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Home My WebLink AboutXR2023-0104 - Permits��EWPoRr City of Newport Beach Community Development Department- Building Division �y. 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-3288 u fin. Inspection Requests Phone: (949) 644-3255 newportbeachca.gov/inspections Combination Type - SFP PLUM Work Class - Demolition 111I��III��111111111111111111111111111111111111111111111111COMB Permit: XR2023-0104 Plan Check No: PC2022-1774 Issued Date : 01/17/2023 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 : 205 TOPAZ AVE Description : DEMO SFR 1335 SF (3 BEDROOMS) Owner: ROBERT FERNANDEZ CONSTRUCTION INC Address : 923 EVERGREEN PLACE COSTA MESA, CA 92627 Phone: (949)981-9169 Applicant: ROBERT FERNANDEZ CONSTRUCTION INC Address : 923 EVERGREEN PLACE COSTA MESA, CA 92627 Phone: (949)981-9169 Owner/Builder : Address : Legal Desc : A TR BALBOA ISLAND RESUB SEC 1 BILK 12 LOT 10 Contractor: ROBERT FERNANDEZ CONSTRUCTION Architect: INC Address : 923 EVERGREEN PLACE Address COSTA MESA, CA 92627 Phone: (949)981-9169 Phone: Con State Lie : 677390 State Lie Lie Expire : 04/30/2024 Bus Lie: BT30046730 Engineer: Bus Lie Expire : 03/31/2023 Address : Workers' Compensation Insurance Phone Carrier: Policy No: EXEMPT Designer W. C. Expire: Address SOMA JR PHILIP GEORGE 252 SOUTH BRENTWOOD ANAHEIM, CA 92804 (949)252-7660 Phone: Phone: Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $15,000.00 Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0 Occupancy Groups : U,R-3 No of Units : 1 Alteration sq. ft. Bldg : Bldg Height: No of Stories : 1 Added/New sq. ft. Garage: 0 TOTAL sq. ft.: 0 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: CERT MAIL RECEIPTS ATTACHED I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate 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, 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 pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division of the Business and Professions Code) or that he or she is exemptfrom licensure and the basis for the alleged exemption. Any violation of Section 7031.6 by any applicant for a permit subjects the applicant to a civil ponally of not more than five hundred dollars ($500). 13 I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) 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 Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale). 1-1 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 'Iapply to an owner of property who builds or Improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). J I am exempt from licensure under the Contractors' Stale 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 least one year prior to completion of the improvements Covered by this permit, I cannotleg� 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 70" of the Business and °rofessions Code,. is available upon request when this application is submitted or at the following Web siteihttp:bWww.leginfo.ca.govlcalaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9(commencing with Sectio 7 00 of (vision 3 of the Business and Prof Ions god,n n 'y linens 's-in full force and effect. License Class License No Date — C Director Signature NORKERS' COMPENSATION DECLARATION YARNING: FAILURE TO SECURE WORMERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS (S100,000), IN ADDITION TO T ;DST OF COMPENSATION, DAMAGFS 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 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 )erformance of the work for which this permit is issued. Policy No. 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' compensatior ranee carder and policy number are: ter Policy Number Expiration Date is of Agent Phone It `certify that, in the poqrryrance of the work for which this permit is issued, I shall notemploy any person in any manner sous to become subjectto this worke ' compensation laws of California, and agree If I should become su et to S worker 'con ensatlon provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant Dat� f �) �- 3-ARATION REGAR.. NG C*0ITIZUC14QR.IdCNDING AGENCY hereby affirm under perkalty of pLKary 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 3y my signature below. I oar* 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 1 have provided is correct. I agree to comply with all applicable city andVoty orc)ittances find slate laws relating to building construction. I authorize representatives of this city or count a 1 r e Rh ve tip -property for inspection purposes. ` r- (Signature of Property Owner or AuthrriTrd !,gent Print Property ert Owner's or Authorized Agent's Name t.L,)L{ Jt3Sla - ! - ACTION DATE Be I D --LAd IO NI CJPLIANCE WITH CODE OF FEDERAL FOR OFFICE U11 ONLY t REGUtAT1IONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERMIT EXPIRED i ILL- _ _ PERMIT CANCFUEU ). FPA PERMIT EXTENDED QMD iC, O;FINAL _21�� tiw' l SBESTO)�Nrrpp11T IFI TION IS NO APPLICABLE TO CERTIFICATEOOCCUPANCYISE Fo^' 9 RO ED OE'�/4 = OCCUPANCY ISSUED TlLi SIGNATURE: //��