HomeMy WebLinkAboutH2023-0634 - Permits04",
City of Newport BeachCommunity Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 718-1888
newportbeachca.gov/civic
Mechanical Permit : H2023-0634
Plan Check No : PC2023-0426
Work Class : Other
Issued Date : 09/29/2023
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 : 14 WILD GOOSE CT Legal Desc : N TR 7852 BILK LOT 1 UN 1 TR 7852 LOT 1 UNIT 1 OF P
Description: MECH INSTALL A/C UNIT AT REAR **TAMPER RESISTANT CAPS REQUIRED**
Owner:
BYE BYE HOUSE INC
Contractor
Address :
18301 VON KARMAN AVE STE330 IRVINE, CA 92612
Address
Phone:
(801)995-5380
Phone:
Con State Lic
Applicant:
KARL PATTEN
Lic Expire
Address :
14 Wild Goose Ct Newport Beach, CA 92663
Bus Lic :
Phone :
(801) 995-5380
Bus Lic Expire:
Workers' Compensation Insurance
OwnerlBuilder
: BYE BYE HOUSE INC
Carrier:
Address :
18301 VON KARMAN AVE STE330 IRVINE, CA 92612
Policy No:
Phone :
(801) 995-5380
W. C. Expire:
Code Edition : 2022 Fire Hazard Zone : NO Manufacturer: AC PRO
Type of Construction : Model# : AULD36W2/A-D(U)
Occupancy Groups:
Building Setbacks :
Flood Zone : X
Use Zone : PC - Newport Crest - UP1585
PROCESSED BY:
SPECIAL CONDITIONS:
DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicatedbelow by the checkmark(s) I have placed next to the applicable items)
(5ectlon 7031.5, Business and Professions Code: Any city or county that requires permit to construct, alter, Improve; demolish, or repair any structure, prior to its issuance, also requires the applicant for
the pormlt to file a signed statement that he or she is licensed pursuant to the provisionsof 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 licensure andthe 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)..
❑ I, as owner of the property, or my employees with wegas as their sole compensation, will do U all of or L) portions of the work., and the structure Is notintended or offered for sale (Section 7044,
Business and Professions Code: The Contractors' State License Low 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
Im1 roved for the purpose of sale).
lJ 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),
I am exempt from licensure under the Contractors' State License Law for the following reason
. __.._r a .__.._._.__.ear prior t s cover,._..--_..--_T—
By my signature ball have
acknowledge builtaanthat, except fort h personal resonance t which I must have resided for at least one year prior to completion of the improvements covered by this permit, i.Cannot legall;
sect a structure Inal I have built as an owner -builder If li has not been constructed In its entirety by licensed Gontractors. I understand that a copy of the applicable law, Section 7044 of the Business and
Professions Code, is available upon request when this a placation is submitted or at the following Web site:trttp:Ilw .leginfo.ca.govlcalaw.html,
Signature of Property Owner or Authorized Agent _- l Dale
LICENSED CONTRACTOR'S DECLARATION
hereby afirmunder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license Is in full force
and effect. License Class License No Date Contractor Signature
NORKERS' COMPENSATION DECLARATION
YARNING: FAILURE TO SECURE WORKERS' COMPENSA7ION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
.DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
-1 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
)erformance 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'
rance carrier and policy number are:
Policy Number
of Agent
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 agre
t if I should become Subjecttothe workers compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply With those. provisions.
CLARATION REGARDING N8TRUCTItlN LENDING AGENCY --- Data
Heby affirm under penalty of pery'ury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Ider s Name _ __ Lender's Address
Iny signature be1cW. certify to each of the following —
I am the pnJperty owner or authorized to act on the properly owner's behalf.
I have read Hers appiivaliarl and the information I have provided is correct.
I agrea to comply with all applicable city and county ordinances and state laws relating to building construction.
I authonze represunt.lives of this city or county tto� enter the above -identified property for inspection purposes.
i,aturd of Property Owner or Authorized Agent 'A„%/ ! Print Properly Owner's or Authorized Arent's Name L11-V, R,)474_ir
Vei,ri7i J£Xf+fRL�U
P'r,,T (CANCELLED
PERAgIr ExT6NUED
BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REe't)LAT10NS PART bt OF TITLE 40 AND AGY RULF
SUBMITCFD
TO
LJ ASBESTOS NOTIFICATION IS NOT APPLICABLE 1'0
Celli lrlLHPE of (��'9�.�3 �/�- PROPOSED DEMOLITION
OCCJ, i NCYISSU_-D .,.-