HomeMy WebLinkAboutH2023-0789 - Permitsy E Po",
City of Newport Beach McChafllCai Permit H2023-0709
III I I I I II
C�- p Community Development Department- Building Division
a1 ^len 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No
Permit Counter Phone: (949) 718-1888
Work Class : Other
newportbeachca.gov/civic
cy� Foa��r Issued : 12/19/2023
_ Inspection
Area :6
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 : 2728 WINDOVER DR Legal Deed: N TR 6113 BLK LOT 64
Description: MECH REMOVE AND REPLACE FURNACE SAME LOCATION IN GARAGE
Owner: DIVINCENZO JOSEPH P TR JPDV TR
Address : 2728 WINDOVER DR 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:
Contractor : SADDLEBACK PLUMBING INC
Address :
23901 REMME RIDGE LAKE FOREST, CA 92630
Phone :
(949) 829-0910
Con State Lic
: 414946
Lic Expire:
01/31/2024
Bus Lie :
BT30076374
Bus Lid Expire:08/24/2024
Workers' Compensation
Insurance
Carrier:
INSURANCE COMPANY OF THE WEST
Policy No :
WPL507192900
W. C. Expire :
7/1/2024
Code Edition : 2022 Fire Hazard Zone :. NO - Manufacturer
Type of Construction : Model# :
Occupancy Groups:
Building Setbacks : Front: 12, Side: 6, Side: 6, Rear: 6
Flood Zone: X
Use Zone : R-1-6000 - Single -Unit Residential (6000 indicatesminimum lot area)
PROCESSED BY: -
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from. the Contractors' State License Lawfor the reasons) indicated below by the checkmark(s) I have placednext to the applicable items)
3ecllon 7031.5. Business and Professions Code: Any city or county trial requires a'permit to construct, alter, improve, demolish, or repair any stricture, prior 'toIts issuance; also requires the applicantfor
ua permit to rile a signed stalonicnt that. he or she is licensed pursuant to the provisions of the Contractors' $taco License Law (Chapter 9 (commencing with Section 7000) of Division 3.of the Business and
rofesslons Code) or that he or she is exempt from licensors 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
at 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 15 not Intended'oroffered for sale (Section 7044,
usiness 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
iprovemants are not Intended or offered for sale. If, however, Ilia 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
cproved for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors to conssIrurt Die project (Section 7044, Business and Professions Coder The Contractors' State LicenseLawdoes noL
pply 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 licensore underthe Contractors' State License Law for the following reason
y my signature below.I acknowledge that, except for my personal residence in which I must have rosidadfor at least.ona year prior to completion of the Improvements covered by this. permit, I cannot legal])
all astructure that I hive built as an owner-bullder If It has not been constructed In its entirety by licensed contractors. I understand that a copy of the applicable low, Section 7044 of the Business and
rofesslons Code, is available upon request when this application Is submitted or at the following Web site:http•llwww.legirifo-ca.govlcsiaw.html..
Ignature of Property Owner or Authorized Agent _ -_Doe _
ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am Ileeiisad under provisinns of Chapl'er9 (commencing with Section 70(�i}). f' "vi i - oftheBusiness and ea:Crr0 a, and my license is in full force
ad effect. License Class License No Date L Contractor Sigl hare
✓ORKERS' COMPENSATION DECLARATION el
ARNING: FAILURETO SECUREWORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUSJECTAN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,,000), IN ADDITION TO THE
DST OF COMPENSATION, DAMAGE'S AS PROVIDED FOR III SECTIONa7aS OFTHELASOR-CO➢E NTER.EST, AND ATTORNEVS FEES.
hereby affirm under penalty of perjury one of'the following declarations:
I I have and will maintain a certificate of Consent (a.self-insure for workers' compensation, Issued by ,the Director a( Industrial' Relations as provided for by Section 3700 of Ilia Labor Code, for lh
fcfformance of the work for which this permit is Issued. Policy No.
have and Alit maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of (he. work for which this permit Ts Issued. My workers'
ranee carrier and policy number are:
is of Agent,
Certify that, in theperformance of the
, If Ishould become subject to{t
of Applicant
Policy Number
Date
for which this permit is issued, I shall not employ any personin any manner so as to become subject to the workers' compensation /laws of California, and ogre
compensation provisions of Section 3700 of the Labor Code, I shelf rorlhwith comply with those provisions
hereby affirm under pe�iaW)-oP>er}u here is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
tinder's Name Lenders Address,._,____._,_,
y my signature b certify to each of the following;'
I am the property: owner or authorized to act'. on die property owner`s behalf.
have read !his arplication and the information I have provided is correct.
I agree to comply •vithall applicable city and county ordinen .s and state laws. relating to building construction.
I authorize representatives of this city or county to an a above identified pia arty for Inspection purposes. ,
,ionadre of F,oDer v Owner or Authorized Acant � Print Prooertv Owner's or Authorized AGent's Name L Vv
ACTION. DATE BY 10ECL OF COMP LIANCE WITH CODE OF FEDERAL FOR OFFICE 111E ONLY
LATIO'NS PART'61 OFTITLE 40 AND AC MD RULE
403
PE9t41TENPIRED iLJ ISUBNfl7rEO ASBESTOS NOTIFICATION TO
F` ! 11T EMEPIOED� - — �__
f_`117FINAL q* 1 MASRESIO$NOIIHCA7IQN'63 NOT APPLICABLE TO
CERTIF CATE 0' UG i PROPOSED DEMOLITION
OCCIIPAplCY ISSUED rry."j I SIGNATURE: