HomeMy WebLinkAboutH2022-0557 - PermitsaEwao� City of Newport Beach III 11111111111
of @ Community Development Department- Building Division I I II I
100 Civic Center Drive, Newport Beach, CA 92660
>+� i Permit Counter Phone: (949) 644-3288
.� Inspection Requests Phone: (949) 644-3255
�'q<rconN'P. newportbeachca.gov/inspections
Mechanical Permit: HZO22-0557
II I1111111 I II II
Plan Check No: PC2022-2536
Work Class : Other
Issued Date : 10/'11/2022
Inspection Area : 7
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: 19 CORPORATE PLZ Legal Desc : P BK:102 PG
2 PAR 2
Description: COMM BOILER REPLACEMENT ON 2ND FLOOR
Owner: MARK P ROBINSON JR LLC
Contractor : ACCO`ENGINEERED SYSTEMS INC
Address : 19 CORPORATE PLAZA DR NEWPORT BEACH, CA 92660
Address: '888 EAST'. WALNUT ST PASADENA, CA 91101
Phone:
Phone: -' (818)244-6571
Con State Lie : 120696
Applicant: ACCO ENGINEERED SYSTEMS INC
tic Expire t: 12/31/2023
Address : 888 EAST WALNUT ST PASADENA, CA 91101
Bus Lie: BT00004502
Phone: (818)244-6571
Bus Lie Expire:12/31/2022
Workers' Compensation Insurance
Owner/Builder: -
Carrier: LM INSURANCE CO
Address :
'::. Policy No: ` WA566DO67353011
Phone:
. W. C. Expire: 10/1/2023
Code Edition : 2019 Fire Hazard Zone : ; NO
Manufacturer
Type of Construction :
Model# :
Occupancy Groups:
Building Setbacks
Flood Zone : X
Use Zone : PC - Corporate Plaza
PROCESSED BY:
SPECIAL CONDITIONS:
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I. hereby affirm under penalty of perjury that I am
action 7031.S. Business and Professions Code: A
Law for the
[,as owner of the property, or my employees With wages as their sole compensation, will do U all of br (_) portions of
mess and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through: e
rovements are not intended or offered for sale, if, however, the building or improvement is: sold within one year of comp
roved for: the purpose of sale).
I, as owner of the property,: am exclusively contracting with licensed Contractors to construct the project ..(Section 7044,
ly to an owner of property who builds or improves thereon, and who contracts for the projects: with a licensed Contractor
I am exempt from licensure under the Contractors' State License:Lawfor the following reason:
ny signature belovt i acknowledge that, except for my personal residence in which I must have resided (or at least one
a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I urn
iessions Code, is available upon request when this application is submitted or at the following Web site.http'J1www:legmi
nn under penalty of perjury that I am licensed under prpvlsiol
License Class.. License. No
V COMPENSATION DECLARATION
below
or rel
for
ded that the
not built or
Business and Professions Code: The Contractors` State Licensee Law does not.
pursuant to the Contractors' State License Law):.
Date
Code, .er ,my Idcepse3s in toll force
AND CIVIL FINES: UP TO ONE HUNDRED THOUSAND DOLLARS IStrW;GSej, IN ADMOON TO THE
hereby affirm under penalty of perjury one of the following' declarations:
I I have and will maintain a<certirleate 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 tt
�erformanceof the work for which this permit is issued.. Policy No.
Phave 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 rssued. My workers' compensatio
sue ce carrier and policy number are:
tinier. Policy Number Expiration Date
lame of Agent - Phone #
-1I certify that, in the ppVTnance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the workers' compensation laves of California, and agrf
Pat, if t should becom 'ect to the workers' Dam�p Petition pr/Oj_�s,a s,of Section 3700 of the Labor Code, I -shall forthwith comply with those provisions. ////�tt/� /� I
:innaiura of Annlinant /SI/Id•�•Yi1l/�•/.//� natPl t t ) r_4n � !/. ZoZZ
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,
.ender's Name - Lender's.. Address
3y my signature below, € cartify 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 spp4t able city: a. ounty ordinances and. state laws relating to building construction.
I authorize representatives of this city or u ty to ant' r the so an roperty, for inspection purposes. t�
3ignature of Property Owner or Authorized Ad Print Pro any Owner's or Authorized Agent's Name 13.r t
AC71ON PATE R CLARATION:OF COMPLIANCE WITH CODE OF FEDERAL. FOR OFFICE USE ONLY
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.PERMIT FINAL AsaQTOS SIOTIFICAMN ISIVOT APPLI E TO
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