HomeMy WebLinkAboutH2023-0532 - Permits04 City olf NDewport Beachnt- Building Division III I I I II I III II III I I III Plan Check No
Comm
Mechanical Permit : H2023-05J32
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 718-1868 ®tn, P p <.. , "•" Work Class : Other
newportbeachca.gov/civic 6 A 1 4 w «.,9 �' 7 _g Issued Date : 08/22/2023
°pt�eonr'`r
Inspection Area : 4
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: 16 SPANISH BAY DR Legal Desc : N TR 15332 BLK LOT 59
Description : MECH R/R 1 FURNACE AND 1 A/C UNIT AT SIDE **TAMPER RESISTANT CAPS REQUIRED **
Owner: ELAINE ORNITZ
Address: 16 SPANISH BAY DR NEWPORT BEACH, CA 92660
Phone
Applicant: RABECCAJOHNSTON
Address : 4370 PALM, D250 San Diego, CA 92154
Phone: (714)804-8886
Owner/Builder :
Address
Phone:
Contractor : ALISO AIR INC
Address :
29736 AVE DE LAS BANDERAS RANCHO SANTA MARGARITA, CA
92688
Phone:
(949)589-2021
Con State Lic:
526420
Lic Expire :
03/31/2024
Bus Lic:
BT30019236
Bus Lic Expire: 02/2812024
Workers' Compensation
Insurance
Carrier :
LIBERTY MUTUAL INSURANCE COMPANY
Policy No :
WC2Z61036218093
W. C. Expire:
7/1/2024
Code Edition : 2022 Fire Hazard Zone : NO Manufacturer : AC PRO
Type of Construction : Model# : AULD60W2/A-D(U)
Occupancy Groups:
Building Setbacks : Front: 5, Side: 5, Side: 5, Rear: 10
Flood Zone : X
Use Zone: PC - Aeronutronic Ford
PROCESSED BY:
SPECIAL CONDITIONS: ....
I hereby affinn under penalty of perjury that 1 am exempt from the Contractors' State License Law for the reasons) Indicated below by the checkmark(s) I have placed'. next to the applicable item(s)
jection 7031.5, Business and Professions Code: Any city or county that requires a permit toConsttuOt, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for
le permit to file a signed statement that he or she is Iicensed pursuant to the provisions of the.CGntractors' State License Law IChapter 9 jcommeneing with Section 7000) of Division 3or the Business and
rof lsslons 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
of more than five hundred dollars ($500).
1 1, 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 oroffered for solo (Section 7044,
us)ness 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
oprovements 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).
1 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
pply 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 leensure under the Contractor State License Law for the following reason ____ ________ —_------
y my signalu ro 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 legall,
oil a structure that I have built as an owner-brdldor If It has not been constructed In its entirety by licensed contractors. 1 understand that copy of the applicable law, Section 7044 of the Business and
'rofessions Code, Is available upon request when HIS application is submitted or at the following Well site:http:llwww.leginfo.oa,govtcalaw.html.
ignature 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 9 (commencing with Section 7000 f DWI ton 3.of the Business and Professi as Code, an my 115pries S in fuPi fume
nd effect. License Class License No Date Contractor Signature
a
VORKERS' COMPENSATION DECLARATION
IARNING: fALURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND Cl FREE UP TO ONE HUNDRED THOUSAND DOLLARS (Sur),Pe6), IN ADDITION TO THE
DST OF COMPENSATIDN, DAMAGES AS PROVIDED FOR 1N SECTION 3T06 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby am Zand
er penalty of perjury one of the following declarations:
I I have and will maintain a carllflcate 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
odformance of the work for which this permit is issued. Policy No.
and will maintain workerscompensation 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
Date
to of Agent rnuna v
certify that, in the performance of the work for which this permit. is Issued, I shall not employ any person in any manner so a$ to become subject to the workers' compensation laws of COIBOD ia, and agre
if I should become subject to the workers Do Ippe�nsabon provrsions of Section 3700 of the Labor Code, I shall forthwith Comply with those provisions.
nature of Applioenf Date
raby affirm under penalty of perjury, that there is a construction fending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code),
)der's Name _ Lender's Address
my signature below, I certify to each of the following_
I am the property owner or authorzed to out on the property owner's behalf.
I have read this application and Lila Information I have provided is correct
I agree to comply with all applicable city and county ordinances and state laws. relating to building construction.
I authorize mvmseritatives of this arty or county in ante the above -id fife property for inspection purposes.
mature of Prauarh° Owner or Authnrzed AUent Print Property Owner's or Authorized Agent's Name
DATc BY / DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 46 AND AQMD RULE
S4g3
i. 'I SORMITTFD ASBESTOS NOTIFICATION TO
P[RM1TFlNAi /r i UASRLSTOS NOTIFICATION 15 NOT APPLICABLE TO
CEPriWCArt OF j _ c/ ( PROPOSED DEMOLITION
D }. OCCUPANCY ISSUE, _f, j I �J' i SIGNATURE::