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Home My WebLink AboutM2022-0003 - PermitsCity of Newport Beach - Building Division 111111III IIIIIpIII IIIII IIII111111p11111111111p11111 100 Civic Center Drive, Newport Beach, CA 92660 M 2 0 2 2 0 0 0 3 H ry. Permit Counter Phone (949)644-3288 Job Address: 403 BAY FRONT N Floor: Suite: Bldg: 0 Description of Work: REMOVE/REPLACE (E) FLOATING DOCK, PIER AND GANGWAY Inspector Area: 2 Legal Description: BALBOA ISLAND RESUB SEC 1 BILK 8 LOT 2 Owner: FORBES TONY Contractor: SWIFT SLIP DOCK/PIER BUILDERS Address: 403 N BAY FRONT Address: 6351 INDUSTRY WAY NEWPORT BEACH, CA - WE$TMINSTER CA 92683 Phone: Phone: 949-63 r-31$1 State Lic: C-066947 Applicant: OCAMPO RANDY Con State Lic:797052 Address: 6351 INDUSTRY WAY Lic Expire: 07/31/2023 WESTMINSTER, CA 92683 Bus Lic: BT01122734 Phone: 949-631-3121 Lic Exp Date: 11/30/2022 Special Cond: Issueddi31e , 02/01/2022 Valuation: $85,000.00 Inspection Fee: $314.00 Plan Check Fee $329.00 OT Plan Check Fee: $0.00 Investigation Fee: $0.00 Building Green Fee : $4.00 -i'OTAL FEE : •t657.00 PROCESSED BY: PLAN CHECK BY: 10 HARBOR Permit: M2022-0 Project No : 0107-2022 Inspection Requests Phone (949)644-3255 Engineer: PETROV PLAMEN Address: 28161 CASITASCT LAGUNA NIGUEL CA 92677�..1, Phone: 714-717-7542 Designer: Address: \ ! !{ �✓® Phone: Longshoremen's and Harbor y �catjap 1�1� on - Carrier: AMERICA , C: 1 R Policy No: WC173816804 Fsnire , 121a112022 4- Fire Inspection Fee: $0.00 $0.00 Fire Plan Check Fee: $0.00 Plan Dep - Counter Review: $0.00 Records Mangement: $10.00 Plan Dep - Zoning Plan Check: $0.00 Harbor Plan Check Fee: $0.00 Plan Dep - OverTime Plan Check: $0.00 ; ,PIEn Check Fee; `,,U90.00 PUBLIC VSQRKS: APPROVAL TC ISSUE: OTHER DEPARTMENTS: FINAL INSP--CTION : PERMIT EXPInES 18o DAYS AFTER IS.QUANCE OR LAST VALID INSPECTION Fee Due at permit Issuance : $267.00 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 fc 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 any 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 c 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, Iiness 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 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). 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 no ply 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 Iicensure under the Contractors' 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 completion of the improvements covered by this permit, I cannot le I 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 rfessions Code, is available upon request when this application is submitted or at the following Web site:hftp://www.leginfo.ca.gov/calaw. html. mature of Property Owner or Authorized Agent Date 10ENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commg�cing with Section 71 00) of Division 3 of the Business ns de-at5d my license is in full nd effect. License Class License No. Date /\ Z/0I/2D yb Contractor Signature ONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE LONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION COVERAGE Is UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND S UP TO ONE HUNDRED THOUSAND DOL �100.000). 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 folk 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 My workers' compensation insurance carrier and policy number are: Policy Number Expiration Date Phone # I 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, that, if I should became subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Iture of Applicant;,) —{/)_ 11,i , / -- LENDING AGENCY I hereby affirm under penalty of pe ury 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 ail applicable city and county ordinances and state laws relating to building construction. I authorize representatives s of this city or county to enter the above -identified property for inspection purposes. ��An Signature: i Print Name: I C"Ayl7% Date: ACTION O TE BY DECLARATION Ot- MPLIANCE tMTHCODEOF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TIRE 40 AND AQMD PUL E 1401 PERA4I T EXPIRED ❑ I SUBMITTrD 1SB-STOS NJT7FA:ATiON TO: ❑ EFA CI AQMD PERMIT CANCELLED PERMIT EXTENDED ❑ ASBESTOS N077FICA77ON IS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL /d. 31-Zt— D+L-+- F07L CERTtRCATE OF SIGNATURE: OCCUPANCYISSUED