HomeMy WebLinkAboutM2021-0053 - Permits�yK'r„�� City of Newport Beach - Building Division "M2021-0053*
0 - 6 100 Civic Center Drive, Newport Beach, CA 92660
a. z, Permit Counter Phone(949)644-3288
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Job Address: 3909 MARCUS AVE Floor: Suite: Bldg: 0
Description of Work: SFR REINFORCE (E) SEAWALL
Legal Description: CANAL SECTION LOT 4 BLK 339(AND SELY 8.5 FT LOT 5 BILK 339
Owner: SHIELDS JUNE
Contractor:
EKEDAL CONCRETE INC
Address: 3909 MARCUS AVE
Address:
19600 FAIRCHILD RD STE 123
NEWPORT BEACH, CA 92663
IRVINE CA 92612
Phone:
Phone:
9491729-8082
State Lic:
C-066947
Applicant:
PETROV PLAMEN
Address:
28161 CASITAS CT
LAGUNA NIGUEL CA 92677
Phone:
714-717-7542
Special Cond:
Issued Date 11/16/2021
Valuation:
$50,000.00
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: $712.00
PROCESSED BY:
PLAN CHECK BY:
Con State Lic:487590
Lic Expire: 0212812022
Bus Lic: BT00005971
Lic Exp Date: 1013112022
HARBOR Permit:
Project No : 1802-2021
Inspection Requests P
M2021-0053
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,-49)644-3255
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Engineer:
PETROV PLAMEN
Address:
28161 CASITAS CT
LAGUNA NIGUEL CA 92677
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Phone:
714-717-7542
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Designer:
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Address:
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Phone:
Longshoremen's
and Harbor Workers' Compensation
Declaration -
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Carrier:
LONGSHOREMAN -ZURICH
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Policy No: WC380494701
Exoire :
10/01/2022
FEES
Fire Inspection Fee:
$0.00
$0.00
Fire Plan Check Fee:
$0.00
Plan Dep - Counter Review:
$0.00
Records Mangement:
$6.00
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 : $322.00
PUBLIC WORKS: c
APPROVAL TO ISSUE: S
OTHER DEPARTMENTS: U�
FINAL INSPECTION:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
ILDER 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)
,lion 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 to
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 am
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,
mass 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 the
rovements 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).
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
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 fallowing reason:
my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year priorto completion of the improvements covered by this permit, I cannot le
a structure that Ihave 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 7044 of the Business
dessions Code, is -available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
nature of FrCpa,ty Owner or Authorized Agent Date
ICENSED CONTRACTOR'S DECLARATION
hereby affirm under benalty of perjury that I am licensed under provisions of Chapter 9 (co cing ith Section 7000) of Division 3 of the Busiltia and Prof ss' ode, and my license is in full force
rd effect. License Cass License No. Date t Contractor Signature
ONGSHOREI".Erl'S & HARBOR WORKERS' COMPENSATION DECLARAVTIOX
ARMNG: FAILURE 1 n SECURE LONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
1]C,00), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following
I hav,: 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
1, My workers' compensation insurance carrier and policy number are:
_ _ _. Policy Number Expiration Date
of Agent Phone #
I certify that, in the perfo;mance of the work for which this permit i5 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 becofyie subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Iture of, oolicant: / �h n \ / I r
III
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 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 city and county ordinances and state laws relating to building construction.
I authorize r resentatives of this city or county to enter the above -identified property for inspection purposes.
I
Signature: -� Print Name�"gr4�� rs Date: t
ACTION
DATE
BY
DECLARATION OFCD PLIANCE INITN CODE OF
FEDERAL REGULATIONS PART 61 OF TIRE 40 AND
AQMD RULE 1403.
❑ I SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE:
FOR OFFfGE USE ONLY
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIRCATEOF
OCCUPANCYISSUED