HomeMy WebLinkAboutM2020-0053 - PermitsCity of Newport Beach - Building Division IIIIII�IIIIIIIIIIIIII�IIIII�IIIIIIIIIIIII II
100 Civic Center Drive, Newport Beach, CA 92660 M 2 0 2 0 0 0 5 3
Permit Counter Phone (949)644-3288
HARBOR Permit: M2020-0053
Project No: 1902-2020
Inspection Requests Phone (949)644-3255
Job Address: 3101 COAST HWY W Floor: Suite: Bldg: 0
Description of Work: COMM (PRIVATE RENTALS ONLY) RIR MARINA SECTION R(2) GANGWAYS W/ NEW CONFIGURATION TO ACCOMODATE GANGWAY, MOVE (3) PILES
& REPLACE (2) PILES
Inspector Area: 7
Legal Description: TR 919 LOT M(AND NWLY 100 FT LOT G
Owner:
JAKOSKY TRUST
Contractor:
SWIFT SLIP DOCK/PIER BUILDERS
Engineer:
PETROV PLAMEN
Address:
503 32ND ST #200
Address:
6351 INDUSTRY WAY
Building Green Fee :
Address:
28161 CASITAS CT
NEWPORT BEACH CA 92663
WESTMINSTER CA 92683
LAGUNA NIGUEL CA 92677
Phone:
949-673-0500
Phone:
C-066947
949-631-3121
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Phone:
714-77 7542
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State Lic:
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Applicant:
MORALES MARISSA
Con State Lic:79705
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Designer:
Address:
6351 INDUSTRY WAY
Lic Expire:
Address:
WESTMINSTER, CA 92683
Buse
1122734
Phone:
949-631-3121
Lic ate:
11/30/2021
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Phone:
Special Cond: AIC 2587-2019
Issued Date 0311712021
Valuation:
$190,000.00
Inspection Fee:
$308.00
Plan Check Fee
$322.00
OT Plan Check Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee :
$8.00
FEES
Fire Inspection Fee: $0.00
Fire Plan Check Fee: $0.00
Records Mangement: $54.00
Harbor Plan Check Fee: $136.00
TOTAL FEE: $1,112.00 Plan Check Fee: $742.00
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PROCESSED BY: ;� E PUBLIC WORKS:
PLAN CHECK BY: Y� APPROVAL TO ISSUE:
Longshoremen's and Harbor Workers' Compensation Declaration -
Carrier : AMERICAN EQUIT
Policy No: WC173816804
$0.00
Plan Dep - Counter Review: $0.00
Plan Dep - Zoning Plan Check: $0.00
Plan Dep - OverTime Plan Check: $0.00
Fee Due at permit Issuance: $370.00
4
OTHER DEPARTMENTS:
.. ..: :
FINAL INSPECTION:
PERR MIT EX EXPIRESS18 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
MER -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)
: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 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 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 th(
rovemenls 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).
I am exempt from licensure under the Contractors' State License Law for the following reason:
my signature below 1 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 lel
I a structure that I have built as an owner -builder if it has not been constructed in its entirely by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business
rfessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
nature of Property Owner or Authorized Agent Date
ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencin ith So 7000) 7000) of Division 3 of the Bu ss an 7rols5 ns nd my license is in full fores
nd effect. License Class License No. Date T y Contractor Sign /_�
ONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION DECLAR N
ARNING: FAILURE TO SECURE LONGSHOREMEN'S 8 HARBOR WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
400,0001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty 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 #
I certify that, in the performance of tha�w6frk-f6Fwhlch 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 beco sub' to w rkers' co ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Iture Applic t 1 2-
Dat
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RATION RE ARDIN ONSTRUCTION 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, 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 Rraftd,cOunty ordinances and state laws relating to building construction.
I authorize rep ante his or unt to enter the above -identified
property for inspection purposes.
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Print Name: 1\' 1� '\ Ei ( J
Date:
signature:
A ON DATE BY
DECLARATO H COMPLIANCE WITH CODE OF
FOR OFFICE USE ONLY
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