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Home My WebLink AboutH2024-0160 - Permits2EWPoR City of Newport Beach Dk Community Development Department- Building Division 0 r a }� 100 Civic Center Drive Newport Beach, CA 92660 n Permit Counter Phone. (949) 71B-1888 �3 S newportbeachca.gov/civic :at,i�,.:o^ Mechanical Permit Plan Check No: Work Class : Other Issued Date : 0312112024 Inspection Area : 5 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 : 315 DAHLIA PL Legal Desc : N TR 7789 BLK LOT 1 UN 1 TR 7789 LOT 1 UNIT 1 OF P Description: MECH CHANGE OUT ROOF MOUNTED A/C, FAU AND DUCT WORK *TAMPER PROOF CAP REQ* Owner: RICKER REBECCA M TR Address : 315 DAHLIA PL CORONA DEL MAR, CA 92625 Phone: Applicant: BEN MEDINA Address : 31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362 Phone: (818)735-7876 Owner/Builder Address Phone: Code Edition : 2022 Type of Construction Occupancy Groups: Building Setbacks : Flood Zone : X Use Zone : RM - Multiple Residential PROCESSED BY: SPECIAL CONDITIONS: Fire Hazard Zone Contractor : SERVICE CHAMPIONS HTG Address : 3150 E BIRCH BREA, CA 92821 Phone : (714) 777-7777 Con State Lic : 799170 Lic Expire : 10/31/2025 Bus Lic : BT01080105 Bus Lic Expire:07/31/2024 Workers' Compensation Insurance Carrier : EVEREST PREMIER INSURANCE COMPANY Policy No: RMBWC00054231 W. C. Expire: 8/1/2024 NO Manufacturer: LENNOX Model# : EL18XCU-036 r r r �, OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the CDmPBCs0rs' State License Law for the resson(s) indicated below by the checkmark(s) I have placed next to the applicable items) ;Sicl nn 7031.5. Business and Professions Code. Any city or county that requires a permit to construct, after, improve, demolish, or repair .any structure, prior to Its Issuance, also requires the applicant for :he pr.rmll to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' Stale License Law (Chapter 9 (commencing with Section 7000) of Division 3 of tho Business and 'rofasaons Code) or that he or she is exempt from Ilcensure 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 Tot more than five hundred dollars. (S500). I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all 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 that the improvements 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 improved for the purpose of sale). D. 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 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). ❑ 1 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 havo resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally <:II a structure (hat 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:htb //vvrw leglnfo.ca.gov/calaw.h4ml. Signature of Property Owner or Authori.-ced Agent._.._..._.�_ Date LICENSED CONTRACTOR'S DECLARATION r hereby affirm under penally of perjury Ittat I am licensed under provisions of Chapter 4 (commencing with Section 0 ) 'sjgn of ritl Business and Pro s ions and my license is in full force and effect. License Mass License NO Date �G 4ri:Dntractor Siynature NORKERS' COMPENSATION DECLARATION NANNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAw'PUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE NIINORto TN usANO DOLLARS (8100,'Pin, IN A00n10N To THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 370E OF THE LAGOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penally of perjury one of the following declaralions: 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 'ormence of the work for which this permit Is issued. Policy No.. 4_h8vo and will maintain ',workers' compensation insurance., as required by Section 3700 of the Labor Coda, for the performance of the work for which this permit is issued. My workers' ,urance carrier and policy number are'. Policy Number Name. of Agent Date 'LEI certify that, it 1 Lha performance of the work ter which INS permit Is issued, I p oy any person In any manner so as to become subject to the workers' compensation laws of California, and agre Thal. It should tLlx n. i= object to tfte woompanseuon prow eCYlon 3700 of the Labor Code., Ishall forthwith corniply with those provisions. Signatureof Ai.ph-lan ._. _....w ... ,._.._.. ____... oat 2( .. LECf ARATION Ri D T N LEN DING AGENCY by affirm under pen of al there Is a construction lending agency for the performance of the work for which this permit is issued. (Section 3097, Civl Code). I enders Name Lender's Address By my slgnaluir holow. I certify to each of the fulowing: I am the property owner or authorized to act Dn the property owner's behalf. I 1.8v0 read lnls aop6cafion and the Information I have provided is correct. I agree to comply with all applicable city and cpvr}Cy ordlnancc. a Icl state laws relati td % construction. C� / I authorize representatives of this city or con , enter the a ide roperty for inspection purposes. n.CTWN DATE 3'r i/(�l�+lrflptSION OF COMPLIANCE WITH CODE OF FEDERAL { FOR OFFICE USE ONLY j RI'LLIATIONS PART 51 OF TITLE 40 AND AOMD Rl1lF F 1'7M T LXP 2FD LJ I suHlvi TTFn A9RFiTOS NOTIFICATION TO I FR?,VTCANCNLED CPA __ PERMIT FY TFNDED �--r t_IAQMD PCRNr FILIAL j ZN ❑ASBESTOS NOI IHCATION 15 NOT APPLICABLE 'I'0 CERTIFICATE OF 4 Port O rD r'f Ui011TION OCCUPANCY ISSUED SIGNATURE