HomeMy WebLinkAboutH2024-0218 - Permitsc,oWpo,r City of Newport Beach
1'i p Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 718-1888
newportbeachca.gov/civic
Mechanical Permit
Plan Check No:
Work Class: Other
Issued Date : 04/17/2024
Inspection Area : 4
H2O24-0218
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: 1801 PORT CHARLES PL Legal Desc : N TR 6622 BILK LOT 26
Description: MECH R/R (1) A/C UNIT AT SIDE **TAMPER RESISTANT CAPS REQUIRED** R/R FAU IN ATTIC
Owner: LOUIS AND NICHOLE VISSER JOINT REVOCABLE LIVI
Address : 1807 PORT CHARLES PL NEWPORT BEACH, CA 92660
Phone : (480) 399-3436
Applicant: BEN MEDINA
Address: 31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362
Phone : (818) 735-7876
Owner/Builder :
Address
Phone :
Code Edition : 2022
Type of Construction
Occupancy Groups:
Building Setbacks
Flood Zone
Use Zone:
PROCESSED BY:
Front: 25, Side: 5, Side: 5, Rear: 10
X
PC - Harbor View Hills
SPECIAL CONDITIONS:
mik
Fire Hazard Zone : NO
Contractor : TRITON AIR INC
Address : 1221 PUERTA DEL SOL #300 SAN CLEMENTE, CA 92673
Phone : (949) 492-0290
Con State Lic: 774877
Lic Expire : 06/30/2024
Bus Lid: BT30042558
Bus Lic Expire:04/30/2025
Workers' Compensation Insurance
Carrier: A I U INSURANCE COMPANY
Policy No : WCO20396019
W. C. Expire: 4/1/2025
Manufacturer : AC PRO
Model# : AULD60W2/A-D(U)
I hereby affirm under penalty of peryury 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 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
is permit to file a signed statement that he or she is licensed pursuant to the prov€signs 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 sheds exempt from TCenSUre 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
of more than five hundred dollars ($500).
7 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) 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 employeesor 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).
1 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
pply 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 Lew),
I I am exempt from licensure under the Contractors' Slate License Law for the following reason: _
ly my signature below 1 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 legal!,
ell a structure that I have built as an awner-builder if it has not been constructed in its entirely by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
'rofessions Code, Is available upon request when this application is submitted or at the following Web site:http:lYwww.leginfo.ca.govlcalaw.htmi.
Iignalure of Property Owner or Authorized Agent.___ _ ._ ..."."_.._ Date
.ICENSED CONTRACTOR'S DECLARATION `
hereby affirm under penalty of perjury that I am licensed under previsions of Chapter 9 (commencing with Section 70 !�i I the Business and Firryyys�yr ode, and my license is in full force
nd effect. License Class License No Date Contractor Signaturree�� l
VORKERS' COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 16100.0001, IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 1709 OF THE LABOR CODE, INTEREST, AND ATTORNEYS 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 3700 of the Labor Code, for th
evormance 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' compensatiol
rance carrier and policy number are.
ter Policy Number Expiration Date
re of Agent Phone #
certify that, in the performance of ork for which th&-sperimill is issued, t shall not employ any person in any manner so as to become subject to the workers' compensation laws Califomia. and agre
, it I should become subject ti e workers c sation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
lalure, of Applicant Date
•I AMATInAI DFnAOrI �. f'IAI RIIr_TI(1N i FIJniNC. erFN(`v
aeby affirm ❑nd peryury 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
my signatu,e balov:, t certify to each of the following:
I i,m the property owner or authorized to act on the property owner's behalf.
I Cave read thir application and the information I have provided is correct.
agree to comply with all applicable city and county ordinances and state laws relating to building construction.
' authorize representatives of this city or county toe the above-idenlifie ropeflyfor inspection purposes.
Irature of Pronert'vOwner or Authorized Agent Print Property Owner's or Authorized Agent's Name
OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
PART 61 OFTITLE 40 AND, RULE
I SUBMITTED
PERMITFINAL I_„IASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF !/�/ ;//y� I PROPOSED DEMOLITION
OCCUPANCY ISSUED /- / /"�" I SIGNATURE: