HomeMy WebLinkAboutH2022-0734 - Permits�EvuaoRr City of Newport Beach III I I I II I II I II II IIII II II Mechanical Permit : H2O22-0734
Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No
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Permit Counter Phone: (949) 644-3288 Work Class : Other
Inspection Requests Phone: (949) 644-3255 Issued Date : 12/22/2022
�gc�FoaN`". newportbeachca.gov/inspections Inspection Area : 5
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 : 439 FERNLEAF AVE, 1/2 Legal Desc :
P BK 207 PG 29 PAR 1 UN 1 P M 207-29 PAR 1 UNIT 1 OF PROJECT LOCATED ON AP
Description: MECH NEW HEAT PUMP AND AIR HANDLER `TAMPER PROOF CAP REQ'
Owner: CHANDLER MICHAEL TR
Contractor : TRITON AIR INC
Address : 439 FERNLEAF AVE APTB CORONA DEL MAR, CA 92625
Address : 1221 PUERTA DEL SOL #300 SAN CLEMENTE,
CA 92673
Phone :
Phone : (949) 492-0290
Con State Lic : 774877
Applicant: TRITON AIR INC
Lic Expire : 06/30/2024
Address : 1221 PUERTA DEL SOL #300 SAN CLEMENTE, CA 92673
Bus Lic : BT30042558
Phone: (949) 492-0290
Bus Lic Expire:03/31/2023
Workers' Compensation Insurance
Owner/Builder :
Carrier : FALLS LAKE FIRE
Address :
Policy No : FLA01867400
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Phone:
W. C. Expire: 1/1/2023
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Code Edition : 2019 Fire Hazard Zone : NO Manufacturer:
AC PRO
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Type of Construction :
Model# :
AUD36A
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Occupancy Groups:
Building Setbacks : Front: 15, Side: 3, Side: 3, Rear: 5
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Flood Zone : X
Use Zone : R-2 - Two -Unit Residential
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PROCESSED BY:
SPECIAL CONDITIONS:
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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 haveplaced next to the applicable itarl
otion 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 applirent for
Permit to file a signed statement that he or she is licensed pursuantto the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
fesslons Code) or that he or she is exempt from hoensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of
more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or L) portions of the work, and the structure is not: intended or offered for sale (Section 7044,
Iiness 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
rovements 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
roved for the purpose of sale).
1, 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
ly 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 I am exempt from licensure under the Contractors' Stale License Law for the following reason: _
Iy my signature below I acknowledge that, except for my personal residence in which I must have resided for at feast one year prior to completion of the improvements covered by this pr
oil 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
'rdfessions Code, is available upon request when this application Is submitted or at the following Web site:http:llwww.leginfo.ca.govicalaw.html.
,ignature of Property Owner or Authorized Agent .__ Date
hereby
affirm
CONTRACTOR'S DECLARATION ��
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section O) of Division 3 of the Business and Profes o Cod nd my Ik
nd effect. License Class L€cense. No Date I-7 �/.Z-Z L Contractor Signature
and
full farce
VORKERS' COMPENSATION DECLARATION v (/
'WANING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO Cal AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED HO AND DOLLARS ($100,000), IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR. IN SECTION 3706 OF THE LABOR CODE., INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
7 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 IN
erformance 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'
Ni carrier and policy number are:
Policy Number
of Agent
Data
I certify that, in the performa a 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
t, if I should becomes bje t to the rke ' comp nsation provisions of Section 3700 of the Labor Code, I shall. forthwith comply with those provisions. �//
nature of Applicant _ _ L _ pates
CLARATION REGAR N DCTION LADING AGENCY ////��\\ ?reby affirm under penalty of per ry that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civff Code).
)der s Name Lender's Address
my signature below, I certify to each of the following:
I am the pi 3Arar or authorized to act on the property owner's behalf.
I have read this application and the information I have provided is correct.
I agra to ce'.nply wI'h.. all applicable city and coup ordinances and slate laws relating to building construction.
I aLthodze representatives of this city or count enter bo e-identified property, for Inspection purposes. / �v� �ftn��
na tue of Properly Owner or Authorized Agent W i/✓l Print Prooertv Owner's or Authorized Agent's NarT `� jk nary,L
ACTION DATE BY ,J € DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
I REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE
1403
'CF. 41' EXPIRED
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-I MW r ONAL � —
C[IAIFICATEOF �(��Z3 (L�—
OCCUPANCY ISSUED
I SUBMITTED ASSF.STOS
LJ ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
PROPOSED DEMOLITION