HomeMy WebLinkAboutM2020-0027 - PermitsCity of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIII'�IIIIIIIIIIII�� II HARBOR Permit: M2020-0027
100 Civic Center Drive, Newport Beach, CA 92660 M 2 0 2 0 0 0 2 7 Project No : 0812-2020
Permit Counter Phone (949)644-3288
Inspection Requests Phone (949)644-3255
NO CONSTRUCTION NOISE
Job Address: 3904 CHANNEL PL Floor: Suite: Bldg: 0
Description of Work: INSTL NEW FLOATING DOCK, GANGWAY, AND (2) 14' PILE
Inspector Area: 1
$25,000.00
Inspection Fee:
Legal Description: CANAL SECTION LOT 1 BILK 539 ALL -INC BET SAME & HIGH TIDE LINE -(AND
Owner: 3900 CHANNEL PLACE #3 LLC
Contractor:
SWIFT SLIP DOCKIPIER BUILDERS
Address: 15 CORPORATE PLAZA DR #150
Address:
6351 INDUSTRY WAY
NEWPORT BEACH, CA 92660
$1.00
WESTMINSTER CA 92683
Phone:
Phone:
949-631-3121
State Lic:
C-066947
Applicant: MORALES MARISSA
Address: 6351 INDUSTRY WAY
WESTMINSTER CA 92660
Phone: 949-631-3121
Special Condr
Issued Date 05/20/2020
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
TOTAL FEE: $1,198.00
PROCESSED BY:
PLAN CHECK BY:
Con State Lic:797052
Lic Expire: 07/31/2021
Bus Lic: ST01122734
Lic Exp Date: 11/30/2020
ON SATURDAYS
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Engineer: PETROVPLAMEN
Address: 28161 CASITAS CT
LAGUNA NIGUEL CA 92677 `
Phone: 714-717-7542 ®° !
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Designer: I P CTInt? °e
Address: ® i
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Phone:
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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:
$12.00
Plan Dep - Zoning Plan Check: $0.00
Harbor Plan Check Fee:
$576.00
Plan Dep - OverTime Plan Check: $0.00
Plan Check Fee : $888.00
PUBLIC WORKS:
APPROVALTOISSUE:
OTHER DEPARTMENTS:
FINAL INSPECTION:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Fee Due at permit Issuance: $310.00
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INER-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
'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 th(
'ovements 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
"oved 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
'y 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
a structurafhel, 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
�fessions Cp"eavailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
nature of PraerLy Owner or Authorized Agent Date
r••
:I�SED I',;ONI°RACTOR'S DECLARATION
rreby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (com e i with coon 7000) of Division 3 of the Bus! _ and P s 'o Co e,
reffect. License cess License No. Date Contractor Signature
A.SHOR%MlEN•S & HARBOR WORKERS' COMPENSATION DECLARATION'
of the Business
license is in full
NARMG: FAILURS TO SECURE LONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION COVERAGE IS UNWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE AURES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
{109,0001, IN ADDIvio •TG THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 F THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I ereby affirm under penalty of perjury one of the following
6%;r, ions:
• • • I have andytill 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
S d: My°•workers' compensation insurance carrier and policy number are:
'amj Ufa ° • ° Policy Number Expiration Date
fame of Agents •' •' Phone #
] I certify that, in the pelformance of the work for which tWs.Krmit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, anc
agree that, if I should become geeHeAhe v�crkers'compenygiion p ovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
signature of Applicant:
Da
)ECLARATION REGA ING CONST CTION LE I AGENCY
I hereby affirm u der 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' Name Lender'sAddress
By my signature below, I certify to each of the following:
I am the property owner or authorized to act property owner's behalf. -
I have read this application and the informatio I ha provided is correct.
I agree to co wI ap ble cit and cou ord'nances and state laws relating to building con ruction.
I authorize resentative f this ity r ounty to a above -identified property for inspection p rposes. .
signature Print Name: CJ c / / � / Date: Zo Zo
ON I DATE I BY 11 DEC AHATION FCOMPLIANCEtMTHCODEOF FOR OFF FOSE ONLY
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❑ ASBESTOS NOTIFICATIONIS NOT APPLICABLE TO
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