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Home My WebLink AboutM2019-0026 - Permits,. City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII HARBOR Permit: M2019-0026 100 Civic Center Drive, Newport Beach, CA 92660 M 2 0 1 9 0 0 2 6 - Project No: 0736-2019 Permit Counter Phone (949)644-3288 ._�i arnir Inspection Requests Phone (949)844-3255 Job Address: 222 EVENING STAR LN Floor: Suite: Bldg: 0 Description of Work: REMOVE AND REPLACE 12'X 41' SF FLOATING DOCK *LIKE FOR LIKE* i qqq} Inspector Area: 3 M Legal Description: N TR 4224 LOT 129 Owner: 222 EVENINGSTAR LLC Contractor: SWIFT SLIP DOCK/PIER BUILDERS Engineer: PETROVPLAMEN Address: 222 EVENING STAR LN Address: 6351 INDUSTRY WAY Address: 28161 CASITAS CT ... ° e e NEWPORT BEACH, CA 92660 WESTMINSTER CA 92683 LAGUNA NIGUEL CA 92677 Phone: Phone' '949-631-3121.. Phone: 714-717-7542 State Lic: C-066947. ••••. •..e o. Applicant: CHUNG JACQUELYN Con StateLic:797052 Designer: Address: 6351 INDUSTRY WAY Lic Expire: 0713112019 Address: ® c000.e WESTMINSTER, CA 92683 Bus LIC: BT01122734 oe>°eo o Phone: 949-631-3121 Lic Exp Date: 11/30/2019 Phone: Special Cond: Longshoremen's and Harbor Workers' Compensation Declaration - Carrier: AMERICAN LONGSHOR Issued Date 04/04/2019 Policy No: ALMAD1662-01 Expire: 12/31/2019 FEES Valuation: $20,000.00 Fire Inspection Fee: $0.00 $0.00 Inspection Fee: $287.00 Fire Plan Check Fee: $0.00 Plan Dep -Counter Review: $0.00 Plan Check Fee $302.00 Records Mangement: $8.00 Plan Dep - Zoning Plan Check: $0.00 OT Plan Check Feer $0.00 Harbor Plan Check Fee: $131.00 Plan Dep - OverTime Plan Check: $0.00 Investigation Fee: $0.00 Building Green Fee: $1.00 TOTAL FEE : $729.00 Plan Check Fee : $0.00 Fee Due at permit Issuance: $729.00 PROCESSED BY: f)1QN/ \ HARBOR RESOURCES: PLAN CHECK BY: [ - APPROVAL TO ISSUE: L� OTHER DEPARTMENTS: FINAL INSPECTION PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LASTVALID INSPECTION - /NER-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) 1 have placed next to the applicable item(s) ction 7031.5, Business and Professions Coder 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 fc 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 an fessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Anyviolation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty c more than five hundred dollars ($500): I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intendedor offered for sale (Section 7044, ,iness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that th rovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built c roved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does no ly to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I am exempt from licensure under the Contractors' State License Law for the following reason: my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvement a structure that.l.Mve built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable ifessions Codi:. L9.4hilable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. pstull of Progerty.Owner or Authorized Agent ;EN$ED CONTRACTOR'S DECLARATION I§HORE yAffirm unddr penalty of perjury that I am licensed under provisions of Chapter 9 (cornewI ect 000) of Division 3 of the Busin s and rofess iact. License Oars License No. Date ' Contractor Signature S & HARBOR WORKERS' COMPENSATION DECLA TION by this permit, I ion 7044 of the AILUR Q� URE LONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION COVERAGE IS UN WFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE ALTIES AND CIVIL FINE8 P TO ONE OS�fN /,WDI N -THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION J7U6 F THE LABOR CODE, INTEREST, AND AT FEES. I hereby affirm under p na ty of. in full D THOUSAND DOLLARS one of the following • • • f ve and will maintain Longshoremen's and Harbor workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performanc of th work for which this permit is y •:.war:ers' compensation insurance carrier and policy number are: iE • Policy Number Expiration Date �g8t A It • • • Phone # I certify that, in the p ormanc of 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, an e that, if I should becom ubject thew ' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / Tature of Applicant: )ECLARATION REGykDING CO TRUCTTIN LENDING AGENCY / I hereby affirm under penalty f perjury the there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name Lender'sAddress By my signature below, I certify t eaB of the following: I am the property owner or authorized to act on the property owner's behalf. I have read th' appli n and the information I have provided is correct. I agree to co ly wi all a licable city and county ordinances and state laws relating to building c structio . I authorize r resen tives s city or county to enter the above -identified property for inspection urposes. p /' V � 4 signature: Print Name: V {7i U Date: 77 ACTION DATE BY DECLARATIO. O COMPLIANCLIVIIHC0 EOF 1 FOR OFF USE ONLY FEDERAL RE ULATIONS PART 61 OF TITLE40AIVD AQMD RULE 1403. PERMIT €XPtR€D ❑ I SUBWTTEDASUESTOS NODFICATIDAI TO: ❑ EPA ❑ AQMD E3ASBESTOS N017HCATIONIS NOT APPLICABLE TO PROPOS€DDEMOLITION PERMITC.4NCELLED PERMIT EXTENDED FERMITFINAE ZT-40-19 rL> 1Z I CERTtFICATEOF SIGNATURE. OCCUPANCYfSSUED