HomeMy WebLinkAboutH2022-0499 - PermitsCity of Newport Beach
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Community Development Department- Building Division
100 Civic Center Drive, Newport
Beach, CA 92660
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Permit Counter Phone: (949) 644-3288
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Inspection Requests Phone: (949) 644-3255
newportbeachca.gov/inspections
II II IIIIII II Mechanical Permit
Plan Check No:
Work Class : Other
Issued Date : 09/20/2022
Inspection Area : 4
H2O22-0499
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 : 2060 VISTA CAJON Legal Desc
: N TR 5463 BLK LOT 4 TR 5463 (L:L.84-214025) PAR 4
Description: MECH NEW A/C UNIT *TAMPER PROOF CAP REQ*
Owner: VANIAN MARY TR
Contractor
Address : 2060 VISTA CAJON NEWPORT BEACH, CA 92660'
Address
Phone : (949) 759-1677
Phone
Con State Lic
Applicant: VANIAN MARY TR
Lic Expire
Address : 2060 VISTA CAJON NEWPORT BEACH, CA 92660
Bus Lic:
Phone : (949) 759-1677
Bus Lic Expire:
Workers' CompensationInsurance
Owner/Builder : VANIAN MARY TR
Carrier :
Address: 2060 VISTA CAJON NEWPORT BEACH, CA 92660
Phone 759-1677
Policy No:
: (949)
W. C. Expire:
Code Edition : 2019 'Fire Hazard Zone : NO Manufacturer -
Type of Construction :
Model# :
Occupancy Groups:
Building Setbacks
Flood Zone: X
Use Zone: R-1 - Single -Unit Residential
PROCESSED BY: I, U Y —
SPECIAL CONDITIONS: OWNER/BUILDER FORM ATTACHED
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the
next to the applicable itern(s)
oa;+also requires the applicant for
)) of Division 3. of the Business and
is the applicant to a civil penalty of
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,
mess and Professions Code: The Contractors' State License Law does notapply to an owner of property who, through employees' or personal effort. builds or improves the property, provided that the
rovements are not intended or offered for sale, if, however, the building or improvement is sold within oneyear of completion, the Owner-Builderwill have the burden of proving that it was not built or
roved for the purpose of sale).
L 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
ly to an owner of propertywho 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 licensure under the Contractors' State License Law for the following reason:
ny signature below f acknowledge that, except formy personal residence in which I must have resided for least one year prior to completion of the improvements covered by this permit, I cannot lee_
a structure that I have built as on owner -bull If has not been constructed in its ontlroty by licensed Contractors. I understand that a copy of the applicable law, Secti n 7M of the Business and
lessions Code; is available upon requastwh # S spjs4Ajioa Is submltt�r qt fha k1lowing Web site:http.Hwww.leginfo.ca.govicalaw.htmi. _ I Y 0
erjurythat I am licensed under provisions of Chapter 9 (Commencing with Section 7000).of Division 3:of
my license is in full force
COMPENSATION DECLARATION
3E TO SECURE wORHERR' COMPENSATION COVERAGE IS UNLAWFUL.. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CMLFINES VP TO ONE HUNDRED THOUSAND DOLLARS (5100,000),
NSATION. DAMAGES AS PROVIDED FOR IN SECTION3TSO OF THE LABOR CODE; INTEREST, ANDATTORNEY'S FEES.
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, forth
performance of the work forwhirh this permit is issued. Policy No.
-11 have and will maintainworkers' 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
isurance carrier and policy number are:
:arrier Policy Number: Expiration Date
Jame of Agent. Phone tf
:11 certify that, In the performance at the Work for which this permit is issued. t shall not employ any parson In any manner so as to become subject to the worfcars' pensa
a wor4iral laws of California, and ogre
hat, if I should become subje kers' ensation prow€slons of Section 3700 of the Labor Code, I -shalt forthwith comply with those provisions. ^!�
'� j r�`o�rtptp _ � d
3gnature of ADDIiCant X _�L�ii_(�1��__ll_���i'�1 Date
ireby affirm under pevatty of parjury t'nat there Is a construction tending agency for the performance of the work i
iderrsName - Lenders .. Address
my signature below, I certify to each of the following:
I am the property owner or authorized to act on theproperty owner's behalf.
I have read this application and the information f have provided is correct.
I agree to comply with all applicable city. and nt ri inances and state lawslrelating to building construction.
[.authorize representatives of this City or count XVtg(f(se above-idraniped property for Inspection purposes:
PERMIT
DATE BY `/ GtCLAA7MT€EIWOP.Edty1PLIANCE WITH CODE OF FEDERAL. I FOR
REGULATIONS. PART 51 Or TITLE 40 AND.AQMD RULE
ALJ SBESTCi5 NOTIFICATION 15 NOT APPLICABLE TO
PROPOSED OEMOLMON
SIGNATIj 6 . • • ••• t% _--.
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