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Home My WebLink AboutH2023-0303 - Permits��EwPoRr City of Newport Beach p Community Development Department- Building Division ;? y 100 Civic Center Drive, Newport Beach, CA 92660 G lA ? Permit Counter Phone: (949) 718-1888 e+ newportbeachca.gov/civic C �P q<rFonN Mechanical Permit Plan Check No : Work Class : Other Issued Date : 05/09/2023 Inspection Area : 1 H2O23-0303 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: 2104 MIRAMAR DR Legal Desc : N TR 518 BLK 0 LOT 2 Description: MECH NEW A/C UNIT & FURNACE *TAMPER PROOF CAP REQ* caner Address : 2104 MIRAMAR DR NEWPORT BEACH, CA 92661 Address : 411 LEROY DR CORONA, CA 92879 Phone: Phone: (951)739-9501 Con State Lie : 910681 Applicant: BEN MEDINA Lie Expire : 02/29/2024 Address : 31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362 Bus Lie : BT30072844 Phone: (818) 735-7876 Bus Lie Expire:09/30/2023 Workers' Compensation Insurance Owner/Builder: Carrier: FALLS LAKE Address : Policy No: FLA01266703 Phone: W. C. Expire: 10/1/2023 Code Edition : 2022 Type of Construction Occupancy Groups: Building Setbacks : Front: 10, Side: 3, Side: 3, Rear: 0 Flood Zone: X Use Zone : R-1 - Single -Unit Residential PROCESSED BY SPECIAL CONDITIONS: Fire Hazard Zone : NO Manufacturer : CARRIER Model# : 34SCA530 TIMFR p.EQUIRED ON EQUIPMENT TO SHUT OFF BEM/EEN 10 P.M. AND 7 A.M. 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) 1 have placed next to the applicable items) (Section 7031.5. Business and Professions Code: Any city or county that requires a permit to construct, after, improve. demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statemant that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with $action 7000) of Division 3 of the Business and Professions 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 not more than five hundred dollars ($500). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U 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 employers' or parsonat 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 Im roved 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). LJ I am exempt from licensure under the Contractors' Slate 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 pe sell n structure that I have built as an ownor-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 Professions Code, is available upon request when this application is submitted or at the following Web site:httpl/ww^w.leginfo.ca.govlcalaw.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 0 of Divl6 3 f l�i3akausinoss and Pro slons Cod . y�fce and effect. License Class License No Date k ractor Signature COMPENSATION DECLARATION and Is in full force ING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINi UP TO ONE HUNDRED THOUSAND DOLLARS f6700.0001, IN ADDITION TO THE 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: have and will maintain a cartltiicate 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 'nonce 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' carder and policy number are: Policy Number Expiration Date of Agent Phone If JI 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 and agree tat, if I should become subject to the wor s compensation prove . ns-efSecllon 3700 of the Labor Code, I shall forthwith comply with those previsions. Ilgnature of Applicant _ Date z tECLARATION REGA Q�-601 � ON LENDING AGENCY hereby affirm under penalt at there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil ode). orders Name Lender's Address By my signature be'cv:. I certify to each of the following: I am the proper^ '),mar or authorized to act on the property owners behalf. I '111,e read thin "pp'ication and the information I have provided is correct. I agree to complymth all applicable city and cow y ordinances and slate laws relating to kuitd'mg construction. i autnonze represenlalives of this city or count t enter the ab d pre y for inspection purposes. G Signature of Pro art" 0,vner or Authorized Anent Print Property Owner's or Authorized Agent's Name t a[e AITICN DATE RY V ON OMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGUTA NS PART 61 OF TITLE. 40 AND AQMD RULE 1403 PLA,Vd, XPIFEO Ul SUBMITTED ASBESTOSNOTIFICATIONTO Ph5Mll O NCELLEO OEPA PERMIT EXTENDED PE.4MIT FINAL i 04/Z5/2 DL -Pii A5BEST05 NO11NCATION 15 NOT APPLICABLE TO CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCY ISSUED CMS SIGNATURE: