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Home My WebLink AboutH2023-0488 - Permits�W PoRT City of Newport Beach ppQ 2y �> - j Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 718-1888 5 newportbeachca.gov/civic G/F00.N Mechanical Permit Plan Check No : Work Class : Other Issued Date : 0810112023 Inspection Area : 6 H2O23-0488 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 : 24 SALZBURG Legal Desc : N TR 9859 BLK LOT 2 UN 37 TR 9859 LOT 2 UNIT 37 OF Description: MECH CHANGE OUT AIC AND FURNACE W/ DUCT WORK "TAMPER PROOF CAP REQ' Owner: HELMES MICHAEL TR THE M & M A HELMES TR Address : 24 SALZBURG #53 NEWPORT BEACH, CA 92660 Phone: 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 : X Use Zone : PC - Harbor View Hills PROCESSED BY: SPECIAL CONDITIONS: Fire Hazard Zone : NO Contractor : WE CARE Address : 41085 GOLDEN GATE CIR MURRIETA, CA 92562 Phone : (951) 600-0700 Con State Lie : 779604 Lie Expire : 06/30/2024 Bus Lie : BT30038344 Bus Lie Expire: 02129/2024 Workers' Compensation Insurance Carrier : A I U INS CO Policy No : 034281450 W. C. Expire: 7/1/2024 Manufacturer : AC PRO Model#: AULD60W2 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) I have placed next to the applicable item(s) (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 [h0 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 Iicensure 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 then five hundred dollars ($500). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all 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 apply to an owner of property who, through employees' or personal effort, builds or improves the properly, 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). u 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale 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 ticensure under the Contractors' Stale 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, 1 cannot legall} sell a structure that I have built as an owner -builder If it has not been constructed in its entirely by licensed contractors. I understand that a copy of the applicable law, Section 7044 of Iho Business and Professions Code, is available upon request when this application is submitted or at the following Web site:htlp:/fMANw.leginfo.ca..gov/calaw.html, Signature of Properly Owner or Authorized Agent__._._______....._._..._...�.___...._._.._.____._...._..w.,....._.._._---- ___.__ Date ___ _ LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of penury that I am licensed under provisions of Chapter 9 (commencing with SeCtiDI 7 00) NIS r1 It the Business and Pr SIG a Icense is in full force and effect. License Class License No Dat G,S Contractor Signaler WORKERS' COMPENSATION DECLARATION NANNING: FAILURE TO SECURE WORKERS' COMPENSATION GOVERAOE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED NO DOLLARS 15100,000), IN ADDITION TO 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: ❑ 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 th k,a/folmance 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 lame of Agent Phone If �I certify that, in the pedonnaFee of the mar 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 afire {ECLARhould eco aRD b;eetCO it LENDING on provisions of Section 3700 of the Labor Code, I shall forthwith comply with [hose Provisions. i , nrkerti'compensa! ;it nalme Oi A Ilcan ... Data d f ( ZS G AGENCY hereby affirm under penalty, of pe there is a construction lending agency for the performanre of the work for which this permit is issued (Section 3097, CI t1 Code). ender's Name ..__.......... ....._..�______.Lender's Address {y my signature belo certify to each of the following: I am the property owner or authorized to act an the properly owners behalf, I have read this application and the information I have provided is correct. I agree to comply with all applicable city and c on ordinances and st relating !o building construction I authorize representatives of this city nr county�tyJthinto' the abo entitled property for inspection purposes.1\' I' foal, linnawne of Pronedv Owner or Authorized AGent R Print Property Owners or Authorized Anent's NameX 2i ACTION DATE RV vl_ Or RATI COMPLIANCEWITH CODEOF FEDERAL FOR OFFICE USE ONLY ✓IT REGULATIONS PART El OF TITLE 40 AND AQMD RIR F 1403 PER.MIr EXPIRED ' I SUBMITTED ASRFSTOS NOTIFICATION TO PERINIT CAACELIED _ IA PERNT EXTENDED I L„-tAC,MD PERVITFINAL �— �ASb 1JS NOTIFICATION IY NOT APPLICABLE TO CERTIFICATE � PROPOSED ISSUED w16717 aj'7Ot'� SIGNATURE: OCCUPAtJCy