HomeMy WebLinkAboutM2020-0025 - Permits0t�'��Po � City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIII II HARBOR Permit: M2020-0025
t 100 Civic Center Drive, Newport Beach, CA 92660 M 2 0 2 0 0 0 2 5 Project NO : 0810-2020
Permit Counter Phone (949)644-3288
�'myr•slw3'•I Inspection Requests Phone (949)644-3255
NOCONSTRUCTION�,..
Job Address: 3900 CHANNEL PL Floor: Suite: Bldg: 0
Description of Work: INSTALL NEW FLOATING DOCK, GANGWAY AND (2) PILE
Inspector Area: 1
MORALES MARISSA
Address:
Legal Description: CANAL SECTION LOT 1 BLK 539 ALL -INC BET SAME & HIGH TIDE LINE -(AND
Owner: 3900 CHANNEL PLACE 1 LLC
Contractor:
SWIFT SLIP DOCK/PIER BUILDERS
Address: 15 CORPORATE PLAZA #150
Address:
6351 INDUSTRY WAY
NEWPORT BEACH, CA 92658
$1.00
WESTMINSTER CA 92683
Phone:
Phone:
949-631-3121
State Lie:
C-066947
•
Applicant:
MORALES MARISSA
Address:
6351 INDUSTRY WAY
Plan Check Fee
WESTMINSTER CA 92660
Phone:
949-631-3121
Special Cond: AIC#2801-2018
Issued Date 05/20/2020
Valuation:
$25,000.00
Inspection Fee:
$297.00
Plan Check Fee
$312.00
OT Plan Check Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $622.00
Con State Lic:797052
Lie Expire: 07/31/2021
Bus Lie: BT01122734
Lie Exp Date: 11/30/2020
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Fire Inspection Fee:
$0.00
$0.00
Fire Plan Check Fee:
$0.00
Plan Dep - Counter Review: $0.00
Records Mangement:
$12.00
Engineer:
PETROV PLAMEN
°••°
Plan Dep - OverTime Plan Check: $0.00
Address:
28161 CASITAS CT
° `
LAGUNA NIGUEL CA 92677
•
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Phone:
714-717-7542
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Designer:
0
Address:
o0 0
�cc o°`o
Phone:
INS EG
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1
Longshoremen's and Harbor Workers' Compensation Declaration -
Carrier
: AMERICAN EQUIT
Policy No: ALMA01661-04
Fire Inspection Fee:
$0.00
$0.00
Fire Plan Check Fee:
$0.00
Plan Dep - Counter Review: $0.00
Records Mangement:
$12.00
Plan Dep - Zoning Plan Check: $0.00
Harbor Plan Check Fee:
$0.00
Plan Dep - OverTime Plan Check: $0.00
PROCESSED BY: C�
PLAN CHECK BY: 4/
Plan Check Fee : $312.00 Fee Due at permit Issuance: $310.00
�R�[aIIi73:(�
APPROVAL TO ISSUE:
OTHER DEPARTMENTS:
FINAL INSPECTION:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID 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) 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 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 anc
lessions 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 L) all of or L) 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 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 o.
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
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).
J I am exempt from licensure under the Contractors' State License Law for the following reason:
!y 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 cannot legs
ell a structure WV4l 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 t
'rofessions 13 �d�iS available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw. html.
tignaWre of Property Owner or Authorized Agent Date
.•.. ••.
.ICENSED iOWrRACTOR'S DECLARATION
'hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (com ent g rjttl Se lel 7000) of Division 3 of the Bus' as and ofe si SC nd my license is in full to
mdLIffect. License Class License No. Date o 6 Contractor Signatur .
!QNr4SHOR$f10ENS & HARBOR WORKERS' COMPENSATION DECLATIO
DARNING: FAILURE; 145ECURE LONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION COVERAGE IS U LAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P NALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLA
6''++''����QQ111101, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the followi
1x2tions:
„• I have and will 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
etd� My' .workers' compensation insurance carrier and policy number are:
:arrler • • . Policy Number Expiration Date
tah%ofAgent •••• Phone#
] I certify that, in the erformance the work for ich t is 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
gree that, if I should beco a ubje t the o s' co ensat on provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Iignature of Applican f 7
D/e
)ECLARATION REG RDING CONSTRUCTION L G 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
Lender's Name Lender'sAddress
By my signature below, 1 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.
1 agree to cc pi with all applicable city my ordinances and state laws relating to buildinc
I authorize r Santa' as this 'ty or ounty t enter the above -identified property for inspecti(
signature: Print Name:
Code).
CTION DATE BY
DECLARATION OF,,CCOMPLIANCE IMTH CODE OF
FOROFYbEUSEONLY
FEDERAL REGLIASTIOI+IS PART 61 OF TITLE40AND
AQMDRULE1403.
PERMITEXPIR€D
El I SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
PERMITCAPICELLED
❑ AQMD
PERMIT EXTENDED
ASBESTOS
P❑ROPOSEDDEMOLITION,7IONISNOTAPPLtCABLETO
PERMIT FINAL —2� 2C> DMda_
CERTIFICATEOF
SIGNATURE;
OCCUPANCYISSUED
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