HomeMy WebLinkAboutM2021-0078 - Permitsfit'8,nt'l'G+p
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City of Newport Beach - Building Division 111111111111111111111111111111111111111�11111111111
100 Civic Center Drive, Newport Beach, CA 92660 M 2 0 2 1 0 0 7 8
Permit Counter Phone (949)644-3288
HARBOR Permit: M2021-0078
Project No : 2897-2021
Inspection Requests Phone (949)644-3255
Job Address: 499 VIA LIDO SOUD Floor: Suite: Bldg: 0
Description of Work: REMOVE/REPLACE (E) PIER
Inspector Area: 2 ss
Legal Description: TR 907 LOT 20 AND LOTS 21 TO 25 INCLUSIVE AND POR ABAND STIR
Owner: LIDO ISLE COMMUNITY ASSN Contractor: SHELLMAKER INC �,`` Engineer: PETROV PLAMEN
Address: 701 VIA LIDO SOLD Address: 837 W 17TH STREET lt� Address: 2816 ITAS CT
NEWPORT BEACH, CA 92663 COSTA MESA CA 92627 ag IGUEL CA 92677
Phone: Phone: 949-548-5359 Ph 4-717-7542
State Lic: C-066947 0 1
Applicant:
LIDO ISLE COMMUNITY ASSN
Address:
701 VIA LIDO SOLD
NEWPORT BEACH, CA 92663
Phone:
949.673-6170
Special Cond:
Issued Date 01/20/2022
Valuation:
$30,000.00
Inspection Fee:
$314.00
Plan Check Fee .
$329.00
OT Plan Check Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee :
$2.00
TOTAL FEE : $706.00
PROCESSED BY: 'J1
PLAN CHECK BY: R5
Con State Lic:561434 Designer:
Lic Expire: 03/31/2023 Address:
Bus Lic: BT00009706
Lic Exp Date: 01/31/2022 Phone:
Longshoremen's and Harbor Workers' Compensation Dec
Carrier: LONGSHORE
Policy No: L&H-9049451( b�F.. I
Expire : 07/11/2022�
FEES
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 Plan Check Fee:
$61.00
Plan Dep - OverTime Plan Check:
$0.00
Plan Check Fee
: $390.00
Fee Due at permit Issuance :
$316.00
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PUBLIC WORKS:
APPROVAL TO ISSUE:
OTHER DEPARTMENTS:
FINAL INSPECTION: _
E ° PERMITEZPIR&180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
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I hereby affirm under penalty of perjury that 1 am exempt from the Contractors' State License Law for the resson(s) Indicated below by the checkmark(s) I have placed next to the applicable Item(s)
ction 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 R
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 an
fessions Code) or that he or she is exempt from icensure and the basis for the alleged exemption. Ally 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 U allofor U por lom of the work, and the structure Is not intended or offered for sate (Section 7044,
Iness and Professions Code: The Contractors' Slate License Law does not apply to an owner of property who, through employees' or personal effort, builds or 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 complet(on,the Owner-Bullder will have the burden 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 Lew 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 licensureunder the Contractors' State License Law for the following mason:
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 this pem
a structure that 1 have built as an owner-0uilder if It has not been constructed In Its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of
desslons Code, is available upon request when this application Is submitted or at the following Web site:hltp:/lwww.leginto.ca.gov/calaw.himl.
nature of Property Owner or Authorized Agent Dale
TCENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty rjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business a d Pr sans Code, and Iy loan�e s in
nd effect. License Class License No. $hI �t c— Dale J— Contractor Signature • `��
.ONGSHOREMEN'S & HARBOR WORKERS' COMPENS T(A ON OECLARATION
IARN'ING: FAILURE TO SECURE LONGSHOREMEN'S 6 HARBOR WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES. AND CIVIL PINES UP TO ONE HUNDRED THOUSAND
:100,000), IN ADDITION TO THE COST OF COMPENSATION, OAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penally of perjury one of the
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
My r ers' compensation _ (insurance carder and policy nu�eb �p.� Expiration Date
A—af G`O' Policy Number _.. i
1 Card that, in the dominance of the work for which this permit is Issued I,lsga 1 ploy any person in any manner so as to become subject to the workers' compensation laws of California,
that, (f I Quid bSo subject to workers' co anon p visions of SJr do 70D o the LahorCotle, I shall forthwith comply with those provisions.
rture of pplic _ ^
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�4670111
DATE
BY
EC RATIO D PLIA CE MTH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONSPART6I OFTJTLE40AND
AQMD.RULE 1403.
❑ 1SUBMITTEDASBESTOSNOTIFfCATIONTO:
❑ EPA
❑ AQMD
❑ ASBESTOS N07IRCATIONJS NOTAPPLICABLETO
POPOSED.DEMOLIT(ON. • • • •
PERMIT EXPIRED
PERMITCANCELLED
PERMITEXTENDED
PERMITFJNAL
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CERTIFICATEOF
SIGNATURE:
OCCUPANCYISSUED