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HomeMy WebLinkAboutH2022-0535 - Permitse'�wcoR� City of Newport Beach p @ Community Development Department- Building Division Y , y 100 Civic Center Drive, Newport Beach, CA 92660 u ,T Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 c9crcoaN�P newportbeachca.gov/inspections III I I I II I II I II IIIIII II II Mechanical Permit : H2O22-0535 Plan Check No : 0490-2021 Work Class : Other Issued Date : 09/30/2022 Inspection Area : 5 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 : 250 HAZEL DR Legal Desc : N TR 673 BLK ALOT 44 TRACT NO 673 BLK A LOT 44 AND FOR ABAN D STIR (GLEN Description: MECH -INSTALL HEAT PUMP(MINI-SPLIT). TAMPER-RESISTANTCAP REQ'D Owner: KAN STEPHEN WAYLAND TR Contractor s Address : 250 HAZEL DR CORONA DEL MAR, CA 92625 ` Address Phone: Phone: Con State Lic Applicant: KAN STEPHEN WAYLAND TR tic Expire Address: 250 HAZEL DR CORONA DEL MAR, CA 92625 "��� s Lic : Phone : iLZ 'BGs Lic Expire: INSFPtEWorkers' Compensation Insurance Owner/Builder : KAN STEPHEN WAYLAND TR Carrier : Address : 250 HAZEL DR CORONA DEL MAR, CA 92625.-. Policy No Phone : W. C. Expire: Code Edition : 2019 Fire Hazard Zone : YES Manufacturer Type of Construction Model# Occupancy Groups: Building Setbacks : Front: 1, Side: 4, Side: 4, Rear: 10 Flood Zone : X Use Zone PROCESSED BY: R-1 - Single -Unit Residential — AX%\VP 111 SPECIAL CONDITIONS: MITSUBISHI a eaa • ® a® ® G 9 a q J iJ• i ! a_ � 9 G P- a 7 ie a 4'ry SO; O a JO v 3 �a I hereby affirm under penalty of perjurythat 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 applicableitem(s) etion 70211,5, Business and Profession$ Code: Any city or county that requires permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for permitter file a signed statement that he nr she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter9 (commencing with Section 7000) Of Division 3 of the Business and fessions Cade) or that he or she is exemptfrarn licensure and the basis for the alleged exemption. Any violation of Section 703t.5 by any applicant for a permit. subjects the applicant to a Civil penalty of more then fiive. hundred dollars ($500). I, as owner of the property, or my employees with wages is their sole compensation, will do (_) all of of (_) Portions of the work, and the structure is not intended or offered for sale (Section 7044, ;iness and Professions Code: The Comractcr,' 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 irovements are not intended or offered for sale. If,. however„ the building or improvement is sold within oneyear of completion, the Owner -Builder will have the burden of proving that it was not built or Noved 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' State License Law does not I a an owner of pro builds Or improves thereon, and who contracts far the praJeats with a licensed Contractor pursuant io :the Can[ractprs' State License Law). I • m exempt from ifcensura under the GDntraOUrrs' State Lkanse Law for the t011owing reason:. n signs to inoelow f er"a' edge that, oxcDpt for my pers¢nai residence in which I m have resided for at feast one year prior to nomplebon Of the improvements covered by this permit; I.cannnt legal astructure that I have built. as an owner -builder ii it has not been aonstnictad in is racy 6y licensed contractors. 1 understand theta copy of IheappliOabis-.law, Section 04A of thoBusinessand rfessions Coda, is avafEable upon request w. application 4 Ib ed or a foiloms-�Vyeb site:hop:/luww.leginio.ca.gov/calaw.htmL 0 O nature of Proparfy Owner or Authanzed Aganti m under penalty of perjury License Class ;','rW licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3:of the Business and Professions Cod ,.and my license is in full force License No Date Contractor Signature. VORKERS' COMPENSATION DECLARATION iARNING: FAILURE TO SECURE WORKERS• COMPENSATION COVERAGE 15 UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS tStleD.BODj, IN ADDITION TO THE iOST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37116 OF THE LABOR COOS, INTEREST, AND ATTORNEYS FEES, hereby affirm under penalty at perjury one of the following declarations: 1 have and will maintain a certificate of consent to.self•fnsure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th ierformance of the work for which this permit is Issued. Policy No. :11 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 compensatio nsurance carrier and policy number are: rrier. . Policy Number. Expiration Date Oqeof Agent Phone If 1 rdfy that, in the performance of the work for whic this pe it Is issued, I shall not employ any person m any manner so as to become subject to the workers` compensation laws of California, and agra. hat, f 1 should become subject to the workers mpen ati it of Section 3700 of the Labor Code,' I Shelf forthwith comply with those Provisions. y signature of Applicant Dat 2 Z )ECLARATION REGAR GONSTRON LENDING AGENCY hereby affirm under penalty of perjury that there is a construction fending agenoyfor the performance of the. work forwhich this permitis;issued (Section 3097, Civil Code). -enders Name Lenders. Address 3y my signature below, €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 a unty ordinances andstate,41aA relating to building construction. I:autharize representatives of this city or count to ant he ove-Ida ed proper€ Inspection purposes. _ �,!. °` - .... _,.--- _-noel-./.--i .1 _:,J 1�.,, In., 43d4 z ACTION CEIMFtCATFOr OCCUPANCY ISSi >LIAN0 WITH CODE OF FEDERAL I FOR OFFICE OF TITLE 4D AND AG2MD RULE I 6 1403 ULi ISU- MSi1ESL •D jja• i� 'BESTOS NOTIEICAT -r? X PROPOSED DEMOLITION FTr .-• a • • • • • a •tee +n gym^ .. o co-. .� To APPLICABLE TO