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Home My WebLink AboutXC2023-0172 - Permits�E.vPoRT City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit : XC2023-0172 .9 Community Development Department - Building Division X C 2 0 2 3 0 1 7 2 j 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2023-1218 n Permit Counter Phone: (949) 718-1888 Issued Date : 05/23/2023 J pm S newportbeachca.gov/civic 7—,--- rl Inspection Area : 8 Combination Type - MECH; - -`�� , Work Class - Other I' 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: 600 ST ANDREWS RD Legal Desc : A TR IRVINE SUB BLK 54 LOT 171 IRVINE SUB BLK 54 LOT 171 POR OF LOT FOR ABAND Description: MECH - R/R 5 COMM ROOFTOP PACKAGE UNITS Owner: CHURCH ST ANDREWS PRESBYTERIAN OF Contractor: MESA ENERGY SYSTEMS INC NEWPORT Address : 600 SAINT ANDREWS RD Address : 2 CROMWELL NEWPORT BEACH, CA 92663 IRVINE, CA 92618 Phone: (949)574-2205 Phone: (949)244-1341 Con State Lic : 611215 Lic Expire: 01 /31 /2025 Applicant: SEAN HICKEY Bus Lic : BT98039750 Address : 2 CROMWLL Bus Lic Expire : 12/31/2023 IRVINE, CA 92618 Phone: (949) 244-1341 Workers' Compensation Insurance Carrier: CONTINENTAL INSURANCE COMPANY (THE) Owner/Builder : Policy No: WC734181601 Address : W. C. Expire : 10/1/2023 Phone Code Edition : 2022 Fire Sprinklers : NO Type of Construction : V-B Fire Hazard Zone : NO Occupancy Groups : A-3,U No of Units : 0 Bldg Height: No of Stories Building Setbacks Flood Zone : X Use Zone: PI - Private Institutions I� J PROCESSED BY: SPECIAL CONDITIONS: Architect : Address : Phone : State Lic Engineer: ALMQUIST GLENN N Address : 1400 QUAIL ST #245 NEWPORT BEACH, CA 92660 Phone: (949)261-6161 Designer: KENNETH MT VAN DISSEL Address : 2 CROMWELL IRVINE, CA 92618 Phone: (949)460-0460 Construction Valuation : $8,000.00 Added/New/Ti sq. ft. Bldg : 0 Alteration sq. ft. Bldg Added/New sq. ft. Garage: 0 ' TOTAL sq. ft. 0 OWNER -BUILDER DECLARATION I hereby affirm under penalty 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 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 the 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 Professions Code) or that he or she is exempt from licensure 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 not more than five hundred dollars ($500). �I❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, 'Business 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 ,improvements 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 improved for 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 not apply 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). ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: _ By 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 legalll Ilsell a structure that I have built as 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 Professions Code, is available upon request when this application is submitted or at the following Web site:http:/Aw .leginfo.ca.gov/calaw.html. (Signature of Property Owner or Authorized Agent Date _ LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profession Code, and my license is in full farce and effect. License Class License No Date S (23 (2 3 Contractor Signature /b WORKERS' COMPENSATION DECLARATION (WARNING: 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 ($10g000), IN AOO/TION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 37M OF THE LABOR CODE. INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 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 :irmance 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' compensal Car ttne nk oFI CGStnml Policy Number U L �6 5 `` 1 ii �a 6 Expiration Date I o I D i � dOd3 of Agent GrC tit clwt � Phone# u19-a T-m-3--q1 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 if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. of areby 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 lder s Name Lenders Address my signature below, 1 certify to each of the following: I am the propel tv owner or authorized to act on the property owner's behalf. 1 have lead this application and the information I have provided is correct. I agree to comply m th 311 applicable city and county ordinances and state laws relating to building construction. I authzirize representatives of this city or county to enter th above -identified property for inspection purposes. r.,atura of Pronertv Owner or Authorized ADent Print Procertv Owner's or Authorized Aaents Name ACTION P6;heT E; rP/RED P64AT CA,7CELLED PERMIT EXPENDED' CEM INLnJE OF OCCUPANCY155VED DATE I BY DECLARATION OF COMPLIANCE WITH CODE OF PED-c RAL ! FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE. 40 AND AOMD R01 F IXI ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO PROPOSED DEMOLIJJON I SIGNATURE: /L1 — Civil Code). 19