HomeMy WebLinkAboutH2023-0103 - Permits_P0
City of Newport Beach
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Community Development Department- Building Division
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100 Civic Center Drive, Newport Beach, CA 92660
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Permit Counter Phone (949) 644-3288
Inspection Requests Phone (949) 644-3255
newportbeachca.gov/inspections
Mechanical Permit
Plan Check No:
Work Class : Other
Issued Date : 02/13/2023
Inspection Area : 2
H2O23-0103
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 : 315 APOLENA AVE Legal Desc : A TR BALBOA ISLAND SEC 3 BLK 16 LOT 29
Description : MECH CHANGE OUT FURNACE & DUCTS
Owner: SWANSON JOYCE BELLUSCIO TR
Contractor:
SERVICE CHAMPIONS HTG
Address : 315 APOLENA AVE NEWPORT BEACH, CA 92662
Address :
3150 E BIRCH BREA, CA 92821
Phone:
Phone:
(714)777-7777
Con State Lie
: 799170
Applicant: SERVICE CHAMPIONS HTG
Lie Expire :
10/31/2023
Address : 3150 E BIRCH BREA, CA 92821
Bus Lie :
RM8WC00054221
Phone: (714)777-7777
Bus Lie Expire:04/01/2023 ••�� .
Workers' Compensation
Insurance
Owner/Builder:
Carrier:
EVEREST PREMIER INS CO
Address ;
Policy No :
RMBWC00054221 ,
Phone :
W. C. Expire:
4/1/2023
Code Edition: 2023 Fire Hazard Zone : NO
Manufacturer
Type of Construction :
Model# :
Occupancy Groups:
,
Building Setbacks : Front: 8, Side: 3, Side: 3, Rear: 5
Flood Zone : X; AO 1
Use Zone : R-BI - Two -Unit Residential, Balboa Island
PROCESSED BY:
SPECIAL CONDITIONS: C
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.$. 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 thathe or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with $action 7000) of Olvision 3 of the Business and
'rofessfons Code) or that he or she is exempt from lioensure and the basis for the alleged exemption. Any violation of Section 7C31.5 by any applicant for a permit subjects the applicant to a civil penalty of
of more than five hundred dollars ($500).
11, 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,
,usiness 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
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).
1 I, 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
pply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' Slate License Law),
I I am exempt from licensure under the Contractors' State 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 completion of the Improvements covered by this permit, I.Gannet legall)
at 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:http:pwww.leginfo.ca.govlcalaw.html,
signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 f " " of the Business and P ;a at and my license Is in full force
no effect. License Class License, No Date ` Contractor a
VORKERS' COMPENSATION DECLARATION
IARNING: FAILURE TO SECURE WORXERS' COMPENSATIDN COVERAGE IS UNI-AWUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE D THOUSAND DOLLARS (5300.000), IN ADDITION TO THE
EST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'SFEEs.
hereby affirm under penalty of perjury one of the following declarations:
J 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
erfornI of it,f, r,rk for which this permit is. issued. Policy No.
11 Lava and vein mam!ain 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` compensaflol
Isurance carrier and policy number are:
:airier Policy Number Expiration Date
tame of Agent _ _ Phone H
�I cs-Fify that. in the performance of Of I 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
Iat if I should I'ecome sD ct mpensatlon proy'rsiot+s'ot Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
.iq,,oure of AIDatyy ylLs
rCCL' KATION $EGA NG CONS w, N LENDING AGENCY
hereby affirm apethat there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civil Code).
enders Name nd nalty of Iry Lender's 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 provided is correct.
I agree to comply with all applicable city and county ordinances and slate laws relating to buildineac on.
I authorize representatives of this city or coo ty t nter oue-44ent"' d pro nspection purposes. ' A r `
nature of Property Owner or Authorzed R gian
t Print Property Owner's or Authorized Agent's Na (/ r Oat z `
SCTION DATE BY DEC C COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
F.G ONS PART EI OF TITLE, 40 AND AQN RULE
PERMITEXPiRED
PERMIT CANCELLED
PERMIT EMENDED
PERMIT FINAL
CERTINCATE OF
OCCUPANCYISSUED LS'B.-
LIASBESTOS 1,101IFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION