HomeMy WebLinkAboutH2023-0469 - Permits4a�WPoRr City of Newport Beach
o ec� Community Development Department - Building Division
D. 100 Civic Center Drive, Newport Beach, CA 92660
S Permit Counter Phone: (949) 718-1888
n.. newportbeachca.gov/civic
Cq<JFORN`P
Mechanical Permit : H2O23-0469
Plan Check No:
Work Class : Other
Issued Date : 07/20/2023
Inspection Area : 6
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: 9 BORDEAUX Legal Desc : N TR 9858 BLK LOT 11 UN 75 TR 9858 LOT 11 UNIT 75
Description: MECH - R/R 2 HEAT PUMPS. 2 AIR HANDLERS & DUCTWORK.
Owner: JEANE MARLETT
Address : 9 BORDEAUX NEWPORT BEACH, CA 92660
Phone:
Applicant: GOETTL AIR CONDITIONING & PLUMBING
Address: 532 MALLOY COURT CORONA, CA 92880
Phone: (714)462-8174
Owner/Builder :
Address
Phone:
Code Edition :
Type of Construction
Occupancy Groups:
Building Setbacks
Flood Zone
Use Zone:
PROCESSED BY
SPECIAL CONDITIONS:
v
ji
Contractor : GOETTL AIR CONDITIONING & PLUMBING
Address :
532 MALLOY COURT CORONA, CA 92880
Phone:
(714)462-8174
Con State Lie
: 1047781
Lie Expire :
12/31/2024
Bus Lie:
BT30077958
Bus Lie Expire:02128/2024
Workers' Compensation
Insurance
Carrier :
STARR INDEMNITY & LIABILITY CO
Policy No :
1000004860
W. C. Expire:
12/1/2023
Fire Hazard Zone : NO Manufacturer: GOODMAN
Model# : GSZB403010/GSZB404810
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that i. am exempt from the Contractom' State License Law for the resson(s) indicated below by the checturr s) I have placed next to the applicableifam(s)
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
to permit to file a signed statement that he or she is licensed pursuantto the provisions of the Contractors' State License Law (Chapter g (commencing with Section 7000) of Division 3 of the Business and
rofesaions Code) or that he or she is exempt from foensure and the basis for the alleged exemption. Anyvlolation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of
of mom then five hundred dollars ($500),
L as owner of the property, or my employees with wages as their sole compensation, will do (_) ail of or U portions of the work, and the structure is not intended or offered for sale (Section 70",
usiness and Professions Godw The Contractors' State License Law does not apply town owner of property who, through employees' or personal effort, builds or Improves the property, provided (hat 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 four 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 hot
poly 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' State License Low for the following reason
y 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 legall,
ell a structure that I have built as an owner-bulldar it It has not boon constructed in its entirety by licensed Contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http:liwww.leginto.ca.: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) of vision of the Business and Pro ss , and my license is in full force
nd effect. License Class License No Date Contractor Si
WORKERS' COMPENSATION DECLARATION
'ARMING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, ANO SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEWALTIEB AND GYIL FINES UP TO ONE HUNG. THOUSAND DOLLARS ($100,0001, IN AOOITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN BECTON 31113 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES,
hereby affirm under penalty of perjury one of the following declarations:
I I have and will maintain a certificate of consent to self fnsure for workers' compensation, issued by the Director of industrial Relations as provided for by Section 3700 of the Labor Code, for th
kformance of the work for which this permit is issued, Policy No.
nave 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' compensatioi
s ranca carrier and policy number are:
ler Policy Number Expiration Date
Jame of Agent Phone #
:1I certify that, in the performance of the work for which this permit is issued'.., t shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
hat, if I should become subject to th ' compensation provisions of Section 3700 of the Labor Code, Ishall. forthwith comply with those provisions.
itgnafure of Applican Da
)ECLARATION REGA ING CONSTR _ LENDING AGE
hereby affirm under penal at ther ctding agency for t ion fenhe performance of the work for which this permit is issued (Section 3097, Civil Code).
.endar's Name Lenders Address
ty my signature bale o each of the following:
I am the property owner or authorized to act on the property owner's behalf.
I have read thisapplication and the information I have provided is correct.
I agree to comply withall applicable city and county ordin nd state laws relating to building construction.
I authorize representatives of this city or cou ty to
love-identified r Inspection purposes.
ii nature of Property Owner or Authorized A ant Print Premix Owner's or Authorized Agent's Name U/ ((� \ W" ✓polo C
ACTION DATE. BY N OF COMPLIANCE 1N17H CODE DF FEDERAt FOR OFFICE USE ONLY Y
LATIONS PART 61 OF TITLE 40 AND AOMD RULE
PERMiTCXPUrI I I I U iSUBMITTFDASBESTOSNOTiPICATIONTO
PERMIT FINAC I L,JA,6t3TOS NOTIFICATION I5 NOl APPLICABLE TO
CERTfFtCATE OF POSED DEMOLITION
OCCUPANCY ISSUED �t�'I C. /.� J;"�& , siGNATURE: