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Home My WebLink AboutH2023-0683 - Permits�PoR� p; City of Newport Beach @ Community Development Department - Building Division r>? y �' 100 Civic Center Drive, Newport Beach, CA 92660 '` ' 7 Permit Counter Phone: (949) 718-1888 �- `'w;4cicaa'`, P✓` newportbeachca.gov/civic II II II Mechanical Permit Plan Check No : Work Class : Other Issued Date : 1012312023 Inspection Area :1 H2O23-0683 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 : 117 24TH ST Legal Desc : A TR NEWPORT BEACH CITY BLK 24 LOT 27 Description: MECH -NEW HEAT PUMP. TAMPER RESISTANT CAP REQUIRED Owner: DAS BEACHIN MON LLC Address: 21243 PO BOX MESA, AZ 85227 Phone: Applicant: URBAN MECHANICAL Address : 10621 BLOOMFIELD #25 LOS ALAMITOS, CA 90720 Phone: (714)614-2446 Owner/Builder : Address Phone: Contractor: URBAN MECHANICAL Address: 10621 BLOOMFIELD #25 LOS ALAMITOS, CA 90720 Phone: (714)614-2446 Con State Lic : 594181 Lic Expire : 05/31/2024 Bus Lic: BT30005613 Bus Lic Expire:08/31/2024 Workers' Compensation Insurance Carrier: 'WESCO INSURANCE COMPANY' Policy No : 1028251 W. C. Expire: 9/9/2024 Code Edition : 2022 Fire Hazard Zone : NO Manufacturer : MITSUBISHI Type of Construction : Model# : MXZ-5C42NA4 Occupancy Groups: Building Setbacks : Front: 5, Side: 3, Side: 3, Rear: 5 Flood Zone : X Use Zone : R-1 - Single -Unit Residential PROCESSED BY SPECIAL CONDITIONS: I%a �g. r OWNER -BUILDER DECLARATION I hereby Effort under penally 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 7031.5. Business and Professions Code: Any city or county that requires a permit to construct, after. Improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for :he permit to file a signed statement that he or she is licensed pursuant to the provisions of the ContractorsState License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and ?rofesstons 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 no€ more than five hundred dollars ($500).. ❑ 1, 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 notintended or offered for sale (Section 7044, Business and Professions Cade: 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 '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 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' Slate License Law does not ra�rply 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). Ll I am exempt from licensure under the Contractors' Stale License Law for the following reason' _ __-_- ____ ,... _ ___.___—._.__T . _.,--..---------., 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, cannot legal sell a structure that I have built as an owner -builder if it has not been constructed in its entirely 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:htlp://www.leginfo.ce..gov/calaw.htmi. Signature or Property Owner or Authnrvad 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 700WLf Business and Professions n i u ce and effect. License Class License No -Date �(�'ntractor Signature WORKERS' COMPENSATION DECLARATION WARNING: 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 11190,000), IN ADDITION TO TH COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE., INTEREST, Me ATTORNEY-3 FEES. I hereby affirm under penalty of perjury one of the fallowing declarations: 0 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 1 ale of the work for which this permit is. issued. Policy No, ale 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' compensati Insurance carrier and policy number are: Policy Number Date is of Agent —vnone IT certify that, in the performance of the work f' his ,lit is u , 1 shall not employ any person in any manner so as to become subject to the workerscompensation If I Should become subject to the worker c nsaho ro o Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 3reby affirm under penalty of perjury thatthere is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). lder s Name Lender's Address 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 c re� t I agree to comply with all applicable city and county ordinancy (fate I In ilding construction. I authorize representatives Of this city or county to enter Lh =de " r op 'Dn rposes. � _ Pnnr Pronarty Owner's or Authorized Auent's Name !�` -- ( of California, and ACTION DATE BY DECLARATION OF COMPLIAICICE WITiI CODE OF FEDERAL FOR OFFICE USE ONLY r a 1 REGOIATIONS PART Fl OF TITLE, 4O AND AQMD ROLE 1403 PERMIT ExpIRED I LJ 15l1RMITTFD ASRFSTOS NOTIFICATION TO PERMIT- ANC EitrO - EPA -_ PERMIT FINAL i� ASBESTOS Nor IFICATION IS N07 APPLI{ABLE TO CERTIFICATE OF ID/Zl/2w DL 7.01^KK PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: