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Home My WebLink AboutM2020-0028 - Permitsa City of Newport Beach - Building Division IIIIIINIIIIIIIIIIIIIII��III�IIIIIIIIIIIIIIIIII II HARBOR Permit: M2020-0028 100 Civic Center Drive, Newport Beach, CA 92660 M 2 0 2 0 0 0 2 a Project No: 0816-2020 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 1 PUBLIC ROW Floor: Suite: Bldg: 0 Description of Work: (RUBY AVE & N. BAY FRONT) NEW SWIM DOCK AND (2) 12" SQ CONCRETE PILE *CITY JOB* Inspector Area: Legal Description: Owner: CITY OF NEWPORT BEACH Address: 100 CIVIC CENTER DR NEWPORT BEACH, CA 92660 Phone: 949-644-3043 State Lic: Applicant: MORALES MARISSA Address: 6351 INDUSTRY WAY WESTMINSTER, CA 92660 Phone: 949-631-3121 Special Cond: Issued Date 05/18/2020 Contractor: SWIFT SLIP DOCKIPIER BUILDERS Address: 6351 INDUSTRY WAY Expire: 12/31/2020 WESTMINSTER CA 92683 Phone: 949-631-3121 C-066947 FEES Con State Lic:797052 Lic Expire: 07/31/2021 Bus Lic: BT01122734 Lic Exp Date: 11/30/2020 Engineer: PETROV PLAMEN Address: 28161 CASITAS CT Expire: 12/31/2020 LAGUNA NIGUEL CA 92677 Phone: 714-717-7542 Designer Address:g`�� U.0 Orr - Phone: Longshoremen's and Harbor Workers' Compensation Declaration - Carrier : AMERICAN EQUIT Policy No: ALMA01661-04 PROCESSED BY: PLAN CHECK BY: PUBLIC WORKS: APPROVALTOISSUE: OTHER DEPARTMENTS: FINAL INSPECTION: _ PERMIT EXPIRES 180 DAYSAFTER ISSUANCE OR LAST VALID INSPECTION Expire: 12/31/2020 FEES Valuation: $25,000.00 Fire Inspection Fee: $0.00 $0.00 Inspection Fee: $297.00 Fire Plan Check Fee: $0.00 Plan Dep - Counter Review: $0.00 Plan Check Fee $0.00 Records Mangement: $0.00 Plan Dep - Zoning Plan Check: $0.00 OT Plan Check Fee: $0.00 Harbor Plan Check Fee: $576.00 Plan Dep - OverTime Plan Check: $0.00 Investigation Fee: $0.00 Building Green Fee: $1.00 TOTAL FEE : $1.00 Plan Check Fee: $1.00 Fee Due at permit Issuance : $0.00 PROCESSED BY: PLAN CHECK BY: PUBLIC WORKS: APPROVALTOISSUE: OTHER DEPARTMENTS: FINAL INSPECTION: _ PERMIT EXPIRES 180 DAYSAFTER ISSUANCE OR LAST VALID INSPECTION 1NER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' Stale License Law for the reason(s) indicated below by the checkmark(s) 1 have pieced next to the applicable 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 IN 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 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 improvements covered by this pern 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 applicable law, Section 7044 of Ifessions Code, is available upon request when this application is submitted or at the following Web site:hltp://www.leginfo.ca.gov/calaw.htmi. nature of Property Owner or Authorized Agent Date Business -ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force Ind effect. License Class License No. Date Contractor Signature -ONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION DECLARATION YARNING: FAILURE TO SECURE LONGSHOREMEN'S a HARBOR WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS $100,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 7706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penally of perjury one of the following 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 is My workers' compensation insurance carrier and policy number are: Policy Number Expiration Date of Agent Phone If I certify that, in the performance of the 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, that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Iture of Applicant: LARATION REGARDING CONSTRUCTION LENDING 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, Civil 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 representatives of this city or county to enter the above -identified property for inspection purposes. Print Name: ACTION I DATE I BY `"" ,_ _I Z 1 ❑1SOBMITTEDASBESTOS N071F1CATIONTO: PERMIT CANCELLED ❑ EPA PERMLTEXTENDED ❑ AQMD ❑ ASBESTOS NODRCAAONIS NOT APPLICABLE TO PERMIT FINAL PROPOSEDDEMOUTION, CERTIFICATE OF OCCOPANCYtSSOED SIGNATURE: OSEONtY