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H2024-0204 - Permits
D �WCoaT City of Newport Beach II I I I II I I II II II I I II II II Mechanical Permit : H2U24-OZU4 e Community Development Department - Building Division > y 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: `� i Permit Counter Phone: (949) 718-1888 Work Class : Other newportbeachca.gov/civic Issued Date: 04/11/2024 Inspection Area : 2 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: 204 ONYX AVE, 1/2 Legal Desc : A TR BALBOA ISLAND SEC 4 BLK 12 LOT 3 Description: MECH INSTALL HEAT PUMP **TAMPER RESISTANT CAPS REQUIRED & TIMERS PROHIBITED** Owner: PAULSACKMAN Address : 204 ONYX AVE NEWPORT BEACH, CA 92662 Phone: (949)533-3751 Applicant: BEN MEDINA Address: 31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362 Phone: (818)735-7876 Owner/Builder : Address Phone: Code Edition : 2022 Fire Hazard Zone : NO Type of Construction Occupancy Groups: Building Setbacks : Front: 7, Side: 3, Side: 3, Rear: 5 Flood Zone : X Use Zone : R-BI - Two -Unit Residential, Balboa Island PROCESSED BY. 85 SPECIAL CONDITIONS: Contractor : TRUE HOME HEATING A/C Address: 4 FARADAY IRVINE, CA 92618 Phone: (949)382-6337 Con State Lie : 1025397 Lie Expire : 04/30/2025 Bus Lie: BT30064629 Bus Lie Expire:10/31/2024 Workers' Compensation Insurance Carrier : TRAVELERS PROPERTY CASUALTY CO OF AMERICA Policy No: UB9S682838232SG W. C. Expire: 12/1/2024 Manufacturer: LENNOX Model#: MPCO24S4M-1P TIMERS PROHIBITEDDJ ®N HEAT PUMPS,,,,, OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicatedbelow by the checkmark(s) I have placed next to the applicable Item(s) 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 is permit to ftla a signed statement that he or she is licensed pursuantto the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Irofessons Code) or that he or she is exempt from licensure 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 at more than five hundred dollars ($500). 3 I, as owner of the property, or my employees with wages as their sole compensation, will do U all Of or L) 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 nprovement , 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 reproved for the purpose of sale). 1 I, 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 (poly 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 lcensure 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, 1 cannot legally ell a structure that I have built as an owner -builder If It has not been constructed in itsentirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and (rofessions Code, is available upon request when this application is submitted or at the following Web sits:http:/lwwW.leginfo.ca..gov/calaw.html. Signature of Property Owner or Authorized Agent Date JCENSED CONTRACTOR'S DECLARATION hereby affirmunder penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7t 3Q of Di a offn of the Business and ProfessiG and my license is in full force and effect. License Class License No Date "'[ 1+- - Contractor Signal VORKERS' COMPENSATION DECLARATION 1ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 15100,0001, IN ADDITION TO THE :DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: -11 have and wRl 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, erjQrmance of the work for which this permit is issued. Policy No, 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' carrier and policy number are: as of Agent certify that, in the performance of , if i should became subj lature of Applicant ect e Policy Number Date work 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 agre, rkers compensation provisions of Section 3700 of the Labor Code, Ishall forthwith comply with those provisions. Date_ `CI IrTlnu I cuniur nn_cllry ,reby affirm un er 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). Ider's Nam Lenders Address my signature heluw, I certify to each of the following. I am 'he property owner or authorized to act on the property owners behalf, I h1V9 read tins application and the information I have provided is corr I agree to comp.y wizh.. all applicable city and county ordinanc tl state laws relating to building construction. I Pvtlmrize reprusentalives of this city or County to ent e above -identified property for inspection purposes. nature of Pronr+rty OVvner or Authorized Agent _._ Print Property Owner's or Authorized Agent's Name DATE ( * DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL I FOR OFFICE USE ONLY REGULATIONS PART 51 of TITLE 40, AQMD Rl1LF. PFRVdT FXPIRfO LJ I SUBMITTED ASBESTOS NOTIFICATION TO "F.RMIT, ANCELt Fn) I ©EPA CP%'1 XTENDED LJAQmD P'F..41 FINAL P/ ❑ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATE OF `�5 ,'rli JI` PROPOSED DEMOUTION OCCUPANCYISSUED l 1 SIGNATURE: Date ` (r I