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Home My WebLink AboutH2024-0129 - Permits�eWIPORr City of Newport Beach Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 ,T Permit Counter Phone: (949) 718-1888 newportbeachca.gov/civic _C9(iFO ftN�P,. III I I I II I I II II!�II I�� Ilil II r crie l Permit: H2O24-0129 t'hn Cheo:k No: Work Class : Other Issued Date : 03/0812024 Inspection Area : 4 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: 3 RUE CHATEAU ROYAL Legal Desc : N TR 7788 BILK LOT 57 Description: MECH - INSTIL HVAC SYSTEM @ ROOF, TIMER AND TAMPER RESISTANT CAP REQ Owner: EDWARDS J TROY Contractor : HG HOME SERVICES Address: 3 RUE CHATEAU ROYAL NEWPORT BEACH, CA 92260 Address : 1501 WESTCLIFF DR NEWPORT BEACH, CA 92660 Phone: (949)500-1147 Phone: (949)877-2821 Con State Lic : 1077757 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: 10, Rear: 15 Flood Zone : X Use Zone : PC - Big Canyon PROCESSED BY: &r SPECIAL CONDITIONS: Lic Expire : 07/31/2025 Bus Lic: BT300768818 Bus Lic Expire: 024'914-Q 4'31,31175 vC Workers' Compensation Insurance Carrier : CLEAR SPRING PROP & CASUALTY CO Policy No: CWC00016801 W. C. Expire: 6/16/2024 Manufacturer: AC PRO Model#: AUD60W OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I am exempt from We Cortra.ac:s' Sf&le Ljpl nse.Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031.5. Business and Professions Code: Any city or COLJm y that reeuims 3 permit to co'dstruct, alter, 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 p: rsjant lu tho orovlslons cr the-Ccntractors' 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 penaky of not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as thAir s9le compensation, will do t_) aR of or L) 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 reply to 3n awn.:r of oroperty who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however_ViG bui.ding or .mpro,ement iE sc'd 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 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). ❑ I am exempt from licensure under the Contractors' Slate License Law for the fallowing 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 he Business and Professions Code, is available upon request when this application Is submitted or at the following Web site:http:l/www.leginfo.ca.gov/calaw.html. � y Signature of Property Owner or Authorized Agent Date .3 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect. License Class License No — _ Dale Contractor Signature COMPENSATION DECLARATION %RNING: 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 (6100,000), IN AODrr10N TO T '.DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0706 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 for by Section 3700 of the Labor Code, for erformance 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 Date is of Agent rnone R 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 , if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /(��q� ',` eture of Applicant _ Dale_ T/ vy _ _ hereby affirm underaligiAlFrof perjury that there is a construction lending agency for the performance of the work for which this permit Is issued (Section 3097, Civil Code) ender's Name Lenders Address 'y 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 enter the above-identifi roperty for inspection purposes. ionature of Property Owner or Authorized Agent 5 � Print Property Owner's or Authorized Agent's Name DATE CLARATION OF COMPLIANCE WITH CODE OF FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT EXTENDED LJAQMD PERMIT FINAL E3ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATEOF / PROPOSED DEMOLITION OCCUPANCY 155UED % I !G� SIGNATURE: FOR OFFICE USE ONLY