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Home My WebLink AboutH2023-0011 - Permits�,r�wponr. City of Newport Beach 0 9 Community Development Department - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-3288 Inspection Requests Phone: (949) 644-3255 O'<IFoaN�r,y' newportbeachca.gov/inspections Mechanical Permit Plan Check No: Work Class : Other Issued Date : Inspection Area : 5 H2O23-0011 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: 4621 TREMONT LN Legal Desc : N TR 3357 BLK LOT 90 Description: MECH - R/R F.A.U. & DUCTWORK Owner: JACKSON JOHN E TR Contractor Address: 4621 TREMONT LN CORONA DEL MAR, CA 92625 Address : Phone Applicant: SOCALAIRFLOW PROS Address: 29816 AVENIDA DE LAS BANDERAS RANCHO SANTA MARGARITA, CA 92688 Phone: (949)303-5525 Owner/Builder: Address Phone: Code Edition : 2022 Type of Construction Occupancy Groups: Building Setbacks Flood Zone Use Zone: PROCESSED BY: Fire Hazard Zone : NO Front: 6, Front: 30, Side: 6, Side: 6 X R-1-6000 - Single -Unit Residential (6000 indicates minimum lot area) SPECIAL CONDITIONS: Phone: Con State Lic Lic Expire Bus Lic : SOCIAL AIRFLOW PROS 29816 AVENIDA DE LAS BANDERAS RANCHO SANTA MARGARITA, CA 92688 (949) 303-5525 1010956 01/31/2025 BT30055229 Bus Lic Expire:05/31/2027J Workers' Compensation Insurance Carrier : AMERISURE MUTUAL INS CO Policy No: WC21221200002 W. C. Expire: 12/1/2023 d s i Manufacturer Model# : 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) 1 have placed next to the applicable item(s) Section 7031.5. Business and Professions Code: Any city or county that requires a permit tD construct, alter, improve, demolish, or repair any structure,prior to its Issuance; also requires the applicant for to 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 rofessions 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 fora permit subjects the applicant to a civil penalty of at more than five hundred dollars ($500). ] 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 offerad for sale (Section 7044, usiness 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 nprovements 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 nproved 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 ly to anowner 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 am exempt from licensure under the Contractors' State 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 legall, all 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 'rofessions Code, is available uponrequest when this application is submitted or at the following Web site:bttp:/lwww.leginfo.ca.govlcalaw.html,. ignature of Property Owner or Authorized Agent Date _ .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) othe Business and Professi Code, a se Is in full torte no effect. License Class License. No Date / -!�` Contractor SignaWr VORKERS' COMPENSATION DECLARATION 'ARNING: 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 ($100,000), IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, ANDATTORNEY'S FEES, hereby affirm under penalty of perjury one of the following declarations: 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 ,��,��r��f�orTrance of the work for which this permit is. issued. Policy No. 'llL�rrve 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 Isu nce carrier and policy number are: a�iSir Policy Number Expiration Date Jame of Agent Phone ff :11 certify that, in the performance of the work f Lwhich this permit is issued'.. I shall not employ any person in any manner so as to become subject to the werke�mpensatlon laws of California, and agre 'tat, it) should become subject to thew rs' compensation provi'• ion 3700 of the Labor Code, I shall forthwith comply with those provisions. (_ signature of Applicant _ a YECLARATION iZEGAR NG ON LENDING AGENCY hereby affirm under penalty o ry that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). .enders Name Lender's Address _ iy 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 provi correct. I agree to comply with.. all applicable city and county or anees and state laws relating to building. construction. I authorize representatives of this city or county to entar bove-identifi y for inspection purposes. C Z� 3iljnalure of Property Owner or Authorized A Print PropertyOwner's or Authorized Agent's Name �C Dale ACTION DATE B RATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY , RECULATIONS PART fit OFTITLF. 40 AND ACMD RULE i 1403 PERMIT EXPIRED I SUBMITTED ASBESTO5 NOTIFICATION TO FERMI TENDED �gMD PEEN PERMIT FINAL y� UAiBESfOr NIITtFICfTrON IS NOT APPLICABLE TO CERTIFICATE OF ^G PRJi USED OEMOLl i ION OCCLIPANCY 15SUEO SIGNATURE: