The URL can be used to link to this page

Home My WebLink AboutH2023-0716 - Permits416`wP0/jr City of Newport Beach Community Development Denartment,- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 718-1888 u �'*�►. newportbeachca.gov/civic cq</FORN�P Mechanical Permit Plan Check No : Work Class : Other Issued Date : 1110712023 Inspection Area :B H2O23-0716 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: 23 CAPE WOODBURY Legal Desc : N TR 15012 BLK LOT 64 Description: MECH REPLACE (1) A/C IN THE REAR YARD AND FURNACE `TAMPER RESISTANT CAP REQ* Owner : MEREDITH CURCI Contractor : SERVICE CHAMPIONS HTG Address : 23 CAPE WOODBURY NEWPORT BEACH, CA 92660 Address : 3150 E BIRCH BREA, CA 92821 Phone : Phone : (714) 777-7777 Con State Lic : 799170 Applicant : BEN MEDINA Lic Expire : 10/31/2025 Address : 31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362 Bus Lic : BT01080105 Phone : (818) 735-7876 Bus Lic Expire:07/31/2024 Workers' Compensation Insurance Owner/Builder: Carrier: EVEREST PREMIER INSURANCE COMPANY Address : Policy No: RM8WC00054231 Phone : W. C. Expire : 8/1/2024 • - Code Edition : 2022 Fire Hazard Zone : NO Manufacturer: LENNOX Type of Construction : Model# : ML17XCl-036 Occupancy Groups Building Setbacks : Front: 10. Side: 5, Side: 5, Rear: 10 ' Flood Zone : X Use Zone : PC - Upper Castaways • - PROCESSED B 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) I have placed next to the applicable Item(s) Linn 7031.5, Business and Profossions Code: Any city or county that requires a permit to Construct, alter, improve, demolish, or repair anystruclus3, prior it Hs issuance, also requires the applicant for 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 fessions 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 to a civil penalty of more than five hundred dollars ($500). I. as owner of the property,or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, ;iness and Professions Code: The Contractors' State License Law does not apply to on owner of property who, through employeesor personal effort, builds or improves the property, provided thatthe Tovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that It was not built or roved for the purpose of'Iii 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not )ly to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). J I am exempt from licensure under the Contractors' State License Law for the following reason y my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion oft[ all a structure that 1 have built as an owner-buildor if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the 'rofessions Code, is available upon request when this application is submitted or at the following Web site:httpllwww.leginfo.ca..gov/calaw.html. ,ignature of Property Owner or Authorized Agent ICENSED CONTRACTOR'$ DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Seth 17( I o Divd ion of the Busin nd effect. License Class License. No a 1. Contrac PORKERS' COMPENSATION DECLARATION rents covered by this permit, I cannot law, Section 7044 of the Business and my license is in full force 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 (4100A00), IN ABOTrION TO THE DST OF COMPENSATION, DAMAGES ASP ROVIDED 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 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 ih grformance of the work fir which this permit is. issued. Policy No.. 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' .arrier Prd poliny number are: Policy Number Date la.re cf.4gent Phone if _ ]I oarthy that. in the perfcrmance of work for WNCI )wit is issued'. I shall not employ any person in any manner so as to become subject to the workers' compen odor aws of California, and agre iat, if ; bhould It Chia subjec workers ertsaLion provisions of Section 3700 of the Labor Code., I shall forthwith comply with those provisions. ,ignature of Applr n a IE.CL.ARATIO ARDIN RUCTION LENDING AGENCY h�aleoy a -firm und. r pe perjury that there o a construction lending agency for the performance of the work for which this permit is issued (Section 309 ivil Code), e.Ider s Name el _ _ Lender's Address _ ;y m; ,i;4r,ature below, certify to each of the following: I the prop^.rLi' 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 I agree to comply wdhall appllcabl city and county ounces and state laws r o building construction. fff y I authorize representatives of this cit r county to ter the above-ide property for inspection purposes. !^ ^- l ( Z ignature of Prooertv Owner or AULT e Roant Print Property Owner's or Authorized Agent's N I�U t' "mil D e ACTION DATE a D :ATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY `✓ I / FGUI.ATION$ PART 61 OF TITLE AO AND AQMD RULE 1403 VENMIT ENViREi] i S118MITTFD ASBESTOS NOTIFICATION TO 'LJEPA -- PERM(TCANCEUED PERMITEMENDED ,I_-__ —__— - LIAQMD --- --_�— PERTIMCANAL CERTIFICATE Of _* %. Z`f QN IS NOT APPLICABLE TO tPRASBSED DEMOLITION PROPOSED DEMOLITION OCCUPANCY ISSUED I SIGNATURE: