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Home My WebLink AboutH2023-0623 - Permits�"F,Wpo", City of Newport Beach Community Development Department - Building Division �y 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 718-1888 0 rh T newportbeachca.gov/civic °qu co aN�P III I I I III III II IIII I III II Mechanical Permit Plan Check No : Work Class : Other Issued Date : 09/25/2023 Inspection Area: 8 H2O23-0623 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: 1224 PEMBROKE LN Legal Desc : N TR 3607 BLK LOT 5 Description: MECH - R/R A/C CONDENSER. TAMPER -RESISTANT CAP & TIMER REQ'D Owner: OFFERNEST LLC Contractor Address : 555 ANTON BLVD, 150 COSTA MESA, CA 92626 Address Phone: (714)235-3572 Phone: Corr State Lic Applicant: MIGUEL ANGEL GARCIA Lic Expire Address : 555 ANTON BLVD, 150 COSTA MESA, CA 92626 Bus Lic: Phone : (714) 363-8345 Bus Lic Expire: Workers' Compensation Insurance Owner/Builder : Carrier : Address : Policy No: Phone : W. C. Expire: Code Edition : 2022 Fire Hazard Zone : NO Manufacturer: OMNIGUARD Type of Construction : Model# : 4AC17L 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: LDER DECLARATION I hereby affirm 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 hems) 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 ie permit to rile a signed statement that he or she is 6consed pursuant to the pFOVISIOnS 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 lioensure and the basis for the alleged exemption. Any violation of Section 7031.6 by any applicant for a permit subjects the applicant to a civil penalty of of more than five hundred dollars ($5DO). 3 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of the work, and the structure Is not intended or offered for sale (Section 7044, ,usiness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the rimovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that It was not built or n roved for the purpose of sale) s owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not ply t an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). [a I exempt from licensure under the Contractors' State License Law for the folio 'ng reason: ly y signature below I acknowledge that, except for my personal ro ' a in w must have real or at least one year prior to completion of the improvements covered by this per It, Lea 1 legal) oil structure that I have built as in owner -builder If it has not b structa Its entirety by ]it D contractors. I understand that copy of the applicable law, Soctio 1 70" of in usinas and essons Code, is available upon request wh t Is applic IT a fit r at the owin sita:hftp:ftwww.loginfo.ca.govicalaw:html. lignatue Of Property Owner or Authorized Agent D$t( .ICENSED CONTRACTOR'S DECLARA ON \ hereby affirm under penalty of perjury that I am the sed un er provisi s of Chapter omme clog with Section 7000) of Division 3 of the Business and Professions Code, and p ficensidis in full force nd effect. License Class License Date. Contractor Signature VORKERS' COMPENSATION DECLARATION YARNING: FAILURE TO SECURE WORXERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL EWES UP TO ONE HUNDRED THOUSAND DOLLARS PI100,000), IN ADDITION TO THE `AST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 5705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'$ FEES. hereby affirm under penalty of perjury one of the following declarations: have and will maintain a certificate of consent 10 self -insure for workers' Compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th )art Rance of the work for which this permit is issued. Policy No. v 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` compereatim U Pea artier and policy number are: ar Policy Number Expiration Date J4�a1tm�e f Agent Phone ff �lUxeni that,. in the performance of t rk fo hick is p it is issued.[ shall not employ any person in any manner so as to become subject to the workers' compensation laws of alfforn a, and agre at, if I hould becomes sect io t ars' $ ' provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant- _ _ . Date J i )ECLARATION RE D N C STR O NDiNiGACrENCY l/d1 hereby affirm under penalty of perjury t. at there Is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Ci it Code).. .ender's Name Lender's Address 3y my signature below, I cadify to each of the following: I am the property owner or authorized to act on the propeOwner's:. behalf. I have read this application and the information I havXpro7vid Is ComeI agree to comply with all applicable city and county and to la 9 to building construction.I authorize representatives of this city or county to a identifi. Fly for inspection purposes. /I7 3i nafura of Property Owner or Authorized About Print Pro art owner's Or Authorized Agent's Noma I I III/ ' Date Zs z ACTION DATE I BV ECLARAT ONI. CO kNCF, WITH CODE OF FEDERAL FOR OFFICE USE ONLY RBGULAT DNS PART&t OFTITLE AO AND AO.MD RULE PERMIT EXP?RFD j U I SUNITTrOASB STO5 NOTIFICATION TO PERMIT CANCELLED 1 LIEEPA PERM1iENTENDED f -ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCY 15SUED i SIGNATURE: