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HomeMy WebLinkAboutH2022-0659 - Permits��WPOaT City of Newport Beach Q Community Development Department- Building Division F y 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 c9G/FORN`P newportbeachca.gov/inspections Mechanical Permit Plan Check No : Work Class : Other Issued Date: 1112112022 Inspection Area : 5 H2O22-0659 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 : 324 POINSETTIA AVE Legal Desc : A TR CORONA DEL MAR BLK 243 LOT 26 CORONA DEL MAR LOT 26 BLK 243(AND SWLY1/2 28 Description : MECH FURNACE CHANGE OUT Owner: ARCANGELO LOUIS ANTHONY TR Address: 324 POINSETTIA AVE CORONA DEL MAR, CA 92625 Phone : Applicant: AIR CONCEPTS Address: 801 S. LAKEVIEW AVE #E PLACENTIA, CA 92870 Phone: (714)779-1000 Owner/Builder : Address Phone: Code Edition : 2019 Fire Hazard Zone Type of Construction Occupancy Groups: Building Setbacks : Front: 20, Side: 3, Side: 3, Rear: 5 Flood Zone : X Use Zone: R-1 - Single -Unit Residential PROCESSED BY: SPECIAL CONDITIONS: Contractor: AIR CONCEPTS Address : 801 S. LAKEVIEW AVE #E PLACENTIA, CA 92870 Phone: (714)779-1000 Con State Lic : 534722 Lic Expire: 08/31/2024 Bus Lic: BT30075249 Bus Lic Expire:05/31/2023 Workers' Compensation Insurance Carrier: ACE+AMERICAN+INSURANCE+COMPANY Policy No: C70047500 W. C. Expire: 10/1/2022 NO Manufacturer Model# : 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 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 the permit to file a signed statement that he or she is lloonsed 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 licensure 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 ($500). ❑ I, as owner of the property.,or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not: intended or offered for sale (Section 7044, Business and Professions Coda: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the properly, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not bullt or improved for the purpose of sale). ❑ 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not Ia-'prply to an owner of property who builds or improves thereon and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). — 1,.l I am exempt from licensure under the ContraCtors' Slate License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at [east one year prior to completion of the improvements covered by this permit, I.cannot legall, sell a structure that I have built as an owner-buildor if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following Web site:http:ti . .leginfo.ca..gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of pequp that I am licensed under provisions of Chapter 9 (commencing with Sect$n7000 of ivlsion 3 of the Business and Pr f sio�ns C�o.�d an�d `� nse Is In full force and effect. License Class License No DZI '�`- Contractor Signatur, mil — WORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37QS OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm underpenalty of perjury one of the following declarations: ❑ I 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 th performance 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 performance of the work for which this permit is issued. My workers' canter and policy number are: Policy Number Date ne of Agent vnone IT certify that, in the perfoii1riance of the work for which this. Its Issued'., I. shall not employ any person in any manner so as to become subject to the workers' ompensatlon laws of California, and agre t, 1f I should beconje u ject to a rkers' comp Ian provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant_ - � _ Date %i/Z-//;— CL.ARATION RE J A ONSTR ION LENDING AGENCY �^ Ireby affirm under nalty of pa that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civi Coda). lost s Name Lender's Address my signature below, 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 informaliI have provided is correct.. I agree to comply with all applicable city an unty, In as and state laws Ing to building Construction. I authorize representatives of this city or cou y W the a-iden pr property far inspection purposes. Ip\\\ � nnturp of Prnnerty Owner or Authorized An Print Property Owner's or Authorized Apart's Name V C)J � 0at2 ACTION ( DATE By DECLARATrON OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY RFGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRE61 I I I I -I I SUBhA9*EC,^,PflESTCs NOT, PERMIT ETENOEO TJgO:SC PEAMITFINAL l..fL'S �Z rfjL,- UASSES705 NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCY 155UEO E'BNITURE: