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HomeMy WebLinkAboutE2023-0015 - PermitsaEWPoRr City of Newport Beach Community Development Department- Building Division n 100 Civic Center Drive, Newport Beach, CA 92660 7+� S Permit Counter Phone: (949) 644-3288 C9��FD0.��P Inspection Requests Phone: (949) 644-3255 newportbeachca.gov/inspections Electrical Permit Plan Check No : Work Class : Other Issued Date : Inspection Area : 4 E2023-0015 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: 3123 COLONY PLZ Legal Desc : N TR 15178 BLK LOT 1 Description: ELEC -DISCONNECT FOR A/C CONDENSER REPLACEMENT Owner: THE COLONY AT FI LLC Address: NEWPORT BEACH, CA 92658 Phone: Applicant: AMTECH HEATING & AIR INC Address : 17751 SKY PARK CIR, STE F IRVINE, CA 92614 Phone: (800)882-3019 Owner/Builder : Address Phone: Code Edition : 2022 Type of Construction : Building Setbacks : Flood Zone : X Use Zone : PC - North Newport Center PROCESSED BY: SPECIAL CONDITIONS: Contractor : AMTECH HEATING & AIR INC Address : 17751 SKY PARK CIR, STE F IRVINE, CA 92614 Phone: (800)882-3019 Con State Lie : 1003704 Lie Expire : 04/30/2023 Bus Lie : BT30060143 Bus Lie Expire:08/3112023 Workers' Compensation Insurance Carrier : SIRIUS AMERICA INS CO Policy No : WC85553vt W. C. Expire: 12/20/202b Fire Hazard Zone : NO Occupancy Groups: R2 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 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 Hem(a) Section 7031.5, Business and Professions Code: Any city or county that requires a penult to construct, alter, improve, demolish, or repair any structure, prior to its Issuance, also requires the applicant for 1a permit to file a signed statement 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 �rofassions Code) or that he or she is exempt from licensute 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 of more than five hundred dollars ($500). 11, as owner of the property,. or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, msmess and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal Effort, builds or improves the property, provided that the nprovemenls are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or nproved for the purpose of sale). 1, as owner of the property, am exclusively contrasting with licensed Contractors to construct the project ($action 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). 3 lam exempt from ticensure 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 feast one year prior to completion of the Improvements covered by this permit, I Cannot legal. all a structure that I have built as an owner-buildor if it has not been Constructed in itsentirely by licensed contractors. I understand that a copy of theapplicable law, Section 7044 of the Business and Yofessions Code, is available upon request when this application Is submitted or at the following Web site:http:ilwww.leginfo.ca.gov/calow.html. signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am Ilconsed under provisions of Chapter 9 (commencing with Section 7 pp) f iv' ign 3,tthe Business and Professi d m , use i t II force nd effect. License Class License No Date Y HJL Contractor Signature WORKERS' COMPENSATION DECLARATION !ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1b100,0001, IN ADDITION TO TH OST OF COMPENSATION, OAMAOES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, ANO ATTORNEY'S FFFS. hereby affirm under penalty of perjury one of the following declarafions: ] 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 0 Qdormanee of the work forwhich this permit is issued. Polley No.. un,have and will maintain workers' compensation insurance, as required by Section 3700ofthe Labor Code, for the performance of the work for which this permit is issued. My workers' compensator 1 rance carrier and policy number are: ;enter Policy Number Expiration Date Jame of Agent Phone N -1I certify that, in the performance of the rk 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( hat, if I should become subjec to t e nsabon provisions of Section 3700 of the Labor Code. I shall forthwith comply wigs those provisions. Signature of Applicant D,aff� )ECLARATION REGARD NG CONSTRUCTI N LEND G AGENCY hereby affirm under penalty of perjury that there Is a nstruction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code), .enders Name Lender's Address iy my signature below, I certify to each of the following: 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 ordinance and state laws relating to building construction. I authorize representatives of this city or cou ty to ant ti ' r erty for inspection purposes. 'ri nature of PropertyOwner or Authorized Agent Print Pro ert Owner's or Authorized Agent's Name a Dale ACTION DATE BY DECLARATION OF CO PLIA CE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OE ITLE 40 AND AQMD RULE 1403 _ PERMIT EXPIRED 17141 BBtc:ITTED ASBESTOS NGTIFICATION TO PERMIT CANCELLED J-rLPA_ ' PERMIT EXTENDED w _M fL1AUM.D 4 PERMITRNAL /7/J/-- fi ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATEOF �O! i PROPOSED DEMOLITION OCCUPANCY 155UED _ SIGNATURE' _