HomeMy WebLinkAboutE2022-0682 - Permits�tiWPORT City of Newport Beach
p� a Community Development Department- Building Division
k q 100 Civic Center Drive, Newport Beach, CA 92660
i Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
°"4FoaN�P newportbeachca.gov/inspections
IIII I I II I II I II II III I I I II Electrical Permit _ E2022-0682
Plan Check No:
Work Class : Other
Issued Date:
Inspection Area: 6
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 : 618 IRIS AVE, A Legal. Desc
: P BK353 PG 36'PAR 1 LIN'1 PM 353-36, PAR 1 OF PROJECT 938-01 LOCATED ON
Description: ELEC - AC DISCONNECT AT NEW ROOF -TOP AC
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Owner: BLOOM SHERRY L TR 2012 SHERRY BLOOM TR
6
Contractor: ALPS AIR CONDITIONING & HEATING INC. „
Address : 618 IRIS AVE #A CORONA DEL MAR, CA 92625
Address :.". ''1895 S SANTA CRUZ ST ANAHEIM, CA 92805
Phone :
Phone : (714). 633-8892
Con State lLie: 667953, ®, ,
Applicant: BEN MEDINA
Lie Expire: 04/30/2023
Address: 31225 LA BAYA DR WESTLAKE VILLAGE,: CA 91362
Bus Lie : G - BT30047511
Phone : (818) 735-7876
Bus Lie Expire:06/30/2023
Workers' Compensation Insurance ,
Owner/Builder :
Carrier : INS CO OF THE WEST a, ,
Address: -
Policy. No:-WSD506354500
Phone :
W. C.:Expire: 12/25/2022
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Code Edition: 2019
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•Fire Hazard Zone: NO
Type of Construction :
'Occupancy Groups : R-3
Building Setbacks : Front: 20, Side: 3, Side: 3, Rear 5`
Flood Zone : X
Use Zone : R-2 - Two -Unit Residential
NO CONSTRUCTION NOISE
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PROCESSED BY: / -C
SPECIAL CONDITIONS:
ON THE WEEKEND
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Contractors State License Late for the reason(s) indicated below by the checkmark(s) i have pieced next to the applicable{tem(s)
hat requires -a permit to construct, alter, improve, demolish. or repair any structure, prior to its issuance, also requires the applicant for
ntto the provisions ofihe Contractore State License Law (Chapter 9 (Commencing with Section 7000) of Division 3 of the Business and
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
more than five hundred dollars (WO).-
I, as owner of theproperty, 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 forsale.(Section 7044,
,mess 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 theproperty, provided that the
rovements are not intended or offered for sale. If, however, the building or Improvement is said within one year of completion; the Owner-Buiiderwill have the burden of proving that it was not built or
i; as owner of the property,: am exclusivelycontracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors` State License Law does not
lyto-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 licensure under the Contractors' State License Law for the following reason:.
ny signature below I acknowledge that, except for my personal residence in which I must have. resided For at leastone year prior to completion of the improvements covered by this permit, I cannot tegafl;
a structure that I have built as an owner -builder If it ties not been constructed in its.entirely by licensed contractors, I understand that a copy of the applicable. law, Section 7044 of the Business and
lessions Code, is available upon request when this application is submitted or at the following Web site:http'f[w .teginfo.ca.gorlcalaw:html..
tature of Propectf Owner or Authorized Agent Date
ENSED COMMCTOR'S DECLARATION
r p::affirm utW.-r psrmaity of peliurythat I am licensed under provisions of Chapter 3 (commencing with Section 7Q00 D'€visi n f the Business. and Prate my license is in full force
effect. LicLYiyngPlIss License No Date Jt Contractor Signature
1ZR& RS' COf4PENSATiON DECLARATION
NIMM FAILURE Tg SEfwlWE wORKEW COMPENSATION COVERAGE IS UNLAWFUL,:AND SMALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS J$100,000), IN ADDITION TO THE
C OF�COMPE106TIOW DAMAGES AS PROVIDED FOR IN SECTION 3796 OF THE LABOR COOS, INTEREST, AND ATTORNEY'S FEES.
r%.,i2ffirm unr%r penalty cf perjury one of the following declarations:
I.hswe and *]I4r(pjrltam 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 to
4fiinnce of the fork for which this permit is Issued. Policy No.
6:1nd will Qtaintsin 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' compar saboi
ance.carieren� pol ynumber are:
uiar•+. _. Policy Number Expiration Date
ueef•Agent. • ` Phone If
certify that, in the--pedormanaeof the or which this rmit Is Issued, 1 shall not employ any person in any manner so as to become subject to the +,vorkers' compensation laws of California, and agre
If I should become subject tothe ers sation provisionsof Section 3700 of the Labor Code. I shall forthwith comply with those provisions.
iaiure of Applicanf7l Date
•r we nrrev aen. �nawrn-fnwrern rn�ar ew,rviwlr_ wrew,nv
a Construction lending agency for the
my signature below, € certify W each of the. following:
I am the property owner or authorized to act on the pro
I have read this application and the information I have.
I agree to comply with all applicable city and county or
I -authorize representatives of this city of county to pats
PERMIT EXTENDED
-10
CERTIFIEATEOr
1403
the work for which this permit. is issued (Section 3097, Civil Code),.
lto building construction,
for inspection purposes.
OF TITLE AO AND AQVID RULE
rQS NQTINCATION TD
T[QN 15 N01AJ}'4icAm TO
FOR OFFICE. USE ONLY