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Home My WebLink AboutH2022-0513 - Permits�rwi>o�r; City of Newport Beach III II I III II I II IIIII III II Mechanical Permit : H2O2,2-0513 pa 9 Community Development Department - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No Permit Counter Phone: (949) 644-3288 Work Class : Alteration .m. Inspection Requests Phone: (949) 644-3255 Issued Date : 0912312022 cg4jp,aN�P newportbeachca.gov/inspections Inspection Area : 6 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS NO CONSTRUCTION RELATED NOISE Job Address : 8 JETTY DR Legal Desc : N TR 8428 BLK LOT 7 Description: MECH - MFR RELOCATION OF EXISTING AC UNIT Owner: THOMAS STEPHEN R TR Contractor : LEWIS AIR SERVICES INC 30052 AVENTURA, A RANCHO SANTA MARGARITA, CA 92688 Address : 8 JETTY DR CORONA DEL MAR, CA 92625 Address : Phone : Phone : (949) 589-0609 Con State Lie : 972182 ,,, Applicant : LEWIS AIR SERVICES INC Lie Expire : 04/30/2024 Address : 30052 AVENTURA, A RANCHO SANTA MARGARITA, CA 92688 Bus Lie : BT30079764 Phone: (949) 589-0609 Bus Lie Expire:09/30/2023 Workers' Compensation Insurance Carrier : EMPLOYERS COMPENSATION INSURANCE COMPANY Owner/Builder : Policy No: EIG502538300 Address : W. C. Expire: 6/24/2023 Phone: , Code Edition : 2019 Fire Hazard Zone : NO Manufacturer : CARRIER Model# : 24AHA44BA00300 Type of Construction : Occupancy Groups: Building Setbacks : Front: 15, Side: 5, Rear: 15 Flood Zone: X Use Zone : PC - Jasmine Creek Ir L: 4.� PROCESSED BY: le4 SPECIAL CONDITIONS: LDER DECLARATION I hereby affirm under penalty of perjury that I 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 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 he permit to file a signed statement thathe 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 Irofesslons Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation or Section 7031.5 by any applicant for a permit subjects the applicantto a civil penalty of of more than five hundred dollars €$500). I, as owner of the property, or my employees with wages as their sale compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 3roved for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale License Law does not poly 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 ficensure under the Contractors' State License Law for the following reasom 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 egall; ell a structure that I have built as an owner -builder If It has not been constructed in its entirely by licensed contractors. I undarstand that a copy of the applicable law, Section 7044 of theBusiness and 7ofessions Code, is available upon request when this application Is submitted or at the following Web site:http:/lwww.leglnfo.ca.govlcalaw.html. Vignature of Property Owner or Authorized Agent Date ACENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 rDivit ' n 3 of the Business and Prof �Code,.�.nsi m�i Is in full force no effect. Cleanse Class License No Date 2 22 Contractor Signatur fC VORKERS' 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 f$1(30,000), IN AD➢ITION To THE DST OF COMPENSATION, DAMAGESAS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, "a ATTORNEY'SfEES- hereby affirm under penalty of perjury one of the following declarations: 7 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 thi ql�prmance of fhv wo,k for which this permit is Issued. Policy No. J')h^ve Pro will msintafn 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' compensatiol insurance carrier and policy number are: Came_ _i Policy Number Expiration Date Name ofAgent Phone # 711 gerdfyh,t, in .6e ps formance of the work for which - 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 becone subject to the workars' o n visions of Section 3700 of the Labor Code, I shall forthwith comply With those provisions. Sll:nature of Applinent _ Date Z DECL ARATfON REGAR41NG CON TRUCTION LE NO AGENCY - "-"'— horebv a;"irm under pil0ty 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). _enders Name _ Lender's Address 3y my signature below. I certify to each of [he following: I am the property 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 with all applicable city and county ordinances and state law�lating to building construction. , I authorize representatives of this city or county to enter t e ab for inspection purposes. 3i nature of Pro ert Owner or Authorized Agent ve-id Wulf Print ProleertzOwner's or Authorized A ants Name -' �¢ Date ACTION DATE BY 1 DECLARAPON Ox COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY i REGULATION$ PART Rt OF TITLE 40 AND AQMD RULE 1403 PERMIT EXWREO ' IiI I SUBMITTFD ASBFSTOS NOTIFICATION TO PE.RM;TEXiEMOED __ € 4MD PERMIT FINAL e A' ESTOS NOTIFICATION IS NOT CfRriFICATE or -.20-13 Dili DE`MCCLITION OCCUPANCY ISSUED GI(:N6'TIIOF. JC�� /