HomeMy WebLinkAboutH2023-0562 - Permits4 aEWPoR City of Newport Beach
T
D p Community Development Department- Building Division
Fy 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 71 B-1888
.sn newportbeachca.gov/civic
C9GrFORN�P
Mechanical Permit : H2O23-0562
Plan Check No: PC2023-1523
Work Class : Other
Issued Date : 08/30/2023
Inspection Area: 6
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 : 2318 PORT CARLISLE PL
Legal Desc : N TR 7845 BLK LOT 67
Description: MECH INSTL HEAT PUMP @ THE SIDE YARD (TAMPER RESISTANT CAP REQ), REPLACE (5) DUCTS
Owner: DAVID & MICHELLE A LIPTZ
Address : 35747 RAPHAEL DR PALM DESERT, CA 92211
Phone : (714) 856-6600
Applicant:
ABSOLUTE AIRFLOW INC
Address:
14122 WILLOW LN WESTMINSTER, CA 92683
Phone :
(833) 482-2626
Owner/Builder
:
Address
Phone :
Code Edition : 2022
Type of Construction
Occupancy Groups:
Building Setbacks
Flood Zone
Use Zone:
PROCESSED BY:
Front: 20, Side: 5, Side: 5, Rear: 10
X
PC -Harbor View Hills
SPECIAL CONDITIONS:
Contractor : ABSOLUTE AIRFLOW INC
Address :
14122 WILLOW LN WESTMINSTER, CA 92683
Phone:
(833) 482-2626
Con State Lie
: 1049023
Lie Expire :
01/31/2025
Bus Lie :
BT30079754
Bus Lie Expire:09/30/2024
Workers' Compensation
Insurance
Carrier :
PACIFIC COMP INS CO
Policy No :
1026229
W. C. Expire :
1/27/2024
Fire Hazard Zone : NO Manufacturer: AC PRO
Model#: AUD60W/A-D(U)
DUPLICATE
OWNER -BUILDER DECLARATION
I 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 have placed next to the applicable itern(s)
;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 that he or she is licensed pursuantto the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
'rofesslons Code) or that he or she is exempt from lioenaure 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
not more than five hundred dollars ($500).
1, 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 notintended or offered for sale (Section 7044,
Business 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 theproperty, provided that the
'improvements 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
improved 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' State License Law does not
apply 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 licensure under the Contractors' Slate License Law for the following reason:
By my signature below I acknowledge tl^.at, 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 Iegall!
sell 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, $action 7044 of the Business and
Professions Code, is available upon request when this application Is submitted or at the following web site:http://w .leginfo.ca.govics[aw,html.
Signature, of Property Owner or Authorized Agent _ Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3of the Business and Professions Code,. and my license is in full force
and effect. License Glass License. No Date Contractor Signature
WORKERS' COMPENSATION DECLARATION
NANNING: FAILURE TO SECURE WORXERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND clvrL FINES UP TOONE HUNDRED THOUSAND DOLLARS I3100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm underpenalty of perjuryone of the following dectaratlons:
-1 1 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 in
)erformance of the work for which this permit is issued. Policy No.
-1I 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' compensatioi
nsurance carrier and policy number are:
Policy Number Expiration Date
of Agent Phone 0 __
certify that. in the performance of the work for which thispermit is issued. I shall not employ any person In any manner so as to become subject to the workers' compensation laws of California, and
t, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shallforthwith comply with those provisions.
nature of Applicant Date,
CLARATION REGARDING CONSTRUCTION LENDING AGENCY
!reby affirm under penalty 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),
Ider s Name _ Lender's Address
my signature below. I cerlify to each of the following:
I am the property owner or authorized to act on the prbbe" y 0kne°rr �aflali"
I have read this application and the Information I have fiian ;as its 4 grate DUPLICATE
i agree to comply with all applicable city and county ordinanDasdatad grate Iar45't�lr7tlny to building Dons3ruclion.
I authorize representatives of this city or county to enter the above-identlfled property for inspection purposes.
nature of PfOOertV Owner or Authorized Aoent Print Proverty Owner's or Authorized Acent's Name Date
FOR OFFICE USE ONLY
c RF.GUTATIONS PART 61 OF TITLE 40 AND AQMO RULE
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PERMIF EXPWO I R ISUBMI 7 FU ASBESTOS NOTI FICATIONTO
CERPRCATALU ASBESTOS /�� SIGNATURE: UMCILITION ION I5 NO7 APPUCABtE TO
CERDFICA7FOF ,�/yAF/ OCCUPANCY ISSUED
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