HomeMy WebLinkAboutH2023-0331 - Permits�EWPORT
City of Newport Beach
[ III I I I II I III II IIII II
Mechanical Permit: H2023-0331
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Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Plan Check No : PC2023.1147
3 yrj, S
Permit Counter Phone: (949) 718-1888
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Work Class : Other
....
newportbeachca.gov/civic
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Issued Date : 05/17/2023
Inspection Area : 1
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 : 128 34TH ST Legal Desc : A TR NEWPORT BEACH CITY BLK 33 LOT 18
Description: MECH INSTALL 2 ROOF MOUNTED A/C UNITS **TAMPER RESISTANT CAPS REQUIRED*** (C{cpwnr k T 23- 0946
Owner: Gina Kim
Contractor:
Address : 5557 East Santa Ana Canyon Road #215, #215 Anaheim, CA 92807
Address
Phone : (714) 420-4843
Phone :
Con State Lic
Applicant: Gina Kim
Lic Expire
Address : 5557 East Santa Ana Canyon Road #215, #215 Anaheim, CA 92807
Bus Lic:
Phone : (714) 420-4843
Bus Lic Expire:
Workers' Compensation Insurance
Owner/Builder : Gina Kim
Carrier :
Address : 5557 East Santa Ana Canyon Road #215, #215 Anaheim, CA 92807
Policy No:
Phone : (714) 420-4843
W. C. Expire:
Code Edition : 2022 Fire Hazard Zone : NO
Manufacturer: PAYNE
Type of Construction :
Model# : PA5S24
Occupancy Groups:
Building Setbacks : Front: 5, Side: 3, Side: 3, Rear: 5
Flood Zone: X
Use Zone : R-2 - Two -Unit Residential
. NO CONSTRUCTION NOISE
PROCESSED BY: (�S
SPECIAL CONDITIONS: HIGH DENSITY ZONE & LIQUEFACTION
ON THE WEEKEND .'
OWNER -BUILDER
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasan(s) indicated �efow by the chackrnark(s) I have placed next to the applicable item(s)
ction 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
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
fesslons Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7Q31.5 by any applicant for a permit subjects the applicant to a civil penalty of
more than five hundred dollars ($500).
J I, as owner of the property, or my employees with wages as their sate compensation, will do („_) all of or (_) portions of the v
lusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through emp
nprovemants are not intended or offered for sale. If, however, the building or improvement is sold within one year of complettt
r le).
st proved for the purpose of saI, asowner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Bus
poly to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pur
I 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 1 must have resided for atleast one year
all a structure that I have built as an owner -builder if it has not been constructed in its entirely by licensed contractors. I unden
rofessions Code, is available upon request when this application is submitted or at the following Web site:http:f/www.leginfo.c.
tignatum of Property Owner or Authorized Agent
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Dit
ind effect. License Class License No Date
COMPENSATION DECLARATION
ING' FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of
iormance 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 be
Renee cater and policy number are:
der Policy Number
ne of Agent
<, and the structure is not intended or offered for sale (Section 7044,
ees' or personal effort, builds or Improves the property, provided that the
the Cwner-Builder will have the burden of proving that it was not built or
and Professions Code: The Contractors' State License Law does not
to the Contractors' State License Law).
to completion of the improvements covered by this permit, I cannot
that a copy of the applicable law, Section 7044 of the Business and
Date
3 of the Business and Professions Code, and my license is in full force
Contractor Signature
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100.000), IN ADDITION TO THE
Relations as provided for by Section 3700 of the Labor Code, for
of the wodc for which this permit is issued. My workers'
Date
certify that, in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so a to become subject to the workers' compensation laws of California, and ogre
. if I should become subieot to h , a ker' compensation provisions of Section 3700 or the Labor Code, I shall fortnor It w ply With those provisions.
lature of Applicant 7< __. V V _ oat 9 511 ( 0 2--3
hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which
.ender's Name Lender's Address
3y my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owner's behalf.
I have read iha application and the information I have provided is correct.
I agree to comply with all applicable city and county ordi ances and state laws relating to building construction.
L.Ltl ahite rcpiruo datives of this city or county to en r he abo a dentitied property for inspection purposes.
3LT ature of Pro eny Owner or Authorized Agent Print Property Owner's or ADl
ACTION DATE BY DECLARATION OF COMPLIANCE WITH'. CODE OF FEDERAL FOR OFFICE
I REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
I SUBMITTED ASBESTOS
:KNIT C;:NCEi4E✓
PLRkdTFI,VAL L,5'ASBESTOS NOTIFICATION 15 Nor APPLICABLE TO
CERTIFICATE OF 3 `� I PROPOSEDDEMOLITGO
OrCUPANCY ISSUES I I SIGNATUREI
N LY
Is issued (Section 3097, Civil Code).