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Home My WebLink AboutH2023-0137 - Permits-poRe oityoTyDewportBPamhnt-BuildingDivision IIIIIIIIIIII II III III II II Mechanical Permit:H2O23-0137 > y 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: = Permit Counter Phone: (949) 644-3288 �+!+ Work Class :Other w.. Inspection Requests Phone: (949) 644-3255 C�</FORN�P newportbeachca.gov/inspections Issued Date: 02/2412023 Inspection Area : 3 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 : 2427 SIERRA VISTA Description : MECH REPLACE FURNACE IN ATTIC Owner: KELLY KEVIN J TR KELLY FAMILY TR Address : 2427 SIERRA VIS NEWPORT BEACH, CA 92660 Phone: Legal Desc : N TR 1801 BLK LOT 5 Applicant: BEN MEDINA Address: 31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362 Phone: (818)735-7876 Owner/Builder : Address Phone: Contractor : SERVICE CHAMPIONS HTG Address : 3150 E BIRCH BREA, CA 92821 Phone: (714)777-7777 Con State Lic : 799170 Lic Expire : 10/31/2023 Bus Lic : RM8WC00054221 Bus Lic Expire:04/01/2023 Workers' Compensation Insurance Carrier : EVEREST PREMIER INS CO Policy No : RM8WC00054221 W. C. Expire: 4/1/2023 Code Edition : 2022 Fire Hazard Zone : NO Manufacturer Type of Construction : Model# : Occupancy Groups: Building Setbacks : Front: 20, Side: 4, Side: 4, Rear: 10 Flood Zone : X Use Zone : R-1 - Single -Unit Residential PROCESSED BY: SPECIAL CONDITIONS: OWNER -BUILDER DECLARATION I hereby affirm underpenally of perjurythat 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 items) iection 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 a 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 kcensure 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 3t more than five hundred dollars ($500).. 1 I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure Is not intended or offered for sale (Section 7044, usiness and Professions Code: The Contractors' State Licensee 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 nproved 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 fy 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' Slate License Law for the following reason: y my signature below I acknowledge that, except for my personal re ' a m which I must have resided to tJeast-eRe�eer Orto'completion of the improvements covered by this permit, I.Gannet legalq ail a structure that I have built as an owner -builder if it has n rotted in its entir used contractors. I understand that a copy of the applicable law, Section 7044 the Bus' ess and 'rofessions Code, Is available upon request when this application IS sub ad a following VJeb site:hitp:ffwww.leginfo.ca..govlcalaw.html. fgnalure of Property Owner or Authorized Agent Date 7 .ICENSED CONTRACTOR'S DECLARAT herebyaffirm under penaltyoff t t I a tensfunder rgvistp t �immencing with Section 70 o D f ion of the Business a o e, and my license is in full farce ad effect. License Classl (/ ense.No / 1"t. ✓ Date Contractor Signature WORKERS' COMPENSATION DECLARATION rARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUDJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDREDTH DOLLARS (E700,000), IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FORM SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. lbTreby affirm under penalty of perjury one of the following declarations: I nd 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 th Vance cc of the work for 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' compensatiol carrier and policy number are: Policy Number Date rie of Agent certify that.. in the performance of the work 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 , it I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shalt forthwith comply with those provisions. Ignature of Applicant Date, iECLARATfON REGARDING CONSTRUCTION LENDING AGENCY hereby affirm unJer pennIty of perjury that there is a construction lending agency for the performance ofthe work for which this permit is issued (Section 3097, Civil Code). eiders Vame _ _ Lender's Address _-- ,y my signatufe below. , erlify to each of the following: ' an, the property owner or authorized to act on the property owner's behalf. I na"e read this application and the information I have provided is correct. agree to comply w.t i all applicable city and county ord2.8 state laws relating to buildin construction. I authorize repiasenWtives of this city or County to erAillPth, ove-i nlif or inspection purposes.- tirmPWre of Prooa;L Dwner or Authorized Agent Pnnt Property Ovrner's or Authorized Agent's Name vim' V A^'ION DATE Y ARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY P. EGUTATIONS PART 61 OF TITLE. 40 AND AQMD RULE SURMITTFD ASBESTOS PERMIT EXTENDCJ IJ.AQMD PERMIT FINAL ////]]]]., ❑ ASBESTOS N011FICATION IS NOT APPLICABLE 10 CERTIFICATE PE (9. 23 PROPOSED'DEMOUTION OCCUPANCY ISSUED //// i SIGNATURE: Date