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Home My WebLink AboutM2020-0047 - Permits�'gNt Pr),�A City of Newport Beach - Building Division VIII IIIIIIIIIIIIIIII�I III�IIIIIIIIIIIIIIII II HARBOR Permit: P12020-0047 oar 100 Civic Center Drive, Newport Beach, CA 92660 M 2 0 2 0 0 0 4 7 Project No :1362-2020 H.. �� Permit Counter Phone (949)644-3288 °�[�yy,µ�a. - Inspection Requests Phone (9-19)644-3255 Job Address: 2525 Work: OCEAN BLVD GE Floor: Suite: Bldg:NN CTOR Description of Work: MFR -EMERGENCY DOCK REPAIR @CHANNEL REEF HOA 1362-2020 I Inspector Area: 5 Legal Description: PM 261-10 PAR. 1 OF PROJECT 895-25 LOCATED ON AP 052-013-35 TOGETHER Owner: CHANNEL REEF COMM ASSOC Contractor: APEX DIVING & MARINE SERV Engineer: Address: 2525 OCEAN BLVD Address: 15061 SHERMAN WAY STE J Address: CDM CA 92625 VAN NUYS, CA 91405 Phone: Phone: 818-787-1794 Phone: State Lic: Applicant: DURAN DWAIN Con State Lic:1006937 Designer: m • • ° ° Address: 15061 SHERMAN WY UNIT J Lic Expire: 08/31/2021 Address: VAN NUYS CA 91405 Bus Lic: BT30069290 • ° ° Phone: 949-590-9966 Lic Exp Date: 05/31/2021 Phone: ° ooco°o e a c a o-. o c o00 Special Cond: Longshoremen's and Harbor Workers' Compensa!ion.Feclafation ...... ° Carrier: LONGSHOREMANS 4 Issued Date 09/15/2020 Policy No: 921 6 743-1 8 Expire: 0812412020 m •• - FEES o000 0 Valuation: $45,600.00 Fire Inspection Fee: $0.00 $O�OU• �• Inspection Fee: $308.00 Fire Plan Check Fee: $0.00 Plan Dep - Counter Review: ^.0.00 Plan Check Fee $322.00 Records Mangement: $12.00 Plan Dep - Zoning Plan Check: $0.00 OT Plan Check Fee: $0 Harbor Plan Check Fee: $136.00 Plan Dep - OverTime Plan Check: '.0.00 Investigation Fee: 0.00 Building Green Fee: $2.0IL 0 TOTAL AT .00 Plan Check Fee: $0.00 Fee Due at permit Issuance: $760.00 PROCESSED BY: PUBLIC WORKS: f PLAN CHECK BY: APPROVAL TO ISSUE: OTHER DEPARTMENTS: FINAL INSPECTION: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LASTVALID INSPECTION I herebyaffirm under. penalty of pedury that I am exempt; from the Contractors' State: License Law for the reason(s) indicated. below cion 7031.6, Business. and Professions Code: Any city orcounty that: requires a permit%toconstruct,' alter, improve,,,demolish,;, or repair permit to file a signed: statement that he or she is licensed pursuant to the:, provisions of the Contractors' State License Law (Chapter'.9,( essionsCode) or that lieorshe isexemptfrom licensure and the basis for the alleged': exemption. Any violation of Section 7031.5 by more than five hundrec dollars ($500). the to 1,. as owner of thepioperty; or my -employees, with wages as their sole compensation, will do U all of or U .portions of the work, and the. structure isnot intended i or offered for sale (Section 704 ass and Professions: Code: The: Contractors' State License Craw does not apply toanowner of property who,':through employees' or personal effort, (builds or improves the property, provided that I vements are not -intended or offered for sale. If,, however, the building or improvement is sold within one yearof completion; the Owner -Builder will have the burden of paving that it was not built ved for the: purpose of sale). I, as owner of the property, am exclusively with licensed Contractors to :construct the project (Section 7044, Business and'Professions Code: The Contractors' State License Law does n to an owner of property who builds or improves and who contracts -'for the.projects with a. licensed Contractor pursuantto thesContractors' State. License Law).. of:the 'Business . :1 ORS DECLARATION ally of perjury that I amlicensed under provisions of- Chapter .9 License No. 2< HARBOR WORKERS' COMPENSATION DECO INV: • . • e . I have;arfti'MI maintain' Longshoremen's and Harbor workers'lcompensaUon'.insurance, as required by Section 3700 of the Labor Code, :for the performance -of the work for which this: permit is •• My -workers' compensation 'insurancecarrier and ,policy number are: Pnnry Nnmhar Exo1ratibn Date _._. • • •� certiydha4 6'4the.performance of the work for which this permit is issued, I shall not employ anyperson in any:manner so as to become subject to the workers' compensation. laws of Cafrfomia; et , if I-shbuldYecwne subject to the workers' compensation provisions Of Section 3700 of the Labor Code, I shalfforthwith comply with those provisions. :an/10C& � Qit� Date.)( ---09/15/2020 • - • .... • • • • I hereby pff 'bn.ler 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). Len f es Name. LendeetAddress: _ By my signature below, I certify to each of the following: I am the: property owner: or authorized to action the propertyowner's. behalf. I have •read 'this application and the information I have provided: is correct::. I agree to: comply with ;ill applicable city. and county ordinances: and state laws relating to building construction. I authorize reoresentati les of this city or county+toenter theyaboveAdentifiedoronerNfor.insoection oumoses. i Deckard Datez-k:57 09/15/2020 - AC7701V DATE BY DECLARA77ON OFCOMPLIANCE.WITH CODEOF 'FOKOFFICEUSEONLY FED ERAL.REGULATfoNS PART'§ f 10F i(TLE40 AND- AQMDRUI E1403. PERMfrapiRED- ❑ ISUBMITTEDASSESTOSN077FlCA77ONTO: ❑. EPA ❑ AomD PERMITCANCELLED PERMITEXTENDED ❑ ASBESTOS 1407IRCARONJS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMfrFINAC ( CER7IFICA7EOF OCCUPANCYISSUED SIGNATURE: