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Home My WebLink AboutH2023-0513 - Permits (2)�aEWPoR City of Newport Beach O Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter phone: (949) 71B-1888 *ate newpoi4beachca.gov/civic CgGIFORN`P Mechanical Permit Plan Check No: Work Class : Other Issued Date : D8/22/2023 Inspection Area : 3 H2O23-0513 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: 20251 RIVERSIDE DR Legal Desc : N TR 2581 BLK LOT 1 Description: MECH CHANGE OUT 2 HEAT PUMPS AND 4 AIR HANDLERS* TAMPER PROOF CAP REQ* Owner: CAROL REAGAN-WEEPIE Address: 20251 RIVERSIDE DR NEWPORT BEACH, CA 92660 Phone: (714)904-1127 Applicant: BEN MEDINA Address: 31225 LA BAYA DR WESTLAKE VILLAGE, CA 91362 Phone: (818)735-7876 Owner/Builder : Address Phone: Code Edition : 2022 Fire Hazard Zone : NO Type of Construction Occupancy Groups: Building Setbacks : Front: 20, Side: 5, Side: 5, Rear: 25 Flood Zone : X Use Zone: SP-7 - Santa Ana Heights Specific Plan PROCESSED BY: SPECIAL CONDITIONS: Contractor : ALPS AIR CONDITIONING & HEATING INC Address : 1895 S SANTA CRUZ ST ANAHEIM, CA 92805 Phone: (714)633-8892 Con State Lie : 667953 Lie Expire : 04/30/2025 Bus Lie: BT30047511 Bus Lie Expire:06/30/2024 Workers' Compensation Insurance Carrier : INS CO OF THE WEST Policy No : WSD506354500 W. C. Expire: 12/25/2023 Manufacturer: LENNOX Model# : MPCO1854 J u V U U u U u 4 t r"— ( .'I a 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 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 statement that he or she is licensed 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 huensure 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 U all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Coda: The Contracom' 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 of 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)- ❑ 1, 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 properly who builds or Improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Conlractors' Stale License Law). ❑ 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 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 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:http://%ww.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 Sectio 000) `ton he Business and P_ r- _ _ i 4 dl y�leense is In (uIl force and effort License Class License. No Doi Ontractor Sign WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMP40YER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($40.000), IN ADUEDON TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES I 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 for by Section 3700 of the Labor Code, for 'ormance 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' carrier and policy number are: Policy Number of Agent Date 11 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 fo the workers' compensation laws of California, and afire rat, if I should baeorn Subject ID RrD ,vorkers co — �mm comply provisions. mpe sahon provisions of 3700 of the Labor Code, shall forthwith com with those rovislo 'ignalure of Apf: o i Date � IECLARATtON RE AR--Cj1'1STRUCTION LENDING AGENCY hereby affirm under penal perjury thatthere is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ Code). enders Name _ _ Lender's Address ly my signature below, I certify to each of the followings _ I am the property owner or authorized to act on the property owner pehalf. I have read this application and the information I have provided i ep rect. ! agree to comply with all applicable city and coujttY romance d state laws relating to building construction I authorize representatives of this city or rounty (rTrbnter the r`v &e'I is ?ropertylor inspection purposes. / I`7 �„� ionature of Pmoartv Owner or Authorized Auenf i�a R� a j-' Print Property Owners or Authorized AoenCs Nama'u FOR OFFICE USE ONLY j RFGIIf ATIONS PART El OF TITLE 40 AND AQMD ROLE I 1404 Pk'RMrr'FXWH(•'b IJ 1 i8Nh TTFD ASRFSTOS NOTIFICATION TO PERFJIIT CANCEitfD = [][^A PERMIT FXTFNOED ❑qOM D PERMlTFINAL 01/16/Z4 DL �'or-JM ASBESTOS .NOT IFICATION 15 NOT APPLICABLE TO CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCY I$$UEp SIGNATURE: