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Home My WebLink AboutM2021-0003 - PermitsCity of Newport Beach - Building Division *M2021-0003* 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Job Address: 936 VIA LIDO NORD Floor: Suite: Bldg: 0 Description of Work: SFR REMOVEIREPLACE (E) FLOAT, GANGWAY & (4) PILES Inspector Area: 2 Legal Description: N TR 907 LOT 326 Owner: HARDER STEPHEN Contractor: SWIFT SLIP DOCK/PIER BUILDERS Address: 2148 NE M L KING BLVD Address: 6351 INDUSTRY WAY PORTLAND OR 97212 WESTMINSTER CA 92683 Phone: Phone: 949-631-3121 State Lie. C-066947 Applicant: MARISSA/SWIFT SLIP Con State Lic:797052 Address: 6351 INDUSTRY WAY Lie Expire: 07/31/2021 WESTMINSTR CA 92683 Bus Lie: BT01122734 Phone: 949-631-3121 Lie Exp Date: 11/30/2021 Special Cond: LIQUEFACTION & HIGH DENSITY AREA Workers' Compensation Declaration - Issued Date 0111512021 Valuation: $65,000.00 Inspection Fee: $308.00 Plan Check Fee $322.00 OT Plan Check Fee: $0.00 Investigation Fee: $0.00 Building Green Fee: $3.00 TOTAL FEE: $645.00 PROCESSED BY: PLAN CHECK BY: i 5t.& Engineer: Address: Phone: HARBOR Permit: M2021-0003 Project No : 0080-2021 Inspection Requests Phone (949)644-3255 INSPEO.— PETROV PLAMEN ° 28161 CASITAS CT LAGUNA NIGUEL CA 92677 714-717-7542 ° Iv� .. ® . Designer:®rVNa7lS7R��e Address: -r ON Wgyt Phone: j�/t o N sAT R" iBliMRImen's and�Harboi Carrier: AMERICAN EQUIT Policy No: WC173816804 FEES 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: $0.00 Plan Dep - Over -Time Plan Check: $0.00 Plan Check Fee: $0.00 Fee Due at permit Issuance: $645.00 PUBLIC WORKS: APPROVAL TO ISSUE: OTHER DEPARTMENTS: FINAL INSPECTION: PERMIT EXPIRES 180 DAVSAFTER ISSUANCE OR LAST VALID INSPECTION ass,• 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(: sction 7031.5, Business and Professions Code: Ally city or county that requires a permit to construct. alter, Improve, demolish, or repair any sl,,A m, prior to Its issuance, also requires the applicant permit to fife 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 a Asssions Code) or that he or she Is exempt from l oansure and the basis for the alleged exemption. Any violation Of Section 7031.5 by any apPkcant for a permit subjects the applicant to a civil penalty t more than five hundred dollars ($500). I. as Owner of the property, or my employees with wages as their sole compensation, will do U ah of or U potions of the work, and the structure is not intended or offered for sale (Section 704. siness 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 t rrovements 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 xoved for the purpose or seta). 1, as owner Of the property, am exclusively contracting with licensed Contractors to Contact the project (Section 7044, Busirress and Professions Code: The Contractors' State License Law does n, )Iy 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 llcensure under the Contraclone 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 comple0an of the im a SkVc ue�re� 'th�at 1 have bulk as an owner -builder if It has not been Constructed in Its entirely by licensed Contractors. I understand that a co r the larovemehfs coveted to this 4 of th I cannot toga feaslons IXI , is available upon request when this application is submitted or at the following Web she:hap.'Il ww.legirdo.ce.govfcalaw.html pWeabth law, 5uniton 7044 of the Business n nahhd OPPmperty Owner or Authorized Anent • uare `N TOD; ONTRACTOR'S DECLARATION Iby affirm under penalty of perjury that I am licensed under provisions of Chapter � end cal 7 00) of DWisfoic r i the BusNes�a P alone e, a my Ifcense is in full to dfe6t License Class License NO. __r) Contra gnature,' ty9SHOREMEN'S & HARBOR WORKERS' COMPENSATION DEC TION NG:FI4'ik,�RE TO SECURE LONpeNpagAEN'ea MIRROR wORIrsRS' COMPENSATION COVERAGE n UN wwl, AND SNALL$UaIECT AN EMPLOYER TO CRIMINAL PENAL71F3 Crva INK UP NUNOR TNOUSM1Np OoLu "I' IN AI MmON TI Tni COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECmON area OF Tie ,,,M CODE. RiTH1EeT, AID ATTORNEYS FEES. I hereby 8ttilrii Ulld' pane Of Ws: qury one ofYhe, fog wf ' i nave 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 d! My workers' compensation Insurance carder and policy number are: v N81711 UPAgent Expiration Deft f�7' ' 111�ri,,,ps,,, Phone ti ur : • .Lltrtiry that, in the performance of the work for v parmh is issued, I shall not emplpy any person in any manner so as to become subject to the workers' compensal agree that, if I should become suD a wo rs' onset n provisions of Section 3700 of the Labor Code, I shale forthwith comply whh those provisions. Signature of Apip -� DECLARATION REG RDING CONS T RUC VION LENDING 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 - LendereAddress By my signature below, t eerily tO each of the following: I am the property owner Or authorized to act on the propedy owners behalf. I have read this application and the infarnation 1 have provided Is correcL I agree to Comply with an applicable nd County ordinances and state laws relating to building construction. I authorize datives of this city untytoenter the above4dent'flied property for Inspection purposes. Hill Print Name. C �, ' u lkl S are: 'AMOro DATE Y 10ECLARA OFG'OMPIfAN(�wil ❑ 7SLAWI EDASBE5'TDSNOnRCg7100(70: 0 EPA 0 Awo [j ASBESMSNOURCABONISNOTAPPUGIB.ETO PROPOSED DEMW.fAOfL OCCUPANCYISSpm I i `'mil 11 SIGNATUW, laws of calffomia, Z Z