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Home My WebLink AboutH2022-0618 - Permits�EWPoRT City of Newport Beach Community Development Department - Building Division j" 100 Civic Center Drive, Newport Beach, CA 92660 Uyy .Q Permit Counter Phone: (949) 644-3288 o� Inspection Requests Phone: (949) 644-3255 newportbeachca.gov/inspections III I I II I II I II II II I II I II Mechanical Permit : H2022,-0618 Plan Check No : 1467-2022 Work Class : Other [ Issued Date : 11/03/2022 Inspection Area : 2 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 : 124 TURQUOISE AVE Legal Dose : A TR BALBOA ISLAND RESUB SEC 1 BLK 15 LOT 19 Description: MECH: INSTALL ROOF MOUNTED A/C UNIT. R/R FURNACE.*** TAMPER RESISTANT CAPS REQUIRED*** (X2022-1602) Owner: CAMILLE LYNN BURKE TRUST Address: 124 TURQUOISE AVE NEWPORT BEACH, CA 92662 Phone: (949)375-4235 Applicant: ACCOLADE AIR INC Address: 22622 DUN KEN FIELD CIR LAKE FOREST, CA 92630 Phone : (714) 709-6672 Owner/Builder : Address Phone : Code Edition : 2019 Fire Hazard Zone : NO Type of Construction Occupancy Groups: Building Setbacks : Front: 5, Side: 3, Side: 3, Rear: 5 Flood Zone: X; AO 1 Use Zone : R-BI - Two -Unit Residential, Balboa Island PROCESSED BY SPECIAL CONDITIONS: HIGH DENSITY ZONE Contractor : .ACCOLADE AIR INC Address: 22622 DUNKENFIELD CIR LAKE FOREST, CA 92630 Phone : (714) 709-6672 Con State Lie : 1005513 Lie Expire: 07/31/2023 Bus Lie: BT30072509 Bus Lie Expire:06130/2023 Workers' Compensation Insurance Carrier : STATE COMPENSATION INSURANCE FUND Policy No : 9274102 W. C. Expire: 4/4/2023 Manufacturer: AC PRO Model# : AULD36W2/A-D(U) OWNER -BUILDER DECLARATION I hereby affirm 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 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 Iicensure 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 not more than five hundred dollars ($500). 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the 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 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 raved for the purpose of sale). LI 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). 1 am exempt from Iicensure 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 for at least one year prior to completion of the improvements covered by this permit, I cannot legally self 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, Section 7044 of the Business and Professions Code, Is available upon request when this application is submitted or at the following Web site:httplAw .leginfo.ca.govlealaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) f Of isi0rA3 of the Business and Professions e, and my license is in full force and effect. License Class License No Date -Z,-L—Contractor Signature WORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THO D DOL S100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGESAS PROVIDED FOR IN SECTION 37H OF THE LABOR CODE. INTEREST, AND ATTORNEY'$ FEES. hereby affirm under penalty of perjury one of the following declarations: I have and will maintaina 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 'ormance 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' compensa trance carder and policy number are: Policy Number Expiralic of Agent Phone N Date certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and if I should become subject to the vyffli compensation provisions of Section 3700 of the Labor Code, I shag forthwith comply with those provisions. m Date j/ —Z—ZI-L- Lre'.by affirm Linder penalty of perjurj/thaYthere is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Ider s Name // Lenders Address my signature below, I certify to eaM 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 with all applicable city and county ordinances and state laws relating to building construction. I authorise rep-esentagves of this city or county to enter he. bove-identified property for inspection purposes. (p nature of Prooe-ty Owner or Authorzed Anent Print Pmnanv Owner'a nr AuthnrivPrl AnPnh'e Nam. cjt(,7O Lt. W ObC7� I ACTION DATE I BY DECk RATION OF COW LIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY / REGU TIONS PART 63.. OF TITLE 40 AND AQMD RULE 1403 PFRMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PFRMITCAN_ELLED - _---®EPA PERMITEXTENDED grvlD P4^MITFINA, CERPFICATEOF OCCUPANCYfSSUED I+� 1'� y� _I v ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION SIGNATURE: