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Home My WebLink AboutH2023-0170 - PermitsBeach D��EWPpQ � City of Deelopoir Department -Building Division II1I I I IIII II I I I II II II Mechanical Permit : H2023'U170 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: n Permit Counter Phone: (949) 644-3288 Work Class : Other u w T Inspection Requests Phone: (949) 644-3255 c9�/FpRN�P newportbeachca.gov/inspections Issued Date : e3/10/2923 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: 1 CATANIA Legal Desc : N TR 15�LK LQQ�� 17 TRACT NO 15705 LOT 17 POR OF LOT Description: MECH - R/R 2 F.A.U. & 2 A/C CONDENSERS W/COIL. TAO��E IPNp TI� P REQ'D Owner: TAGHAVI REZA TR R �,�ti ,OQ• v Contractor: ROCKLIN HEATING & AIR Address : 1701 QUAIL ST STE300 NEWPORT BEACH, CA Address : 5706 LONETREE BLVD ROCKLIN CA 95765, CA 95765 Phone : ssP Phone : (916) 626-5151 -IV v Con State Lic : 959466 Applicant: ROCKLIN HEATING & AIR j0 Lic Expire : 09/30/2023 Address : 5706 LONETREE BLVD ROCKLIN CA 8 CA 95765 Bus Lic: BT30074728 Phone: (916) 626-5151 Bus Lic Expire:03/31/2023 Workers' Compensation Insurance Owner/Builder : Carrier : EMPLOYERS PREFERRED INS CO Address : Policy No : EIG4913614 Phone: W. C. Expire: 1/1/2024 Code Edition : 2- sl- D Fire Hazard Zone : YES Manufacturer: CARRIER Type of Construction : �� Q��IgITE Model# : 24SCA5 Occupancy Group1�1lpVA' pP-1 C /��° Building Setbacks : 0P VAEX ° u�P� Flood Zone : � Use Zone: PC - Newport Coast PROCESSED BY: Nh SPECIAL CONDITIONS: v OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I. am exempt from the Contractors' State License Law for the resson(s) indicated below by the checkmark(s) I have placed next to the applicable items) ;Serlion 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 file a signed statement that he or she is licensed pursuantto the provisions of the Contractors' State License Law (Chapter 9 (commencing with $action 7000) of Division 3 of the Business and crofessions 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 lot more than five hundred dollars ($500).. 1 1, 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 is not intended or offered for sale (Section 7044, 3ustness and Professions Code: The Contractors' State License Law does not apply to anowner of property who, through employeas' or personal effort, builds or improves the property, provided that the mprovements 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 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). 'L7 i am exempt from licensure 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 feast one year prior to completion of the improvementscovered by this permit, I.cannot legally sell a structure that I have built as an owner -builder If It has not been constructed in its entirely 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:htip;Uovnv.leglnfo.ca.gov/calaw.html. Signature. of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section.7000) f vis)on 3 of the Business and Professlo od y license is in full force and effect. License Class License. No Date: Contractor Signatur�iL WORKERS' COMPENSATION DECLARATION NARNING: 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 (E100,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: have and *0 maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relatioife.asprovided for by Section 3700 of the Labor Code, for thl PRromIgpoe of the work for which this permit is issued. Policy No. and will maintain warners' 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: Policy Number of Agent Date 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 subject to the workers' compensation laws of California, and , 111 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shallforthwith comply with those provisions. of Dal,._. 3/0/2a 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). .enders Name Lender's Address ty 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 ordinances and state laws relating to building construction. I authorize representatives of this city or county to ant ttr above -identified property for inspection purposes. Signature of PrODertv Owner or Authorized AgenP1l _!; - V F' c Print Property Owner's or Authorized Agent's Nanv--rsA Date ACTION DATE BY \ DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY - r Rf.GULA71ONS PART 51 OF TITLE 40 AND AQMD RULE 1403 PEANUT EXPIRED' I SUBMITTED ASBESTOS NOTIFICATION TO _ PERMITCANCELCED OEPA PERMIT EXTENDED QM D PERMIT FINAL �/(0/0 I� r�. e DLTor('IA,�I t ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: d 3 0 F7 j 31 IN c O J'V n