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HomeMy WebLinkAboutM2019-0017 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIilllllllllllllll II IIPM HARBOR Permit: M2019-0017 cx Re: ivavwIn o oo�000 FEES Valuations $20,000.00 Fire Inspection Fee: $0.00 $0.00 ..Bova Inspection Fee:. a 100 Civic Center Drive, Newport Beach, CA 92660 2 0 1 9. 0 0 1 7 $0.00 Aeon Check Fees a a Project No: 0321-2019 Permit Counter Phone (949)644-3268 $4.00 Plan Dep -Zoning Plan Check: $0.00 u $0.00 Harbor Plan Check Fee: $131.00 Plan Dep - OverTime Plan Check: $0.00 Inovesttigation Fee: o Inspection Requests Phone (949)644-3255 Job Address: 29 LINDA ISLE Floor: Suite: Bldg: 0 9 Description of Work:, R/R (3) EXISTING 14" SQUARE CONCRETE MARINA GUIDE PILE, LIKE FOR LIKE .a . o a a o o TOTAL r=EEt- $725.00 Inspector Area: 2 $0.00 ' Fee Due at permit Issuance: $725.00 Legal Description: N TR 4003 LOT 26 Owner: JUDA TOM Contractor: SWIFT SLIP DOCK/PIER BUILDERS Engineer: PETROV PLAMEN Address: ' -410 S LUCERNE BLVD Address: 6351 INDUSTRY WAY Address: 28161 CASITAS CT LOS ANGELES, CA WESTMINSTER CA 92683 LAGUNA NIGUEL CA 92677 Phone: 0 Phone: 949-631-3121 Phone: 714-717-7542 State Lic: C-066947 U Applicant: JACQUELYN CHUNG Con State Lic:797052 Designer. Address: 6351 INDUSTRY WY Lic Expire: 07/31/2019 Address: WESTMINSTER CA 92683 Bus Lic BT01122734 Phone: 949-631-3121 Lic Exp Date: 11/30/2019 Phone: Special Cond: - Longshoremen's and Harbor Workers' Compensation Declaration - 0 o a m Carrier: AMERICAN LONGSHOR IssugaVate 02/22F2019 Policy No: ALMA01662-01 PROCESSED BY: r�� HARBOR RESOURCES: PLAN CHECK BY: W APPROVAL TO ISSUE: OTHER DEPARTMENTS: FINAL INSPECTION: ' PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION cx Re: ivavwIn o oo�000 FEES Valuations $20,000.00 Fire Inspection Fee: $0.00 $0.00 ..Bova Inspection Fee:. a $287.00 Fire Plan Check Fee: $0.00 Plan Dep - Counter Review: $0.00 Aeon Check Fees a a $302.00 Records Mangement: $4.00 Plan Dep -Zoning Plan Check: $0.00 ©o -Tara Check Fee. $0.00 Harbor Plan Check Fee: $131.00 Plan Dep - OverTime Plan Check: $0.00 Inovesttigation Fee: o $0.00 Buiildircg+Green Fee: $1.00 .a . o a a o o TOTAL r=EEt- $725.00 Plan Check Fee: $0.00 ' Fee Due at permit Issuance: $725.00 PROCESSED BY: r�� HARBOR RESOURCES: PLAN CHECK BY: W APPROVAL TO ISSUE: OTHER DEPARTMENTS: FINAL INSPECTION: ' PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION INER-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) I have placed next to the aftcable item(s) :tion 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 fo 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( essions Code) or that he or she is exempt from licensure 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 o 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 intended or 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 thl 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 o ;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 not y 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 im I 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 )fessions Code, is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.htmi. (nature of Property Owner or Authorized Agent CONTRACTOR'S DECLARATION n under penalty of perjury that I am licensed under provisions of Chapter 9 (com cing'ritb �62!yrfy00(yP�f Division 3 of the usine a Prof cense Class License No. Date L VV``__ �0 Contractor Signat r REMEN'S & HARBOR WORKERS' COMPENSATION DECLARATION QTO CURE LONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTI S AND CIVIL pNo THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I herb y affirm IS I covered by this permit, I cannot le law, Section 7044 of the Business Date Code, and my license is in full 1 S UP TO ONE HUNDRED THOUSAND DOLL penalty of perjury one of the follor avl�jl will maintain Longshoremen's and Harbor workers' compensation insurance, as required by Section 3700 of the Labor Code, forth€performance of the work for which this permit MyV\ orkers' compensation insurance carrier and policy number are: Policy Number Expiration Date ant Phone # 3 that, ' the perfor once o he 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, I I should ecome sub% ect t rkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. of App] cent: / / Dar's: 12' 1.41: )ECLARATIONREbkRDINICONST7ut TIDNLENDING AGENCY :••••• ° I herebyaffirm under a alt of hat there is a construction lendin a enc for the erformance of the work for which this ermit is issued Section 3097, Civil Code . P Y P9 agency P P ( ) Lender's Name Lender'sAddress By my signature below, I ce t sich of the following: .. I am the prope o r or authorized to act on the property owner's behalf. '.. I have rea Is ap I n and the information I have provided is correct. ;"';' ' '. I agree to omply wi all licable city and count ordinances and state laws relating to building constru tion. c6yll '.. I authors repress ati s o is ci y or coun o enter the above -identified property for inspection purpos �•sigIq nature: Print Na v 1 Date: ACTION DATE y DECLARATt N * COMPLIANCEK?TN CODE OF FORDFRCE USMVY. FEDERAL REGULATIONSPART 61 OF TITLE40AND PERMIT€XPIRED AQMD RULE 1403. ❑ I SUBMITED ASBESTOS W17FICATIOIY TO., PERMITCANCELL€ ❑ EPA PERMITEXTENDED ❑ AQMD ASBESTOS NORRCA770NIS NOT APPLICABLE TO PERMITFINAL PROPOSEDDEMOLITION. CERTFRCAT€ OF ,,,,,....,,, F..............�.. SIGNATURE: