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HomeMy WebLinkAboutH2022-0385 - Permits3 00R� City of Newport Beach III I I I II I II Community Development Department - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-32B8 Inspection Requests Phone: (949) 644 3255 newportbeachca.gov/inspections t y Mechanical Permit : H2O22-0385 Plan Check No : 2437-2021 Work Class: Other Issued Date: Inspection Area : 3 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 : 1912 HIGHLAND DR Legal Desc : N TR 3057 BILK LOT.43 Description: MECH: INSTALL HEATPUMP (TIMERS PROHIBITED)"TAMPER RESISTANT CAPS REQUIRED** (X2021-2798) Owner: CAMERON SINCLAIR Contractor : ANDREW.LEE MINER Address : 1912 HIGHLAND DR NEWPORT BEACH CA 92660 Address : ` P O BOX 1336 NEWPORT BEACH, CA 92663 Phone: Phone: ,(949)645-5666 Con State Lie 328952 ' Applicant : ANDREW LEE MINER Lie Expire :: 08/31/2024 Address : P O BOX 1336 NEWPORT BEACH, CA 92663 Bus Lie: BT30043939 Phone: (949)645-5666 Bus Lie Expire:07/31/2022 - Workers' Compensation Insurance Owner/Builder : - Carrier : - STATE COMPENSATION INSURANCE FUND Address : Policy No:, 9168668, _ Phone: W. C. Expire: - 7/1/2023 Code Edition : 2019 Fire Sprinklers : NO Manufacturer: MITSAIR Type of Construction : ;': Fire Hazard Zone : YCiQ ' Model# : MOD31-24HFN1-MTOW Occupancy Groups: Building Setbacks : Front: 20, Side: 6, Side: 6, Rear: 6 Flood Zone: X aaa, Use Zone : R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area) ...... ,9a , 'dJO4.:P 2 a a 0C D G PROCESSED BY: c © oa ae® a , a �a o...a o „tee c � .a •� ec�ca aaac- , o as ° tea, o ,avac. a I hereby affirm under penalty of perjury that t 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 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 toits issuance, also requires the applicant for is permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors` Sude License Law {Chapter 9 (commencing with Section 7000) of Division 3 of the Business and rofessions Code) or that he or she Is exempt from llcensure andthe basis for the alleged exemption. Any violation of action 7031.5 by any applicant for a permit subjects the applicant to a civil Density of of more than five hundred dollars ($500). 11, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, usiness 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 nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of complegon, the Owner -Builder will have the burden of proving that it was not built or nproved for the purpose of sale). 11, 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 poly to an owner of property who builds or improves iherson, and who contracts for the projects with a licensed Contra for pursuantto the Contractors' State License Law). I I am exempt from Heensure under the Contractors' State License Law for the following reason: y my signature below I acknowledge that, except for my personal residence in which I must have resided for at least o a year prior to completion of the improvements covered by this permit, I cannot legall: Bit a structure that I have built as an owner -builder ifit has not been constmcted in its entirety by licensed contractors. urxlerstand 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:httg:.11 w.leginfo.ca.govlcalaw.html. ignature of Property Owner or Authorized Agent Date 10ENSED CONTRACTOR'S DECLARATION hereby affirm under penally of perjury that 1 am licensed under previsions of Chapter {commencing with Section 70001of DiY}Sion 3 01 the Business and Psofessio a a To is in full force Ind affect. License Class License No Date �(' -{� ^ Iw(- %8entractor Signature WORKERS' COMPENSATI.ON'. DECLARATION r WARNING: PATLURE TO SECURE WORKERS' COMPENSATION. COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL COST OF COMPENSATION, DAMAGESAS 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 have and Will maintain a certificate of consent to self -insure for workers' compensation, issued by the Dire, perf rmance of the work for which this permit Is issued. Policy No. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for insurance carrier and policy number are: Cartier Policy Number Name of Agent AND CNR. FINES UP TO ONE HUNDRED THOUSAND DOLLARS tSl DD,DDD), IN ADOPTION TO THE of Industrial Relationsasprovided for by Section 3700 of the Labor Code, for performance of the work for which this permit is issued. My workers' Date 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' compensation laws of California, and agre , 41 should become subje a compensa 'tion provisions of Section 370D of the Labor Code, I shall fort 'with comply with those Rrovisions. n Wore of Applicant Date I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name Lenders Address By my signatpr&Jgfow, I certify to each of the following: I am the prppCTy owner or authorized to act on the property owner's behalf. • • •? have rVad jjljsapplicatlon and the information I have provided is correct. • •I agreeoeomply with all applicable city and county or wood and state laws relating to building construction. • • I authorize representatives of this city or county a e-i tifled property for inspection purposes. r x Signature of Pr*rperty Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name / \ C juDiate 'y • AL71ON • • DATE BY D' ARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY s w • • •I REGULATIONS PART 61 OF TITLE 40 AND AQMO RULE •• E . .• jrERM1FEXPIFfE'D•'F1 SUBMITTED ASBESTOS NOTIFICATION TO .B.`.MITCAN£E1LED PA �• j PE1kMI7EMF DiAr• _ QMD • • 1-PGr1�AlPFINAL NOTIFICATION 15 NOT APPLICA8IE TO • - ,t ,ASKSTOS ,CftTrFICATF,1F ••� �1/ rl (r PROPOSED DEMOLITION =UPANCY759UED• V SIGNATURE! All requj ed alarms, latches gates and fences which serve as part of a poollspa barrier, shall be in puce priorto approval to fill poollspa & shall remain in place & be maintained for the life of the pool.