HomeMy WebLinkAboutH2022-0728 - Permits,EWPoRr City of Newport 'Beach
p @ Community Development Department - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
i Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
°g4FoaN`P newportbeachca.gov/inspections
Mechanical Permit : H2022-0%28
Plan Check No
Wor"I s : Other
Date
2
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LASTVALID INCTI T NO LATER THAN 3 YEARS FROM R
NO CONSTRUCTION RELATED NOISE ON SATURDAY OR NDAY IN HIGHO ITY AREAS AND NO WORK ON SUN DAY
Job Address: 404 ORION WAY Legal Desc : N T' 92 BLK LOT 71 TR 4692 LOT 71 TOGI�WITH AN
Description: MECH NEW A/C UNITXONOF�*T71R PROOF CAP REQ`" _^
Owner: CARTER FIELDS
Address : 404 ORION WAY
Phone : (949) 727-637V
Applicant : A PLUa4
Address: 113 0-Kt
Phone: (714
Owner/Builder :
Address
Phone :
Code Edition :
Type of Construction
Occupancy Groups:
Building Setbacks
Flood Zone
Use Zone :
PROCESSED BY:
Contractor :
Address: IC
Phone t ->"^
Con State Lic
.Lic Exire
BUS Llc 1:,��
Bus Lic Expire
Workers' Coml
Carrier :
s Policy No .
W. C. pire :
2019 Fire Hazard Zone : NO
X
RM - Multiple.Resldenti n
SPECIAL CONDITIONS:
I, CA 92663
RAL WNTRACTORSINC
12EET GARDEN GROVE, CA 92841 j
'54
1/2023
)08 7
31NAL ISSUANCE DATE
D HOLIDAYS IN ALL AREAS
/9 8 INT IN
Manufacturer: LENNOX
Model# : SL28XCV
CA 92841
owN•ER_eulOt7ER DECLARATION _ a autos state u�cns� Lmw ror tnm rem (a) indicated befc y the checkmark(s) I have placed next to the applicableitem(s)
Ilion 7G31.5^Bu5lruess aSld T iDtemSlOnS Cotle' Any city or collnl} that requVes a permlt to consllVCS, 91ter - prove. GemoPsh, p2" any sl'u tui'e, prior to its i%uaOCE, 3ISD tegUlfES the apPHCanI for
pDrmst to (le a signed statemont that. he or she is licensod pursuant. to the provisions of tho Gontragtor late n Onseof Set Lev , an ornmpplencmg with permit
Section jests of Division n t the Business and
fesslons Cade) or that he or she is exempt from licensure and the basis for the alleged exemption. violation of Secti�o� 3i.5 by an pplicant for a permiE subjects the applicant {o a civil penalty of
more than five hundred dollars ($5D0). Oto
1, as owner of the propedy, or my em.Rloyeas with wages as thelrsole oompensation, will do a31 of oT��,) t h the work., d the struon re is not intended raves proffered for sale (Section d that
;mess and Professions Gode: The Contractors' State License Law does not apply to an o t Gf prop c y wh h IefI s' Or personal r, builds or Improves the property, provided fuel the
rrovemen[s are no# intended or offered for sale. If, however, the building or improvem Is sold q�ifn one ea o! compleli , the Owner -builder have the burden of proving that it was not built or
,roved lOf the purpose of sale). Q�
I, as owner of the property, am exclusively contracting with licensed Contractor o connt{ c f1i or (Sec# on 70 , Business and Professions Cod The Contractors' State License law does not
fly to an owner of property who bullds or improves thereon, and who contra or the pro)eL s wit {�anSadyC(�on ctor pursuant to the Contractors' Slat Ieense Law).
I am exempt front Iicensure under the Contractors Stale License Law fo a following reaso `
By my signature below I. acknowledge that, except for my personal To Id in whichJ must have esided least one year prior to completion of the improve..
soft a structure that I have built a$ an owner -builder If it has not been StntCted lmKs or iirefy by licens nifactors. I Understand that a copy of th. IIcable'
Professions Code, is available upon requestwhen this application - ubmitted7it the following `R'eb a:http:/JwWw.leglnfo.cSDgovlcalaw.hEm.
Signature of Property Owner or Authorized Agent -.-- — -
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am icense der prow s of Chapter 9 (Commending with Section 700 jof ivisi n 3:o a Hess and ure)
and effect. License Class _ Li ns "Date ZO it Dtor Signature
a�
VORKERS' COMPENSATION DECLAF
!ARMING' FAILURE TO SECURE WORKERS' OOMPENE
DST OF COMPENSATION, DAMAGES AS PROVIDED' F
hereby affirm under penalty of perjury p o
I have and will maintain a certificate of
rformance of the work for which this permit
have and will maintain workers p?nper
Tsurance canter and policy number are:
�.
OV G E THE LABOR
CO SHALL SVBT A AN EMPLOYER TO CRIMIN PENALTIES ANDCIVII
_/ Oa OF THE fABDR CODE, INTEREST, AND ATTORNEYS FEES
16. Ing declarations:
it to se't-insure lot workerscompensation, issued by the Diractor,pf)nd 'dl I
ad.. Policy No. _--.-- -- �{{��O
insurance, as required by Section 3700 of the Labor Code. for the pbYformance
Policy Number /
no ofAgent
certify that, in the perform. Catof-the,,ork for which this pemtit is issue, I shall not am,
if I should be e subject the Nc£Ekers' mpensuhon praxis�onS nt Section 0700
nature of Applica
CLARAT[ON RE AG CONS /UCTIO N NG AGENCY
�reby affirm and r penalty of perjury t{her nst`ructian lending agency -for thef{
iders Name
my signature below, certify to each of th allow " (~
1 am the property owner or authorized to act6�on the property owner s behalf. _
I have read this application and the informal: 1 have pro ' "s carro%,ya
I agree to compty with'. all applicable city and cp t Ord' d state`lews ifaIJ
I authorize representatives of this city or count ter t ve-identifl probe for
DATE
REGUL
1403
OF
Tit
TO ONE HUPOREC
s provided to
covered by this permit, I.cannot
option 7044 of the Business and
($400,000), IN ADDITION TO THE
Section 3700 of the Labor Code, for
work for which this permit is issued. My workers"
[lion Date _.
'person in any mann so as to ec a subject to the workers' pensation laws of California, and agre
Ir Code., I shall to ith con y these provisions.
Date
ce of t work Ito ON his permit is Issued lSection 3097, Civil Code).
as
rcc uction.
If Uryoses.
roperty Owner's or Authorized Agent's Name D
_ x
:EDEAAL I FOR OFFICE USE ONLY
RULE
PERMIT EXTENDED
r—t.aUm u
PERMIT FINAL
ASBESTOS NOTIFICATION IS NOT APPLICABLE 70
CERTIFICATE DF
PROPOSED' DEMOLITION
OCCUPANCY ISSUED
SIGNATLf