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Home My WebLink AboutH2023-0138 - PermitstiwPoRT City of Newport Beach ,p d Community Development Department - Building Division y, Fy 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-3288 �a� r Inspection Requests Phone: (949) 644-3255 +°quco aN`P newportbeachca.gov/inspections Mechanical Permit Plan Check No : Work Class : Other Issued Date : 02/24/2023 Inspection Area : 3 H2O23-0138 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 : 2412 UNIVERSITY DR Description: MECH R/R DUCTWORK Legal Desc : N TR 4444 BLK. LOT 17 TR 4444 LOT 17 TOGETHER WITH AN UND 1/3 3 INT IN Owner: IRENE MASUNAKA Address : 2412 UNIVERSITY DR NEWPORT BEACH, CA 92660 Phone: Applicant: BEN MEDINA Address: 31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362 Phone: (818)735-7876 Owner/Builder : Address Phone: Code Edition : 2022 Type of Construction Occupancy Groups: Building Setbacks Flood Zone Use Zone : PROCESSED BY: X R-1 - Single -Unit Residential SPECIAL CONDITIONS: a Fire Hazard Zone Contractor : SERVICE CHAMPIONS HTG Address : 3150 E BIRCH BREA, CA 92821 Phone : (714) 777-7777 Con State Lic : 799170 Lic Expire : 10/31/2023 Bus Lic: RM8WC00054221 Bus Lic Expire:04/01/2023 Workers' Compensation Insurance Carrier : EVEREST PREMIER INS CO Policy No: RM8WC00054221 W. C. Expire: 4/1/2023 NO Manufacturer Model# : I hereby affirm under penalty Of perjury that I. am exempt from. the Contractors' Slate License Law for the reason(s) Indicated below by the checkmark(s) 1 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, after, Improve; demaltsh, or repair any structure, prior to its Issuance, also requires the applicant for io 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 'rofess ons Code) or that he or she is exempt from iicensure andthe basis for the alleged exemption. Any violation of Section 7031.E by any applicant for a permit subjects the applicant to a civil penalty of of more than five hundred dollars 1$500). I, as owner of the property, or my employees with wages as theirsole compensation, will do U all of or U portions of the work; and the structure is not intended or offered for sale (Section 7044, �usmess and professions Code: The Contractors' State License Law does not. apply to anowner of property who, through employees" or personal effort, builds or improves the property: provided that the nprovements 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 nproved for the purpose of sale), h as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Sactlon 7044, Business and Professions Code: The Contractors' State License Law does not pply 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). tam exempt from licensure under the Contractors' State License Law for the following reasow ly 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 legall, ell 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 copy of the applicable law, $action 7044 of the Business and Irofessions Code, Is available upon request when this applicationIs submitted or at the following Web site:,httpalwww.Ininfo.ca.gov)calaw,html, signature of Property Owner or Authorized Agent Gate .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under previsions of Chapter 9 (commencing with Section 70g9. rf of the Busine ,s and r ,, ado, and my license is in full force nd effect. License Class License No Date I� Contra nature VORICERS' COMPENSATION DECLARATION 1ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVILFINES UP TO ONE HUNDRED THOUSAND DOLLARS IS100,000), IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 77G6 OF THE LABOR CODE, INTEREST, AND ATTORNEY'$ FEES, hereby affirm under penalty of perjury one of the following declarations: I have and Phil 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, for th ormance of the work for which this parmk is issued. Policy No. I 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' compensatiol I u ce carrier and policy number are: armor Policy Number Exptraton Date fame of Agent Phone # ll certify that, in the performance of I<work for which this ssued, I shall not employ any person in any manner so as to become subject to the worke s` oomponsattan Taws of California, and ogre tat, It I should become subject to th ere' Do ion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / signature of Applicant _ Date IECLARATICIN RE:G.1i6l CTIDN LENDING AGENCY ._.. hereby affirm Curia- ; Pna o perjury that thereis a construction lending agency for the performance of the. word for which this permrtis issued (Section 3097, Civil Code). rr;!i:= -lame Lender's Address ly my signature delntd, I Certify to each of the following: I ant the property owner oraumorized to act on the property owner's behalf. I have read this application and the Information 1 have provided is correct 1 agrea to co mpl} wr`h all applicable city and county ordlnan nd state laws ref p-bttlyding construction. _ I ,.Lthorize representatives of this city or county to ant above- prfiitrdd' opi�or inspection purposes, '�{(y�,1/t I�,t/ n (� ,rt.r,.Y.l.. R nT Pranartu t7nmur nr Authnn>Rd Anent Print Prnnarty 0wner's or AuthnA70d Anant'c Names 41 U "`� rat / ACTi(JN f DATE 6� _J_RLLPAPAT1 ON OF COMPLIANCE WITH CODE OF FEDERAL FOR REGULATIONS PART 61 OF TITLE. 40 AND AQMb RULE 1403 PCfi,L;f';XPIRFD II SUBIAMED ASBESTOS NOTIFICATION TO PERM)T FINAL j9' 3i L,,�^�"p"3rgE5TOS NOTIFICATION IS NOT APPLICABLE TO CERTIFiCtITEOFOCCUPANCYISS '�I In 2� C%�'/ /3 OSED i)Efv10L1TION OCCUPANCYISSUED /'I(/ SIGNATURE: