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HomeMy WebLinkAboutH2023-0297 - Permits�atiwPoRr City of Newport Beach p @ Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 u S Permit Counter Phone: (949) 718-1888 newportbeachca.gov/civic c9G/F00.N`P Mechanical Permit Plan Check No : Work Class : Other Issued Date : 05/04/2023 Inspection Area : 6 H2O23-0297 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: 1 FIORE Legal Desc : N TR 15337 BLK LOT 31 Description: MECH CHANGE OUT A/C UNIT *TAMPER PROOF CAP REQ* Owner: JESSECHEN - - - - - - — Contractor:- AL -PS - AIR CONDITIONING -&-FIEATING-INC- Address : 36 FAENZA NEWPORT COAST, CA 92657 Address : 1895 S SANTA CRUZ ST ANAHEIM, CA 92805 Phone: Phone: (714)633-8892 Con State Lie : 667953 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: Lie Expire : 04130/2025 Bus Lie: BT30047511 Bus Lie Expire:06/30/2023 Workers' Compensation Insurance Carrier : INS CO OF THE WEST _- Policy No: WSD506354500 W. C. Expire: 12/25/2023 Manufacturer:. I]EN NOX Model# : f 1t18XC2-060 t F .d OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury 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 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 signed statement that he or she is licensed pursuant to the provisions of the Contractors' Stale License Law (Chapter g (commencing with Section 7000) of Division.3 of the Business and Professions Code) or that he or she is exempt from lioensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora 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 (_) 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 BE 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 year of completion, the Owner -Builder will have the burden of proving that it was not built or Improved for the purpose of sole). 13 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 A410 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 liceraure under the Contractors' Stale 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 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 if it has not been constructed to 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:llwww.leginfo.ca.govlcalaw.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 0) ac he Business andJ,esa:i5-o my license Is in full force and effect. License Class License.No Date 5 ontractor Signa WORKERS' COMPENSATION DECLARATION NANNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUN HOUSAND DOLLARS tb1S0,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. I hereby affirm under penalty of perjury one of the following declarations: © 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 th pehformance 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: ie. of Agent codify that, in the performance of the , it I should become sulpgOt to the we of Applicant Policy Number Date San 1-shall not employ any person in any manner so as to become subject to the workers' compensation laws of California. and agre this permit Is i ahon p1 1s of Section 3700of the Labor Code., I shall forthwith comply with those provisions. DatJ Z> NG AGENCY hereby affirm under penalty o - adhere is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil ode). enders Name Lender's 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 informa(for) I hav provided is correct. I agree to comply with all applicable city and cow rdinance state laws relating to building construction. I authorize representatives of this city or county t ter the above- ntified property for! purposes. A / .,,..,,,, — -f o,,.,. n,.,.,o. — a m.,a,on A,Ant Prior PfanRrtv Owner's Or Authorized Aaent's Name A DATE BY AR.- COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY i �NS PART 610E TITLE 40 AND AOMO RULE PERMIT EXPIR£p 1 1 1 U I SUBrvIITTEOASBFST05 PERMIT EXTENDED _ �. AQZ� Mt' PERMITFINAL 4 ASSES OS PC'][ FICATION 15 NOT APPLICABLE TO CERTIFICATE OF II/03/23 DI fov RL I PROPOSED DEMOLITION OCCUPANCY I5SUEI 1 SIGNATURE: N "'14