HomeMy WebLinkAboutH2023-0167 - PermitsaEWPORT City of Newport Beach III I I I II I III II III III II II O
A Community Development Department- Building Division Mechanical Permit
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No
S Permit Counter Phone: (949) 644-3288 Work Class : Other
Inspection Requests Phone: (949) 644-3255 Issued Date : 03/0812023
C4CrF00.N\P newportbeachca.gov/inspections Inspection Area : 1
H2O23-0167
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 : 3810 CHANNEL PL Legal Desc : A TR CANAL SECTION ELK 638 LOT 6 CANAL SECTION LOT 6 BLK 638 ALL -INC BET SAME i,
Description: MECH CHANGE OUT A/C ON DECK; TAMPER PROOF CAP REQ'D; %1% RalmtS w &Ae*-e
Owner: SHELLIE CLUETT
Address : 3810 CHANNEL PL NEWPORT BEACH, CA 92663
Phone:
Applicant: WALTERS MARK T
Address : 1972 ADOBE AVE CORONA, CA 92882
Phone : (951) 768-5173
Owner/Builder:
Address
Phone:
Code Edition :
2D22 Fire Hazard Zone
Type of Construction
Occupancy Groups:
Building Setbacks :
Front: 3, Front: 20, Side: 3, Side: 3
Flood Zone :
AE, 8 FT; X; AO 1
Use Zone :
R-2 - Two -Unit Residential
PROCESSED BY:
SPECIAL CONDITIONS:
Contractor : WALTERS MARK T
Address : 1972 ADOBE AVE CORONA, CA 92882
Phone: (951)768-5173
Con State Lic : 865930
Lic Expire : 07/31/2023
Bus Lic : BT30077069
Bus Lic Expire:10/31/2023
Workers' Compensation Insurance
Carrier:
Policy No: EXEMPT
W. C. Expire :
NO Manufacturer: INNOVAIR
Model#: SEC48H2R19
NO CONSTRUCTION NOISE
ON THE WEEKEND
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjurythat I am exempt from the Contractors' State License Law forthe reason(s) indicated below by the checkmark(s) I have placed next to the applicable Items)
Section 7031.5.. Business and Professions Code: Any city or county that requires permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for
ha permit to file a signed statement that he or 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
'rofesslons 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 for a permit subjects the applicant to a civil penalty of
lot more than five hundred dollars ($500).
I, as owner of the property, of my employees with wages as their sale compensation, will do (_j all of or L) portions of the work, and the structure Is not intended or offered for sale (Section 7044,
Suseess 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 the property, provided that the
nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that if was not built or
mproved for the purpose of sale).
1, 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
Ipply 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).
I am exempt from Roensure under the Contractors' State License Law for the following reason._�
—
Sy my signature below 1 acknowledge That, except for my personal residence in which I must have resided for at least one year prior to completion of the Improvements covered by this pormit, I cannot leg -all)
sell a structure that I have built as an owner -builder if it has not been constructed in itsentirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
Irofessions Code, isavailable upon request when this application is submitted or at the following Web site:http:/1www.leginfo.ca..govicalaw.html.
Signature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that t am licensed under provisions of Chapter 9 (commencing with Section 700 of Division 3 f the Business and P fessi➢ s God , an m e is in full force
and effect. License Class License. No Date Contractor Signal
VORKERS' COMPENSATION DECLARATION
rARNING: FAILURE TO 4�CV9E WORMERS' COMPENSATION COVERAGE 15 UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS L$100,0001, IN ADDITION TO THE
:OST OF COMPENSA-ION, DAKAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, "a ATTORNEYS FEES,
hcreby affirm under penally of perjury one of the following declarations:
I I have and wiry mvimain 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 th
ericrma, Ice of the work for which this permit is issued. Policy No,
have and will rre;rt-in 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'
rance rarrier and oolicy number are:
Policy Number
is of Agent
certifv that, in the performance of the work for which this
if I sh-)uld becc ri e''c/cbject to the workers'
C pens ati
mto,E, of Applicant
Date
Is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
d of8ection 3700 of the Labor Code, I shalt forthwith comply with those provisions.
hereby affirm unda. p,:r.alty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
enders Name Lenders Address
ly my signature below, I certify to each of the following:
I am the property owner or aulhorlZed to act on the property owner's behalf,
I have read this application and the information 1 have provided is correct.
I agree to comply with all applicable city and county ordinances and state laws retail g to building construction.
I authorize representatives of this city or cant en he ve-id jfied O9n�� inspection purposes. f �,M
li0nature of Property Owner or Authorized Aoenl i i G Pont Property Owner's or Authorized Auent's Name K/ 1 r 1!X`( (,C�(,
ACTION
DATE
BY 'I DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED
LI I SUBMITTED ASBESTOS NOTIFICATION TO
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PERMIT EMENDED
E1AQMD
PERMITFINAL
DASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
CERTIFICATE OF
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PROPOSED DEMOLITION
OCCUPANCY ISSUED
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