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Home My WebLink AboutM2023-0022 - PermitsQ ��WPORT City of Newport Beach O Community Development Department- Building Division �y 100 Civic Center Drive, Newport Beach, CA 92660 >h i Permit Counter Phone: (949) 644-3288 o-. Inspection Requests Phone: (949) 644-3255 CqC/FORN\P newportbeachca.gov/inspections II I I II I III II II I I II I II Harbor Permit : M2023-0022 CheckPlan PC2023-0667 Work Class Other Issued Date: Inspection Area : 1 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays. Job Address : 5 BALBOA COVES Legal Desc : N TR 1011 BLK LOT 5 Description: SFR RELOCATE & RE -DECK FLOATING DOCK & GANGWAY. R/R 2 PILES Owner: ERWIN CHERYL A TR SURVIVORS TRUST Address: 5 BALBOA CVS NEWPORT BEACH, CA 92663 Phone Applicant: MARISSA MORALES Address: 6351 INDUSTRY WAY WESTMINSTER, 92663 Phone: (949)631-3121 Contractor: SWIFT SLIP DOCKIPIER BUILDERS Address : 6351 INDUSTRY WAY WESTMINSTER, CA 92683 Phone: (949)631-3121 Con State Lic: 797052 Lic Expire : 07/31/2023 Bus Lic: BT01122734 Bus Lic Expire : 11/30/2023 The Longshore and Harbor Workers' Insurance Carrier: GREAT AMERICAN ALLIANCE INS CO Policy No: WC173816805 Policy Expire: 12/31/2023 Code Edition : 2022 Fire Sprinklers : NO Type of Construction : Fire Hazard Zone : NO Occupancy Groups: U Building Setbacks : Front: 5, Front: 15, Side: 3, Side: 3 Flood Zone : AE, 8 FT; X Use Zone : R-1 - Single -Unit Residential Processed By: !�§� SPECIAL CONDITIONS: Architect Address Phone: State Lic Engineer: PETROVPLAMEN Address : 28161 CASITAS CT LAGUNA 92677 Phone: (714)717-7542 Designer: Address Phone: Construction Valuation : $26,000.00 CA OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable. ltem(s) >ection 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 for Ic permit to file a signed statement that he or she is licensed pursuant to the provisionsof the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and rofessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 70$1.5 by any applicant for a.. permit subjects the applicant to a civil penalty of of more than five hundred dollars ($500). 7 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, ,usiess and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or Impmves the property, provided that the nprovements 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 riot built or nproved for the purpose of sale). 3 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 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). J I am exempt from licensure under the Contractors' Slate 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 legally) all a structure that I have built asan owner -builder if it has not been constructed in itsentirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and 'rofessions Code, is available upon request when this application Is submitted or at the following Web site:http://www.leginfo.ca..gov/calaw.htmi, signature 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 with Section D0j o ivision 3 of the Business and Pr a sions +u[��^,p,, m license is in full force nd effect. License Class License. No Do Contractor Signatur �I 1 /� VORKERS' COMPENSATION DECLARATION —k 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE. IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS U 100,000), IN ADDITION TO THE DST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 0716 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, hereby affirm under penalty, of perjury one of the fallowing declarations: I I have and will maintain a. certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided tar by Section 3700 of the Labor Code, for the orformance of the work for which this permit is issued. Policy No. have and Will maintain 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' Dance carrier and policy number are: Policy Number is of Agent _ Date It 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 agre ist, If I should becoa su I to ll a/rtr Ir npensahon provisions of Section 3700 of the Labor Code, I shall forthwith comply Win those provisions. �I ignature of Applicar t r I y �� / 1 DafmiCode). fil IECLARATION RE I'2 1G CONSTRUCnON ENDING56,00 ' hereby affirm under enalty oo perjury that there is a construction lending agency for the performance of the. work for which this permit is issued (Section 3097:, enders Name Lender's Address Iy 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 count �f to� er t ov a ified r ertfor Inspection urposes. q\ p q,�`�/� ICnature of Pro erty Owner or Authorized Anent 1 �LI y Print Property Owner's or Authorized Agent's Name X' `rn Iv o r�l I � ate ACTION DATE RY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 PERivNrEXPiRFD ! LJ I SUBMITTED ASBESTOS NOTIFICATION TO PERM?T CANCELLED i DEPA PERMIT EXTENDED OAQMD ASBESTOS NOTIFICATION IC NOT APPLI.ABLL ,O PERMITFINAL CERTIFICATE OF I ��, PROPOSED DEMOLITION OCCUPANCY ISSUED 516NATURE: E )} )( w co \ \ -0 �\ ca In / > �C� ) - / E /* ° ) - I:a/ c § ` \ k e \\ _ ,))�% /§){$ »� ) _ . ) _u c .% {2§0c E; & / �\ R {\ \§7y-e z/ co a) E )) Q ® / \ 0§\\«22 \\ L) {. L C}{ k !\&&/// -06iR� ; �2C}®&� s)c \G a \)77 ) 0\j« zE 2z7 w9St VA k +