HomeMy WebLinkAboutH2024-0108 - PermitsCity of Newport Beach
Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 718-1888
.,�., newportbeachca.gov/civic
C4G/FO M1N`P
III II I II III III III Mechanical Permit
Plan Work Class k Other
Issued Date : 02/27/2024
Inspection Area : 2
H2O24-0108
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 : 615 BAYSIDE DR
Description : MECH FURNACE CHANGE OUT
Owner: TESLOW-GERLACH LINDA TR \
Address : 615 BAYSIDE DR NEWPORT,'CA 92660
Phone: (818)624-8031
Legal Desc : N TR 3867 BLK LOT 48
Applicant: BEN MEDINA
Address: 31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362
Phone : (818) 735-7876
Owner/Builder :
Address
Phone:
Code Edition :
2022 Fire Hazard Zone
Type of Construction
Occupancy Groups:
Building Setbacks :
Front: 10, Front: 6, Side: 4, Side: 4
Flood Zone :
AE, 8 FT; X
Use Zone :
R-1 - Single -Unit Residential
PROCESSED BY:
SPECIAL CONDITIONS:
Contractor : TRITON AIR INC
Address :
1221 PUERTA DEL SOL #300 SAN CLEMENTE, CA 92673
Phone:
(949)492-0290
Con State Lie
: 774877-
Lic 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
NO Manufacturer
Model#
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, Eller, improve, demolish, or repair any structure, prior to its issuance; also requires the applicant for
the permit to file a signed statement that ho 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 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
not 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 U portions of the work., and the structure is notintended dr offered for sale (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to anowner 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 oneyear of completion, the Owner -Builder will have the burden of proving that it was not built or
improved for the purpose of sale).
❑ 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
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).
❑ I am exempt from licensors 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 legalll
sell a structure that I have built aaan 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
Professions Code, is available upon request when this application is submitted or at the following Web site:http:llwww.leginfo.ca..govlcalaw.html,
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION '.E
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0) Di f ion 3 f I usiness and Pr Ion, , nd my loans, is in full force
and effect. License Class License. No Date tractor Signatur
WORKERS' COMPENSATION DECLARATION
✓YARNING: FAILURE TO SECURE WOR3tER8' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNG OUSANO DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR 1N SECTION e706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
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
xmance of the work. for which this permit is issued. Policy No.
have 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' compensa
ranee carrier and policy number are:
Policy Number
of Agent
certify that. in the perfor�r ante of the work for which this permit is issued
II I should trecomer>zu2elct to the workers'_Campensabon provi�lsff`S
talon of Applican
Date
employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
3700 of the Labor Code, I shallforthwith comply with those provisions. I /
patg_-
!reby affirm under penalty of per at there is a construction lending agency for the performance of the work for which this permit is issued. (Section 3097, Civil Code).
rders Name Lender's Address
my signature below, r5ei 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 correc
I agree to comply with all applicable city and cobinty ordinances a ate la
I authorize representatives of this city or cknh/to enter the ve-i . ec
of
1403
PERMIT FXPiRV
I�atiag o building construction.
property for inspection purposes.
OF COMPLIANCE WITH CODE OF FEDERAL � FOR
PART 61 OF TITLE 40 AND A, Rl1LE
fR•yifj[�7Li7QQ�7
PERMITFINAL ��,/ UA'BES`OS NUIIFICATION 15 NOT APPLICABLE TO
CERTIFfCATE Or /� �W ��'h— PROPOSED DEMOLITION
OCCUPANCY ISSUED SIGNATURE:
NLY