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Home My WebLink AboutH2023-0204 - PermitsSEW PORT City of Newport Beach III I I I II I III II II I I II II II Mechanical Permit : H2023-0204 @ Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : 2268-2021 Permit Counter Phone: (949) 644-3288 Work Class : Other G s Inspection Requests Phone: (949) 644-3255 Issued Date : 03/2712023 c4(�F�pN�P newportbeachca.gov/inspections Inspection Area : 4 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; 4 PINEHURST LN Legal Desc : N TR 7223 BLK LOT 66 Description: MECH - SFR INSTALL (3) NEW HEAT PUMPS `PROVIDE TAMPER -PROOF CAPS AS REQ'D Owner: ROGER JEWKES Contractor : "Bill" James W. Jackson Address : 3750 LAS VEGAS BLVD S UNIT4701 LAS VEGAS, NV 89158 Address : 1000 Quail Street Quail Street, Suite 220 Newport Beach, CA 92660 Phone: Phone: (949)679-7086 ,,,, Con State Lic : 986194 Applicant: "Bill" James W. Jackson Address : 1000 Quail Street Quail Street, Suite 220 Newport Beach, CA 92660 Phone : (949) 679-7086 Owner/Builder : Address Phone : Code Edition : 2022 Fire Hazard Zone : NO Type of Construction Occupancy Groups: Building Setbacks : Front: 10, Front: 20, Side: 5, Side: 5 Flood Zone : X Use Zone : PC - Big Canyon PROCESSED BY: A SPECIAL CONDITIONS: Lic Expire : 08/31/2023 Bus Lic: BT30045036 Bus Lic Expire:10131/2023 Workers' Compensation Insurance Carrier : Policy No : LEWC321951 W. C. Expire: 12/20/2023 Manufacturer: MITSUBISHI Model# : MXZ-SM60NAM TIMERS PRO UIM� ON HEAT OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury 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 items) (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 the parmit 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 Professions Code) or that he or she is exempt from ficensure and the basis for the alleged exemption, Any violation of Section 70311.5 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 wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered 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 theproperty, 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 Improved for the purpose of sale). ❑ 1, as owner of the properly, 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 projectswith a licensed Contractor pursuant to the Contractors' State License Caw). ❑ I am exempt from llcensure Under the Contractors' State License Law for the following reeson: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at leastone year prior to completion of the improvements covered by this permit, I.cannot legall, sell a structure that I have built as an owner -builder if it has not been constructed in itsentirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available uponrequest when this application is submitted or at the following Web site:http:/1%v .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 7 ) If Dtvisian 3 of the Business and Professions aQ0, as is in full force and effect. License Class License No bate yZ Contractor Signature '< VORKERS' COMPENSATION DECLARATION 'ARMING: FAILURE TO ec_ "RE WORKERS' COMPENSATION COVERAGE IS UNLAWFU CST O":r�MPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 Of THE LAB hereby affirm under penalty of perjury one of the following declarations: L, AND SHALL SUBJECT AN EMPLOYER 4O CRIMINAL PENALTIES AND CIVIL FINES UP TOONE H THOU O DOLLARS ($100.000), IN AOORNON TO THE OR CODE, INTEREST, AND ATTORNEY'S FEES, 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 e of the work for which this permit is issued. Policy No. nave and will TI aintrin workers' compensation insurance, as required by Section 3700 of fie Labor Code., for the performance of the work for which this permit is Issued. My workers' ranee carrier and policy number are: ler. ag yVumber _ Expiration Date of Agent ceniy that, to the performance if I vhould became subject to mture of Applicant 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 afire i provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. A Date.. - ZA-Z 3 hereby affirm underr llty of p u at there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).. -enders Name (vJ' Lender's Address 3y my signature below, k. c2Wo each of the following: I am the property owner or authorized to act on 4propertyner's behalf• I have read this application and the information orreI agree to comply with all app:cable city and coand relating to building construction. I authorize representatives of this city crcountyov property for Inspection purposes. 3i ,nature of Progeny Owner or. Authorized Agent PrintProperty Owner's or Authorized Agent', Name GL TA-CK;l-i ACTION DATE - BY ECLA OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY RW IONS PART 51 OFTITLE 40 AND AQMD RULE 74t13 PERTAT EXPIRED I 0 1 SUBMITTED ASBESTOS NOT[ FICA TION TO PERMIT EXTENDED L.JAQM'.D PERMIT FINAL / SBESTOS NOTIFICA7 S NOT I P TO CERTIFICATE OF L /`/�ljlr OCCUPANCY ISSUED / z 65 GNp"�ttt"'r"iT ___