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Home My WebLink AboutH2023-0641 - Permits�EW!o�T City of Newport Beach III II I III III II IIII III I II Mechanical Permit : H2O23-0641 4 e Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Work Class :Other rt Check No >� T Permit Counter Phone: (949) 718-1886 Work a„ newportbeachca.gov/civic Issued Date : 10/04/2023 Inspection Area : 4 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 : 15 LONG BAY DR Legal Desc : N TR 15332 BLK LOT 22 Description: MECH - R/R HEAT PUMP, AIR HANDLER, & DUCTWORK. TAMPER RESISTANT CAP REQUIRED Contractor : GOETTL AIR CONDITIONING & PLUMBING Owner: PETER LAST Address : 532 MALLOY COURT CORONA, CA 92880 Address : 15 LONG BAY DR NEWPORT BEACH, CA 92660 (714)462-8174 Phone: Phone Con State Lie : 1047781 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 : Front: 5, Side: 5, Side: 5, Rear: 3 Flood Zone : X Use Zone: PC - Aeronutronic Ford PROCESSED BY: AM SPECIAL CONDITIONS: Fire Hazard Zone : NO m Lie Expire : 12/31/2024 Bus Lie: BT30077958 Bus Lie Expire:02/28/2024 Workers' Compensation Insurance Carrier : AMERISURE MUTUAL INSURANCE COMPANY Policy NO: 21221200002 W. C. Expire: 12/1/2023 Manufacturer : GE Model#: AUH4860ZGDA OWNER -BUILDER DEC 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 applicableiterl 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 fie 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 'rofessions Code) or that he or she is exempt from licensors and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of lot more than five hundred dollars ($500). I, as owner of the property,or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure Is not intended proffered for sale (Section 7044, tusiness 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 sale). 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 ply 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' State License Law for the following reason: Iy 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 legall all 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 7C44 of the Business and 'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. ,ignature 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 7VA)�t Q�isigl3 of the Business and rofess e, and my license is in full force Ind effect. License Class Llcense.No Date' tf7Biii i LPL n ----ci,.,,�i„e WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORMERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER i0 CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (3100,000), IN ADDITION T6 THE COST OF COMPENSATION, DAMAGES A5 PROVIDED FOR 1N SECTION DTge OF THE LABOR COOS, INTEREST, ANDATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: 111 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 pert mance of the work for which this permit is issued. Policy No.. "ve and will maintain workers' compensation insurance, as requlred by Section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. My workers' compensation insurdnce carrier and policy number are: Carrier Policy Number Name of Agent Phone Expiration Date Phone # ❑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' compensetlo laws of California, and agree that, it I should become subject to the wor ompensation provisions of Section 3700 of the Labor Code, I shall forthwith Comply With those provisions. 0 1 r'+CONST ION L ,- ENCY VOW hereby affirm under penal Iry th Is a construction lending agency for the performance of the work for which this permit is issued (5aciion 3097, Civil Code}. _tinder's Name _ Lender's Address 3y my signature belcw y to each of the 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' rrect. I agree to comply with all applicable city and county ordin es and state la g to building construction. P f authorize representatives of this City or county to enter ove-' ad property for inspection purposes, p i ii nature of Pro art. Owner at'Aulhoffzed Agent - - Print Property Owner's or Authorized A U ent'S Name G - ACTION DATG ay RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY p EGUTATIONS PART 51 OF TITLE. 40 AND AOMD RULE. 1 1403 PE'HMlr fXl+iNfb 1 ❑I SUBMITTED ASBF,STOSNOTIFICATION TO PERiL91r CANCECL F(� _ �' EPA _OM PERMIT fXTENOED ^/ Lr�7a 73 D �ASBESTOSNOTIFICATPON 13 NOT APPLICABLE TO S PROPOSED DEMOLITION PERMIT FINAL CERTIFICATEOF OCCUPANCY ISSUED SurrNATURE: ___