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Home My WebLink AboutH2023-0763 - Permits�FWorr City of Newport Beach I I II I I I III II II IIII II II Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 718-1888 S newportbeachca.gov/civic C9GIF0 RN P Mechanical Permit : H2O23-0763 Plan Check No: PC2023-1237 Work Class : Other Issued Date: 12/06/2023 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 : 5409 LIDO SANDS DR Legal Desc : N TR 3162 BLK LOT 82 Description: MECH INSTL ROOF MOUNTED HEAT PUMP, TAMPER RESISTANT CAP RED, INCLDS 2 AIR HANDLERS Owner: HAROLD GUBERNICK - Contractor : TRUE HOME HEATING A/C Address : 5409 LIDO SANDS DR NEWPORT BEACH, CA 92663 Address : 4 FARADAY IRVINE, CA 92618 Phone : (714) 401-4132 Phone : (949) 382-6337 Con State Lic : 1025397 Applicant : BEN MEDINA Lic Expire : 04/30/2025 Address : 31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362 Bus Lic : BT30064629 Phone: (818) 735-7876 Bus Lic Expire:10/31/2024 Workers' Compensation Insurance Owner/Builder : Carrier : TRAVELERS PROPERTY CASUALTY CO OF AMERICH Address : Policy No : UB9S682838232SG Phone: W. C. Expire : 12/1/2024 Code Edition : 2022 Fire Hazard Zone : NO Manufacturer: LENNOX Type of Construction : Model# : MPC018S4M-1 P' occupancy Groups: , Building Setbacks : Front: 0, Side: 4, Side: 4, Rear: 10 • • , Flood Zone : X Use Zone : R-1 - Single -Unit Residential PROCESSED BY SPECIAL CONDITIONS: 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) 1 have placed next to the applicable Items) Section 7031.5, Business and Professions Code: Any City or county that requires a permit to construct, after, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for io 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 Irofessfons Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section7031.5 by any applicant for a. permit subjects the applicant to a civil penalty of of more than five hundred dollars ($500). I, as owner of the proparty, or my employees with wages as their sole compensation, will do U all of or L) portions of the work., and the structure is not intended or offeredfor sale (Section 7044, lusiness 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 (hat 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 tt was not built or n'tproved for the purpose of sale)- _„E 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 oply 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), 3 1 am exempt from licensure under the Contractors' State License Law for the following reason; try 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 legall, all a structure that I have built as an owner -buildar if it has not been constructed In its entirety 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./iwvAv.leginfo.ca.govlcalaw.html. signature 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 7000)D r,;'I 3 of the Busines,p a}i6 Profess' ' and my license is in full force nd effect. License Class License. No Dy� -G Contractor wnatur VORKERS' COMPENSATION DECLARATION IARNINO: 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 (0100,000), IN ADDITION TO THE DST OF COMPENSATION, DAMAGESAS 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: I I have and ell T3•main 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 erformance of the warn for which this permit is issued. Policy No. J*v3 and v.ill rr.asr.;ain 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' compensation n;urance carrier and policy number are: .amr — Policy Number Exp€ration Date V3me pf Agent Phone H :1I certify that, in the pi ormanc the work for which this p s issued, shall not employ any parson in any manner so as to become subject to the workers' compensation laws of California, and ogre ha., J I should oeuombje a the workers comme n provsions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �',��.G�� Signature of Aunt �i�7Ea.ARATlOREGQING CTION LENDING AGENCY hereby affirm under po rjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Name Lender's Address 3' ry signature I cerl.ify to each of die 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 to Comply with all applicable city and county ordil ances and state laws Fig to building construction. I authorize representatives of this city Or county toe r the above -de property for inspection purposes. 5i .nature of Property Owner or Aulkiillpeed Agent Print Property Owner's or Authorized A ent 1e oktWaData ACTION DATE Ijy,- DDE N OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY / . F. �TIONS PART 61 OFTITLE AD AND, RULE PERMIT LXP;REO — I LI'SUBMITTFF) ASBESTOS NOTIFICATION TO Pf.RMIi CANCELLED ;.. EPA PERMIT EXTENDED.,LgQMD -•—'�. PERMIT FINAL CERTIFICATE OF OCCUPANCY ISSUED r�C4 l SBESTOS NOTIFICATION IS NOT APPLICABLE TO -, PROPOSED OEMOLRION l SIGNATUREi