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H2023-0171 - Permits
��EWPoRr City of Newport Beach p A Community Development Department - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 ? Permit Counter Phone: (949) 718-1888 newportbeachca.gov/civic CgGlF00.�\P Mechanical Permit Plan Check No: Work Class : Other Issued Date : 03/10/2023 Inspection Area : 2 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 : 4307 HILARIA WAY Legal Desc : N TR 4692 BILK LOT 27 TR 4692 LOT 27 TOGETHERWITHAN UND 1/9 8 INT IN Description: MECH -INSTALL HEAT -PUMP ON ROOF. TAMPER -RESISTANT CAP REQ'D C VNOa' 13 �—' A Noje.` -b;" Owner: MATTHEW BRUNMEIER Address : 4307 HILARIA WAY NEWPORT BEACH, CA 92663 Phone : Applicant: ROCKLIN HEATING & AIR Address: 5706 LONETREE BLVD ROCKLIN, CA 95765 Phone: (916)626-5151 Owner/Builder : Address Phone : Code Edition : 2022 Type of Construction Occupancy Groups: Building Setbacks Flood Zone: Use Zone: PROCESSED BY RM - Multiple Residential SPECIAL CONDITIONS: Fire Hazard Zone : INee'�►�� 4@�4�. I r �1� Contractor : ROCKLIN HEATING & AIR Address : 5706 LONETREE BLVD ROCKLIN, CA 95765 Phone: (916)626-5151 Con State Lie : 959466 Lie Expire : 09130/2023 Bus Lie: BT30074728 Bus Lie Expire:03/31/2024 Workers' Compensation Insurance Carrier : EMPLOYERS PREFERRED INS CO Policy No : EIG4913614 W. C. Expire: 1/1/2024 NO Manufacturer: TRANE Model# : 4TW R6030H 1000A OWNER -BUILDER DECLARATION I hereby affirm under penalty of penury 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 rem(s) ;Section T031 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 :he permit to file a stalled 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 arofesslons Code) or that he or she is exempt from lioensure and the basis for the alleged exemption. Any violation of Section 7031.S by any applicant fora permit subjects the applicant to a civil ponalty of not more than five hundred dollars ($500).. 1 I, as owner of the property, or my employees with wages as their sale compensation, will do (_) all of or (_) portions of the work, and the structure Is notintended or offered for sale (Section 7044, 3usiness and Professions Code' The Cartractor5' Skate License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the mprovements 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 ^mproved for the purpose of sate) �tn. t 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 I am exempt from licensure under the Contractors' Stale License Law for the following reason,_. _. ... _ ,�_. _..._. -__ . �_�..------- By my signature below I acknowledge that, oxcopt for my personal residence in which I must have resided for at feast one year prior to completion of the improvements covered by this permit I.cannot legally sell a structure that I have built as an owner -builder It 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 sitehiip:f(www.loginfo.ca..govlcalaw.html. Signature of Property Owner or Authorized Agent Data LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under previsions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No Date Contractor Signature iNORKERS' COMPENSATION DECLARATION MARRING: FAILURE TO SECURE WOR%ERS' COMPENSATION COVERAGE 16 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (1000.000r, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3703 OF THE LABOR CODE, INTEREST, ANOATTORNEY's FEES. hereby affirm under penalty of perjury one of the following declarations: © 1 have and wail 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 th performance of the work for which this permit is issued. Policy No. Ell 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' compensatiol Insurance carrier and policy number are: Policy Number Date 5e Of Agent rl Vo re n 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 , if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code.. I shall forthwith comply with those provisions. UECIARATION R6GARD3NG CONS7Rl1CT1ON LENDING AGENCY 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). Lender's Name _ _ _ _ ____ Lender's 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. I authorize representatives of this city or County to enter the above --identified property for inspection purposes. 8i nature of Property Owner or Authorized Agent Print PropertyOwner`s or Authorized Agent's Name Date ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART fit OF TITLE 40 AND AOMD RULE 1403 Pitillm f EXPIRED I SUBMITTED ASRESTO5 NOTIFICATION TO PERMIT CANCELLED ChPA P£ftfvtlT EXiENDEO � � a0iA0' PFflM17 FINAL I� rAS9eSTrJS N[7iIFkCATION IS NOT APPLICABLE TO CERTIFICATE OF Z/Zy a,tO'h DR PROPI) EDD€MOLITION OCCUPANCY ISSUED SIGNATURE ..........._...__...�.._..___...� ��EWPO?T City of Newport Beach O Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, `CA 92660 s Permit Counter Phone: (949) 644-3288 t - Inspection Requests Phone: (949) 644-3255 c9� Fc>aNv`"a� newportbeachca.gov/inspections +;.wow Mechanical Permit Plan Check No : Work Class : Other Issued Date : 03/10/2023 Inspection Area : 2 H2O23-0171 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 : 4307 HILARIA WAY Legal Desc : N TR 4692 BLK LOT 27 TR 4692 LOT 27 TOGETHER WITH Description: MECH -INSTALL HEAT -PUMP ON ROOF. TAMPER -RESISTANT CAP REQ'D Owner: MATTHEWBRUNMEIER Contractor: Address: 4307 HILARIA WAY NEWPORT BEACH, CA 92663 Address Phone: Phone: Con State Lic Applicant: ROCKLIN HEATING & AIR Address : 5706 LONETREE BLVD ROCKLIN CA 95765, CA 95765 Phone: (916)626-5151 Owner/Builder: Address Phone: Code Edition : 2022 Type of Construction Occupancy Groups: Building Setbacks Flood Zone: Use Zone : PROCESSED BY: RM - Multiple Residential SPECIAL CONDITIONS: Fire Hazard Zone : NO Lic Expire Bus Lic: ROCKLIN HEATING & AIR 5706 LONETREE BLVD ROCKLIN CA (916)626-5151 959466 09/30/2023 BT30074728 Bus Lic Expire:03131/2024 Workers' Compensation Insurance Carrier : EMPLOYERS PREFERRED INS CO Policy No : EIG4913614 W. C. Expire: 1/1/2024 95765, CA 95765 Manufacturer: TRANE Model#: 4TTX503OAl 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) faction 7031.5. Business and Professions Code: Any city or county that requires a permit to construct, slier, improve, demolish, or repair any structure, prior to its Issuance, also requires the appkcsnLfOr ie 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 rofessions Code) or that he or she is exempt from kcensure, 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 Cf more than five hundred dollars ($500). 1 1, as ,,,"Of the property, or my employees with wages as their sole compensation, will do O all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, usiness and Professions Cie' 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 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 it was not built or nproved for the'purpase of sale), 11, 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 poly to an owner of property wind, bulids or improves thereon, and who contracts for the projects with a licensed Contractor pursuant. to the Contractors' State License Law).. I am exempt from ticensure under the Contractors State License Law for the following reason ___ ....____.—........._..0 _._..,......_____...,...®......_.......Tu.._..._.._..__-�.._.._--__.._..,..,.____ 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 of the improvements covered by this permit, I cannot legailt all 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 e copy of the applicable law, Section 7044 of the Business and 'rofessicns Code, is available upon request when this application is submitted or at the following Web site:http:llwww.leginfo.ca.govtcalaw.htmi. igrrature of Properly Owner or Authorized Agent __ Date ,ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing. with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force rid effect. License Class License. No. Hate Contractor Signature WORKERS' COMPENSATION DECLARATION 'ARRING: FAILURETO SECURE WORI[ERS' COMPENSATION COVERAGE M UNLAWFUL, AND SHALL SUBJECT. AN EMPLOYER TO CRMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5104,000), IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEI"S FEES, hereby affirm under penalty of perjury are of the following declarations: I i have and will maintain a certificate of consent to self-inabre for workers' compensation, issued by the Director of industrial Relations as provided for by Section 3700 of the Labor Code, for th arformance of the work for which this permit is issued. Policy No. 11 have and will maintain workers' compensation insurance, as required by Sectors 3700 of the Labor Code, for the performance Of the work for which this permit is issued. My workers' compensadol vsurance carrier and pokey number are: :arrmr Policy Numoer Expiration Date re of Agent IT 1p1e " certify that, in the Performance of the work for which this permit is issued, I shall not emp€oy any person in any manner so as to become subject 10 the workers' compensation laws of California, and , if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ugmevra of Applicant'------ rECLARATION RE43ARDING CONSTRUCTION LENDING AGENCY 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). .endors Name Lenders Address ly 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 ordinenoes and state laws relating to building construction. I authorize representatives of this City or county to enter the above -identified property for inspection purposes. .irtnan3re of Prnnerty Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED i { I U I SURMiTTED ASREST05 NOTIFICATION TO PERMIT AWAL OY1212y U- o- L IASSESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF PROPOSED DEMOLITION F?nOIPAN{7/55UED DR SIGNATURE: