION TO THE
:DST OF COMPEPSAT)ON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
4h$ye and wli, mamtain a certincate 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. for I.h
r rmn - nce of the work. for which this permit is issued. Policy No. _ ....
and wit! mwi'ain 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'
carve, ano policy number are:
Policy Number
cf Agent _
Date
L6rufy that. in th3 performance of thew r which this permit Is issued, I shall not employ any person in any manner so as to become subject to the workers'
, if I a;lould become Lubje • to the ers' con lion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
lature of Applicalel _? r..�_ —
he', aby affirm under T.z.a per' -there is a construction lending agency for the performance of the. work for which this permit is issued (SGoton 3097, Civil Code).
enders Name Lender's Address
y my signature below, I cerf.ify to each of the following:
I am the property owner or authorized to act on the property owner's behalf.
I have read this application and the information I have provided is correct.
I agree to comply wittl.. all applicable city and county ordinances and state laws rel g to buildingconstruction. h
I authorize representatives of this city or county to le ahoy-identif' roparty for inspection purposes. t
ignature of Property Owner or Authorized Agent _ Print Property Owner's or Authorized Ananl NamaJC--)om,
ACTION I DATE
PERMIT CANCELLED
PERYfIT EXTENDED
PERMIT FINAL
CERTIFICATE Or
OCCUPANCY ISSUED
OrCOMPLIANCE WITH CODE OF FEDE.
PART 51 OF TITLE AO AND AOMD RULE
SUBMITTED ASBESTOS NOTIFICATION
L_I ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
PROPOSED DEMOLITION
FOR OFFICE USE ONLY
of California, and
L?
9
l
m
m
D
m
0
0
n
m
m
Z
1
1
m
m
x
m
0
cn
Do
0
z
z
C
K
00
m
m
m
l J
m
O
n
Z
r
Z
n
W
m
A
N
w
0
N
O
0
0
N
D
0
0
O
0
O
O
0
0
O
O
O
O
0
0
O
0
D
m
0
0
n
m
m
Z
1
m
m
x
m
c)
U)
0
z
z
C
m
m
C 0
cn cn
oca
m W
O
D v
'p
m
�3
Ocnm
0
m
Z 0
c
m
m
z
m
m
_T
'm
-moo
Q m
N
' 1
�
�
C
n
�
y
D
m
O
T
n
O
z
m
x
D
N
O
Z
NCl)
x 0
?
Z
^^
J
m
W?
D
o 0
m
�o
m
D
n
Nmo�U)Z
n
j
cam
g_
Km
yM
'D.M
Cl) C0
mm
zo
my
C) „
D
m
W
r
m
uu
n
m
0
d