HomeMy WebLinkAboutH2023-0163 - PermitsCity of Newport Beach
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Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
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newportbeachca.gov/inspections
Mechanical Permit
Plan Check No:
Work Class : Other
Issued Date : 03/06/2023
Inspection Area: 1
H2O23-0163
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 : 4019 CHANNEL PL Legal Desc : A TR CANAL SECTION BILK 340 LOT 9 CANAL SECTION LOT 9 BILK 340 ALL -EX SELY 15 FT -
Description: MECH FAU CHANGEOUT W/DUCT WORK
o
Owner: ENTENZA KENNETH TR THE MARJORIE A MC CONNELL LIVIN
Contractor : KLONDIKE AIR INC
Address: 4019 CHANNEL PL NEWPORT BEACH, CA 92663
Address : 1308 LOGAN STE E COSTA MESA, CA 92626
Phone : (714) 979-2070
Phone: (714) 979-2070 0
Can State Lic : 754456
Applicant: JERMAINE MAEWEATHER
Lic Expire : 09/30/2024
Address : 3675 RUFFIN RD. SAN DIEGO, CA 92123
Bus Lic: BT30080447
Phone: (619) 677-8487
Bus Lic Expire:01/31/2024 "
Workers' Compensation Insurance o
Owner/Builder:
Carrier : FALLS LAKE FIRE & CASUALTY CO a
Address :
Policy No: FLA01974800
Phone:
W. C. Expire: 10/10/2023
Code Edition : 2022 Fire Hazard Zone : NO
Manufacturer
Type of Construction :
Model# :
Occupancy Groups :
Building Setbacks :
Flood Zone: X
Use Zone: R-2 - Two -Unit Residential
PROCESSED BY: 41
SPECIAL CONDITIONS:
NO CONSTRUCTION NOISE
ON THE WEEKEND
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' Stake License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable Item(s)
(Section 7031.6. Business and Professions Code: Any city or county that requires a permit to construct, after, improve, demolish, or repair any structure, prior to its Issuance, also requires the applicent for
the 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
Professions Code) or that he or she is exempt from Iicensure 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 owrier of the property, or my employees with wages as their sole compensation, will do O all of or (_,) portions of the work, and the structure is notintended 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. 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 sale).
❑ I, as owner of the property, ant exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale License Law does not
apply 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).
❑ 1 am exempt from Iicensure under the Contractors' State License Law for Are 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.cannot legally
sell a structure that I have built as an owner -builder if it has not been constructed in itsentirely by licensed contractors. I understand that a copy of the applicable law. Section 7044 of the Business and
Professions Code, is available upon requestw'hen this application Is submitted or at the following Web site:hhp:/lwww.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED COIY7 RACTOR'S DECLARATION
I hereby affirm ur,de, penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 00) of Division 3 of the Business and Profe sions Code, d my license is in full force
Ord efr_a Lic�nsa Class Licenses No Date G- Contractor Signature
WORKERS' CMIENSATION DECLARATION
PAR4ING: FAILURE TG SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (SI00,099), IN ADDITION TO THE
COST dt COMPENSATION, DAMAGES ASPROVIDED FOR IN SECTION 3766 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
h3reb7 affirm wldpr penalty of perjury one of the following declarations:
I nave and wit n.wntain 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,
cat rur,nanco of the w-yk for which this permit is issued. Policy No.
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'
Yence carrier End pY,:cy number are:
to of lgenl __ _
certify that, in the performance of the work for
, it I should becomesubjectto the workers' cD
Ialure Of Applicant/`''su
Policy Number
Date
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
often proytsions. of Seclion 3700 of the Labor Code, I shall forthwith comply with those provisions.
Dat
hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for whichthispermit is issued (Section 3097, Civil Code).
enders Name Lenders Address
�y my signature below, I certify to each of the following:
I am the property owner or authorized to act on the properly owner's behalf.
I have read this application and the information I have provideP is Correct.
I agree to comply with all applicable city and county ordinance and SIR a laws relating to building construction.
I authorize representatives of this city or counUventer the a d tined property for inspection purposes.
ACTION DATE BY r ( DECLARATION OF COMPLIANCE WITFI CODE OF FEDERAL FOR OFFICE USE ONLY
It( REGULATIONS PART bl OF TITLE 40 AND AQMD RULE.
1403
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