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Home My WebLink AboutH2024-0229 - Permits (3)City of Newport Beach p I Community Development Department - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 718-1888 U > newportbeachca.gov/civic Cq</FOM1�\P Mechanical Permit Plan Check No: Work Class : Other Issued Date : 04/22/2024 Inspection Area: 1 H2O24-0229 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: 127 26TH ST Legal Desc : A TR NEWPORT BEACH CITY BLK 26 LOT 22 Description: MECH -INSTALL MINI -SPLIT HEAT -PUMP CONDENSER. TAMPER -RESISTANT CAP REQ'D. Owner: LAWRENCE PITKIN Address : 127 26TH ST NEWPORT BEACH, CA 92663 Phone: (858) 245-7454 Applicant: THOMSON AIR CONDITIONING Address: 21205 JUAN AVE UNIT A HAWAIIAN GARDENS, CA 90716 Phone: (562) 201-3014 Owner/Builder : Address Phone: Code Edition: 2022 Type of Construction Occupancy Groups: Building Setbacks Flood Zone Use Zone: PROCESSED BY: Front: 5, Side: 3, Side: 3, Rear: 5 X R-1 - Single -Unit Residential SPECIAL CONDITIONS: Fire Hazard Zone : NO Contractor : THOMSON AIR CONDITIONING Address : 21205 JUAN AVE UNIT A HAWAIIAN GARDENS, CA 90716 Phone: (562)201-3014 Con State Lie: 959811 Lie Expire : 04/30/2025 Bus Lie: BT30081704 Bus Lie Expire:05/31/2024 Workers' Compensation Insurance Carrier: A I U INSURANCE COMPANY Policy No: WC034279549 W. C. Expire: 7/1/2024 Manufacturer: BOSCH Model#: BMS500-AAM036-1CSXRC OWNER -BUILDER DECLARATION 1 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 itern(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 io permit to rile a signed statement that he or she is licensed pursuant to the provisions of the Contractors' Slate License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Irofessions Code) or that he or she is exempt from licensors 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 of 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 (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 nprovemenls 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 purpose of sale). 3 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 pply 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' State License Law for the following reason ly my signature below I acknowledge that, except for my personal residence in which I must have resided for at leastoneyear prior to completion of the improvements covered by this permit, I cannot legally ell 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 'rofessions Code, is available upon request when this application is submitted or at the following Web site:httpJlwww.leginfo.ca.govicalaw.html. signature of Property 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) ofDiv, ion 3 f the Business and Professions Code and my license is in full force ad effect. License Class License No Date Contractor Signatur PORKERS' COMPENSATION DECLARATION15-1 rARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP 70 ONE HUNORE THOUSAND DOLLARS ($100.000), IN ADDITION TO THE AST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: I 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 ih1 �kformance of the work for which this permit is issued. Policy No. and will maintain workers' compensation insurance, as required by Section 3100 of the Labor Code, for the performance of the work for which this permit is issued. My workers' carrier and policy number are: Policy Number of Agent Date 3 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' compensate n laws of California, and agree iat, if I should become subject to the work 9A,compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those previsions. dgnature, of Applicant "wL L ZZ IECLARATIpN REGA I UO ON LP-NDIN AGENCY hereby affirm under penally o perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). enders Name Lender's Address y 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, ova= entified property for Inspection purposes. Z ionature of Propedv Owner or Authorized Anent ,Y `l Print Properly Owner's or Authorized Agent's NanR�/_ __.. f `� 5 Date BY �' DECLAkWtON OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PFRMITEXPIRED ! U I SUBMITTED ASBESTOS NOTIFICATION TO _ PERMIT CANCELLED 11EPA PERMITEXTENDED 4M0 PERMITFINAL 1 /13/7_J l.!' (J 1 �OY ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF ^uc PROPOSED DEMOLITION OCCUPANCY ISSUED l•l rJ , SIGNATURE: