HomeMy WebLinkAboutX2022-1774 - Permits�EWPO�T
City of Newport Beach
� . 10
Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
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Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
newportbeachca.gov/inspections
II II II II COMB Permit
: X2O2,2-1774
Plan Check No :
1623-2022
Combination Type
Work Class : Other
Issued Date : 07111/2022�
Inspection Area:
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 : 21119 NEWPORT COAST DR Legal Desc :
Description: COMM - R/R 2 ROOFTOP 5 TON HEAT PUMPS FOR SHARKY'S
Owner: IRVINE COMPANY LLC
Address : NEWPORT BEACH, CA 92658
Phone:
Applicant: LUIS RAMIREZ
Address : 1702 W FIFTH ST SANTA ANA, CA 92703
Phone:
Code Edition :
Type of Construction
Occupancy Groups:
Bldg Height:
Building Setbacks
Flood Zone
Use Zone :
Processed By:
Zoning Approval:
Grading Approval:
Contractor: CHANDLERS AIR CONDITIONING & Architect:
REFRIGERATION
Address
Phone:
Con State Lic:
677263
Lic Expire :
09/30/2023
Bus Lic :
bt30049105
Bus Lic Expire:
11/30/2022
Workers' Compensation
Insurance
Carrier:
Policy No
W. C. Expire
Fire Sprinklers :
Fire Hazard Zone
No of Units :
No of Stories
NO
N
Public Works Approval:
Plan Check By:
Approval To Issue:
Address
Phone:
State Lic
Engineer:
Address
Phone:
Designer:
Address
Phone:
Construction Valuation :
Added/New sq. ft. Bldg : 0
Added/New sq. ft. Garage: 0
0 Ow
SPECIAL CONDITIONS:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next io the applicable iterri(s)
(Section 7031.5, Business and Professlons Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, Imor to Its Issuance, also requires the applicant for
the permit to fife 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)cf Division 3 of the Buslness and
Professions Code) or that he or she is exempt from fuensure-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
not more than five hundred dollars ($50D).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_)all of or L) portions of the work, and the structure Is not intendedor 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, II 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),
❑ 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
apply to an owner of property who builds or improvesthereon, and Whe contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law),
E I a n exempt from lcensure under the Contractors' Slate License Law (or the following reason:.
By my signature below I acknowledge trial, except for my personal residence in which I most have resided for at least oneyear prior to completion of the improvements covered by this. permit, I.cannot legally
sell a structure that t have built as an owner -builder if It has not been constructed in its entirety by licensed contractors. I understand that n copy of theapplicable law, Section 7044 of the 'Br mess and
Professions Code, is availableuponrequest when this application is submitted or at the following Web site: hhip flwn w,leginfo ca.govIcalaw.btml.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalt'j of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) o Ivl on 3 f Business and Prol scions C fAe'„a'nd my i, a is In full farce
and effect. License Class License No Date ntraGOF Signatd `
WORKERS` COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE, IS UNLAWFUL, AND SHALL SUBJECT AN eMPLOVER' TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONEHUNDRED!HOUaAND LAR315100„000), 3N ADDITION TO THE
COST 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:
haveand will maintain a certificate of consent to self -insure for workers' Compensation, issued by the Director of Industrial Relations as provided for by Beclloh 3700 of the Labor Code, for ih,
rf manta of the work for which this permit is issued. Policy No.
I h ve and will maintain workers' compensation insurance, as'�requlmd by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued, My workers' compensatior
Ins nce carrier and policy number are:
Policy Number
of Agent
Date
LJI certify that, In the performance of the work for whit) -. -1 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
that, If I should become s of ct to the war comp s. on 'sions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Slgnaflure of Applicant Dat
DECLARATION REGA IN RUCTI LENDIRG A ENCY 7
I hereby affirm under penalty o perjurytha ere Is a cons ction 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 the 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 with all applicable city and county ordinances and s - vs relating to building construction,.
I authorize representatives of this city or county to enter the ad property for inspection purposes.
SI nalure of Pre arty Owner or Authorized Agent-, Print Property Owner's or Authorized Agenl'S Name //`�-���'/,%'v (,� Date
ACTION DATE By CCL IqN OF COINPLIANC4 WITW CgpE OF FEp EpAL �FGR OFFICE USE ONLYREG LATICIN5 PART ES OF TITLE 40 AND AQMD RULE
i4U3
PERNT)l FXPIREO I SUBMITTED ASBFST05 NO7i FICATION TO
PER,WCTCAAICELLEO - EPA All required alarms, latchesgates and fences which serve as part of a poollspa barrier, shall
PERNliTEXTErvOED ) OMD. be In place prior to approval to fill pool/spa & shall remain In place & be maintained for the
PERiN1TFJNAL (j -$f iZ} c ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO life Of the pool.
CERTIFICATE OF (r5 I SGNOSEDEDEMOLITION
OCCUPANCYfSSUED