HomeMy WebLinkAboutH2022-0503 - PermitsQ �EWPO�� City of Newport Beach
p d Community Development Department= Building Division
r 100 Civic Center Drive, Newport Beach, CA 92660
u Wb S Permit Counter Phone: (949) 644-3288
oe. Inspection Requests Phone: (949) 644-3255
C4C/F�pt��P newportbeachca.gov/inspections
Mechanical Permit
Plan Check No
Work Class : Other
Issued Date :
Inspection Area : 2
H2O22-0503
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 : 18 BARLOVENTO CT Legal Desc : N TR 7817 ELK LOT 2 UN 1 TR 7817 LOT 2 UNIT 1 OF PROJECT LOC ATED ON AP
Description: MECH - R/R F.A.U. & AIR HANDLER. TAMPER -RESISTANT CAP REGO
Owner: KAPLAN ROBIN DUNKLEMAN TR R L DUNKLEMAN TR
Address : 940 E CHAPMAN AVE ORANGE, CA 92866
Phone:
Applicant: THOMASCOLLINS
Address: 5186 SANDBAR COVE WY SAN DIEGO, CA 9 154
Phone: (714)804-8886 o
Owner/Builder: 001111
Address :"!.
Phone: 0"
Contractor : PHOENIX SOUTH INC
Address :
23192 VERDUGO DR STE B LAGUNA HILLS, CA 92653
Phone:
(949)481-0204
Con State Lic
: 752275
Lic Expire :
07/31/2024
Bus Lic :
BT30072914
Bus Lic Expire:09/30/2022
Workers' Compensation
Insurance
Carrier:
WESCOINS CO
Policy No:
WWC3553675
W. C. Expire:
10/1/2022
Code Edition : 2019 Fire Hazard Zone : NO Manufacturer : FUJITSU
Type of Construction : - Model# : 36LMAS1
Occupancy Groups
Building Setbacks :
Flood Zone: X i SPEC
Use Zone : PC - Newport Crest - UP1585
PROCESSED BY:
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm under penally of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkrnack(s) 1 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, pdOr1O its issuance, also requires the applicant for
the permit to Pie a signed statement that he or she is licensed pursuant to the provisions of the ContractorsState 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).
111, 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,
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 far 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 properly, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
Ia�rply to an owner of property ",he builds or Improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
Lt I am exempt from licensure under the Contractors' State License Law for the following reason:
By my signature below I aeknawledga that, except for my personal residence in which I must have resided for at Yeast one year prior to completlon of the improvements covered bythis permit, I cannot lagalh
sell 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, $action 7044 of the Business and
Professions Code, is available upon request when this application is submitted or at the following Web site:http:l/www.leginfo.ca:.govfcalaw.htrl.
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 7g 00tl ,of Division 3 of the Business and Professions Code, nd fnp e, is in full force
and effect. License Class License No Da�� Contractor Signatukr�IA �� _ r4YJLm
WORKERS' COMPENSATION DECLARATION �{\
NANNING: 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 f$100.000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3703 OF THE LABOR CODE., INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
0 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 th
gWormance 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 permlt is issued. My workers'
carrier and policy number are:
ne of Agent
certify that, in the performance of the
If I should become Sub'e to the we
Policy Number Expiration Date
Phone 0
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 Callfomia, and
�V omperest, provisions of Section 3700 of the Labor Code, I shall. forthwith comply with those provisions.
nature of Applicant°Dal�\i �I�d-L1�d �C
CLARATION REGARDING CONSTRUCTION LENDING AGENCY
:retry 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, Civil Code).
Iders Name Lenders 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 I have provided is correct.
I agree to comply withall applicable city and county ordinances and state laws relating to building construction.
I authorize representatives of this city or county-{��-tg\r_the a1pgve�1(�mI(e��,��rgjed property for inspection purposes. ,.%
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ACTION
DATE
By
DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY f
REGULATIONS PART Fl OF TITLE 40 AND AQMD RULE.
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PERMITEXPfRED
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PERMITCANCELED
PERMIT EXTENDED
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PERMIT FINAL
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ASBESTOS NOTIFICATION IS NOT APPLICABLE 10
CERTIFICATE OF
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PROPOSED DEMOLITION
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