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HomeMy WebLinkAboutH2023-0677 - PermitsPCRr City of Newport Beach I I I I II I II II II II II II II Mechanical Permit : H2O23-0677 04 r { Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No >� m Permit Counter Phone: (949) 718-1888 Work Class : Other .a. newportbeachca.gov/civic = ---,,. 5 Issued Date: 1012012023 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 : 46 HILLSDALE DR Legal Desc : N TR 11785 BLK LOT 4 UN 20 TR 11785 LOT 4 UNIT 20 Description: MECH R/R FURNACE AND A/C UNIT **TAMPER RESISTANT CAPS REQUIRED" Owner: ROBERT & KIMBERLY BERNATZ Address : NEWPORT BEACH, CA 92658 Phone : (714) 824-9597 Applicant: JERMAINE MAEWEATHER Address : 3675 RUFFIN RD. SAN DIEGO, CA 92123 Phone : (619) 677-8487 Owner/Builder : Address: Phone : Code Edition : 2022 Type of Construction Occupancy Groups: Building Setbacks : Flood Zone: X Use Zone : PC - Aeronutronic Ford PROCESSED BY: SPECIAL CONDITIONS: Contractor : SERVICE LION PLUMBING HEATING AIR ELECTRIC Address : 252 GEMINI AVE BREA, CA 92821 Phone : (714) 890-1602 Con State Lie : 871067 Lie Expire : 01/31/2024 Bus Lie : BT30082404 Bus Lie Expire:08/3112024 Workers' Compensation Insurance Carrier : SECURITY NATIONAL INSURANCE COMPANY Policy No : SWC1429994 W. C. Expire: 3/3/2024 Fire Hazard Zone : NO Manufacturer: AC PRO Model#: AULD36W2/A1-D(U) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that t. 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 item(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 is 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 Ilcensure 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 ot more than five hundred dollars ($500). 3 I, as owner of the property, or my employees with wages as their sots compensation, will do (_) all of or (_) 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 uproyements 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 of nproved for the purpose of sate). ] 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 not 'pTply 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). J I am exempt from licensors under the Contractors' Slate 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 legally ell a structure that I have built as an owner -builder if 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 Irofessions Code, is available upon request when this application is submitted or at the following Web site:http:llwww,leginfo.ca.gov/calaw.html. signature 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 70D ) of Division of the Business and Professions Co nd my license is in full force nd effect. License Class License No Date U' Contractor Signature YORKERS' COMPENSATION DECLARATION IV !ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 4100.0001, IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROvioen rcR IN SECTION 3706 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 -insure for workers' compensation, Issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the arformance of the work for which this permit is issued. Policy No - have 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' lance carrier and policy number are: Policy Number of Agent Date JI certify that, in the performance of the work for Mirth this permit is issued, I sh I not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre rat, if I shouldbecomesub ecl to ore workers comp erisetion provisions of Seclio 3700 of the Labor Code, I shall forthwith comply with those provisions. 1- � Ii natureofA licant ECI-ARATION REGARDING CONSTRUCTION LENDING AGENCY hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work For which this permit Is issued (Section 3097, Clvll Code). ander's Name _ Lender's Address _ q 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 I have provided is correct. I agree to comply with all applicable city and county ord antes and state laws relating to building construction. I authorize repress datives of this city or county to ente t e -Identified property for inspection purposes. , r� G nature of Property Cwner or Authorized Agent Print PrODedv Owner's or Aulhor17Pd Ansel's Name \'-� v� \`I `rd1�\r- rJ AG'Idry DATE t BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGUI ATIONS PART Fl OF TITLE 40AND AQMD RULE r 1403 PERlAr EXVIRI ISO[IMITTED ASBESTOS NOTIFICATION TO ._.. EU __ ...,.,.,.. j _... .______.. �Er.M1T CANCELLE.7 ❑EPA CERTIFICATE MFICATEL -- ' 1 j,ROP0ASBESTOS NOTLITIO ilON IS NO?APPLICABLE TO CER71FlC4TE OF iU PROPOSCO OF,rYIOUTION 7CCLIPANCY ISSUED V SIGNATURE: Date �U