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HomeMy WebLinkAboutH2023-0241 - PermitsCity of Newport Beach ¢a�WvoRr 0 @ Community Development Department- Building Division F ;t 100 Civic Center Drive, Newport Beach, CA 92660 U > Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 cg4cone`r newportbeachca.gov/inspections Mechanical Permit Plan Check No : Work Class : Other Issued Date : 04/11/2023 Inspection Area : 8 H2O23-0241 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: 521 SAN BERNARDINO AVE Legal Desc : A TR FIRST ADD TO NEWPORT HEIGHTS BILK 32 LOT 19 Description: MECH CHANGE OUT HEAT PUMP AND AIR HANDLER *TAMPER PROOF CAP REQ* Owner: LOUIS FLOCCO Contractor : GOETTL A/C PLUMBING r. Address : 521 SAN BERNARDINO AVE NEWPORT BEACH, CA 92663 Address : 532 MALLOY CT CORONA, CA 92880 _ Phone : Phone : (714) 336-6159 - Con State Lic : 1047781 E 't Applicant : BEN MEDINA Lic Expire : 12/31/2024 `} Address : 31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362 Bus Lic; BT30077958 t Phone: (818) 735-7876 Bus Lic Expire:02/28/2024 Workers' Compensation Insurance _ Owner/Builder: Carrier: AMERISURE Address : Policy No: 21221200002 " Phone: W. C. Expire: 12/1/2023 4. Code Edition : 2022 Fire Hazard Zone : NO Manufacturer: AC PRO Type of Construction : Model# : AOVB18HN1 Occupancy Groups: Building Setbacks : Front: 20, Side: 4, Side: 4, Rear: 5 - Flood Zone : X Use Zone : R-1 - Single -Unit Residential PROCESSED BY: ° SPECIAL CONDITIONS: r� 11MERS3 PROHIBITED ON HEAT PUMPS OWNER -BUILDER DECLARATION i hereby affirm under penalty of parjurythat I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable KAFFIR) Section 7031.5. 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 in permit to file a signed statement thathe or she is licensed pursuantto the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 'rofessions Code) or that he or she is exempt from ficensureand 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 of more than five hundred dollars ($500). 3 I, as owner of the property, or my employees with wages as their sole compensation, will do (_ ) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, lusines , and Professions Cade: 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 it was not built or reproved for the purpose of sale). 11. as owner of the property, am exclusively contracting with licensed Contractors to construct [lie project (Section 7044, Business and Professions Code: The Contractors' State License Law does not iply 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 licensure under the Contractors' State License Law for the following reason, N my signature below I 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 permit, I.cannot legally ell a structure that I have Dallas an owner -builder if It has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and 'rofessions Code, is available upon request when this application Is submitted or at the following Web site:http:/twww.leginfo.ca..gov/calaw.htmi. signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter (commencing with Section 7 of Pit on Baf the Business and Profes 'ons C nd I ise anse is in full force nd effect. License Class License No Date 4, Conlractor Signature VORKERS' COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED TH USAND DOLLARS ($100.000), IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AMID ATTORNEY'S FEES, hereby affirm under penalty of perjury one of the following declarations: I I have and will maintain 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 IN ertormance of the work for which this permit is issued. Policy No. ,LJhhaue-aud 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. My workers` compensatior ❑surance carrier and policy number are: farrier Policy Number Expiration Date Vame of Agent Phone ff :1I certify that, in the performance of th for which this permit is issued. I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree hat, ff I should become s or to the kers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant DateN...... )ECLARATION REGAR NG CO CTI END CY . J hereby affirm under penalty of u a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). -enders Name Lenders Address 3y my signature L£ICY', I certt y o each of the following: I am the propert' o'vner orauthorized to act on the property owner`s behalf. I hav, read this application and the information I have provided i _ rrect. I agree to comply with all applicable city and count ordinan and state laws relating to building construction. ' authorize representatives of this city or eoun enter the above-identi I property forjaspectian purposes. 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