HomeMy WebLinkAboutH2022-0623 - PermitsaeWPoRr City of Newport Beach I I I I I 11111
I I II I II II I I III II
o� @ Community Development Department- Building Division Mechanical Permit: HZO22���23
11 0 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : 0957-2019
Permit Counter Phone: (949) 644-3288 Work Class: Other
Inspection Requests Phone: (949) 644-3255
c4C/p�p��P newportbeachca.gov/inspections Issued Date : 11I0212022
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 : 133 46TH ST Legal Desc : A TR RIVER SECTION BLK 46 LOT 10 RIVER SECTION LOT 10 BLK 46 NELY TRIANG 27 FT
Description: MECH (2) NEW A/C UNITS *TAMPER PROOF CAP REQ*
Owner: RONALD STANFORD
Address : 156 PEPPERTREE CT WALNUT, CA 91789
Phone:
Applicant:
RICHARD BANNING (AUTH AGENT)
Address:
74191 ANASTACIA LN PALM DESERT, CA 92211
Phone :
(714) 404-1112
Owner/Builder
: RICHARD BANNING (AUTH AGENT)
Address:
74191 ANASTACIA LN PALM DESERT, CA 92211
Phone:
(714)404-1112
Code Edition : 2019
Type of Construction
Occupancy Groups:
Building Setbacks
Flood Zone
Use Zone :
PROCESSED BY:
Front: 10, Side: 3, Side: 3, Rear: 5
X
R-2 - Two -Unit Residential
SPECIAL CONDITIONS: O/B FORM ATTACHED
Contractor
Address
Phone:
Con State Lie
Lie Expire
Bus Lie:
Bus Lie Expire:
Workers' Compensation Insurance
Carrier :
Policy No:
W. C. Expire:
Fire Hazard Zone NO Manufacturer: BLUERIDGE
Model# : BMK-H30M
OWNER -BUILDER DECLARATION
I hereby affirm under penally of per},ury that I am exempt from the Onntractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable ttem(s)
clon 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
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 BU:Iness and
-fessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of
more than five hundred dollars ($500).
1, 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 thestructureIs not intended oroffered for sale (Section 7044,
>iness 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
Irovements 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
moved for the purpose of sale)..
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
tly 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).
a I am exempt from licensure under the Contractors' State License Law for the following reason:
y my signature below I acknowledge that, exceptAppli
esidence in which I must have resided for at feast one year prior to completion of the improvements
all a structure that I have built as an owner-builden constructed In its entirety by licensed contractors. I understand that a copy of the applicable taw, S
'rofessions Code, Is available upon. request when submitted or at th'fcllowing Web site:httpl/w .leginfo.ca.gov/calaw.htmi.
ignature of Property OwnerorAuthorized Agent
,ICENSED CONTRACTOR'S DECLARATIhereby affirm under penalty of perjury Thal I am livisions-of Cha ter 9 commencing with Section 7000) of Division 3 of the Business and Professions
nd effect. License Class License No Date Contractor Signature
Date A /J
my license is in full force
NORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARS f5000,0001, IN ADDmON TO THE
:OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37" Or THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
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 37DO of the Labor Code, for thi
rformanee of the work 'of
which this permit 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` compensatior
as nee Cartier and policy number are:
Manor Policy Number Expiration Date
Yame of Agent Phone If
-1I certify that., in the perfor tan Q e of the work for which thi permit Is issued, I shall not employ any person in any manner so as to become subject to the works `co nsatlon laws of California, and agret
hat, if I should becom su. eel orkers' compens ion provisions or Section 3700 of the Labor Code, I shall. forthwith comply with those provisions.
Signature of Applies _ Data
DECLARATION RE NSTRUCTION DING., AGENCY
hereby affirm under pe ally of erJury that there a onstruction lending agency for the performance of the work for which this permit is issued (Section 3097, ivil ode).
-enders Name Lender's Address
3y my signature below, I Certify to each of the olio fig:
I am the property Owner or authorized to n the property owner's behalf.
I have read this application and the information I hilive provided is correct..
I agree to comply with all applicable city and u❑ and state laws rotating to building construction.
I authorize representatives of this city or county me ve-identified property for inspection purposes. �7
Si nature of Prop" Owner or Authorized Agent Print Pro p ert Owner's or Authorized A ent's Nam bb AJv,NJ .Nji Data I
ACTION DATE BV=1403
ATEON OF C PLIA LE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
TIONSP 610 1TLE 40 AND AQMO RULE
PERMrfEXPIRiFo I U(SUBMI77FDOBEST05NOTIrICATION-ro
PERiNITEXTENOED ! I t_IAOMD
PERMIT FINAL 10 El ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
CERTIFICATE of PROPOSED DEMOLITION
OCCUPANCY ISSUED SIGNATURE: