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Home My WebLink AboutH2023-0495 - Permits��WPoRr City of Newport Beach p p Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 U i Permit Counter Phone: (949) 71 B-1888 Cq(/fORN�P newportbeachca.gov/civic Mechanical Permit Plan Check No: Work Class : Other Issued Date : 0810412023 Inspection Area : 5 H2O23-0495 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: 221 POINSETTIA AVE Legal Desc : A TR RESUB OF CORONA DEL MAR BLK 142 LOT 19 RESUB Description: MECH CHANGE OUT 2 A/C UNITS AND 2 FURNACES `TAMPER PROOF CAP REQ` Owner: SAMANTHA SAIKI Address : 221 POINSETTIA AVE NEWPORT BEACH, CA 92625 Phone : (949) 280-5227 Applicant: BEN MEDINA Address : 31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362 Phone : (818) 735-7876 Owner/Builder Address Phone : Code Edition : 2019 Type of Construction Occupancy Groups: Building Setbacks Flood Zone Use Zone: PROCESSED BY Front: 20, Side: 3, Side: 3, Rear: 5 X R-1 - Single -Unit Residential SPECIAL CONDITIONS: Fire Hazard Zone Contractor : SERVICE CHAMPIONS HTG Address : 3150 E BIRCH BREA, CA 92821 Phone : (714) 777-7777 Can State Lic : 799170 Lic Expire : 10/31/2023 Bus Lic: BT01080105 Bus Lic Expire:0713112024 Workers' Compensation Insurance Carrier : EVEREST PREMIER INSURANCE COMPANY Policy No: RM8WC00054231 W. C. Expire: 8/1/2024 NO Manufacturer: CARRIER Model# : DLCURAH48 OWNER-6UILUEK Ut-c.LrA.KAI JUN I hereby afArtn 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 3eCton 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 e 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 rofessions Code) or that he or she is exempt from licensors 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 penalty of Dt more than five hundred dollars ($500).. I, 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 7041, Heiress 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 tprovements 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). 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 poly 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 I am exempt from licensors Under the Contractors' $tale License Law for the following reason y my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to contpletlon of the improvements covered by this permit, I cannot Iagailt all 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, Section 7044 of the Business and 'rofessions Code, is available upon request when this application is submitted or at the following Web site:htip:/1www.leginfo.ce.govfcalaw.html. Date ,ignature of Property Owner or Authorized Agent .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with SectiQnj1000 of tivi ion of the Business and Pr ssio and se is in full force no effect. License Class License No Date Contractor Signal VORKERS'COMPENSATION DECLARATION N rARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL PEN ALTIeS AND CIVIL PINES UP TO ONE NUN HOUSAND DOLLARS IS100,000)• IN ADDITION TO THE COST OF COMPENSATION, DAMAGESAS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE., INTEREST, AND ATTORNEYS FEES, hereby affirm under penalty of perjury one of the following declarations: -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 th orformance of the work. for which this permit is. Issued. Policy No. lahave 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' compensatio once carrier and policy number are: of Agent certify that. in. the , d I should becom Ialure of Applicant Policy Number Ice of the work for which this parm� issued, I shall not employ any person in any manner so as to become subject to the workers' compensation �Iws of California, and ogre to the workers' co ion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Dt _ ;p- DING AGENCY hereby affirm under penalty of perjury t is a construction lending agency for the performance of the work for which thisued s permit is is. (Section 3097, Civil Code). ender's Name __- Lenders Address y 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 Information I have pr d is correct.. I agree to comply with all applicable city and c unty dinances and IS a I authorize representatives of this city or couftt'to identifier signature of Pro eit Owner or AI ACTION I DATE PERMIT EXPIRED PERMITCANCELLED PERMIT EXTENDED PERMIT FINAL —It i CERTIFICATE DE OCCUPANCY ISSUED is relating to building construction. property For inspection purposes. Print Property Owner OF COMPLIANCE WITH CODE OF FEDEd PART 61 OF TITLE 40 AND AOMD RULE. ASBESTOS ❑ ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO PROPOSEDDEMOLITION FOR OFFICE USE ONLY M