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Home My WebLink AboutH2023-0578 - Permits��EWPORT City of Newport Beach O Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 ? Permit Counter Phone: (949) 718-1888 newportbeachca.gov/civic Mechanical Permit Plan Check No : Work Class : Other Issued Date: 0910512023 Inspection Area : 2 H2O23-0578 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 : 986 BAYSIDE COVE W Description: MECH DUCT WORK Legal Desc : N TR 8073 BLK LOT 2 UN 101 TR 8073 LOT 2 UNIT 101, Owner: SUZY DEWITT Address: 986 BAYSIDE COVE W NEWPORT BEACH, CA 92660 Phone: (858)922-2877 Applicant: BEN MEDINA Address: 31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362 Phone: (818)735-7876 Owner/Builder Address: Phone: Code Edition : 2022 Type of Construction Occupancy Groups: Building Setbacks : Flood Zone : AE, 8 FT; X Use Zone : RM - Multiple Residential PROCESSED BY: SPECIAL CONDITIONS: Fire Hazard Zone : NO 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: BT01080105 Bus Lic Expire:07/31/202:y Workers' Compensation Insurance Carrier : EVEREST PREMIER INSURANCE COMPANY Policy No : RMBWC00054231 W. C. Expire: 8/1/2024 Manufacturer Model# : OWNER -BUILDER DECLARATION I hereby affirm under penally 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 itern(s) (Section 7031.5. Business and Professions Coda. Any city or county that requires a permll to construct, alter, improve, demoflsh, 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 Ilcensod pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 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 () portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions CodeThe 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). ❑ i, as owner of the properly, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not rappty 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' 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 cannot Iegall) soil a structure that I have built as an owner-buildBr if it has not been constructed in its entirety by licensed contractors. I understand that n 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:htlp://www.leginfo.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 70 " ' the Business and, Prof dons Cod n il Ifd� tens"N"AD'Orr"Oe"TO n llorce and effect License Class License No t)ate� Contractor Signaure WORKERS' COMPENSATION DECLARATION NANNING' FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMIN L PENALTIES AND CIVIL FINES UP TO ONE HUN RED HOUSANO DOLLARS00,000i, 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: I have and will maintain a certificate of consent to self -insure for Workers' compensation, issued by the Director of Industrial Relations as provided far by Section 3700 of the Labor Code, for 'ormance of the work for which this permit is issued. Policy No.. have and will maintain workers' compensation insurance, Be required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compense Il'aese carrier and policy number are: is of Agent _ certify that, in the , It I should becoa of ApplicHul Roby affirm under Iders Name _ my signature bolo Policy Number Date Ice of the work for Ich this perm ssued I shall not employ any person in any manner so as to become subject to this worker ' compensation law of California, and agre to the worker ompen provisions or Section 3700 of the Labor Code, I shall forthwith comply moth those provisions. _ :QN C LENDING AGENCY Data there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, in Code). _ Lender's Address to each Of the fbllowina: I am the property owner or authorized to act on the property owner'Eat lf. I have read this application and the Information I have provided is I agree to comply With all applcable amity and cou ty o Trances Laws relating to building construction. I authorize representatives of'his cih or county to er th e-identified property for inspection purposes, ii nature of Property Uwnel or Authorf-z�ed A ent Print Property Owner's or Authorized A f ACTION j DATE T I BY D COMPLIANCE WITFI CODE OF FEDERAL I FOR OFFICE USE ONLY FrbRMIV LAIVLtLLtU j PERMIT ENTENOEV I_ PERMIT FINAL I r� r+ CERTIFICATE OF ! ✓)- TOI" OCCUPANCY ISSUED 06r I CS 61 OF TITLE 40 AND AOMD RULE SUBMITTED ASRFSTO5 NOTIFICATION TO NOT I FICA LION 15 NOT APPLICABLE 1'0 PROPOSED DEMOLITION Name X (y [,A