HomeMy WebLinkAboutH2022-0495 - Permits�EWPO,4T City of Newport Beach
Community Development Department- Building Division
y 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 644-3288
.ems. S Inspection Requests Phone: (949) 644-3255
c9��F00.N�P newportbeachca.gov/inspections
II II IIIIII Mechanical Permit
Plan Work Class k Other
Issued Date : 09/19/2022
Inspection Area : 3
H2O22-0495
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 : 29 CAPE ANDOVER Legal Desc : N TR 15012 BLK LOT 21
Description: MECH - R/R 2 FAUs & 2 A/C CONDENSERS. TAMPER -RESISTANT CAPS REQUIRED
Owner: MARK ADAMS
Address: 29 CAPE ANDOVER NEWPORT BEACH, CA 92660
Phone :
Applicant: BEN MEDINA
Address: 31225 LA BAYA DR, 213 WESTLAKE VILLAGE, CA 91362
Phone : (818) 735-7876
Owner/Builder :
Address
Phone:
Code Edition : 2019
Type of Construction
Occupancy Groups:
Building Setbacks
Flood Zone
Use Zone :
PROCESSED BY.
Front: 10, Side: 5, Side: 5, Rear: 10
X
PC - Upper Castaways
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SPECIAL CONDITIONS:
Fire Hazard Zone : NO
Contractor : ALPS AIR CONDITIONING & HEATING INC
Address: 1895 S SANTA CRUZ ST ANAHEIM, CA 92805
Phone : (714) 633-8892
Con State Lic: 667953
Lic Expire : 04/30/2023
Bus Lic: BT30047511
Bus Lic Expire:06/30/2023
Workers' Compensation Insurance
Carrier: INS CO OF THE WEST
Policy No: WSD506354500
W. C. Expire: 12/25/2022
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Manufacturer : AC PRO
Model# : AULD60W2
DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable items)
ction 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 applicant for
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
fesslons 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
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 (_) portions of the work, and the structure is not intended oroffered for sale (Section 7044,
linass 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
ply 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),
`l I am exempt from licensure under the Contractors' Stale License Law for the following reason
By 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 permit, I cannot
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, Section 7044 of the Business and
Professions Code, is available upon request when this application is submitted or at the following Web site.http:ffwww.leginfo.ca..gov/calaw.htmi.
Signature of Property Owner or Authorized Agent Data
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) o dvtsjon 3 of the Business and P and my license is in full fr
and effect. License Class License. No Data ,,� , , Contractor Sig turen/
NORKERS' COMPENSATION DECLARATION V \ I_( 111 vC` W )
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRADJtITFUSAND DOLLARS (E/0,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION e706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the fallowing declarations:
1 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
rmance of the work for which this permit is. issued. Policy No.
e 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' compensatiol
ns ante carrier and policy number are:
Lamer Policy Number Expiration Date
Name of Agent Phone H
711 certify that in the performance of the work for which thispermit 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
Ihat, if I should become subject to the rs CDmpensailDn prow on 0 of the Labor Code, I shall . forthwith comply with those provisions. r��Jf' I(�/ �f'�%
Signature of Applicant _ _ _ DA^^_ `�{ f `Av`�
DECLARATION REGl_XDMG C TION LENOIIJG AGENCY !/+
I hereby affirm and :jury that there is a construction lending agency for the performance of the work for which this permit is issued. ($action 3097, Civil Code).
Lenders 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 this application and the information I have provided is correct..
I agree to comply with all applicable city and county Ord"
rd hence state laws relating to building construction.
I authorize representatives of this city or county to ante, th above -identified pro spection purposes. pz q,
Signature of Property Owner or Authorized A en Print PropertyOwner's or Authorized Agent's Name r Date _l G�
ACTION DATE RY DE N OF COMPLIANCE WITH COD[ OF FEDERAL FOR OFFICE USE ONLY
.GIJIATIONS PART 51 OF TITLE 40 AND AQMD RULE
140E
P£RMiT£ WI) L1 I SUBMITTED ASRESTOS NOTIFICATION TO
PERMITCANCEUED 13EPA
PE.RA4I P EXTENDED�AQML
PERPOITFINAL Q,T n _I LI A113ES10S NDI'IFK ATION 15 NOT APPLICABLE TO
CERTIFICATE OF ( .�1:�711 -I_ PRGPOSED OLMOLD ION
OCCUPANCY155UED /(rF 1UJ F(rl�'SIGNATURE:
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