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Home My WebLink AboutH2023-0733 - Permits4 ��WPORr City of Newport Beach III I I III @fi Community Development Department- Building Division > y 100 Civic Center Drive, Newport Beach, CA 92660 i Permit Counter Phone: (949) 718-1888 newportbeachca.gov/civic C9CIF00.H`P s Mechanical Permit : H2023-0733 Plan Check No : 0565-2020 Work Class : Other Issued Date : 11/16/2023 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 : 200 RUBY AVE Legal Desc : A TR BALBOA ISLAND SEC 2 BLK 10 LOT 17 BALBOA ISLA Description: MECH R/R (2) HEAT PUMPS **TAMPER RESISTANT CAPS REQUIRED & TIMERS PROHIBITED** (XR2023-2815 ) Owner: RICHARD CUSHMAN Address : 73 LINDA ISLE NEWPORT BEACH, CA 92660 Phone : (949) 500-6315 Applicant: VICTOR GOMEZ INC Address : 1318 W 130th St Compton, CA 90222 Phone : (844) 455-4377 Owner/Builder : Address Phone: Code Edition : 2022 Fire Hazard Zone Type of Construction Occupancy Groups: Building Setbacks : Front: 4, Side: 4, Side: 4, Rear: 10 Flood Zone : X; AO 1 Use Zone: R-BI -Two-Unit Residential, Balboa Island PROCESSED BY: 61 SPECIAL CONDITIONS: Contractor : VICTOR GOMEZ INC Address : 1318 W 130th St Compton, CA 90222 Phone : (844) 455-4377 Con State Lic : 1058567 Lic Expire : 05/31/2024 Bus Lic: BT30081696 Bus Lic Expire: 05131/2024 Workers' Compensation Insurance Carrier: EXEMPT - NO EMPLOYEES Policy No: EXEMPT W. C. Expire : NO Manufacturer: KEEPRITE Model# : NH4A436AKA ON HEAT Pu IPS NO CONSTRUCTION WO RK ON SA I l_ RDAYS 1 OWNER -BUILDER DECLARATION I hereby affirm under penally 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 items) 3eclion 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 issue nce, also requires the applicant for is permit to filea signed statement that he or she is licensed pursuant to the provisionsof the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and 'rofessions Code) or that he or she is exempt from lice nsure 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 of more than five hundred dollars (S500). 7 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 er 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 nprovements 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 n roved for the purpose of Sale)- 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 piety to an owner of property who bulids or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). 3 1 am exempt from licensure under the Contractors' State License Law for (he following reason Iy my signature below I acknowledge that, except for my personal residence In which I must have resided for at lead one year prior to completion of the improvements covered by this permit, I cannot legally all 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 ausiness and 'rofessions Cede, is available uponrequest when this application Is submitted or at the following Web site:http:/fwww.leginfo.ca..gov/calaw.htmi. signature of Property Owner or Authorized Agent Date .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 ) of Divi ion 3 of the Business and Profess cis �. rid my license is in full force nd effect. License Class License. No Date Contractor Signature VORKERS' COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORXERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUND D THOUSAND DOLLARS ($100,000), IN ADDITION TO THE OST 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 daclarations: ] 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 the 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' ranee carrier and policy number are: ierlof Agent certify that. in the p , If I should become Ialure of Applicant._ Policy Number Date 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 agI 'kers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date_[ L/�r(0 lzu If`TIf1.AI 1 CLINArl_ i1GC\If`V'-�' hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued. (Section 3097, Civil Code). enders Name _ Lender's Address ly 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 ap,ca to conkoly wita all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or county to above -identified property for inspection purposes. �I Rome',--" �%o lien€ture of Prooerle Owner or Authorized Anent i Print ProDerty Owner's or Authorized Auenta Name e e {'Y m 1, -, ACTION —� DATE ByDECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND At1MD RULE 1403 PEPoMII L �'NEDLJ I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CAACELI ED CPA PL RNITFA TENDFD ( ❑AOMD PfNMrr FLUAL CErMFICA, f OF I, ly i� OCCUPANCY lSSUEJ I �! IJ ASBESTOS N011FICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION -, SIGNATURE: Date r 1//