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Home My WebLink AboutE2023-0442 - PermitsQ ��WROQT City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II Electrical Permit : E2023-0442 p 4�'r, Community Development Department- Building Division E 2 0 2 3 e 4 4 2 n 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: ' --' 2' Permit Counter Phone: (949) 716-1888 Work Class : Other C,� ORH\P newportbeachca.gov/civic Issued Date : 05/16/2023 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: ELEC OUTLET FOR AIR HANDLER IN ATTIC Owner: CHANDLER MICHAEL TR Address : 439 FERNLEAF AVE APTB CORONA DEL MAR, CA 92625 Phone: Applicant: BEN MEDINA Address : 31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362 Phone : (818) 735-7876 Owner/Builder : Address Phone : Code Edition : 2022 Type of Construction : Building Setbacks : Front: 15, Side: 3, Side: 3, Rear: 5 Flood Zone : X Use Zone : R-2 - Two -Unit Residential PROCESSED BY: SPECIAL CONDITIONS: Contractor : TRITON AIR INC Address : 1221 PUERTA DEL SOL #300 SAN CLEMENTE, CA 92673 Phone: (949)492-0290 Con State Lie : 774877 Lie Expire : 06/30/2024 Bus Lie : BT30042558 Bus Lie Expire:03/31/2024 Workers' Compensation Insurance Carrier : LIBERTY MUTUAL FIRE INSURANCE COMPANY Policy No: 292549 W. C. Expire: 4/1/2024 ' Fire Hazard Zone : NO Occupancy Groups: U OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reeson(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, orrepair 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 'rolossfons Code) or that he or she is exempt from licensare 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 of more than five hundred dollars ($500). 3 I, 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, luseess 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 theproperty, provided that the nprovements are not intended or offered for safe, 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 tlproved for the purpose of sale). 3 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 poly 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 Ilcensure under the Contractors' Slate 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 legalh ell a structure that I have built asan owner-buildor if it has not boon constructed in its entirety by licensed contractors. I understand that a copy of tho applicable law, Section 7044 of the Business and 'rofessions Code, isavailable upon request when this application is submitted or at the following Web site:tlttp:!(www.leginfo.ce.gDvic law.html, signature of Property Owner or Authorized Agent -�T Date__ JCENSED CONTRACTOR'S DECLARATION ., hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section �fA�r,f��00 f Ms n of the Business and Pr d sicn ,-f` d nd ma y license is In full force no effect. License Class License No DEILY Contractor Signature 70RKERS' COMPENSATION DECLARATION / \\ 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HU SAND DOLLARS 15100.000), IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.. ''.I hereby affirm under penalty of perjury one of the following declarations: El 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 ITT iforTrance of the work for which this permit is issued. Policy No.. ha ,a 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' compensatioi nsu. -ce carrier and policy number are: Carrier Policy Number Expiration Dale Name of Agent Phone k MI certify that, in the performance of the work for wnic is permit is itisued, I shall net employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre that, if I should become Sub act to the workers' corn cation runs of Section 3700 of the Labor Code, I shall forthwith comply watt those provisions. Signature of Applicant m _ Date �iia[ DECLARATION REGA ING a LFfR LENIDIN� AGENCY .-....._...____�.. I hereby affirm under penalty of e that 3s a construction lending agency for the performance of the work for which this, permit Is issued (Section 3097, Civil Code). Lender's Name Lender's Address By 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 firs application and the information I have provided is correct. E agraj to comply with all applicable city and c unty ordinances an fs laws "rill o building construction. I auth xize repre entaives of this city or co to enter the ve-ide property for inspection purposes. Bigr.atura of Property Owner or Authorized A BI Print Properlyowner's or Authorized Agent's Nam koit-- Da / L At,T101+ DATE BY ° D - RATI F COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY - TIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PrPh9 XPiRED _ iiLJ I SUBMITTED ASBFST05 NOTIFICATION TO _ ..._.- .._..__--_ —( P'FTI AACECCFD ii ��-rEpq LIAQMD MASSES FOS NOT IHCArION 15 Nof APPLiCA13i TO L�f r,F CA,E OF 1�W1 f/�� f PROPOSED DEMOLITION OU-4-FIAVCY155UED i SIGNATURE: