HomeMy WebLinkAboutH2022-0538 - Permits�Ewao� City of Newport Beach
Community Development Department- Building Division
> �y 100 Civic Center Drive, Newport Beach, CA 92660
u - $ Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
C9[(FO�N\P newportbeachca.gov/inspections
Mechanical Permit
Plan Check No:
Work Class : Other
Issued Date :
Inspection Area : 4
H2O22-0538
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 : 22 COLONIAL DR
Description: MECH - R/R F.A.U. & A/C CONDENSER. T
Owner: HALVORSEN CLAY ALLEN TR
Address: 22 COLONIAL DR NEWPORT BEACH, CA
Legal Desc : N TR 15389 BLK`LOT 45
PER RESISTANT CAI? REQUIRED
Contractor ALISO AIR INC
Address : 29736 AVE'. DE LAS BANDERAS RANCHO SANTA MARGARITA, CA
92688
Phone :
Phone : (949) 589-2021
Con State Lie : 526420
Applicant: THOMAS COLLINS
Lc Expire :.. 03131/2024
Address: 5186 SANDBAR COVE WY SAN DIEGO, CA 92154
Bus Lie : BT30019236
Phone: (714) 804-8886
Bus Lie Expire:02/28/2023
Workers' Compensation Insurance
Owner/Builder :
Carrier : LIBERTY MUTUAL INS CO
Address :
Policy No : WC2Z61036218092
Phone:
W. C. Expire:, 7/1/2023
Code Edition : 2019 - Fire Hazard Zone : -:-NO
Manufacturer: AC PRO
Type of Construction :
del# : AULD36W2/A-D(U)
Occupancy Groups:
10
Building Setbacks : Front: 10, Side: 5, Side: 5, Rear. 10
Flood Zone : X
Use Zone: PC - Aeronutronic Ford
PROCESSED BY:
SPECIAL CONDITIONS:
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i hereby affirm Under penalty of perjury that tam exempt from the Contractors'.State License Law :for the feason(s) indicated below by the checkmark(s) I have placed next to the applicable"item(s)
:cdon 7031-5, Business and :Professions Code: Any city or county that requiresa'permit to construct, alter: improve, demolish, or repair any structure, prior to its issuance, also requites the applicant, for
permit to Me signed statement thathe -or she is licensed Pursuant to the provisions of the. Contractors` State License Law (Chapter u (commencing with Section 7000) of Division 3: of the Business and
,fessions Code) or that he or she is exempt from liconsure and the basis for the alleged exemption. Any violation of Section 7031.5 by. any applicant fora permitsubjects the; applicant to a civil penalty of
morethanfive hundred dollars ($500)::
I; as owner of the property, or my employees with wages as theirsole, compensation, will do (_) all of or U portions ofthe work; and the structure is not intended or offered for sale.. (Section 7044,.
;mess and Professions Code: The Contractors' State Ucense Low does not apply to anowner of property who, through employees` or personal effort, builds or improves the property, provided that the .
Irovements are not intended or offered for safe. If, however, the building or improvement is sold within oneyear of completion, the Owner -Builder will have the burden of proving that was not built or
,roved for the purpose of sale)..
I; as owner of the property, am exclusively contracting with licensed Contractorsto construct the project (Section 7044, Business and Professions Code: The Contractors' State LicenseLawdoes not.
ily 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).
1 am exempt from ticensure-under the Contractors' State License Law for the following reason:
my signature below I acknowledge that, except for my personal residence in which I must have resided for at feast one year prior to completion of the improvements. Covered by this' permit,. I. cannot iegalli
a structure that I have built as an owner -builder if ithas not been constructed inits ontirety by licensed contractors. I understand that copy of the. applicable law, Section 7044 of the Business and.
�fessions Code, is available upon request when this application Is submitted or at: "the following Web site:httpa/www.leginfo.ce.gov)calaw.htmi.
nature of Property Owner or Authorized Agent Date.
TENSED CONTRACTOR'S DECLARATION
:reby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0) o p,vision 3:of the Business and Pr essions Cotle antl my license is in full force
I effect. License Class License. No DatO/3 Contractor Signatu(e1
)RISERS' COMPENSATION DECLARATION
AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONEHUNDRED THOUSAND DOLLARS t3706A0aj.IN. ADDITION TO
a ATTORNEY'SFEES.
reby affirm under penalty of perjury one of the following declarations"
I have and will maintain a. certificate of consent to self -insure for workers' compensation, issued by the Director of industrialRelations as provided for by Section 3700 of the Labor Code, for th.
ante of the work for which this permit is issued. Policy No.
ve and wilt maintain workers' Compensation insurance, asrequiredby Section 3700 of the Labor Code, for the performance of the work for which this, permit is issued. My workers' compansatior
Ir ce carrier and policy number are:
Wrr Policy Number.. Expiration Date
as of Agent. Phone #
certify that, In the performance of the work for which this permit Is issued, I. shall not employ any person in any manner so as to become subject tp the workers` compensation laws of California, and agre,
If 1 should become subject to t> wo kers' compensation provisions of Section: 3700 of the Labor Code,: I shall forthwith comply with those provisions.
of Applicant
hereby affirm under penalty. of. perjury that there is a construction lending agency for
ender's Name 1
iy 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 state laws rel
I authorize representatives of this city or County to enter th ydeath;' led prop
14W
CER77FICATE OF
yOCCUPANCY I55
FEDERAL
RULE
NOTIFICATION I5-NOT. APPLICABLE TO
Dare
for which this permit is issued (Section 3097, Ill Code).
FOR OFFICE USE ONLY
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