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HomeMy WebLinkAboutH2023-0199 - PermitsU4. City of Newport Beach 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 newportbeachca.gov/inspections Mechanical Permit Plan Check No : Work Class: Other Issued Date : 03/24/2023 Inspection Area : 6 H2O23-0199 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: 5 BEACH PINE Legal Desc : TRACT 14103, LOT 10 OF PROJECT 935-90 LOCATED ON AP 473-021- 65 TOGETHERWITH AN UND. 1/10 INT. IN LOT 22 OF TRACT 14103 & Description: MECH: R/R A/C AT SIDE*** TAMPER RESISTANT CAPS & TIMERS REQUIRED*** R/R FAU Owner: GOWDY HUGH W TR Address: 5 BEACH PINE DR NEWPORT COAST, CA 92657 Phone: (949)701-9658 Applicant: BEN MEDINA Address: 31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362 Phone: (818)735-7876 Owner/Builder : Address Phone : Code Edition : 2022 Type of Construction Occupancy Groups: Building Setbacks Flood Zone: Use Zone : PROCESSED BY X PC - Newport Coast 19:5 Contractor : TRITON AIR INC Address : 1221 PUERTA DEL SOL #300 SAN CLEMENTE, CA 92673 Phone: (949)492-0290 Con State Lie : 774877 Lie Expire : 06/30/2024 Bus Lie : BT30042558 Bus Lie Expire:03/31/2023 Workers' Compensation Insurance Carrier : FALLS LAKE FIRE Policy No : FLA01867400 W. C. Expire: 4/1/2023 Fire Hazard Zone : YES Manufacturer: AC PRO Model# : AULD60W2/A-D(U) TINIER REQUIRED ON EQUIPMENT SPECIAL CONDITIONS: NEIGHBOR NOISE AGREEMENT ON PLANS TO SHUT OFF BETWEEN 10 P.M. AND 7 A.M. OWNER -BUILDER DECLARATION I hereby affirm under penally 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 items) (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 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 for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). 111, 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, 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 roved for the purpose or sale). L! 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 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). ❑ I am exempt from Iicensure 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 least one year prior to completion of the improvements covered by this permit, I cannot legal) sell a structure that I have built as an owner -builder if It has not been constructed in its entirely 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:llw'ww.teginfo.ca.govlcalaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 9 ' ' ' the Business a=THOUSAND se is in full farce and effect. License Class License No Date Contractor Sig WORKERS' COMPENSATION DECLARATION it WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE ), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37" OF THE LABOR CODE, INTEREST, AND ATTORNEY's FEES. I hereby affirm under penalty of perjury one of the following declarations: D 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 IN p rma the work for which (his 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' compensatio insurance carrier and policy number are: Carrier _. Policy Number Expiration Date Name of Agent Phone N ©I 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' compelkation laws of California, and ogre that, if I should become subject to the wo pensalion provisions of Section 3700 of the Labor Code, I shall forthwith comply with Date____c] //��" those provisions. 7 1 — 2� Signature of Applicant DECLARATION REGA TION LENDING AGENCY I hereby affirm under pe—niff7bfperjury that there is a construction lending agency forthe performance of the work for which this permit is issued (Section 3097, Civil Code). Lenders Name Lender's Address By my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner' behalf. I have read this application and the information I have is correct. I agree to comply with all applicable city and count s and stale laws relating to building construction. I authorize representatives of this city or county to enter the above -I entitled propert for ction purposes. ^Si more of Property, Owner or Authorized Agent Print Pro orIOwner's or Authorized Agent's Name Date 2 ACTION DATE BY ATIONOFCOMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE 1403 �P:RMI; EXPIRED I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANC€.L.0 EIEPA_. MML EXTENDED1�- qMD PFRMITFINAL 9.� D�r`Ji LAyBESTO5 NOTIFICATION 15 NOT APPLICABLE TO C RTIECATE OF I PROPOSED DEMOLITION I OCCUPANCY FSSUEn SIGNATURE: