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Home My WebLink AboutH2024-0101 - PermitsQ ��WPORT City of Newport Beach Community Development Department- Building Division F 1"y 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 718-1888 u newportbeachca.gov/civic CgCIFORR�P Mechanical Permit : H2O24-0101 Plan Check No : PC2023-0617 PC Issued Date : 02/22/2024 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: 2433 BLACKTHORN ST Legal Desc : N TR 4893 BLK LOT 83 Description: MECH - INSTL (N) HEATPUMP W/ DUCTWORK Owner: ARTHUR JAMES MOSER Address : 2433 BLACKTHORN ST NEWPORT BEACH, CA 92660 Phone : (412) 334-6717 Applicant: BEN MEDINA Address : 31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362 Phone : (818) 735-7876 Owner/Builder Address Phone : Code Edition : 2022 Fire Hazard Zone : NO Type of Construction Occupancy Groups: 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) PROCESSED BY: IZPU SPECIAL CONDITIONS: Contractor : HG HOME SERVICES Address : 1501 WESTCLIFF DR NEWPORT BEACH, CA 92660 Phone : (949) 877-2821 Con State Lic : 1077757 Lic Expire : 07/31/2025 Bus Lic: BT300768818 Bus Lic Expire:02/28/2024 Workers' Compensation Insurance Carrier : CLEAR SPRING PROP & CASUALTY CO Policy No: CWC00016801 W. C. Expire: 6/16/2024 Manufacturer: AC PRO Model#: AUD60W OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable-kem(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 the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' Stale 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 Iicensure 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 not more than five hundred dollars ($500).. ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is notintended 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 the property, 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 property, am exclusively contracting With licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State 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). ❑ I ant exempt from licensure under the Contractors' State License Law for the following reason:. By my signature below t 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, sell a structure that I have quilt as an owner-buildar If ithas not been constructed In its entirety by licensed contractors. 1 understand that a 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 following Web site.httpall" w .leginfo.ca.govicalaw.html. Signature of Property Owner or Authorized Agent _ Date _ LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sec _70. f 'tog f the Business and Professions , and my license is in full force and effect. License Class License. No O Contractor Signaturg/ COMPENSATION DECLARATION FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SMALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP 'OMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 370E OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: DOLLARS ($100,000), IN AODMON TO THE 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 Trance of the work for which this permit is issued. Policy No. Sind 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' carrier and policy number are: Policy Number Expiration Dale re. of Agent certify that, in the performance of the work for which this permit is issued, I , if I should become subject to the workers' Compensation provisioI retire of Applicant LDetempUy any person in any manner so as to become subject to the workers' 3700 of the Labor Code, I shatl. forthwith comply with those provisions. areby affirm under penalty of perju = ere is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Coda). rider's Name Lender's Address my signature balowdlf o each of the following: I am the property owner or authorized to act on the properly Owner's, behalf. I have read this application and the -information I have provided is Correct. I agree to comply withall applicable city and county ordinan and slate laws relating to.buill construction. I authorizerepresemetives of this city or county to en e above -Identified -property for inspection purposes. nature of Property Owner or Authorized Agent _. Print Prooariv Owner's or Authorized Adam's Name lY X of California, and ACTION DATE BY TC'N OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY _ RFGUTATIONS PART bl OF TITLE 40 AND AQMD RULE. 1IF03 PPRfvif FXPIPEO r SUBMYTTEDASRFSTOSNOTIFICATIONTO PERAMTCANCIFI EO PERt4lT EXTENDED �s 1_LhQMD PERMITFINAL 081711Zg DL.Po, Br! ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF , PROPOSED DEMOLITION OCCUPANCY ISSUED j..CI3N.>'URE: