HomeMy WebLinkAboutH2023-0647 - Permits�EWPO,gT City of NewportReach
@ Community Development Department- Building Division
>1 �" 100 Civic Center Drive, Newport Beach, CA 92660
F r Permit Counter Phone: (949) 718-1888
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newportbeachca.gov/civio
II III I Mechanical Permit
Plan Check No:
Work Class : Other
Issued Date : 10106/2023
Inspection Area:
H2O23-0647
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: 1 BAY ISLAND Legal Desc : 1
Description: MECH - NEW AC CondZ.r15¢r (1). To,wrptr t2 25 �5 ✓' } Coo? i1el
Owner: BAY ISLAND CLUB
Address : 18 BAY IS NEWPORT BEACH, CA 92661
Phone:
Applicant : SELECT HEATING AND A/C INC
Address : 767 N MAIN STREET ORANGE, CA 92868
Phone : (714) 516-9970
Owner/Builder:
Address
Phone:
Code Edition : 2022
Type of Construction
Occupancy Groups:
Building Setbacks :
Flood Zone : AE, 8 FT
Use Zone :
PROCESSED BY:
SPECIAL CONDITIONS:
Fire Hazard Zone
Contractor : SELECT HEATING AND A/C INC
Address :
767 N MAIN STREET ORANGE, CA 92868
Phone :
(714) 516-9970
Con State Lic :
445205
Lic Expire :
08/31/2025
Bus Lic:
BT00007476
Bus Lic Expire:09/30/2024
Workers' Compensation Insurance
Carrier :
INS. COMPANY OF THE WEST
Policy No :
WSD5073121
W. C. Expire :
10/1/2024
NO Manufacturer: TEMPSTAR
Model# : N4A660GKB
OWNER -BUILDER DECLARATION
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 applicable Iter(s)
(Section 7031.5. Business and Professions Code: Any city or county that requires a permit to construct, oiler, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for
the 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
Professions Code) or that he or she is exempt from Iioensure and the basis for the alleged exemption. Any violation of Section 7034.E by any applicant for a 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 (_) all of or (_) portions of the work., and the structure is not intended or offered for sale (Section 7044,
Busmess 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
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' Slate 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).
❑ 1 am exempt from ficensure 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 for at least one year prior to completion of the Improvements covered by this permit I cannot legallf
SO[: a structure that I have built as an owner -builder If It has not been constructed in its entirely by licensed contractors. I understand that 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:http://www.leg,nfo.ce.goy/calaw.html.
Signature of Property Owner or Authorized Agent _ Date _
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm Linder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of 6yr 'on 3 of the Business and Professions Co. dg, agdi=y lidones is in fall force
and effect. License Class License No "'"Date D (O Z Contractor Signature
WORKERS' COMPENSATION DECLARATION
NANNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUalECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (S000.000), IN AUDrON TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 371M OF THE LASOR CODE., INTEREST, AND ATTORNEY'S FEES,
hereby affirm under penalty of perjury one of the following declarations:
have and will maintain a. certificate or 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
Tnance of the work 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 pedormarice of the work for which this permit is issued. My workers'
carrier and policy number are:
Policy Number
of Agent
Date
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' compensation laws of California, and agre
if I should become subject to the w rkers compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
mature of Applicant _ '".. `Date io �O123
'I ARATICIN RFr:AROINfI CONSTRLICTIr1N L FNDINf: ALIFNCY �...M � W
!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)
Iders Name _ _ Lender's Address
my signature below, 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 I have provided is correct.
I agree to comply with all applicable city and county ordinances and state laws relating to building construction.
1 authorize representatives of this city or county to enter th b -identified ro arty for inspection purposes. D
naturR of PranRrtv Owner or Aulhod7ad.Anent' � � Print Pronerly Owner's or Authorized AoifoLs Name Bev,
ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART El OF TITI F 40 AND AQ RUlE
PERMIT EXPWFD I_ t L I SUBMITTFD ASBESTOS
PERMIT FXTENOED UAQMD
_
PCAMITFINAL � �/ � ASBESTOS NOTIHCATION IS NOT At pLICABLE TO
CERTIFICATE OF Iv-10, �� I / / PROPOSED DEMOLITION
OCCUPANCYISSUEO II (/_1 SIGNATURE.
Date