HomeMy WebLinkAboutH2023-0548 - PermitsCity of Newport Beach III I I I II
I III II IIII III I1111Mechanical Permit : H2O23-0548
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Community Development Department- Building Divisio,
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100 Civic Center Drive, Newport Beach, CA 92660
Plan Check No:
Other
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Permit Counter Phone: (949) 718-1888
Work Class :
W.,".
newportbeachca.gov/civic
Issued Date : 08/24/2023
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Inspection Area : 2
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 : 215 APOLENA AVE Legal Desc : A TR BALBOA ISLAND SEC 2 BLK 7 LOT 8 BALBOA ISLAND
Description: MECH 1 HEAT PUMP @ THE REAR YARD AND 1 AIR HANDLER *TAMPER RESISTANT CAP REQ*
Owner: JAMES CASSIDY
Address : 215 APOLENA AVE NEWPORT BEACH, CA 92662
Phone : (202) 415-3563
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:
Fire Hazard Zone : NO
Building Setbacks : Front: 10, Side: 4, Side: 4, Rear: 5
Flood Zone : X
Use Zone: R-BI - Two -Unit Residential, Balboa Island
PROCESSED BY:
SPECIAL CONDITIONS: PERMIT SCO EVISED 01/17/2024
Contractor : TRITON AIR INC
Address :
1221 PUERTA DEL SOL #300 SAN CLEMENTE, ,-A. 9LR73
Phone :
(949) 492-0290
Can 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: LG
Model# : LMU243HV (2)
TRIERS PROHIBITED
EP A( PUMPS
OWNER -BUILDER DECLARATION
I hereby affirm under penally of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated belo� , the r'leckmark(s) I have placed next to the applicable items
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
is 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
'rofessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7WI.5 by any applicant fora permit subjects the applicant to a civil penalty of
of more than five hundred dollars ($500).
3 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) a0 of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
luslness and Professions CodeThe Cent ractora 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).
t, 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
pfy to an owner of property "fie builds or Improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I ant exempt from licensure under the Contractors' State License Law for the following reason:
ly 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 itsentirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
'rofessions Code, is available upon request when this application Is submitted or at the following Web site:http:llwww.leginfo.ca.govlcalaw.htmt.
signature of Property Owner or Authorized Agent _ Date
.ICENSED CONITPACTOR'S DECLARATION
hereby affirm. under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 70, ) Dwu ' a 3 of the Business ad Professions Code, an ieerr�is in full force
I,d effec.. License Class L€tense. No D Contra o attire
,,ORKERS' CUlrirENSATION DECLARATION
'ARNING: FAILURE TO SECURE WORHERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED HOUSANO DOLLARS ($10( D00i, IN ADDITION TO THE
r`ST C° ^.OMPENSATION, DAMAOES AS PROVIDED FOR IN SECTION 3766 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEE&
hereby affirm urde• nPralty of perjury one of the following declarations:
I 1 ace 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
crr:vnce of tta cor*. for which this permit is. issued. Policy No
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'
carrier and policy number are:
;arrier. _ _ Policy Number Expiration Date
!wile. o, Mgerit . - - - Phone #
�I certify that, in the . ormance 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 rs' compensation ws of California, and agre
let, it I #haNId bec re subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall. forthwith comply with those provisions.
iignalufe of plicant _ ,. D t
IECL.ARA N REGARL}tNG- umm,DlNfa AGENCY "—
hereby affirm under penal at there is a construction landing 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 bslow. 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 this application and the Information 1 have provided is correct.
I agree to comply with all applicable city and county ordinances Bad state laws tg1F to building. construction
I authorize representatives of this Ity o ounty to enter th ove-ide property, for Inspection purposes.
ionature of PIOUS Owner or Aulho rl Anen4 Pant ornnon„
BY !RFG7W�TIONS
ATION OF COMPLIANCE WITH CODE OF FEDERAL FORO11ICE
PART 51 OF TITLE 40 AND AOMD RULE
I SUBMITTED ASBESTOS NOTIFICATION TO
PERMrTCANCELLED
PERMITEXiENDED
PFRNUTFlNAL LI ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF [ PROPOSED DEMOLITION
OCCUPANCY ISSUED IV�O•!/"" I. p SIGNATURE;
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