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Home My WebLink AboutH2023-0213 - PermitsEWeoRr City of Newport Beach pF r, d Community Development Department - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-3288 We'* Inspection Requests Phone: (949) 644-3255 CgtIFO0.N`P newportbeachca.gov/inspections Mechanical Permit Plan Check No : Work Class : Other Issued Date : 03/28/2023 Inspection Area : 6 H2O23-0213 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: 8 FIORE Legal Desc : N TR 15337 BLK LOT 27 Description: MECH R/R HEAT PUMP AT SIDE*** TAMPER RESISTANT CAPS REQUIRED AND TIMERS PROHIBITED*** Owner: KEVIN MA Address : 8 FIORE NEWPORT BEACH, CA 92657 Phone: (626)818-5560 Applicant: BEN MEDINA Address: 31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362 Phone: (818)735-7876 Owner/Builder Address Phone: Code Edition : 2022 Fire Hazard Zone : YES Type of Construction Occupancy Groups: Building Setbacks : Front: 10, Side: 5, Side: 5, Rear: 10 Flood Zone : X Use Zone : PC - Newport Ridge PROCESSED BY: SPECIAL CONDITIONS: FIRE FUEL MOD / HAZARD SEVERITY ZONE Contractor : SERVICE CHAMPIONS HTG Address : 3150 E BIRCH BREA, CA 92821 Phone: (714)777-7777 Con State Lic : 799170 Lic Expire : 10/31/2023 Bus Lic: RMBWCOOD54221 Bus Lic Expire:04/01/2023 Workers' Compensation Insurance Carrier : EVEREST PREMIER INS CO Policy No: RMBWCD0054221 W. C. Expire: 4/1/2023 Manufacturer : LENNOX Model# : VPBO60H4M-3P TIMERS PROW I-rr �- ON HEAD" PUKA OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I am exempt from the Contractors' Slate License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(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 the permit to file a signedstatement 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 Professions Code) or that he or she is exempt from lcensure andthe 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 U all of or (_) 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 property, provided that the Improvements are not intended or offered for sale. 14 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). [31, 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 properly who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State license Law). I am exempt from licensors 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 Gannet legal]) 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:Nwmv.leginfo.ca.govfoalaw.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 711Y f Di 3 of the Business and Professlo e, and my license is in full forts and effect. License Class License No Date O Contractor Sign WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSAT)ON COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL MINES UP TO ONE HUNORE aANo DOLLARS ($100,000), IN ADUMON TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37" OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: El I have and will maintain a certifiG le 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, 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 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 am _ - OFF ITT -arty, -m3'nner so as to become subject to the workers' compy atlon laws of California, and agre tat, if I should become subject to the workers' eo mensation provisions of. - of the Labor Code, I shall forthwith comply with those provisions. 22 - Do€e 2 signature or Applicant IECLARATION REGARDING CONSTRU NOING AGENCY hereby affirm under penalty of at 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 my to each of the I am the property owner or authorized to act on the property owners behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county order and state laws rel ` - I ding construction I authorize representatives of this city or county t ter the above -ids 'property for inspection purposes. Ialure of Prcj3,11� Owner or Authorized Artent Print Property Owner's or Authorized A ION DATE BY L ON OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY ULATIONS PART 61 OF TITLE 40 AND AQMD RULE ( 1403 I PFRMITEXTENVF(P .,^/__ r_L _ LAAQMD PERMIT FINAL j6/47/ 23 µ. •F��, g5BE5T05 NOTIFICATION IS NOT APPLICABLE TO 1CGh),FICATEOr 1 PROPOSED DEMOLITION 5«L'PANCYISSUFD ( DR ' SIGNATURE: