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HomeMy WebLinkAboutH2023-0569 - Permits��eWPOR City of Newport Beach A�A Community Development Department - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 ~ Permit Counter Phone: (949) 718-1888 U M T � newportbeachca.govlcivic Ob �W LI Fn AN Mechanical Permit Plan Check No : Work Class : Other Issued Date: Inspection Area :4 H2O23-0569 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 : 5100 COLONY PLZ, 3135 Legal Desc : N TR.15178 BLK TRACT 15178, FOR. OF TRACT; EITHER Description: MECH - R/R A/C CONDENSER & FAU. LIKE FOR LIKE. LOWER DB LEVEL THAN (E) UNIT Owner: IRVINE CO Contractor : AMTECH HEATING & AIR INC Address : 111 INNOVATION IRVINE, CA 92618 Address : 17751 SKY PARK CIR, STE F IRVINE, CA 92614 Phone: (949)720-3100 Phone: (800)882-3019 Con State Lic : 1003704 Applicant: AMTECH HEATING & AIR INC Address : 17751 SKY PARK CIR, STE F IRVINE, CA 92614 Phone : (800) B82-3019 Owner/Builder Address Phone: Code Edition : 2022 Type of Construction Occupancy Groups: Building Setbacks Flood Zone Use Zone : PROCESSED BY PC - North Newport Center SPECIAL CONDITIONS: Lic Expire : 04/30/2025 Bus Lic : BT30060143 Bus Lic Expire:08131/2023 Workers' Compensation Insurance Carrier : SIRIUS AMERICA INS CO Policy No: WC8555301 W. C. Expire: 12/20/2023 Fire Hazard Zone : NO Manufacturer: CARRIER Model# : GA5SAN43600W OWNER -BUILDER DECLARATION I hereby aftimt 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 applicable items) Section T031.5. Business and Professions Coda: 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 is 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 'rofessions Code) or that he or she is exempt from liconsure and the basis for the alleged exemption, Any violation of Section 7031.6 by any applicant for a permit subjects the applicantto a civil penalty of of more than five hundred dollars ($500). 11, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of the work, and the structure Is not intended or offered for sale (Section 7044, usineRs 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 Timovements 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 eproved for the purpose of eale). J 1, as owner of the property, are exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not ply 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) I am exempt from lieensure under the Contractors' State License Law for the following reason �y 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 Iegall, UP 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 three applicable law, Section 70" of the Business and 'rofessions Code, is available upon request when this application Is submitted or at the folowing Web site:http:Nwww.leginfo.ce..govfcalaw,html, ;Ignature of Property Owner or Authorized Agent Date ,ICENSED CONTRACTOR'S DECLARATION hereby affirmunder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio f rv'Sipppp 0 the Business and Profs .one ode s I in full force rid effect. License Cta.ss License No Date G(/ Contractor Signature s VORKERS' COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED T. OUSAND DOLLARS 05100, 0), IN ADMION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0203 OF THE LABOR CODE., INTEREST, ANDATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following decUratiars_ L.) I have and Will 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 IN Cormance of the work for which this permit is issued. Policy No. _ ave 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' compensatio insurance carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # DI certify that., in the performance of the o k f which this. permit is issued, # shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agra that, it I should become bjeut 1 he r r ' perlsatldn provisions of Badtlen 3700 of the Lobar Coda, I shall forthwith comply with those provisions. r� ,Signature of Applioanl, Dat DECLARATION 1; A�G CONSTRU4 TION LEN OENCY I hereby affirm under penalty of perjury that there is nstruction lending agency for the performance of the work for which this permit Is issued (Section 3097, Coil Code). Lender s Name Lender's Address By my signature below, 1 cariify to each of "the I am the property owner of 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 with all applicable city and county, orr inanDa old state taws relating to building construction. I authorize representatives of this city or coun# to nter the d tilted property for Inspection purposes. S1 nature of PropeitOwner or Authorzed A ent Print Pro art Ovmar's or Authoriz©d A ent's Nema ACTION DATE BY DE LAR..TION OF COMP ANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY R$GUt ATIONS pAR7B F TITLE 40 AND AOMD RULE 1403 PCftM1r fXP1l3k'U 1 SOHMITTF0 ASEFSTOS NOTIFICATION TO PERMO CANCELLED.. CPA........ PiMMIT NAL CERTIFICATE OF �13 I IASBESTOS NOTIFICATION LIO ICA ION 15 NOT APPLICABLE TO GER—�_ OCCUPANCY ISSUED SIGNATORE: