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Home My WebLink AboutH2023-0761 - Permits�lE'eORT City of Newport Beach Q @m Community Development Department- Building Division F Y 100 Civic Center Drive, Newport B;,acn, CF:,92660 2 Permit Counter Phone: (949) 71B-1888 .�. newportbeachca.gov/civic CSC/FOAN�P III I I I II I III II II IIII I I II Mechanical Permit : H202,3-0761 Plan Work Class k Other 0679-2022 Issued Date : 12/04/2023 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 : 113 TOPAZ AVE Legal Desc : A TR BALBOA ISLAND RESUB SEC 1 BLK 11 LOT 9 s n Description: MECH INSTL (2) ROOF MOUNTED HEAT PUMPS, TAMPER RESISTANT CAPS REO ;R.,.�.a-+• 3,-'�• k Owner: 113 TOPAZ GROUP LLC Address: 2901 W MACARTHUR BLVD S SANTA ANA, CA 92704 Phone: (714)791-3771 Applicant: KEYSTONE D C S INC Address : 17272 NEWHOPE ST, STE K FOUNTAIN VALLEY, CA 92708 Phone: (714)791-3771 Owner/Builder : Address Phone: Code Edition : 2022 Type of Construction Occupancy Groups: Fire Hazard Zone Building Setbacks : Front: 10, Side: 3, Side: 3, Rear: 5 Flood Zone : X. AO 1 Use Zone: R-BI - Two -Unit Residential, Balboa Island PROCESSED BY: SPECIAL CONDITIONS: Contractor : KEYSTONE D C S INC ' Address : 17272 NEWHOPE ST, STE K FOUNTAIN VALLEY, CAA 92708, - Phone: (714)791-3771 ' Con State Lic : 1013293 Lic Expire: 04/30/2024 •. "" ' Bus Lic: BT30076080 Bus Lic Expire:07131/2024 Workers' Compensation Insurance " Carrier: STATE FUND Policy No: 9157538 W. C. Expire : 4/21/2024 NO Manufacturer: MITSUBISHI Model#: MXZ-3C30NA2-U1/5C42NA2-U1 TIMERS PROHIBITED ON HEAT PUMPS OWNER -BUILDER DECLARATION I hereby affirm under penalty of penury 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 applicableitem(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 :he permit to file a signed statement that he or she is licensed pursuantto the provisions of the Contractors' Stale License Law (Chapter g (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 iot 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 U portions of the work, and the structure is notintended or offered for sale (Section 7044, 3ustness 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 mprovements 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 mprovedfor the purpose of sale). 1 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). n I am exempt from hcensure under the Contractors' State License Law for the following reason 3y my signature below i acknowledge that, except for my personal residence in which I must have resided for at leastone year prior to completion of the improvements covered by this permit, I cannot legal sell a structure that I have built as an owner-buildor if it has not been construGted In its entirety by licensed contractors. I understand theta 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:llwww.leginfo.ca,govlcalaw.html. Signature of PropFry Or=rar or Authorized Agent __ Date LICENSED CONTRACFOR'S DECLARATION hnlauy abirm under penalty of perjury that I am licensed under previsions of Chapter 9 (commencing with Se on 7 ) of DWision 3of the Business a Professions C e, and my license is" fWl force and effect_ LicensU ClaSL License. No D e 12 )pu1� Z3 Contractor nature NORAERS' COMPENSATION DECLARATION MASHING: FAILURE TO uLCJdE WORKERS' COMPENSATION COVERAGE. IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP To ON. DRED THOUSAND DOLLARS sn""01. IN ADDITION TO TM COSTOFCOMPENSATIOM n~GES AS PROVIDED FOR IN SECTION STOS OF THE"SOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under nRnalty of perjury one of the following declarations: I have and will ma.r.i6in 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 brmance of the w^rk for which this permit is. issued. Policy No. and will n�airrbii i 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 anJ policy number are: ter_' _ ne. of Agent Policy Number Expiration Date certify that, in the performance of the work for which thispermit is issued, I shall not employ any person in any manner so as to become subject to the workers` compensation laws of California, and agre If I should Deco subject to a workers compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. latureof AP)_ ._.. 12. Ot' 2u� 3 areby affirrryuf'igar petty of perjury that there is a construction lending agency for the performance of the Work for which this permit is issued (Section 3047. Civil Code). rder4 N ®/ Lenders Address my s' 4 lure 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 applioation and the information I have provided is correct.. I agree to comply with all applicable city and Bounty ordilta and state laws relating to building. construction. l authorize representatives of this city or coua o e e above -don property for Inspection purposes. Iner's or Authorized AOenLA Name ACTION I DATE ! t j DECLARATION OF COMPLIANCE OF TITLE 40 AND AOMO RID FEDERAL FOR OFFICE 11.5E ONLY 03 PERMIT EXPiRFp .LJ I SUBMITTFEI ASBESTOS NOTIFICATION TO PERMIT FINAL t LJ ASBESTOS NOT IFICATION 15 NOT APPLICABLE TO CERTIFICATE OF �i 2N ,�fC.��1 PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: