HomeMy WebLinkAboutH2023-0644 - Permits42�WPORT
City of Newport Beach
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Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 718-1888
newportbeachca.gov/civic
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CI FO RN
Mechanical Permit
Plan Check No :
Work Class : Other
Issued Date: 1010512023
Inspection Area :1
H2O23-0644
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 : 212 29TH ST, B
Description : MECH - R/R FURNACE IN CLOSET
Owner: 212 29TH STREET PROPERTY LLC
Address : 212 29TH ST NEWPORT BEACH, CA 92663
Phone:
Applicant: COASTAL HEATING & COOLING INC
Address : 21418 SILVER SPUR LN WILDOMAR, CA 92595
Phone: (949)482-2599
Owner/Builder :
Address
Phone:
Code Edition : 2022
Type of Construction
Occupancy Groups:
Building Setbacks : Front: 5, Side: 3, Side: 3, Rear: 5
Flood Zone : X
Use Zone :
PROCESSED BY:
SPECIAL CONDITIONS:
Legal Desc : A TR LAKE TR BILK 128 LOT 7
Fire Hazard Zone : NO
Contractor : COASTAL HEATING & COOLING INC
Address :
21418 SILVER SPUR LN WILDOMAR, CA 92595
Phone:
(949)482-2599
Con State Lic
: 1045446
Lic Expire :
01/31/2025
Bus Lic :
BT30080419
Bus Lic Expire:D1/31/2024
Workers' Compensation
Insurance
Carrier :
SIRIUSPOINT INS. COMPANY
Policy No :
WC78187
W. C. Expire:
7/15/2024
Manufacturer
Model# :
OWNER -BUILDER DECLARATION
I hereby affirm under penalty or perjury that I am exempt from the Contractors' State License Law for the resson(s) indicated below by the checkmarkls) 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 filea 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
'rofasslons Code) or that he or she is exempt from licensure and the basis for the alleged exemption.. Any violation of Section 7031.6 by any applicant fora permit subjects the applicant to a civil penalty of
iot more than five hundred dollars ($500).
1, 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 notintended 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 properly, 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
mproved for the purpose of sale).
❑ I, as owner of the property, am exclusively contracting with licensed Contractors t0 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).
I am exernt from licensure under the Contractors' Slate
p License Law lor the frillowirip reason.
By my signature below I acknowledge that, except for my personal residence inwhich I must have resided for at least one year prior to completion of the Improvements covered by this permit, I cannot Iegall)
self a structure that 1 have built eS an ➢caner -budder 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:tlwww.leginfo.ce.gov/calaw,html.
Signature of Property Owner or Authoriznrt Agent ._ Delp
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions Of Chapter 9 (Commencing with Section 7 0) of D'visi 3 of the Business and Professio(�s.4od�aPd my license is in full force
and effect. License Class License No - I I--=—"�'ainar re 1^,,//�� ��
WORKERS' COMPENSATION DECLARATION'S
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE le UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS IE100,0000N ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AN➢ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
0 1 have and will maintain a certificate of consent to self -insure for Workers' compensation, issued by the Cirector of Industrial Relations as provided for by Section 3700 of the Labor Code, for th
performance of the work for which this permit is issued. Policy No.
yarfretie and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. My workers' compensatiol
Iisulance carrier and policy number are:
Carrier Policy Number Expiration Date
Name of Agent Phone #
❑I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subjectto the workers` compensation laws of California, and agre
Thal, if I should become subject to work �compensation provisions of Section 3700 of the Labor Code, I shall. forthwith Comply with those provisions
Signature of Apphcan
bECLARATfON RE -C N9TR CT1tlN LENDING AGENCY
I 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).
Lender's Name -Lender's Address _
By my signature below, I certify to each of the following:
I am Ilia property owner or authorized to act on the properly owner's behalf,
I have read this application and the information I have provided is Correct.
I agree to comply 'nthall applicable city and county ordinances and state laws relating to building construction.
I authonae representatives of this city or county to enter the Bove= ' led property for Inspection purposes. /- w ,� `J `
Signature of PP � dt Owner or Authorized A" lint EMMIMEEBS!Print Proper Owner's or Authorized A ents Name I q' � by
ACTION DATE RY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
'.. RFC10LATIONS PART 51 OF TITLE 40 AND AQMD RULE
1403
PERNIIr lXPWL0 ;j --( LJ 15URMITTFD A5HFSTOS NOTIFICATION TO
PERMI T CAW-, U FJ I
PERMIT FINAL J �� /�' PROPOSED
NOl ITION ON 15 NOT APPLICABLE TO
CERTIFICATE OF / PROPDSEt)'f)FMOLITION
OCCUPANCY ISSUED i SIGNATURE: