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Home My WebLink AboutH2023-0672 - Permits4 a6WaoR� City of Newport Beach p d Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 718-1888 .xnewportbeachca.gov/civic cqG/FORN`P III I I I Il I lII II II II II I II Mechanical Permit : H2023-0672 Plan Check No : 1462-2021 Work Class : Other Issued Date : 10/18/2023 Inspection Area : 5 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: 552 SEAWARD RD Legal Desc : N TR 1237 BLK LOT 178 TRACT NO 1237 LOT 178 AND TR Description: MECH -NEW HEAT PUMP FOR SOUTH BUILDING. TAMPER RESISTANT CAP REQUIRED Owner: BRYAN ROGERS Address : 552 SEAWARD RD NEWPORT BEACH, CA 92625 Phone: (909)945-7250 Applicant: Scott T Hata Address : 271 Ott St #26 Corona, CA 92881 Phone: Owner/Builder : Address Phone: Code Edition : 2022 Type of Construction Occupancy Groups: Fire Hazard Zone : YES Building Setbacks : Front: 5, Side: 6, Side: 6, Rear: 6 Flood Zone: X Use Zone : R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area) PROCESSED BY: ` SPECIAL CONDITIONS Contractor : RED WHITE & BLUE HVAC Address : 271 OTT ST #26 CORONA, CA 92881 Phone : (714) 972-9652 Con State Lic : 1025542 Lic Expire : 04/30/2025 Bus Lic: BT30081591 Bus Lic Expire:05131/2024 Workers' Compensation Insurance Carrier : INSURANCE COMPANY OF THE WEST Policy No: WSD505909302 W. C. Expire: 1/24/2024 Manufacturer : MITSUBISHI Model# : MXZ-3C24NA3 OWNER -BUILDER DECLARATION I hereby affirm 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 items) Section T031.5. 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 Le permit to file a signed statement that he or she is liconsed pursuant to the provisions of [he Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and ro(essions 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 for a permit subjects the applicant to a civil penalty of of more than five hundred dollars ($500). 7 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, ustness 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 n roved for the purpose of sale). I. as owner of the properly, 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' State License Law). 3 1 am exempt from licensors under the Contractors' State License Law for the following reason: y my signature below t acknowledge that, exceptfor my personal residence In which I must have resided for at least one year prior to completion of the improveme Covemd b thin ermit, Leannot legali, all a structure that I have built as an owner -builder if it has not beep constructed in its entirety by licensed contractors. I understand that a copy of the applicable 1a action 70 011. a Business and 'rofessions Code, is available upon request when this application Is submitted or at the following Web site:http:Nwww.leginfo.ca.govicalaw.html. igri. of Property Owner or Authorized Agent Datell .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700�2 )1 fivil,n &Ayc 3 of the Business and Profes I se is in full force nd effect. License Class License. No ' <.wy Q I) A Contractor Signature` VORKERS' COMPENSATION DECLARATION 'ARNING: 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 1E100p00j, IN ADOmON TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE., INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: I 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 in pdormance of the work for which this permit is issued. Policy No. r6ave 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' compensatiol lsurance carrier and policy number are: :arrier ; \ Policy Number Expiration Date Jame of Agent Phone # -1I certify that. in the pert rmance o h rk f r 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 hat, If I should become a 1 jec. w pensetion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. r 10 4 23 gnature of Applicant - _ �'v'' e )ECLARATION REGARDING CO TRU N ENDI:NG AGENCY hereby 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 Cade). -enders Name, Lender's Address iy my signature below, cerdifiy 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 vide is Correct. € agree to comply with all applicable city and county 1 a s and state laws relating to building construction. I authorize representatives of this city or county toe ter b d property for inspection purposes. ii nature of Property Owner or Authorized A enl Print Property Owner's or Authorized A ens Name Date ACTION DATE BY 4 DE RATIO OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY 1 REGULATIONS PART 61 of TITLE 40 AND AOMD RIILF l 1403 PERMIT kXP?RkA _ _ _ _ SUBMITTED ASREST05 NOTIFICATION TO CPA i�,581110SIlDlIFICATII)N15NOTAIILICABLE 10 PERMIT CANCELLED PERMIT EXTENDED PERMITFINAL CERTIFIEATEOF ..,1 Y2� r PROPOSEDDEMOLITION CCCUPANCYISSUEO _1 J� P ry :