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HomeMy WebLinkAboutM2019-0061 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIII�I�III�II�IIIIIIIII'IIIIII II HARBOR Permit: M2019-0061 o 100 Civic Center Drive, NewportBeach, CA 92660 M 2 0 1 0 0. 6 1 Project NO : 1728-2019 Permit Counter Phone (949)644-3288 "�dErrne�' Inspection Requests Phone (949)644-3255 Job Address: 3700 CHANNEL PL Floor. Suite: Bldg: 0 NsPECTOR Description of Work: SFR REMOVE/REPLACE (4) EXISTING CRACKED PILES W/ NEW *LIKE FOR LIKE* Inspector Area: 1 Legal Description: CANAL SECTION LOT 1 BILK 637 ALL -INC BET SAME & HIGH TIDE LINE- , • ° • e Owner: SIMMONS DAVID Contractor: SWIFT SLIP DOCK/PIER BUILDERS Engineer: PETROV PLAMEN Address: 3700 CHANNEL PIL Address: 6351 INDUSTRY WAY Address: 28161 CASITAS CT NEWPORT BEACH, CA 92663 WESTMINSTER CA 92683 • • LAGUNA NIGUEL CA 92677 • ° ° Phone: Phone: 949-631-3121 Phone: 714-717-7542 -°• State Lie: C-066947 ...... ...o� o Applicant: MORALES MARISSA Con State Lic:797052 Designer: • ..... Address: 6351 INDUSTRY WAY Lie Expire:` 07/31/2021 Address: ...... o „ e WESTMINSTER, CA 92683 Bus Lie: BT01122734 ®• Phone: 949-631-3121 Lie Exp Date: 11/30/2019 Phone: • °goo •®•® Special Cond: Longshoremen's and Harbor Workers' Compensation Declaration - Carrier- AMERICAN LONGSHOR Issued Date 07/3112019 Policy No: ALMA01662-01 Expire i 12/31/2019 FEES Valuation: $26,000.00 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 $0.00 Plan Dep - Zoning Plan Check: $0.00 OT Plan Check Fee: $0.00 Harbor Plan Check Fee: $131.00 Plan Dep - OverTime Plan Check: $0.00 Investigation Fee: $0.00 Building Green Fee : $2.00 TOTAL FEE: $722.00 Plan Check Fee : $0.00 Fee Due at permit Issuance: $722.00 PROCESSED BY: ��a�/ � PUBLIC WORKS; PLAN CHECK BY: �i/ � APPROVAL TO ISSUE: �I OTHER DEPARTMENTS: FINAL INSPECTION: PERMIT EXPIRES 180 DAYSAFTER ISSUANCE OR LAST VALID INSPECTION 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 applicable item(s) ction 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 foi 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 anc Fessions 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 ol 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, providedthat the 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 of 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 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 Mdu0l 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 cannot Is a structure the6 t 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 Business for,WQns Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw:html. naturE of PropeRy Owner or Authorized Agent - Date ECtN&D CONtRACTOR'S DECLARATION hereby affirm *der p'analty of perjury that I am licensed under provisions of Chapter 9 (commen ng with Section 7000) of Division 3 of the 1 pd1brgdt. Liceds9 CIAss License No. Date -7 • 1' 1 Contractor Signal �OI�?SHOREFM'? & HARBOR WORKERS' COMPENSATION DECLARA ON 'ARNIN :,FAILURE TO SECBRE LONGSHOREMEN'S &HARBOR WORKERS' COMPENSATION COVERAGE I5 UNLA FUL, ANO SHALL SUBJECT AN EMPLOYER TO CRIMINAL 9dnll(n, IN ADDITIOIy TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. license is in full TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND )by affirm under penalty of perjury one of the 1 have slid Mll;maintain Longshoremen's and Harbor workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit 1.•: My ��workers. compensation insurance carrier and policy number are: r. Policy Number Expiration Date of Agent • "' • Phone # I certify that, in the erformance of the work for M 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 that, if I should becom 'ect to the workers' c mpen anon provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. iture of Applicant: - Da : x'31 iq .ARATION REGARDING CONSTRUCTION LENQIVG AGENCY I 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, CMI Code). Lender's Name - Lender'sAddress By 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 agree to comply with all applicable city and county ordinances and state laws relating to building construction. _ I authorize Opresentatives of this ci o county to enter the above -identified property for inspectio purposes. Signature: Print Name/ M&hisso, MorALe5 Date/ «' AC77ON DATE BY DECLARATfO. OFCOMPLIANCEW/TNCODEOF FORD TICE USE ONLY FEDERAL R ULATIONSPART61 OFTITLE40ANO AQMDRULE 1403. P€RMITEXPLRED 0 I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMIT EXTENDED PROPOSED DEMOLITION.NON/S NOT APPLICABLE TO PERMIT FINAL —f1 —( -i CERTIFICATEOF OCCUPANCYISSUED SIGNATURE., 0 W Z c O n Y U O • a rn o 0 c 'S AU _N 0) Cc: F rro1 0, �� M 11 C O m o C7 o oi Y O c AU. co U _C O G Ey r O 3 > 'd 2 N 0] R1 1 '7 , 1 Z oCO �(V W O .G Rf 3 ,� �Ei o CO TON •p Q d y I- E O p. C� N N LY C : OLO MSo X v ro -0 air E E c a s7 r N C j O a) w '� ... 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