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Home My WebLink AboutH2024-0172 - Permitso ��Wln d B City of Newport B Pa cent-BuilCing Diiision I�I��I I I II I I II II III I III I II Mechanical Permit: H2O24-0172 Community Development 100 Civic Center Drive, Newport Beach, CA926F0 Plan Check No Permit Counter Phone: (949) 718-1888 Work Class: Other u S newportbeachca.gov/civic Issued Date : 03/27/2024 c"<�FoaN�P 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 : 58 SEA PINE LN Legal Desc : N TR 8445 BLK LOT 1 UN 1 TR 8445 LOT 1 UNIT 1 G1, Description: MECH REPLACE A/C CONDENSER. TAMPER -RESISTANT CAP REQUIRED Owner: BRENDA LEE Contractor : NEXGEN A/C INC Address: 58 SEA PINE LANE NEWPORT BEACH, CA 92660 Address : 5472 EAST LA PALMA AVENUE ANAHEIM, CA 92807 Phone: Phone : (657) 208-1987 Con State Lic : 1011173 Applicant: CECILIA GUTIERREZ Address: 26111 YNEZ RD, C3 TEMECULA, CA 92591 Phone : (877) 600-0123 Owner/Builder : Address Phone : Code Edition : 2022 Type of Construction Occupancy Groups: Building Setbacks Flood Zone: Use Zone: PROCESSED BY: X PC - Big Canyon SPECIAL CONDITIONS: Lic Expire : 07/31/2025 Bus Lic: BT30055503 Bus Lic Expire:06/30/2024 Workers' Compensation Insurance Carrier : AMERISURE MUTUAL INSURANCE COMPANY Policy No: WC21148830402 W. C. Expire: 10/1/2024 Fire Hazard Zone : NO Manufacturer: ACPRO Model# : AUD36W OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the renscn(s) Irdic3ted below by t`Ie c. eckmark(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 repiir any Ftructure, 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' SILLS Jcenss Law (COapte, 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 7031.5 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 L) all of or L) pgrtioes of the ,vjrk, -md the 3'rictur3 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 property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one yaar of eompletioi., the, Ownel-Builder will have the burden of proving that It was not built or improved for the purpose of sale). - ❑ I, 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' Slate License Law). ❑ I am exempt from licensure under the Contractors' State License Law for the following reason: 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 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 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://www.leginfo.ca.gov/calaw.htmi. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penally of perjury that I am licensed under provisions of Qh?pter 9 (commencing with Section 7000) of Division 3 of the Business and Professi s Code, and my license is in full force and effect. License Class Z-0 License No [/`/ ((('%� Date �/2 %/ Contractor Signature NORKERS' COMPENSATION DECLARATION NARNING: 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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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, forth, Jerformance of the work for which this permit is issued. Policy No. Z1 have 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' compensatior hsurance c ner a0nd� policy number are: L I �7 X Uarrier Y../ .�;W& Z U T c(d l Policy Number �D �(� � Expiration Date / D f 2 Name of Agent Phone # ❑1 certify that. in the performance of the work for which 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, .hat, if I should become Sub* cct to the workers' comppeeWtion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. signature of Applicant I v /l�(.Y��r es�J Date Ocrl ADAT•Inlu Ornnoin Ii�nnueTOnrTInM I eunlun Ar_elury I hereby affirm under penalty of perjury that there Is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lenders Name Lenders Address By my signature below, I 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 state laws relating to building construction, authorize representatives of this city or county to nter the bove-idenfied property for inspection purposes. / _ Signature of Property Owner or Authorized Agent ' Print PropertyOwner's or Authorized Agent's Name , 'd 6CZf; Date ACTION DATE BY ' DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EX MIPIRED 1 SuBMITTED ASBESTOS NOTIFICATION TO PERT CANED CELLEPA PERMIT EXTENDED L3AQMD PERMIT FINAL 07/015/Zy ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO CERTIFICATE OF 1 , 1 PROPOSED DEMOLITION OCCUPANCYISSUED ✓V I SIGNATURE: