HomeMy WebLinkAboutH2023-0393 - PermitsawWvo�T City of Newport Beach III I I I II I III II IIII I III o� @ Community Development Department- Building Division Mechanical Permit
F 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No:
U ) T Permit Counter Phone: (949) 718-1888 Work Class : Other
h.. newportbeachca.gov/civic
°q� fopH`r.. Issued Date : a : 512023
Inspection Area:S
H2O23-0393
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 : 448 MENDOZA TER Legal Desc : N TR 1237 BILK LOT 138
Description: MECH - R/R A/C CONDENSER. TAMPER -RESISTANT CAP REQ'D
Owner: HENDERSON SCOTT TR DASH FAMILY TR Contractor
Address: 448 MENDOZA TER CORONA DEL MAR, CA 92625 Address :
Phone:
Applicant: ALISO AIR INC
Address: 29736AVE DE LAS BANDERAS RANCHO SANTA MARGARITA, CA
92688
Phone: (949)589-2021
Owner/Builder :
Address
Phone:
Code Edition : 2022
Type of Construction
Occupancy Groups:
Fire Hazard Zone : NO
Building Setbacks : Front: 5, Front: 15, Side: 6, Side: 6
Flood Zone: X
Use Zone : R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area)
PROCESSED BY:
SPECIAL CONDITIONS:
Phone:
Con State Lie
Lie Expire
Bus Lie:
ALISO AIR INC
29736 AVE DE LAS BANDERAS RANCHO SANTA MARGARITA, CA
92688
(949)589-2021
526420
03/31/2024
BT30019236
Bus Lie Expire:02/28/2024
Workers' Compensation Insurance
Carrier : LIBERTY MUTUAL INS CO
Policy No : WC2Z61036218092
W. C. Expire: 7/1/2023
Manufacturer: AC PRO
Model#: AULD36W
I hereby affirm under penalty of pequrythat 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 ftem(s)
Section 7031,5, Business and Professions Code: Any city or county Nat requires a permit to construct, after, improve, demolish, or repair any structure,prior to its issuance, also requires the applicant for
e permit to file a signed statement that he 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
irofessions Code) or that he or she: is exempt from lioensure 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 penafty of
of more then five hundred dollars ($500).
11, as owner of the property, or my employees with wages as their sole compensation, will do ( )tall of of U portions of the work; and the structure is not intended proffered for sale (Section 7D44,
lusiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or Improves the property, provided that the
nprovements are not intended or offered for safe. if, however, the building or improvement Is sold within one year of completion, the Owner -Builder will have the burden of proving that It was not built or
n roved for the purpose of sale).
1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and. Professions Code: The Contractors' State License Law does not
P ly to an owner of property who bullds or Improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
,J I am exempt from licensure under the Contractors' State License Law for the following reason:
ly my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I.Cannot IegaIly
oil a sirueture that I have built as an owner -builder if it has not been constructed In its entirety by licensed contractors. I understand that copy of the applicable law, Section 7044 of the Business and
Imfessions Code, is available upon request when this application is submitted or at the following Web sits:Mtp:/twww.leginfo.ca..govlcaiaw.htmi.
lignature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'$ DECLARATION
hereby athrm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 the Business and r Code, and my license is In full force
nit effect. License Class License No D?X:tq Contractor Sign i
VORKERS' COMI�ENSATION DECLARATION
IARNING: FAILURE TO SECURE WORMERS' COMPENSATION COVERAGE IS UNLAWFUL, ANtl SHALL SUBJECT AN EMPLOYER To CRIMINAL PI NALTS:S AND CM FINES UP TO ONE HUNG THOUSAND DOLLARS ($100,000), IN ADDITION To THE
AST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'SFEES,
hereby affirm under penalty of perjury one of the following declarafions_
3 l 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 37GO of the Labor Code, for thI
ertgrmance 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'
carrier and policy number are:
Policy Number Expiration Date
is of Agent
certify that, in the performance of the wfirk for which this
It I should become subject to the era' uproar
mature of Applicant �____ _
1 shall not amployany parson many manner so as to -become subject to the wcukers`compensation laws of Calffomia, and
action 3700 of the Labor Code,I shall forthwith comply with those provisions. l 2. C �_ I Z
hereby affirm under'fenel lury that there is a constriction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
.ender's Name Lender's. Address
3y my signature below, I Certify to each of the tollowfng:
i am the property owner or authorized to act on the property owner's behalf.
i have read this application and the Information t have provided is correct.
I agree to comply with all applicable city and county ord€n rid Ming to building construction.
I authorize representatives of this city or county to Of ova -identified property for inspection purposes.
3i nature of Property Owner or Auinorizec en Print Property Owner's or Authorized Agent's Name
ACTION DATE=RCGUL0ATIONqS
T[OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
PART Bt OF TITLE 40 AND AOMb RULE
PERMIT Ix"t D n I SUBMITTED ASBESTOS NOTIFICATION TO ..
CERTIFICATE OF �17— 1 ` j I [/ PROFOSE IASBE'TOdEMOLITION NOTIFICATION IS NOT APPLICABLE TO
OCCUPANCY ISSUED C SIGNATURE:
3