HomeMy WebLinkAboutM2021-0084 - Permits (5)City of Newport Beach - Building Division "M2021 -0084'
.? 100 Civic Center Drive, Newport Beach, CA 92660
' Permit Counter Phone (949)644-3288
HARBOR Permit: M2021-0084
Project No : 3023-2021
Inspection Requests Phone (949)644-3255
Job Address: 2676 BAY SHORE DR Floor:
Suite: Bldg:
TIE
0
AND DEADMEN 'KCV-riq P
1![
Comef
Description of Work: SFR REBUILD SEAWALL, INSTALL NEW -BACKS
Inspector Area: 2
Legal Description: IRVINE SUB LOT 171 BLK 54 POR OF LOT
Owner: 8 BAYSHORE PARTNERSHIP LP
Contractor:
ASSOCIATED PACIFIC CONST/JAIME Engineer:
PETROV PLAMEN
Address: 5100 CAMPUS DR STE 300
Address:
495 EMBARCADERO
Address:
28161 CASITAS CT
NEWPORT BEACH, CA 92660
MORRO BAY CA 93442
LAGUNA NIGUEL CA 92677
Phone:
Phone:
805-772-7472
Phone:
714-717-7542
State Lic:
C-066947
Applicant: SMITH SUZETTE
Con State Lic:394886
Designer:
Address: 3654 SACREMENTO ST
Lic Expire:
1113012022
Address:
SAN FRANSISCO, CA 94118
Bus Lic:
ST30047194
Phone: 415-440-4480
Lic Exp Date:
05/31/2022
Phone:
Special Cond:
Issued Date 02/11/2022
Longshoremen's and Harbor Workers' Compensation Declaration -
Carrier : AMERICAN LONGSHORE MUTUAL ASSN
Policy No: 2020010391755Y
Expire : 10101/2022
FEES
Valuation:
$65,000.00
Fire Inspection Fee:
$0.00
$0.00
Inspection Fee:
$314.00
Fire Plan Check Fee:
$0.00
Plan Dep - Counter Review:
$0.00
Plan Check Fee
$329.00
Records Mangement:
$8.00
Plan Dep - Zoning Plan Check:
$0.00
OT Plan Check Fee:
$0.00
Harbor Plan Check Fee:
$61.00
Plan Dep - OverTime Plan Check:
$0.00
Investigation Fee:
$0.00
Building Green Fee :
$3.00
TOTAL FEE :
$715.00
Plan Check Fee :
$715.00
Fee Due at permit Issuance :
$0.00
PROCESSED BY:
PLAN CHECK BY:
DL
PUBLIC WORKS:
APPROVAL TO ISSUE: 5 EC
OTHER DEPARTMENTS:
FINAL INSPECTION
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
OWNER -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 I. n(s)
(Section 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
the 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
Professions 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
not more than five hundred dollars ($500).
11 I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business 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
improvements 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
improved for the purpose of sale).
I, as owner cf 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
apply to an owner Lf 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 exernp! iron licensure under the Contractors' State License Law for the following reason:
IIE,y 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 permit, I cannot legal)
sell 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 applicable law, Section 7044 of the Business an
Professions Cni'c, it available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
I Siynature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
!I nereoy affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full fort
,eaJ a.fzct. License Class License No. Date Contractor Signature
LONGSHOREII & HARBOR WORKERS' COMPENSATION DECLARATION
WR'II'Ir: FAILURE TO SECURE LONGSHOREMEN'S 6 HARBOR WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
�I$100-00U), IN ADDIIJON Yp 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
declarations:
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 is
issued. My workers' compensation insurance carrier and policy number are:
Carrier Policy Number Expiration Date
Name of Agent Phone #
certify that, in the performance of the 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, an
agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Signature of Applicant:
Date:
DECLARATION REGARDING CONSTRUCTION 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 representatives of this city or county to enter the above -identified property for inspection purposes.
Signature: Print Name: Date:
ACTtON FlA7f 8Y DECLARATION OF COMPLIANCE 4tRTH CODE OF FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TITLE 40 AND
AQMD RULE 1403.
PERMIT EHPtRED
❑ t SUBMtTTEDASf3EST05 NOTIFICATION 70:
❑ EPA
❑ AQMD
P€RMfr caNc€tc€D
P€KNIT EXTE7+J"DED
❑ ASBESTOS I+IORFlCAT(ON IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMIT FINAL
CERTf,SfCATE OF
QCCtJPANCYlSSUED
SIGNATURE: