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Home My WebLink AboutH2023-0284 - PermitsC��EWPORT City of Newport Beach b Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 u ? Permit Counter Phone: (949) 644-3288 .r. Inspection Requests Phone: (949) 644-3255 C9</Fe RN�P newportbeachca.gov/inspections Mechanical Permit Plan Check No : Work Class : Alteration Issued Date : 05/01/2023 Inspection Area : 8 H2O23-0284 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 : 1600 ANITA LN Legal Desc : N TR 3800 BLK LOT 27 Description: MECH CHANGE OUT (2) FURNACES AND (2) A/C'S, TAMPER PROOF CAP REQ'D Owner: MATTHEW SHAW Contractor Address : 1600 ANITA LN NEWPORT BEACH, CA 92660 Address Phone: Phone: Can State Lic Applicant: DEPENDABLE GRAHAM AC Address: 2952 CENTURY PLACE COSTA MESA, CA 92626 Phone: (714)546-1653 Owner/Builder : Address Phone: Code Edition : 2022 Type of Construction Occupancy Groups: Fire Hazard Zone : NO DEPENDABLE GRAHAM AC 2952 CENTURY PLACE COSTA MESA, CA 9262E (714) 546-1653 472690 Lic Expire : 04/30/2024 >> > Bus Lic : BT01013104 Bus Lic Expire:12/31/2023 Workers' Compensation Insurance Carrier : SERVICE AMERICAN INDEMNITY CO Policy No : SAMTWC0072801 W. C. Expire: 7/1/2023 Manufacturer: AIRTEMP Model#: GXH36M5K40H Building Setbacks : Front: 20, Side: 6, Side: 6, Rear: 6 Flood Zone: X Use Zone : R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area) ; r9 rre PROCESSED BY: SPECIAL CONDITIONS: Wl.' BJFCT TO FIELD TNSP F.CTOF,'S REV1E.W AND APPROVAL OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the ContractorsState License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable Item(s) '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 he 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 'rofesslons 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 for a permit subjects the applicant 10 a civil penalty, of Tot more than five hundred dollars ($500). I, 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 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 mprovements 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 'mproved for the purpose of saley ❑ t, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale 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). L7 I am exempt from ficensure 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 sell a structure that I have built as an owner -builder if it has not been constructed In its entirely by licensed contractors. I understand that 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 fallowing Web site:hhp:llwww.leginfo.ca.govlcalaw.html. Signature of Property Owner or Authorized Agent Data LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3:of the Business and Professions 1de, y tic a is in full force and effect. License Class License. No Date �_� / 2� Contractor Signature � K== WORKERS' CCIMPrN.SATION DECLARATION NARNING: FAILURE TO SECURE WORI{ERS' COMPENSATION 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 CC!- In CC MPENSA`I]n, DIMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under p=natty of perjury one of the following declarations: 7 1 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 rformance of the A a,k for which this permit is issued. Policy No. SI t.,P and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. My workers' compensatior curance carrier and polG;y number are: Policy Number Date +P of Agent Phone # certify that, iwthe i erformance of the work for which thispermit is issued. I. shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and I'' rhould become subject tD"workers, compensaton provlsiptj9 of Section 3700 of the Labor Code, I -shall. forthwith comply with those provisions. of Appli ant Date✓ hereby affirm under penalty of 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 ty my signature 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 this application and the information I have provided is correct. I agree Io comply with.. all applicable city and county ordi antes and state laws relating to building construction. I authorize representatives of this city or county t an the above= ntif cig�operty for inspection purposes. q �1�n� iianature of PrODerty Owner or Authorized Agent YI / GG� Print Property Owner's or Authorized Agent's Nam /-TD, rU_w L77`4X> l%r DATE I BY '' DECLARATION OrCOMPLANCE WITH CODE OF FEDERAL { FOR OFFICE USE ONLY I RFGUTATIONS PART 61 OF TITLE 40AND AOMO RULE. EXPINED I LJ I SUBMITTED ASBESTOS NOTIFICATION TO PBRMITEXTENDEO _ I—IAQMD PERMIT FINAL /L S ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF 7 PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: = z3