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Home My WebLink AboutXR2023-3553 - Permits2EWn RT City i�f Newport Beach p Community Development Department - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 718-1888 newportbeachca.gov/civic c9 Fi,nN" Combination Type - SFP Work Class - Other 1111111111111111111111111111111111111111111111111111111 111� 11COMB Permit: XR2023-3553 Plan Check No: PC2022-1774 Issued Date : 12/19/2023 Final Date: Permit Status: Issued Inspection Area : 2 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 : 205 TOPAZ AVE Description: SFR BLOCK WALLS 30" X 80' (INSIDE P/L) Owner: ROBERT FERNANDEZ CONSTR INC Address : 923 EVERGREEN PLACE COSTA MESA, CA 92627 Phone: (949)981-9169 Applicant: ROBERT FERNANDEZ CONSTR INC Address : 923 EVERGREEN PLACE COSTA MESA, CA 92627 Phone: (949)981-9169 Owner/Builder: Address : Phone Legal Desc : A TR BALBOA ISLAND RESUB SEC 1 BLK 12 LOT 10 Contractor: ROBERT FERNANDEZ CONSTR INC Address : 923 EVERGREEN PLACE COSTA MESA, CA 92627 Phone: (949)981-9169 Con State Lie : 677390 Lie Expire : 04/30/2024 Bus Lie: BT30046730 Bus Lie Expire : 03/31/2024 Workers' Compensation Insurance Carrier: NO EMPLOYEES Policy No : EXEMPT W. C. Expire: Code Edition : 2022 Fire Sprinklers : Type of Construction : V-B Fire Hazard Zone Occupancy Groups : U No of Units : Bldg Height : No of Stories Building Setbacks : Front: 8, Side: 3, Side: 3, Rear: 5 Flood Zone : X; AO 1 Use Zone : R-BI - Two -Unit Residential, Balboa Island PROCESSED BY: SPECIAL CONDITIONS Architect Address Phone: State Lie Engineer: SOMA JR PHILIP GEORGE Address: 252 SOUTH BRENTWOOD ANAHEIM, CA 92804 Phone: (949)252-7660 Designer: Address Phone: NO Construction Valuation : NO Added/New/TI sq. ft. Bldg 1 Alteration sq. ft. Bldg : 0 Added/New sq. ft. Garage TOTAL sq. ft. : $7,000.00 0 0 0 OWNER -BUILDER DECLARATION 1 hereby Gitlin) under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the check maik(s) I have placed next to the applicable items) (Section 7031.5. Business and Professions Cade: Any city or county that requires a permit to Conslfucl, alter, improve, demolish, or repair any structure, prior la 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 ContractorsState 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 licensors 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 (S500). 1, as owner of the property, or my employees with wages as their sole compensation, will do (_,) all of or U 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 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 Cwner-Builder will have the burden of proving that it was not built or Improved for the purpose of sale). 0 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 Contractors' State License Law)- 0 1 am exempt from Itcensure under the Contractors' State License Low 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 legal) soil 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://www.leginto.ca.gov/celaw.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 7000) of Division 3 of the Business and Profession. o e, and icense is in full force and effect. License Class License No Dale Contractor Signatur 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 HUNDRED THOUSAND DOLLARS (In D0,OW), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR LODE, INTEREST', AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: 131 have and will maintain a certificate or 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 performance of the work for which this permit is issued. Policy No. 0I have 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' eompensatio insurance carrier and policy number are: Ier Policy Number Expiration Date a of Agent Phone # artily 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 Caliromia, and ogre if I should become sub j�NiSfRUTTI ' compertsahon provisions of Section 37W of the Labor Code, I shell forthwith comply with those provisions. �7 f Signature of Applican}/J�DataDECLARATION REGARDON LENDING AGENCY i��j/�— I hereby affirm under penalty of perjurythat there Is a construction lending agency for the performance of the work for which this permit is issued' (Section 3097, Uvil Cede). Lender's Name _ _ Londer s; Address By 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 0 dinan and st a I relating to building construction. !Z� 1 authorize representatives of this City or county to enterth a-! nil ' property for inspection purposes. _ Signature of Property Owner ci Authorized Agent Print Pro ert. Owner's or Authorized A ent's Name ACTION DATE BY DECLA O NIPLANCE WITH COOT OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OFTiTLE 40 AND AONID RLIL.F, i 1403 PEflNiT EXPIRED I — _ SUBMITTED ASBESTOS NOTIFICATION TO PERM17CANCE(I.ED _QEPA FER+t'fiT EXTENDED I +nOMD PERMiT F(NAL MASHESTOS NOIIFICAIION 15 NOl'APPLICABLE TO CERTIFICATE OF [_rll PROPOSED DEMOLITION OCCUPANCY ISSUED 'i SIGNATURE: