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HomeMy WebLinkAboutH2023-0749 - PermitsCity of Newport Beach Q Community Development Department - Building Division y r y 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 718-1888 C9C/FO Q�`P newportheachca.gov/civic Mechanical Permit : H2O23-0749 Plan Check No : Work Class : Other Issued Date : 11/2912023 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: 5219 RIVER AVE Description : MECH REPLACE FURNACE Owner: MLADINICH PHILIP C TR Address : PO BOX 7754 LAGUNA NIGUEL, CA 92607 Phone: Legal Desc : A TR RIVER SECTION BLK 52 LOT 8 RIVER SECTION LOT, , Applicant: BEN MEDINA Address : 31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362 Phone: (818)735-7876 Owner/Builder Address Phone: Code Edition : 2022 Fire Hazard Zone Type of Construction Occupancy Groups : Building Setbacks : Front: 10, Side: 3, Side: 3, Rear: 10 Flood Zone: X Use Zone : R-2 - Two -Unit Residential PROCESSED B : SPECIAL CONDITION Contractor : TRITON AIR INC , Address : 1221 PUERTA DEL SOL #300 SAN CLEMENTE, CA 92673 Phone: (949)492-0290 Con State Lie : 774877 Lie Expire : 06/30/2024 - Bus Lie: BT30042558 Bus Lie Expire:03/31/2024 Workers' Compensation Insurance Carrier : LIBERTY MUTUAL FIRE INSURANCE CO Policy No: 292549 W. C. Expire: 4/1/2024 Manufacturer Model# : 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 item(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 the permit to file a signed statement thathe or she is licensed pursuant to the provisions of the Contractors' State Liconse Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from Iicensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil p---Ta'lty 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 I_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Proresskrns 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 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 properly, 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 w'ho builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant. to the Contractors' State License Law). J I. am exempt from Iicensure under the Contractors' State License Law for the following reason: ----.------- By my signature below I acknowledge that, except for my personal residence in which I must have resided forat least one year prior to completion of the Improvamentscovered by this permitI cannot legally 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 the( a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following Web site:htip:llwwtiv.leginfo.ca.gavlcalaw.html. Signature, of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION �� I hereby affirm ur,da, penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with S c n 7060 f the Business ?07HOUSAND ode, and7mmy license is in full force and effec' License Class License No Dart ontract l WORKERS' CC1.1?2—NSATION DECLARATION NAr.'ANG. FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN .EMPLOYER TO CRIMINAL PENALTIES AND COAL FINES UP TOONE HUDOLLARS ($100,000), IN ADDITION TO THE CLST JF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION ti OF THE LABOR CODE., INTEREST, AND ATTORNEY',$ FEES. I hereby affirm under penalty of perjury one of the following declarations: D I ho, e 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 nice of thq work or which this permit is issued, Policy No. Fand 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' compensator in. c-, r.e carrier and policy number are: Ccrler _ Policy Number Expiration Dale Psi„c of !.g phone 9 ]I Cathy thil thenarrormance 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 work fs' compy sation ws of California, and agra haL II I should 6 ma subject to the workers' compensation Ions of Section 3700 of the Labor Code, I shalt forthwith comply with those provisions � Ignalure o(A plicant_„__,_„ _ e— IECLARATION REGARDING CONSTR ' m ENDNG AGENCY J hereby affirm under penalty of p here 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 ly my signature below, I y to each of the following: I am the property owner or authorized to act on the properly owner's behalf. I have read this application and the information I have provided 19 correct. I agree to comply with all applicable city and county Winances a s authorize representatives of this city or ceG[1(y enter the o entifiec Owner or Is relating to budding construction. property for inspection purposes. Pont Property Owner ACTION I DATE �/ REGafZtnRTIONS PARTCE OFTITLEWITH GO AND AQMD RULE PERMrr EXPiREp U I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED 0EPA PEPoMK fXTENDEO _ AQLt MD _ PERMITFINAL CERLIFICATF OF OCCUPANCY ISSUED /I Z l r r�-TT L_J ASBESTOS NUT IFICATION 15 NOT APPLICABLE TO P lOPOSED DEMOLITION SIGNATURE: FOR OFFICE USE ONLY