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Home My WebLink AboutH2024-0069 - PermitsrF�wr•o?, City of Newport Beach III I I I II I I II II II II II II II Mechanical Permit : H2O24-0069 Community Development Department- Building Division > y; 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No > Permit Counter Phone: : Other sisnewportbeachca.gov/civic Issued Date02211212024 Inspection Area : 8 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: 1224 PEMBROKE LN Legal Desc : N TR 3607 BILK LOT 5 Description: MECH - R/RAC CONDENSER & RELOCATE FURNACE IN ATTIC. TAMPER RESISTANT CAP REQUIRED Owner: OFFERNEST LLC Address : 555 ANTON BLVD, 150 COSTA MESA, CA 92626 Phone: (714) 235-3572 Applicant: A C COOL INC Address: 1116 W COLLINS ORANGE, CA 92867 Phone : (714) 720-3938 Owner/Builder : Address Phone: Code Edition : 2022 Type of Construction Occupancy Groups: Building Setbacks : Front: 20, Side: 4, Side: 4, Rear: 10 Flood Zone : X Use Zone : R-1 - Single -Unit Residential Fire Hazard Zone : NO PROCESSED BY SPECIAL CONDITIONS: RELOCATE AC CONDENSER & FURNACE TO ATTIC Contractor : A C COOL INC Address : 1116 W COLLINS ORANGE, CA 92867 Phone : (714) 720-3938 Con State Lie : 804056 Lie Expire : 01/31/2026 Bus Lie : BT30042073 Bus Lie Expire: 01131/2025 Workers' Compensation Insurance Carrier: SIRIUSPOINT AMERICA INSURANCE COMPANY Policy No: WC46234 W. C. Expire: 6/1/2024 Manufacturer: CARRIER Model# : 38MURA OWNER -BUILDER DECLARATION I hereby affirm underpenallyof perjury that I. am exempt from the Contractors' State License Law for the reaeon(s) indicated below by the checkmark(s) I have placed next to the applicable items) Section 7031.5. Business and Professions Coda: 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 10 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 7090) of Division 3 of the Business and 'rofesslons Code) or that he or she is exempt from iicensure and the basis for the alleged exemption. Any violation of Section7031.5 by any applicant for a permit subjects the applicant to a civil penalty of of more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sale compensation, will do U all of or (_,) portions of the work, and the structure is not intended or offered for sale (Section 7044, lusiness 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 I. as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale 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). I am exempt from licensors under the Contractors' State License Law for the following reason: _ __ ly my signature below t 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 legaly ell a structure that I have built asan owner-buildor If it has not been constructed in its entirety by licensed contractors. 1 understand that copy of the applicable taw, Section 7044 of the Business and Irofessions Code, Is available upon request when this application Is submitted or at the following Web site:hitp:/lwww.leginfo.ca..gov/calaw.html. Ilgnature 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) of Division 3 of the Business and Professio -ode,,, a. �ke�s fuliforce nd effect. License Class License. No Date 7 •r2't.o" Contractor Signature VORKERS' COMPENSATION DECLARATION \ 'ARMING: FAILURE TO SECURE WORXERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS lluD ee8), IN AODMON TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE., INTEREST, Me ATTORNEYSPEES. 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 th arfprmance of the work. for which this permit is. issued. Policy No.. we 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. rDe carri end pollDy number are: y2 / ✓ S Policy Number Expiration Date of Agent Phone If certify that. in the performanc It I should become so fee o iha lalure of Aeolicanl —� My workers' 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 coirlpgnsalyep prov sigps of Section 3700 of the Labor Code, I shall forthwith comply win those provisions. hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the. work for which this Derrell is issued (Section 3097, Civil Code). enders Name Lender's Address y 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 ordinances and state laws relating to building.. construction. I authorize representatives of this city or county tea the gyp/°v entif property for inspection purposes. Iicnature of Prooertv Owner or Authorized Agent / / /' / A. Print Prooertv Owner's or Authorized Aaent's Name 7 ACTION DATE BY - f DECLARATIONOF COMPLIAN¢E WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AO.MD RULE 1403 FERMI FXPIRED U I SUBMITTFD ASBF5TO5 NOTIFICATION TO PERMIT CANCELLED PERMIT EXTENDED ° 0-4ON1.D FCRMITFINAL /l,6j ASBESTOSEDDE NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF � PROPOSED �DEMOL1T10N OCCUPAPICYISSL'EO I SIGNATURE! Z • Z 02y 0