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Home My WebLink AboutM2020-0029 - PermitsY Pt City of Newport Beach - Building a 100 Civic Center Drive, Newport Beach, CA 92660 -} Permit Counter Phone (949)644-3288 Division iiiiiiiiq II NO CONSTRUCTION NOISE HARBOR Permit: M2020-0029 Project No: 0821-2020 Inspection Requests Phone (949)644-3255 ON SATURDAYS 0 Job Address: 1 PUBLIC ROW Floor: Suite: Bid : 0 °* e g. Description of Work: (10TH ST & W. BAY)) REMOVE AND REPLACE SWIM PLATFORM AND (2) 12" CONCRETE PILE "LIKE FOR LIKE"* *CITY JOB** Inspector Area: 1 Legal Description: Owner: CITY OF NEWPORT BEACH Address: 100 CIVIC CENTER DR NEWPORT BEACH CA 92660 Phone: 949-644-3043 State Lie: Applicant: MORALES MARISSA Address: 6351 INDUSTRY WAY WESTMINSTER CA 92660 Phone: Special Cond: Issued Date 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 Contractor: SWIFT SLIP DOCKIPIER BUILDERS Address: 6351 INDUSTRY WAY Engineer: PETROV PLAMEN Address: 28161 CASITAS CT LAGUNA NIGUEL CA 92677 Phone: 714-717-7542 Designer: Address: Phone: Longshoremen's and Harbor Workers' Compensation Declaration - Carrier : AMERICAN EQUIT Policy No: ALMA01661-04 Fire Inspection Fee: WESTMINSTER CA 92683 Phone: 949-631-3121 C-066947 Plan Dep - Counter Review: $0.00 Con State Lic:797052 $0.00 Lie Expire: 07/31/2021 Bus Lie: BT01122734 Lie Exp Date: 1113012020 Engineer: PETROV PLAMEN Address: 28161 CASITAS CT LAGUNA NIGUEL CA 92677 Phone: 714-717-7542 Designer: Address: Phone: 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: $0.00 Plan Dep - Zoning Plan Check: $0.00 Harbor Pian Check Fee: $0.00 Plan Dep - OverTime Plan Check: $0.00 TOTAL FEE : $1.00 Plan Check Fee: PROCESSED BY: PLAN CHECK BY: $1.00 Fee Due at permit Issuance: $0.00 PUBLIC WORKS: v v APPROVAL TO ISSUE: _v OTHER DEPARTMENTS: FINAL INSPECTION: _ PERMIT EXPIRES 190 DAYSAFTER ISSUANCE OR LAST VALID INSPECTION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the feasun(s) Indicated below by the checkmark(s) I have placed next to the applicable Item(a) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, after. Improve, demolish, or repair any structure, prior to Its Issuance, also requires the applicant for the 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 and Professions 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 of not more than five hundred dollars (350D). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure Is not Intended or offered for sale (Section 7044, Business 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 Improvements are not Intended or offered for sale. If, however, the building or Improvement is sold within one year of completion, the Owner-Suilder will have the burden of proving that it was not built or improved for the purpose of sate). t, as owner of the property, am exclusively contracting with licensed Contractors to constmc(the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not • • • ° apply to an owner of propedywfro builds or Improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors State License Law). • • • • ❑ 1 em exempt from licensure underthe Contractors' State Llcense Law for the following reason: • , , , , By'my signature below I acknowledge that, except for my Personal residence In which I must have resided for at least one year riorto com Ietto of the Improvements covered b this ermi I cannot le all • • • • • : • • • sell a structure that I have bulli as an owner-bugder H s not been onstructed in its entirely by licensed contractors. I Understand that a copy of the applicable law, Sect lon 7044 of the Business and g • • • • Professions Code, is available upon _ p o fined twhen iso I " n' sub at the Ilowing Webs'rte:http://www_leginfo,ce.gov/celaw.hlmt, r� • , • • Signature of Property Owner orAuthorizetl Agelrt Dale ' ri '!. GI�_ •+° , • LICENSED CONTRACTOR'S DECLARAT10N— a --D' • . • • • • ( 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 Prof�awftKOR. y I ns full force • • • • and effect License Class License No Date Contractor Signature' YY • • • • , • , • • • ORKERS' COMPENSATION DECLARATION —�� • • • • ARNMG: FARURE TO SE URE WDWERa' COMPEHgpIiDN COVERAGE IS UNLAWRiL, AND SHALL WBUECr AN EMPLOYER 70 CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND WIMARS (S1na,00a), IN AUDITION TO THE ,••.• , Gar OFCOMPENSATION,DAMAGE$ASPRWIOEDFDRMSECTIORMlOFTNEU RGOOE,Ur1EREST,AWATTORNEY5F . „: • • • I hereby affirm under penalty of perjury one of the following declarations: • • • ,' I have and will maintain a certificate of consent to self -insure for workers' compensation, Issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th •,,, once ofthe work'for which this permit is Issued. Policy No. • • „_ , ° • •01 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Coe, for the performance of the work for which this permit Ia Issued. My workers' ompensabol • • • • i nonce carrier and policy number are: tar r Policy Number Expiration Dale Name of Agent Phone # certify that, in the performance ofthe workjoorwhich this permit is Issued, l shall not employ any person in any manner so as to become subject to the workers' ompansation laws of Califomia, and agree If I should become supjeLyto e w <emr- ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. r I Iaareof Appbord '/ \d Date _:'CJI j 2 3 J' 2k7 =LARATION REGARDING CONSTRUCTION LENDINGAGENCY reby 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). des Name Lender's Address ny signature below, I certlly to each ofthe follawing: I am the property owner or authorized to act on the property owner's behalf. I hove read this application and the information I have provided Is correct I scree to comply with all applicable city and quinty ordinances an a lam relating to building construction.I authorize represenatives of this city or coty to a above en[ etl property for inspection purposes. , _ _n _. A n _ . / ACTION REGUTATIONS PART 61 OF TIRE 40 AND AQMD RULE CERMlIC47F l� Ino s NOTIFICATION IS NOTAPPUCABLE 70 CERTIFifATE OF V DEMOUnON OCCUPANCY ISSUED �4 eroiine. FOR OFFICE USE ONLY n \ ! \ \ ) CdOD(D 2 t u % \ 2 \ }/ z;� ;)» 2 VA \ �