HomeMy WebLinkAboutH2023-0180 - Permits�g.+raoRr City of Newport Beach
D� Community Development Department - Building Division
F y 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 644-3288
tea.. Inspection Requests Phone: (949) 644-3255
C4C/FppN�P newportbeachca.gov/inspections
III I I I II I III II III II I I II Mechanical Permit : H2023-01 s0
Plan Work Class k Other
Issued Date : 03/15/2023
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 : 3907 INLET ISLE OR Legal Desc : N TR 6425 BLK LOT 59
Description : MECH FURNACE CHANGE OUT
Owner: KIDDE JOHN E TR
Address : 3907 INLET ISLE DR CORONA DEL MAR, CA 92625
Phone:
Applicant:
DEPENDABLE GRAHAM AC
Address:
2952 CENTURY PLACE COSTA MESA, CA 92626
Phone :
(714) 546-1653
Owner/Builder :
Address
Phone :
Code Edition : 2022
Type of Construction
Occupancy Groups:
Fire Hazard Zone : NO
Building Setbacks : Front: 10, Side: 6, Side: 6, Rear: 6
Flood Zone : X
Use Zone: R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area)
PROCESSED BY:
SPECIAL CONDITIONS:
Contractor : DEPENDABLE GRAHAM AC
Address :
2952 CENTURY PLACE COSTA MESA, CA 92626
Phone :
(714) 546-1653
Con State Lic
: 472690
Lic Expire :
04/30/2024
Bus Lic :
BT01013104
Bus Lic Expire:12131/2023
Workers' Compensation
Insurance
Carrier:
SERVICE+AMERICAN+INDEMNITY+COMPANY
Policy No:
SAMTWC0072801
W. C. Expire:
7/1/2023
Manufacturer:
Model# :
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the resson(s) indicated below by the checkmark(s) I have placed next to the applicable items)
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 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
'rofessions Code) or that he or she is exempt from licensure andthe 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
o€ more than five hundred dollars ($500).
1 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
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 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, as owner of the property, ant exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' $late License Law does not
pply to an owner of property wh..e builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
3 1 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 Iegall7
ell a structure that 1 have built is an owner -builder if it has not been 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:htip:/hwww.leginfo.ca.govlcelaw.html,
iignature 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 ) of i o a Business and Prof ions Code, and If force
nd effect. License Class License. No Date ntractor Signatur
VORKERS' COMPENSATION DECLARATION
rARNING: FAILURE TO SECURE WORN.ERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUN THOUSANO DOLLARS (5100, 000), IN ADDITION TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FORIN SECTION 3706 OF THE LABOR CODE, INTEREST, Me ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
1 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 3700 of the Labor Code, for th
q(formance of the work for which this permit is. issued. Policy No.
1We 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
rance carrier and policy number are:
ter Policy Number Expiration Data
1e of Agent Phone N
certify that in the performance of the e r which this permit is I s all not employ any person in any manner so as to become subject to the workers' ompensation laws of California, and agre
1f I should beco htecl to ti , rl are "repansabo loos of Section 3700 of the Labor Code, I shalt forthwith comply with {hose. provisions. !'
alure of Applica°....... .. .....,..,.,. ., Dat �6�V�
Ireby affirm under p I ry thatthere is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code),
ider's Name Lender's Address _
my signature below. I certify to each of the following:
I am the property owner or authorized to act on the property owner's behalf.
I have read this application and the information 1 have provld L
I agree to comply with all applicable city and uni o d s e laws relwln m construction.
g pY PP Y 9 q r
! authorize representatives of this city or cou{jj to enter the ov entifi erty for Inspection purposes. I A 1 �L
ACTION
DATE
BY r ATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
UTATIONS PART 61 OF TITLE 40 AND AQMD RULE.
1403
PERMITEXP?RED
!LJ ISUBMITTED ASBESTOS NOTIFICATION TO
EIPA
PERMITCANCELLED
OAQMD
ASBESTOS NOTIF,CA'ION'5 NCT AP 7UC.bLE TO
PERMIT EXTENDED
PERMIT FINAL
I .Ly.
CERTIFICATE OF
L�
RC POSED DEMOLITION
OCCUPANCY ISSUED
SIGNATURE: