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Home My WebLink AboutH2022-0597 - Permitsva�wPok' City of Newport Beach Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-3288 U > Inspection Requests Phone: (949) 644-3255 Cq«pepN�P newpodheachca.gov/inspections Mechanical Permit Plan Check No: Work Class : Other Issued Date: Inspection Area : 4 H2O22-0597 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: 7 SAWGRASS DR Legal Desc : N TR 15391 BLK LOT 29 Description: MECH - R/R FAU & A/C CONDENSER. TAMPER -RESISTANT CAP REQ'D Owner: WEIN LAWRENCE PHILLIP TR Address : 7 SAWGRASS DR NEWPORT BEACH, CA 92660 Phone: Applicant: BEN MEDINA Address: 31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362 Phone : (818) 735-7876 Owner/Builder : Address Phone: Code Edition : 2019 Fire Hazard Zone : NO Type of Construction Occupancy Groups: Building Setbacks : Front: 5, Side: 5, Side: 5, Rear: 10 Flood Zone : X Use Zone: PC - Aeronutronic Ford PROCESSED BY: O1 SPECIAL CONDITIONS Contractor : SERVICE CHAMPIONS HTG Address : 3150 E BIRCH BREA, CA 92821 Phone: (714)777-7777 Con State Lic : 799170 Lic Expire : 10131/2023 Bus Lic: RMBWC00054221 Bus Lic Expire:04/01/2023 Workers' Compensation Insurance Carrier : EVEREST PREMIER INS CO Policy No: RM8WC00054221 W. C. Expire: 4/1/2023 Manufacturer : DAY & NIGHT Model# : NH4A436 DECLARATION I hereby afflml under penally of perjury that 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 Item(s) (Section 7031.5. Business and Professions Cutlet 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 the permit to MG a signed statement thathe 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 Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (,_) portions of the work, and the structure Is not intended or offered for sale (Section 7044, Business 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 improvements 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 improved 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 apply 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). 1 am exempt from licensure under the Contractors' State License Law for the fallowing reason By 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 Iegall) 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 low. Section 7044 of the Business and Professions Code, is available upon request when this application Is submitted or at the following Web site:htip;//www.leginfo.ca.gov/calaw.html. Signature of Properly Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of D. sion,3 of the Business an ,dons Gad ,. a icBase is in full force and effect. License Glass License. No 1,07 Contractor Sign WORKERS' COMPENSATION DECLARATION NANNING: FAILURE TO SECURE WORx.ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO ORIMIN L PENALTIES AND CIVIL FINES UP TO ONE N REO THOUSAND DOLLARS (§100,000), IN ADDMON TO THE COST OF COMPENSATION, DAMAGES AS PRDVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. hereby affirm under penalty of perjury one of the following declarations: -1 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 Ih iWLormance of the workfor which this permit is issued. Policy No. 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 issued. My workers' carrier and policy number are: Rer Policy Number is of Agent certify that, in the performance of the work foraWch this permit Is issued, I if 1 should become subject to the worker ' peneation provist - -i store of Applicant Date Irnploy any person in any manner so as to become subject to the of the Labor Code, Ishall forthwith comply with those provisions. I hereby affirm under penalty of psr l ere is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name Lender's Address By my signature below, I certify to each of the following: laws of California, and I am the property owner Or authorized to act on the property owner's behalf. I I have read this application and the information I have provided is correct. I agree to comply with all applicable pity and county ordinances and I laws relating to building construction. I authorize representatives of this city or county to enter the a -i an Jed property for insp tion purposes Signature of Property Owner or Authorized A ant Print Property Owner's or Authorized Agent's Nam Date' NQ ACTION DATE By t ON OF C NCE WITH CODE Of FEDERAL FOR OFFICE USE ONLY EGUTATIONS PART fit OF TITIF 40 AND AQMD RULE 1403 PERMITEXPIRED I! LJf$IfPm1mDASBFSTO5 NOTIFICATION TO PERMITCANCERED �!�A PERMIT EXFENDED 1��T0'Ap PERMITFINAL n UAA,�SBESTOS NOTIFICATION 15 NOT APPLICABLE TO CERDOCATEOF (`j'� 6'r3 '�'"W� PROPOSED DEMOLITION OCCUPANCY ISSUED l / SIGNATIIPE: