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HomeMy WebLinkAboutM2016-0050 - PermitsW,� Division City of Newpoi tgBeech s BuiLdtnq 00 IIIIII $0.00 I I IIIIIIIII $270.00 Fire Plan Check Fee: I I II IIIIII $283.00 /III II HARBOR Permit: M2016-0050 OT Plan Check Fee: 100 Civic Center Drive, liewpoft eaeh, 6A ® 2660 0 M 2 0 1 6 0 0 5 m Plan Dep - OverTime Plan Check: $0.00 Project No: 2395-2016 $0.00 644 Permit Counter Phone (%P)�268: e Building Green Fee: $2.00 • mee s° �earr;k�a_ Inspection Requests Phone (949)644-3255 m mco 000 ° m m m •m m • mmm m m m e e m s • m m° e • m emm mem m Job Address: 104 VIA LIDO NORD Floor: Suite: Bldg: 0 Description of Work: RELOCATE (4) AND RE -USE (1) MARINA GUIDE PILES, ALT EXTG DOCK REMOVE SECTION FROM WIDE FINGER Inspector Area: 1 Legal Description: N TR 907 LOT 873 Owner: MULLAH EY TIMOTHY JAMES Contractor: SWIFT SLIP DOCK/PIER BUILDERS Engineer: VILLAFANA DONALD EUGENE Address: 4620 E CERRO VISTA DR Address: 642 BAKER ST Address: 4737 ORTEGA ST, #19 ANAHEIM, CA 92807 COSTA MESA CA 92626 VENTURA CA 93003 , ��� Phone: Phone: 949-631-3121 Phone: 805-644-3273 ` State Lic: C-037354 "O Applicant: CHUNG JACQUELYN Con State Lic:797052 Designer: R Address: 642 BAKER ST Lic Expire: 07/31/2017 Address: NEWPORT BEACH CA 92626 Bus Lic: BT01122734 Phone: 949.631-3121 Lic Exp Date: 11/30/2017 Phone: Special Cond: Issued Date 05/31/2017 Longshoremen's and Harbor Workers' Compensation Declaration - Carrier : AMERICAN LONGSHOR Policy No: ALMA01662-01 Expire : 12/31/2017 Valuation: $40,000.00 Fire Inspection Fee: $0.00 $0.00 Inspection Fee: $270.00 Fire Plan Check Fee: $0.00 Plan Dep - Counter Review: $0.00 Plan Check Fee $283.00 Records Mangement: $8.00 Plan Dep - Zoning Plan Check: $0.00 OT Plan Check Fee: $0.00 Harbor Plan Check Fee: $0.00 Plan Dep - OverTime Plan Check: $0.00 Investigation Fee: $0.00 Building Green Fee: $2.00 TOTAL FEE: $563.00 Plan Check Fee : $535.92 Fee Due at permit Issuance : $27.08 PROCESSED BY: PLAN CHECK BY: HARBOR RESOURCES: APPROVAL TO ISSUE: OTHER DEPARTMENTS: FINAL INSPECTION: _ PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION MER -BUILDER DECLARATION •• ••• . • •• •• '^ *"' I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indmDe$ below• tMe the ft4k(s):I have placed next to the applicabfe ii.„ ction 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, Ir repjirinK slokure,•prioL"its issuance, also requires the applicant permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law rChapter 9 (ccImmel?cing with SSaction 7000) of Division 3 of the Business an 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 c more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or(_) portions of=Rr?woricrand the•strtrgture;is not intended or offered for sale (Section 7044, iness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employee$' ori ersonal•effort, blidg of improves the property, provided that th rovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completiom,, the Qwne�-$yildecwill have the Curden of proving that it was not built c roved for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does no ly to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). I am exempt from licensure under the Contractors' State License Law for the following reason: my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the im I a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the (fessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi. nature of Property Owner or Authorized Agent 'ED CONTRACTOR=$. DECLARATION affirm under grena4,of perjury that I am licensed under provisions of Chapter 9 (com n t n 7000) of Division 3 of the Busine s Pr essie tLlcepselass , License No. Date Contractor Signature & HARBOR WORKERS' COMPENSATION DECLARATI CURE LONGSHOREMEN'S &HARBOR WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, ANO SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AN CIVIL FINE TION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby aff rm under and will maintain Longshoremen's and Harbor workers' compensation insurance, as required by Section 3700 of the Labor Code, for workers' compensation insurance carrier and policy number are: I certify that, in that, if I should be I hereby affirm under pe Lender's Name By my signature below, I ce I am the property own I have read this a (cation ai I agree to comply with all app I authorize refire entatives d covered by this permit, I cannot leg; law, Section 7044 of the Business Date nlipodefflind my I!Vense is in full fo 3 Uq TO ONE HUNDRED THOUSAND DOLLA 7pe alty of perjury one of the followi ce of the work for which this permit Expiration Phone # 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, :kers Gompe�on provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. I,e,) 5 r 42,0 NSTR CT109 LENDING AGENCY \ I per' ry that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). LendersAddress �d to act on the property owners behalf. information I have provided is correct. Ity and county ordinances and state laws relatin (ding construction. r county to enter the above -identified oroD v fer for n o� adon Durodses. IMMER MPUF MA 5- it 20 A pp} DAA BY CLARAT/O OF COMPLIAN EWIT CODEOF FOR OFFICEUSE ONLY P RAL GULATIONSPART01OFTfTLE40AND AQM LE 1403. P£RMITEXPIRED ❑ I SUBMIITEDASBESTOS NO7tFICATION TO: ❑ EPA ❑ AQMD PERMITCANCELLED PERMIT EXTENDED ❑ ASBESTOS NO7IFICARONIS NOT APPLICABLE TO PROPOSEDDEMOLITION. 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