HomeMy WebLinkAboutH2022-0684 - Permits��aWPORr City of Newport Beach III I I II I II I I I II
p @ Community Development Department - Building Division
y 100 Civic Center Drive; Newport Beach, CA 92660
s Permit Counter Phone: (949) 644-3288
w Inspection Requests Phone: (949) 644-3255
c7LlFORN�P newportbeachca.gov/inspections
Mechanical Permit : H2O22-0684
Plan Check No : 1670-2020
Work Class : Other
Issued Date : 12/05/2022
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 : 1715 PALOMA DR Legal Desc : N TR 3176 BLK LOT 17
Description: MECH: INSTALL HEAT PUMP @ SIDE YARD** TAMPER RESISTANT CAPS REQUIRED & TIMERS PROHIBITED ** (X2020-2042)
Owner: JENNIFER RUSH
Address : 1715 PALOMA DR NEWPORT BEACH, CA 92660
Phone: (408)218-8358
Applicant : Joe Mark
Address : 24451 MUELA MISSION VIEJO, CA 92692
Phone: (949)413-9057
Owner/Builder: JENNIFER RUSH
Address: 1715 PALOMA DR NEWPORT BEACH, CA 92660
Phone: (408)218-8358
Code Edition : 2019
Type of Construction
Occupancy Groups:
Contractor
Address
Phone:
Con State Lic
Lic Expire:
Bus Lic:
Bus Lic Expire:
Workers' Compensation Insurance
Carrier :
Policy No
W. C. Expire:
Fire Hazard Zone : NO Manufacturer: DAY & NIGHT
Model#: NH4A424AKA
Building Setbacks : Front: 15, Side: 10, Side: 10, Rear: 10
Flood Zone: X
Use Zone : R-1-10000 - Single -Unit Residential (10000 indicates minimum lot area)
PROCESSED BY: 1" 5
SPECIAL CONDITIONS:
11MEPS PROHIBITED
N HEAT PluMPS
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law far the reason(s) indicated below by the checkmark(s) I have placed next to the applicable items)
iect on 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
IS 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 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 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 completion, the Owner -Builder will have the burden of proving that it was not built or
nproved for the purpose of safe).
9-1, 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
ly to an owner of properly 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 licensure under the Contractors' Stale 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 least one year prior to completion of the improvements covered by this permit, I cannot legally
oil a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
'rofessions Code, is available upon request when t ' tion is submttte or owing Web site:httpJIw .teginfo.ca.gov/calaw.html.
lignature of Property Owner or Authorized Agent LP �tif�� Date t<�
.ICENSED CONTRACTOR'S DECLARATIQ&_--�
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
nd effect. License Class License No Date Contractor Signature
VORKERS' COMPENSATION DECLARATION
EARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AMU SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS Ri00,000), IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37" OF THE LABOR COPE, INTEREST, AND ATTORNEYS FEES,
hereby affirm under penalty of perjury one of the following declarations:
I 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 th
erformance of the work 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'
rance, Carter and policy number are:
Ior Policv Number .... .......... Expiration Date
e of Agent rnune n
ertify 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 io the workers' compensation laws of California, and agre
If I should become subject to the workers' Goprpensation prrp"ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of
7 ..
hereby affirm un er penalty of perjury th there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
enders Name Lender's Address
y my signature below, I certify to each of the following:
I am the properly 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 e'ith all applicable city and county ordinances and state laws relating to building construction.
I authorize representatives of this city or coun center the abovvIde 1 If property for inspection purposes. ,..iJPdrd Prnnertv Owner's or Authorized Anent's Name E h' k _
DATE
VRA-IT EXPIRE)
AhAOTFINAL 9
=CF.T.F.CATEOF S�IZ
OCCUPANCYIS5'J€D
DECLARA;1�11!)N OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE
REGULATIONS PART 61 OFTITLE 40 AND AQMD RULE
tC
NOTIFICATION IS NOT APPLICABLE TO
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