HomeMy WebLinkAboutH2022-0695 - PermitsD�agWPORT City of Newport Beach
Community Development Department- Building Division
r 100 Civic Center Drive, Newport Beach, CA 92660
u S Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
C9�1F00.N�P newportbeachca.gov/inspections
II I II II I I II I II Mechanical Permit : H2O22-0695
Plan Check No :
Work Class : Other
Issued Date:
Inspection Area : 3
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 : 405 SANTA ANA AVE
Description : MECH - C/O FURNACE
Legal Desc : N TR 27 BILK 12 LOT 11 TR 27 LOT 11 BLK 12 SELY 100 FT
Owner: BOUCHER DARRELL PAUL TR
Address : 405 SANTA ANA AVE NEWPORT BEACH, CA 92663
Phone:
Applicant: KEMNITZ A/C & HEATING INC
Address: 188 TECHNOLOGY SUITE C IRVINE, CA 92618
Phone: (949)453-8500
Owner/Builder :
Address
Phone :
Code Edition : 2019
Type of Construction
Occupancy Groups:
Building Setbacks
Flood Zone
Use Zone:
PROCESSED BY:
Front: 5, Side: 4, Side: 4, Rear: 10
X
R-1 - Single -Unit Residential
SPECIAL CONDITIONS:
N
Fire Hazard Zone : NO
Contractor : KEMNITZ A/C & HEATING INC
Address:
188 TECHNOLOGY SUITE C IRVINE, CA 92618
Phone:
(949)453-8500
Con State Lic
: 695874
Lic Expire :
09/30/2024
Bus Lic :
BT30010593
I
Bus Lic Expire:07/31/2023
Workers' Compensation Insurance
Carrier :
NORGUARD INS CO
Policy No:
KEWC350773
W. C. Expire:
2/1/2023
Manufacturer
Model# :
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors` State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable items)
iect on 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
Ic permit to file a signed statement that he or she Is licensed pursuantto the provisions of the COetmCforS' 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 ficensure and the basis for the alleged exemption. Any violation of Section 7W1.5 by any applicant for a permit subjects the applicant to a civil penalty of
of more than five hundred dollars (S500).
1, as owner of the property, or my employees with wages as their sole compensation, will do (_) 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 on owner of property who, through employees' or personal effort, builds or improves theproperty, 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 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
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).
I am exempt from licensure under the Contractors' State License Law 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 legally
ell a structure that I have built asan 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:http:fiAww.leginfo.ca..gov/calaw,Ntrni.
ignalure of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury thztt I am licensed under provisions of Ore @ter commencing with Section 7000) of Division 3 of the Business and Profes ions Code, and my license is in full force
nd effect. License Class C U License. Na b ��YI t� Date ��' Contractor Signature �-
VORKERS' COMPENSATION DECLARATION V
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND COLLARS 15100,000), IN ADD71ON TO THE
DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
hereby affirm under penalty of perjury one of the following declarations:
I I have and will maintain a certificate or 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 1h.
rJormance of the work for which this permit is issued. Policy No.
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'
carrier and policy number are:
Policy Number
Date
lame of Agent Phone N
3 certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
rat, If I should become subject to the workers' compensation provisions, of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
� ZL
signature of Applicant_ _ _ �__.. DER\ -
IECL.ARATION REGARD CONSTRUCTION LENDING AGENCY
hereby affirm under penaltyof perjury that (here is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, rvil Code).
enders Name _ _ Lender's Address
ly 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, t
I have read this application and the 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 representatives of this city or county to enter the above-identif d property for inspection purposes.
lionalure of Prooertv Owner or Authorized Agent N _.. Print Property Owner's or Authorized Agent's Name t�- -- Date
ACTION
DATE
BY { NECLARATEON OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 51 OF TITLE. 40 AND AQMD RULE
t 1403
PERMIT EXPIRED
U I SUBMITTED ASRF5TnF NOTIWATIOr' TO
�O -tE-PA
Qr en M.D
PERMITCANCELl.ED
PERMIT EXTENDED
PERMITFINAL
7j`�!
ASSESTOSNOTIFICATIONISNDTAPPLICABLE TO
CERTIFICATE OF
PROPOSED DEMOLITION
OCCUPANCY ISSUED