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Home My WebLink AboutH2023-0391 - Permits (3)�EWPo�r City of Newport Beach III I I II I III II IIII II D4 @ Community Development Department - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 ' ' z Permit Counter Phone: (949) 718-1888 newportbeachca.gov/civic 4 Mechanical Permit : H2O23-0391 Plan Check No: PC2022-2381 Work Class: New Issued Date : 06/14/2023 Inspection Area :4 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 : 421 VISTA ROMA Legal Desc : N TR 6996 BLK LOT 55 Description: MECH INSTL HEAT PUMP AT THE REAR YARD *TAMPER RESISTANT CAP REQ* Owner: VISTA ROMA LLC Address : 1807 PORT TIFFIN PL NEWPORT BEACH, CA 92660 Phone: (949)500-6546 Applicant: GROUND TO GABLE INC Address : 23151 ALCALDE STE C-8 LAGUNA HILLS, CA 92653 Phone: (949)395-8333 Owner/Builder : Address Phone: Code Edition : 2022 Type of Construction Occupancy Groups: Building Setbacks Flood Zone Use Zone : PROCESSED BY X R-1 - Single -Unit Residential SPECIAL CONDITIONS: Fire Hazard Zone : NO Contractor : GROUND TO GABLE INC Address : 23151 ALCALDE STE C-8 LAGUNA HILLS, CA 92653 Phone: (949) 395-8333 Con State Lic : 888721 Lic Expire : 12/31/2024 Bus Lic: BT30080636 Bus Lic Expire:02/29/2024 Workers' Compensation Insurance Carrier : EVEREST PREMIER INS CO Policy No: 7600020526231 W. C. Expire: 6/1/2024 Manufacturer: SAMSUNG Model#: A,1020BXJ2CH/AA ) fig Ali 01 dd� OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable items) ;Section 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 he 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 Crofess ons Code) or that he or she is exempt from Iicensure 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 rot more than five hundred dollars ($500),. 1 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) gill of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business 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 thatthe mprovements 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 mproved for the purpose of sale). ❑ h as owner of the property, am exclusively contracting with licensed Contractors to construct Elie project (Section 7044, Business and Professions Code: The Contractors' Stale License Law does not apply 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). El I am exempt from Iicensure under the Contractors' State License Law for file following reesen By 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 lergafl se[i a structurs 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:lfwww.leginfo.ca.govlcalaw.html, Signature. of Property Owner or Authorized Agent - .Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of per{ury that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No Date Contractor Signature COMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER To CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDREO THOUSAND DOLLARS ($100,00i IN ADDITION TO THE CST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 1705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: I 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 the erformance of the workfor which this permit is. issued. Policy No. have 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` ranee carrier and policy number are: Policy Number Expiration Date of Agent ]I certify that, in the performance of the work for which thispermit is issuad., I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre tat, if I should become Subject to the workers compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those previsions. nfrature of Applicant Date_,,. —. ECLARAT€OIN N REGARDING CONT,L' 3CTION LENDING__— AGENCY hereby affirm under penalty of perjury 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 _ y my signature baiow, I certify to each of the following: I am the property owner or authorized to act on the property owr er's behalf. I have read this �Dodralbori and the iiformation'I have provided is correct. I agree to complywith. all applicable city and county -ordinances and state laws relating to building construction. I authorize represeritouees of this city or county to enter the above -identified property for Inspection purposes. Signature of Property O'vnar or Authorized Agent Print Property Owner's or Authorized Ag ACTION DATE ( BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY > RFGLIIATION5 PART 61 of TITLE 40 AND At RUIF PERMIT kNr'IN'ED —� I SUBMITTHO AS6fiSTOS NOTIFICATION TO PERMIT CAA'CELLEO EPA PERMIT ENTENCED ACEMD PERMIT FfNAL LJ ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO CERTIFICATE OF 'I PROPOSED DEMOLITION OCCUPANCYISSUEO / SIGNATURE: