HomeMy WebLinkAboutH2023-0015 - Permits(("
RrCity of Newport Beach
@Community Development Department - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
� SPermit Counter Phone: (949) 644-3288
e.� Inspection Requests Phone: (949) 644-3255
</F00.N`P newportbeachca.gov/inspections
III I I I II I III II II 11i�llll II
Mechanical Permit
Plan Check No:
Work Class : Other
Issued Date : 01/06/2023
Inspection Area : 2
H2O23-0015
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 : 200 PARIS LN, 310 Legal Desc : N TR 8336 BLK LOT 11 UN 101 TRACT 8336, LOT 11 OF PROJECT 93 0-77 LOCATED ON
Description: MECH -CHANGE OUT HEAT PUMP (ROOFTOP) & AIR HANDLER. TAMPER -RESISTANT CAP REQ'D
Owner: COURTNEY STOS
Address : 200 PARIS LN APT310 NEWPORT BEACH, CA 92663
Phone:
Applicant: SERVICE CHAMPIONS HTG
Address: 3150 E BIRCH BREA, CA 92821
Phone: (714)777-7777
Owner/Builder :
Address
Phone :
Code Edition : 2022
Type of Construction
Occupancy Groups:
Building Setbacks :
Flood Zone : X
Use Zone : PC - Versailles on the Bluff
PROCESSED BY:
SPECIAL CONDITIONS:
Contractor : SERVICE CHAMPIONS HTG
Address : 3150 E BIRCH BREA, CA 92821
Phone: (714)777-7777
Con State Lic : 799170
Lic Expire : 10/31/2023
° ® Bus Lic : RM8WC00054221
Bus Lic Expire:04/01/2023
Workers' Compensation Insurance
Carrier : EVEREST PREMIER INS CO
Qom'° Policy No: RM8WC00054221
W. C. Expire: 4/1/2023
Fire Hazard Zone: NO
INSPECT
Manufacturer: YORK
Model#: YHJD30S41S4A
vWNER-BUILDER DECLARATION rom the Contractors' StatLicense Lawicable item(s)
I hereby affirm under penalty of perjuryions Code: Any city or county that requires a permit to co struct,rafterf improve, Idemol demolish, or epairtany structure. (fprior its issu nce. also requirels the applicant for
Section 7031.5, Business and Professslons 'he rofess siness and
Insofile a Code) signed that he o she is exempt from licensureand the basis for he pursuant to the lalleged fe a exemption Any violation lof Section 7031.5 by any applicant or a permit subjeith Section cts the apple ant ton 3 of ta cihe vil penalty of
lot more than five hundred dollars ($500).
7 I, 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 (Section7044,
that the
3usiness 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 properly, provided
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 Contractor
Business and Professions Code: The Contractors' State License Law does no
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' Stale License Law).
❑I am exempt from licensure under the Contractors' State License Law for the following reason: __ t least one year prior to completion 1
By my signature below I acknowledge that, except for my personal residence In which I must have resided for aof the a 6cable law, Section Covere7fW4 of the Businessbythis lnandnot 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 a copy PP
Professions Code, is available upon request when this application Is submitted or at the following Web site:http:lfwww.leginfo.ca.govlcalaw.htmi. Date
Signature of Property Owner or Authorized Agent
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Secttiia` 7000)ef si i the tractor SignaturoFession de, a �iL��
and effect. License Class License No
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNORF�SNG AND DOLLARS /St00,6aaL IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have 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 Ih
rf IT of the work for which this permit is issued. Policy No.
ave 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' compansatio
oa carrier and DOlicy number are: Exoirabon Date
of Agent
certify that, in the performance of
, if I should become suylect to the
Policy Number
any person in any manner so as to become subject to the workers' compensation laws of California, and agre,
Labor Code, I shall forthwith comply with those provisions.
iature of Applica _
;LARATION RIF t�C T ENDING AGENCY
.ing agency for Lender's Address
the work for which this permit is issued (Section 3097, NII Code).
reby affirm under penalty of p at there is a construction lend
der s Name
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.
1 agree to comply with all applicable city and county ordinanc stale law IeUng to building construction. �( ' Date i4z
to e a nbfied property for inspection nl PrnoeU
I authorize representatives of this city or countrtv Owner's or Authorized Agent's Name I y / 1 l X
rer
PERMIT
for which this permit is issued. I shal
nrnvisiO c Ion 3700
RATION OF COMPLIANCE WITH CODE OF FEDERAL
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
TO
PERMIT FINAL ��Q°VZy DL -Foe- Dlj ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICA7E OF PROPOSED DEMOLITION
UPANCY
OCCI55lJED SIGNATURE:
FOR OFFICE USE ONLY