HomeMy WebLinkAboutH2023-0613 - Permits�aE`wPORT City of Newport Beach
0
4 @ Community Development Department- Building Division
r 100 Civic Center Drive, Newport Beach, CA 92660
? Permit Counter Phone: (949) 718-1888
newportbeachca.gov/civic
c9C/FO PN�P
III II Mechanical Permit
Plan Check No:
Work Class : Other
Issued Date : 09/1912023
Inspection Area : 4
H2O23-0613
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 : 5100 COLONY PLZ Legal Desc : N TR 15178 BLK TRACT 15178, POR. OF TRACT; EITHER
Description: MECH - R/R A/C CONDENSER & FAU. LIKE FOR LIKE. LOWER DB LEVEL THAN (E) UNIT
Owner:
IRVINE CO
Address :
111 INNOVATION IRVINE, CA 92618
Phone :
(949) 720-3100
Applicant :
AMTECH HEATING & AIR INC
Address :
17751 SKY PARK CIR, STE F IRVINE, CA 92614
Phone:
(800)882-3019
Owner/Builder :
Address:
Phone:
Code Edition: 2022
Type of Construction
Occupancy Groups:
Building Setbacks
Flood Zone
Use Zone :
PROCESSED BY
PC - North Newport Center
SPECIAL CONDITIONS:
Contractor :
AMTECH HEATING & AIR INC
Address :
17751 SKY PARK CIR, STE F IRVINE, CA 92614
Phone :
(800) 882-3019
Can State Lie
: 1003704
Lie Expire :
04/30/2025
Bus Lie:
BT30060143
Bus Lie Expire:08131/2024
Workers' Compensation
Insurance
Carrier :
SIRIUS AMERICA INS CO
Policy No:
WC8555301
W. C. Expire;
12/20/2023
Fire Hazard Zone : NO Manufacturer: CARRIER
Model# : GASSAN4360OW
r
OWNER -BUILDER DECLARATION
j hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I haveplaced next to the applicable tern(s)
)action 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
to 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
rofessions Code) or that he or she is exempt from Iioensure and the basis for the alleged exemption. Any violation of Section 7031.6 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 role compensation, will do {_) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
1lsiness 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
nsproved for the purpose of sale).
.7 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
ly to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant. to the Conf rectors State License Law).
I am exempt from hcerisure under the Contractors' State License Law for the following reason:
'.y my signature below I. acknowledge that, except for my persona) 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
ell 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 copy of the applicable law, Section 7044 of the Business and
'rofession . Code, is available upon request when this application Is submitted or at the following Web site:httpJiw .leginfo.ca.govlcalaw,html.
signature of Property Owner or Authorized Agent _ Date
,ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 a i 3 the Business and Professions ode �^s�, is in full force
nd effect. License Class License No Date Contractor Signature v `
VORKERS' COMPENSATION DECLARATION
+ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FIBER UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000 IN ADonION TO THE
COST OF COMPENSATION, DAMAGESAS PROVIDED FOR IN sECTION 3706 of THE LABOR CODE., INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
I I have and Wtll 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 to
offormance of the work for which this permit is issued. Policy Nm
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` componsatioi
insurance carrier and policy number are:
ne of Agent
certify that, in the performance of the
, if I should become subject to}Citp�N
of
Policy. Number
Date
for which this permit is issued. I shall not employ any person in any manner so as to become subject to the workers' Campensabon laws of California, and agre
nsation provisions of Section 3700 of the Labor Code, I.shall forthwith comply With those provisions.
Date _AO
i�9�2�
U: AlivlYre rxww.numiv+,vn�+n��."'.) LEND GA ENCY
ropy affirm Under penalty of perjury that there is a nstruction lending agency for the performance of the work for which this permit Is issued (Section 3097, Civil Code).
idor's Name _ Lenders Address
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 nave read this application and the information I have provided is correct.
I agree to comply with all applicable city and county ordinances and state laws relating to building construction.
I authorize representatives of this city or county to an -identified property for inspection purposes.
nature of Pro art Owner or Authorized A ant Print Property Owner's or Authorized A. eot's Name
TON DATE BY `r DECLARATtON OF OMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS till 51 OF I I I Lf 40 ANDAOMD RULE
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