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Home My WebLink AboutH2023-0282 - PermitsagwaoRr City of Newport Beach - D� @ Community Development Department - Building Division F 100 Civic Center Drive, Newport Beach, CA 92660 ' Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 Cq[�FORN`P newportbeachca.gov/inspections 6 �@ d: � w..._ -� i `ice• a Mechanical Permit Plan Check No: Work Class : Other Issued Date : 04/28/2023 Inspection Area : 2 H2O23-0282 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 : 20 ROBON CT Legal Desc : N TR 7852 BLK LOT 1 UN 1 TR 7852 LOT 1 UNIT 1 OF PROJECT LOC ATED ON AP Description: MECH R/R A/C UNIT, FURNACE, AND DUCTWORK. ***TAMPER RESISTANT CAPS REQUIRED*** Owner: JEFFREY PEDDIE Address: 3 TRIBUTE CT NEWPORT BEACH, CA 92663 Phone : (949) 202-6832 Applicant: BEN MEDINA Address: 31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362 Phone: (818)735-7876 Owner/Builder : Address Phone: Contractor : ALPS AIR CONDITIONING & HEATING INC Address : 1895 S SANTA CRUZ ST ANAHEIM, CA 92805 Phone : (714) 633-8892 Con State Lic : 667953 Lic Expire : 04/30/2025 Bus Lic: BT30047511 Bus Lic Expire:06130/2023 Workers' Compensation Insurance Carrier : INS CO OF THE WEST Policy No: WSD506354500 W. C. Expire : 12/25/2023 Code Edition : 2022 Fire Hazard Zone : NO Manufacturer : ELITE Type of Construction : Model# : EL17XC1 Occupancy Groups Building Setbacks : Flood Zone : X Use Zone: PC - Newport Crest - UP1585 PROCESSED BY: SPECIAL CONDITIONS: OWNER -BUILDER DECLARATION I hereby alfiml under penalty of perjury that I am exempt from the Contractors' Slate License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable itern(s) >ectioll 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 ie permit to file a signed statement thathe or she is licensed pursuantto the provisions of the Contractors' Stale 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 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 of more than five hundred dollars 1$500). 3 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 oroffered 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 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). 'T J 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 poly 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 reasom._ .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 legally ell a structure that I have built as on 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 'rofessions Code, is avallable upon request when this application Is submitted or at the following Web site:httpa/www.leginfo.ca..govlcalaw.html. Iignature of Property Owner or Authorized Agent Date _ .ICENSED CONTRACTOR'S DECLARATION �� hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 of ''yi ' 3 of the Business a P ieR�Code.. and my license is in full force no effect. License Class License. No Date Contractor Signaiure VORKERS' COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO ORPMINAL PENALTIES AND CIVIL FINES UP TO ONE HU THOUSAND DOLLARS (4100.000), IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE., INTEREST, AND ATTORNEY'SFEES. hereby affirm under penalty of perjury one of the following declarations: I I have and will maintain a certificate of consent Io self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for thl orformance of the work for which this permit is issued. Policy No. 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' carrier and policy number are: of Agent certify that, in the performance If I should become subject of Applicant Policy Number Date i5e 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 taws of California, and agrer workers' comps 'en-prov-IsTons of Section 3700 of the Labor Code., I shallforthwith comply with those provisions. �! _ Date_ � vJ _ IECLARATfON F RDI UCTION LENDING AGENCY hereby affirm under o perjury that there. is a construction lending agency for the performance of the work for which this permit Is issued: (Section 3097, Civil Code). enders Name Lender's Address y my siunalufe below, I Certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. _ I have read Vila application and the information I have provided is correct.. --- _ I agree to comply with all applicable city and coup nsnces ndslate�vs relating to building.. construction. I authorize representatives of this city or coqEg �to �en/ter the - ove-identified property for inspection purposes. IIC'nalU'e of PrODenV Owner or Authorized Aral:E i Print Prooenv Owner's or Authorized Acent's Name A.CTICN DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY _ � RFCIJi.ATIONS PART 61 OF TITLE 40 AND AC MD RULE ASBESTOS NOTIFICATION TO PE4M'TCANCELLf0 LIEPA fE.?fG'X (XiENOED ' QMD PERMITFINAL CE7``'; '.7E OF (� % / ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION Orcu"NCy l5SUEo SIGNATURE: 23