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Home My WebLink AboutH2022-0532 - PermitsCy of Newport Beach Development Department nt-Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Counter Phone: (949) 94288 Inspection Requests Phone: (949) 644-3255 newportbeachca.gov/inspections 11111 I IIIII I III I I Mechanical Permit : Plan Check No:Permit Work Class : Other Issued Date : 09/30/2022 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: 21 SUPREMA DR Legal Desc : N TR 14773 BLK LOT 10 UN 74.TRACT 14773, LOT 10 OF PROJECT 9 35-34 LOCATED ON Description: MECH DUCT WORK Owner: BAN DOAN Contractor : SERVICE CHAMPIONS HTG Address : 21 SUPREMA DR #83 NEWPORT COAST, CA 92657 Address : 3150 E BIRCH BREA, CA 92821 Phone: Phone: (714)777-7777 Con State Lic : 799170 Applicant: SERVICE CHAMPIONS HTG Lic Expire 10/ ` : Address : 3150 E BIRCH BREA, CA 92821 8WC03 Bus Lic : RM8WC00054221 Phone : (714) 777-7777 Bus Lic Expire:04/01/2023 - Workers' Compensation Insurance Owner/Builder : Carrier : EVEREST PREMIER INS CO Address : Policy No: RMBWC00054221 Phone : W. C. Expire: 4/1/2023 Code Edition : 2019 Fire Hazard Zone : YES Manufacturer Type of Construction : Model# : Occupancy Groups: Building Setbacks Flood Zone : X .®.• Use Zone: PC - Newport Coast PROCESSED BY: S b g, SPECIAL CONDITIONS: • I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the teason(s). indicated below by the checkmark(s) I have placed next to the applicable nem(s) action 7033.5, 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 permit to file a signed statement the& heor she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Ifessions 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 fora permit. subjects the: applicant to a civil penally of. more than five: hundred dollars.($300). I, as owner of the property, Or my employees with wages as theirsole compensation, will do U all of art_) portions of the work, and the structure Is not intended or offered for sale (Section 7044, >iness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through mployeesI or personal effort, builds. or improves the. property, provided that the wovements are not intended or offered for sale. if, however, the building or improvement is sold within one year of Coll led, n, the Owner -Builder will have the burden of proving that itwas not built of )roved for the purpose of sale). I, 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 )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 taw). 1 am exempt from licensors under the Contractors' State License Law for the following reason: my signature below I acknowledge that; except for my personal residence in which 1 must have resided forest feast one year prior to completion of the improvements covered by this permit I:cannot lec i a structure that I have built as an owner -builder if it has not been constructed In its enGroty by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the: Business and rfessions Code, is available upon request when this application is submitted or at the following Web site:hftp./tWww.legl fo.ca.govfcalaw.htmL .nature of Pronerty, Owner or Authorized Agent -_. - _ date hereby affirm under penalty Of perjt ntl effect. License Class License No VORKERS' COMPENSATION DECLARATION V rARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL :DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3716 OF THE LABOR CODE, INTEREST, AND ATTORNEY -SF EE5 hereby affirm under penalty of perjury one of the fallowing declarations: ] I have and will maintain a certificate Of consent to self -insure for workers' compensation. Issued by the Dire ,efftj'manee of the work for which this permit is issued. Policy No. my license is In full force AND CIVIL FINES UP TO ONE HUNDREO THbusAND DOLLARS (S100.000), IN ADDMON TO THE Industrial Relations as provided for by Section 3700 of theLaborcode, for 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.: iMy workers' ter and policy number. are: Policy Number Expiration Date ne, of Agent certify that, in the fp/rmanca of a wor or which this permit is issued, I shall not employ any person In any If I should betoma sjltiject to the work ' compansatoa-provis;MO1 Section 3700 of the Labor Code,I-shall hereby affirm Under penal of perjury thatthere is a construction lending agency forthe of the work ender's Names - Lenders Address ly my signature bopyv, Rcartify to each of the following:: • ark I the propgV oVer or authorized to act on the property owner's behalf. .•.• . • 1 have road tilis •apelitation and the information I have COrreOL .I agree to comp with all applicable fity_and count rdina as and slate laws relating to building construction raiecrize representatives of this. city or con o mer th bove4d tiflattF pperty for inspection purposes. :iouatura Of Protiadapvater or AuthorizepAgent Print Property Owne ETtoN• • ... DATE BY N OF COMPLIANCE WITH CODE OF FEDERAL FOR •..••• ....14 33 'EaPC/TEYPtR£D . I LJ I SUAMH`TEO ASBESTOS NOTIFICATION TO 11�� UASSEST05 NOTIFICATION IS NOT APPLICABLE TO r. ••• •..1 i-23 A--ti PROPOSED DEMOLITION f SIGNATURE: :I�so as to become subject to the workers' compensation laws of California, and agre Ift comply with those provisions. Dal :h this permit is issued (Section 30g7, Civil ode).