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Home My WebLink AboutM2021-0016 - Permits/tr � City of Newport Beach - Building Division 1pill111111111111111111111111111111111111111111111111 100 Civic Center Drive, Newport Beach, CA 92660 M 2 0 2 1 0 0 1 6 xlF,tr i n Permit Counter Phone (949)644-3288 NO cnhl4z-rnr _ Job Address: 113 BAYSIDE PL Floor: Suite: Bldg: 0 Description of Work: SFR DOCK REPLACEMENT OF PIER, PLATFC}Fi�„GgN�GWA AN ^ "�FLOATING DOCKS Inspector Area: 5 L J�� t V rt r Legal Description: CORONA DEL MAR LOT ELK D POR OF ELK Owner: FRANK SUSAN ALICE TR S A Address: 225 S LAKE AVE STE1150 PASADENA, CA 91101 Phone: State Lic: Applicant: GILLEN PAUL Address: 2901 WEST COAST HWY NEWPORT BEACH CA 92663 Phone: 949-258-4410 Special Cond: LIQUEFACTION HIGH DENSITY Issued Date 08/20/2021 Valuation: $349,000.00 Inspection Fee: $314.00 Plan Check Fee $329.00 OT Plan Check Fee: $0.00 Investigation Fee: $0.00 Building Green Fee : $14.00 TOTAL FEE: $3,621.00 PROCESSED BY: PLAN CHECK BY: Contractor: ASSOCIATED PACIFIC CONST Address: 495 EMBARCADERO MORRO BAY CA 93442 Phone: 805-772-7472 C-091467 Con State Lic:394886 Lic Expire: 11/30/2022 Bus Lic: ST30047194 Lic Exp Date: 05/31/2022 HARBOR Permit: M2021-0016 Project No : 0539-2021 Inspection Requests Phone (949)644-3255 Cc Engineer: `may' MURPHREE, JOSH UA M �50N Address: 61-655 KAMEHAMEHA 1-11/ ,VAY HALEIWA HI 96712 Phone: V 808-349-4990 L ' Designer: �'J >> co Address: ' Phone: Longshoremen's and Harbor Workers' Compensation Declarabon - Carrier: AMERICAN LONGSHORE MUTUAL " Policy No: ALMA00765-071 USLB FEES Fire Inspection Fee: $0.00 $0.00 Fire Plan Check Fee: $0.00 Plan Dep - Counter Review: $0.00 Records Mangement: $76.00 Plan Dep - Zoning Plan Check: $0.00 Harbor Plan Check Fee: $245.00 Plan Dep - OverTime Plan Check: $0.00 Plan Check Fee : $613.00 PUBLIC WORKS: APPROVAL TO ISSUE: OTHER DEPARTMENTS: FINAL INSPECTION: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION Fee Due at permit Issuance : $3,008.00 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) 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 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 and fessions Code) or that he or she is exempt from Iicensure 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 0 more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U 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 thi 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 c roved for the purpose of sale). 1, 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 nol 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). J I am exempt from Iicensure under the Contractors' State License Law for the following reason: 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 legalh all 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 anc rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw. htm 1. ignature of Property Owner or Authorized Agent Date ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing wit Sec'on 7000) of Division 3 of the Busine�yB aPPro son ,and my license is in full force id effect. License Class License No. DaContractor Signature ® ) ONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION DECLARAT16N ARNING: FAILURE 7C DE-URE 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 16qq,,pp001, IN ADDITL7N Tn 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 o^1a%Ptlons: I have and wil, 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 red.. My workers' compensation insurance carrier and policy number are: arne, Policy Number Expiration Date ameof 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, and Tree that, if I shoJlh became sub to the workers' c mpensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. innature of Applicant:� 7 Dates IFCLARATION REGARDING CONSTRUC ION LENDING AGENCY I hereb/ 3Y7m 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 Lenuer's Name Lender'sAddress By my signature below, 1 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 cIth all applicable city and county ordinances and state laws relating to building construction. I authorize rtaDtive ofthis o/�jounty to —enter the above -identified property for inspection purposes. Signature/ —AA /�/,/(�-� Print Name: Civil Code). ACTION DATE BY OF COMPLI DEOF FOR OFFICE USE ONLY LATIONSPART670 !TL AND 03. PERMITEXPIRED rDRE D ASBESTOS NOTIFICATION TO: PE,RAAIT CANCELLED PERMITEXTENDED NOT7FCATIONISNOTAPPLtCA TO MQUTION. PERMIT FINAL q CERT'clCATEOF SIGNATURE: / � O=PANCYISSUED