The URL can be used to link to this page

Home My WebLink AboutH2022-0526 - Permitso ��waoar City of ewport Beach Community Development Department - Building Division > 100 Civic Center Drive, Newport Beach, CA 92660 Permit Coun er Phone: (949) 644-3288 �s. 2 Inspection Requests Phone: (949) 644-3255 °gc�roaN`P newportbeachca.gov/inspections Mechanical Permit Plan Check o Work Class : Other Issued Date Inspection Area : 3 H2O22-0526 10950 1-1 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE NO CONSTRUCTI N RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS Job Address: 20475 UPPgR BAY DR Legal Desc : N TR 6407 BILK LOT 2 Description: MECH - INS ALL HEAT PUMP. TAMPER -RESISTANT CAP REQUIRED Owner: JORDAN FELT Address: 2800 W OCEA FRONT NEWPORT BEACH, CA 92663 Phone: Applicant: BEN MEDINA Address : 31225 LA BAY DR WESTLAKE VILLAGE, CA 91362 Phone: (818) 735-787 3 Owner/Builder : Address Phone : Code Edition : Type of Construction Occupancy Groups: Building Setbacks : F. Flood Zone : X Use Zone : S PROCESSED BY: SPECIAL CONDITIONS Fire Hazard Zone : NO Contractor : HIS HOME SERVICES Address : 1501 WESTCLIFF DR NEWPORT BEACH, CA 92660 Phone: (949)877-2821 Con State Lie : 1077757 Lie Expire : 07/31/2023 Bus Lie: BT300768818 Bus Lie Expire:02/28/2023 Workers' Compensation Insurance Carrier: CLEAR SPRING PROP & CASUALTY CO Policy No ; CWC00016801 W. C. Expire : 6/16/2023 Manufacturer : AC PRO Model#: AOE30U-60HFN1-MRO 20, Side: 5, Side: 5, Rear: 25 TIMERS PROHIBITED Santa Ana Heights Specific Plan ON HEAT PUMPS FER TO X2021-1085 FOR DUCTS, FAU, AIR HANDLER, DISCONNECTS 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 to the applicable hem(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 the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 70DO) of Division 3 of the Business and Professions Code) or that he or she is exempt from lioensure 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 not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do I_) all of or (_) 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)_ 0 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 improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ 1 am exempt from lioensure under the Contractors' State License Law for the following reason: By my signature below I 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, I cannel legall; sell a structure that I have built as an owner -builder If it has not been constructed in its entirety by licensed contractors. I understand that In copy of the applicable law, Section 7044 of the Business and Professions Code, is available uponrequest when this application is submitted otat the following Web site:http://www.leginfo.ca..gov/calaw.html. Signature of Property Owner or Authorized Agent Dale _, LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 ) of D'ri ' 3 of the Business and Prof aloha ode R y Rcense is in full force and effect License Class License No Da� Contractor Signalur WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORHERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (6100,000), IN 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 fallowing declarations: 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 ice 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' compensa carrier and policy number are: Agent certify the(, in the performat If I should become subject lalure of Applicanld Policy Number Expiration Dale Phone N work for whi - permit is issued, I shall not employ any person inany manner so as to become subject to the workers' compensation laws of California, and agre 'ker Tlpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. rr// -.... _. .,- Date 2 ICTION LENDING AGENCY ereby affirm under penalty of perjury that thereis a construction lending agency for the performance of the work for which this permit Is issued (Section 3097, Civil Code). ides s Name Lender's Address my signature below. I certify to each of the following: I am the property owner or authorized to act on the property 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 Drdin eas and state laws relating to building.. construction. 1 authorize representatives of this city or county to enter the ve-idenfifle inspection purposes. nature of Property Owner or Authorized Anent _ Print Property Owner's or Authorized Arent's Name L,F.N' l A /'ter Date ACTION DATE H7172ATf.ON OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMO RULE ( 1403 PERMIT rxpu?pD I SUBMITTED ASBESTOS NOTIFICATION TO PERMiFCANCEUED DEPA PERMIT EXTENDED D PERMIT FINAL ASMSTOS NOTIFICATION 15 NOT APPLICABLE TO CERTiFiCATE OF Q 125 1 ! ' PROPOSED DEMOLITION OCCUPANCYI55UE➢ SIGNATURE: