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HomeMy WebLinkAboutH2023-0591 - Permits0'.""""15; City of Newport Beach III I I II I III II IIII I II I II Mechanical Permit : H2O23-0591 Community Development Department - Building Division100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No Permit Counter Phone: (949) 718-1888 Work Class : Other newportbeachca.gov/civic Issued Date : 09/11/2023 Inspection Area : 6 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: 6 SARACENO Legal Desc : N TR 16195 BLK LOT 12 UN 71 TRACT 16195, LOT 12 OF Description: MECH - R/R A/C CONDENSER. TAMPER -RESISTANT CAP REQ'D Owner: YOLANDA KING Address : 2631 SADDLE RIDGE DR COVINA, CA 91724 Phone: Applicant: BOARDWALK HEATING AND AIR Address : 27271 PRINCIPE ST MISSION VIEJO, CA 92692 Phone: (562)841-7089 Owner/Builder : Address Phone : Code Edition : 2022 Type of Construction Occupancy Groups: Building Setbacks : Flood Zone : X Use Zone : PC - Newport Ridge PROCESSED BY: � t SPECIAL CONDITIONS: Contractor : BOARDWALK HEATING AND AIR Address : 27271 PRINCIPE ST MISSION VIEJO, CA 92692 Phone: (562)841-7089 Con State Lic : 1029478 Lic Expire : 07/31/2025 Bus Lic : BT30079287 Bus Lic Expire:07/31/2024 Workers' Compensation Insurance Carrier : EMPLOYERS PREFERRED INSURANCE CO Policy No : EIG500292800 W. C. Expire: 5/1,2024 ro Fire Hazard Zone : YES Manufacturer: AC PRO �— Model#: AULD36W2/A 9 41 ` `r V 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 7031.6, Business and Professions Code: Any city or county that requires permit to construct, after, improve; demolish, or repair any structure, prior to its Issuance, also requires the applicant for the permit to file a signed statement thathe 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 licensure and the basis for the alleged exemption. Any violation of Section 703L5 by any applicant fora permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). 111. 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, 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 properly, 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 If 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' Stale 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). ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason _11 By 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 improvementscovered by this permit, I can noI Iegall, sell a structure trial I have built as an owner -builder 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 Professions Code, is available upon request when this application Is submitted or at the following Web site:http:/lwww.leginfo.ca.govlcalaw.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 Section 0 o Div sion 3 of the Business and Professions,Co and m I rise is in full force and effect License Class �ZO License No ((yZ °i cI 4 x Date 1 2 Contractor Signature / / WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WOR%ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 370 OF THE LABOR CODE, 017EREST, AND ATTORNEYS FEES. I hereby affirm under penalty of perjury one of the following declarations: © By, and will maintain a certificate of consent to self -insure for workerscompensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for lh o rfa ante of the work for which this permit is issued. Policy No., he a 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' compensation insure Ce carrier and polimy number are: r Policy Number ( 61 )C C_'C,'29?_ 9CC) Expiration Dale Name of Agent Phone # ❑I certify that, in the performance of the wo0�heith this 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 agre, that, if I should become subject to thgork provisions of Section 3700 of the Labor Code., I shalt forthwith comply with those provislons. Signature of Applicant .__ 2DECLARATION REGAR NG ONON LENDING AGENCY �"I hereby affirm under penalty of per}ere is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code), Lenders Name _ Lender's Address _ By my signature bofow. certify to each of the 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 ordinances and store laws relating to building construction. I authorize representatives of this city or county to enter the a6 ve rh any for inspection purposes. Si nature of Pro ert Owner or Authorized Agent Print PropertyOwner's or Authorized A ent's Name Date y I Z3 ACTION DATE BY DECLARATI OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY RfiGUTATI NS PART 51 OF TITLE 40 ANDAQMD RULE 1403 PERMIT£XPfRE'U _ I SUBMITTED ASRFSTOS NOTIFICATION TO PERMIT" CANCELL,:O (; EPA PERMIT FXFFNOFJ { _❑AOMD PERYfl7FINAL i(j7/z7/Zy pL ,F, RL ❑ASBESTOS NOT IHCATIUN 15 NOT APPLICABLE TO CERTfFfCATE OF PROPOSED DEMOLITION OCCUPANCY ISSUES SIGNATURES