HomeMy WebLinkAboutM2024-0004 - PermitsmioRr City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII� II
e Community Development Department- Building Division M 2 0 2 4 0 0 0 4
100 Civic Center Drive, Newport Beach, CA 92660
D }ep Permit Counter Phone: (949) 718-1888
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CgCiFORN�P newportbeachca.gov/civic
Work Class - Other
Harbor Permit :M2024-0004
Plan Check No: PC2024-0128
Issued Date : 02/08/2024
Final Date:
Permit Status: Issued
Inspection Area : 7
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 : 2607 COAST HWY W Legal Desc : N TR 919 BLK LOT H TR 919 LOT H FOR OF LOT AS DESC
Description: COMM R/R DOCK FRAMING AND (2) 4'XS' FLOATS TO MATCH (E) CONDITIONS.
Owner • PCH RESTAURANT AND MARINALLC Contractor : S O U T H SHORE M A R I N E Architect:
CONSTRUCTION INC
Address :
3903 BELLAIRE BLVD HOUSTON, TX 77025
Address : 19051 GOLDENWEST ST, 106-119
HUNTINGTON BEACH, CA 92648
Phone :
(949) 887-5755
Phone : (562) 592-1357
Con State Lie : 1082069
Applicant :
CHANTELE BOYETT
Lie Expire : 10/31/2025
Address :
1024 LAKE ST HUNTINGTON BEACH, CA
Bus Lie: BT30076917
92648
Phone:
(562) 592-1357
Bus Lie Expire : 10/31/2024
Code Edition : 2022
Type of Construction :
Occupancy Groups: U
Building Setbacks :
Flood Zone : AE, 8 FT; X; X
Use Zone : MU-W1 - Mixed -Use Water
Processed By:
SPECIAL CONDITIONS:
The Longshore and Harbor Workers' Insurance
Carrier: NEW YORK MARINE & GEN INSURANCE CO
Policy No; WC202100023269
Policy Expire: 11/3/2024
Fire Sprinklers : NO
Fire Hazard Zone : NO
Address :
Phone
State Lie
Engineer:
Address
Phone:
„
Designer:
MAX ZAYV JACKSON
Address :
19051 GOLDEN WEST ST, 106-119
HUNTINGTON BEACH, CA 92648
Phone:
(714)732-6127
Construction Valuation : $4,800.00
c i 'a.,' ..,g
DECLARATION
I hereby amrm Linder penalty of perjury that I am exempt fromthe Contractors' State Lcense Law for the. reasons) indicated below by the eheckmark(s) I have placed next to the applicable items)
Aion 7031.5, Business and Professions Code:. Any city or county that requires a permittD construct, after, improve, demolish, or repair any structure, prior to Is issuance, also requires the applicant fo
permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors' State License Law (Chapter9 (commencing with Section 7000) of Division 3 of the Business am
fessions Code) or that he or she is exempt from I censure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applcant for a permil subjects the apple to a civil penalty o
more than five hundred dollars (5500).
I, as owner of the property, or my employees with wages as their sole compensation, will. do (, all of or L) portions of the work, and the structure Is not Intended or offered for sale (Section 7044,
mess and ProreS510nS Code, The Contractors' State License Law does not apply to an owner of property who, through employeesor personal effort, bulds or improves the property, provided that the
movements are not intended or Offered for sale. IF, however, the building or improvement is solo within one year of completion, the Owner-Buider will have the burden of proving that it was not built a
owed for the purpose of sale).
I, as owner of the property, am exclus"mely contracting with licensed Contractors to construct the. project (Section 7044. Business and Professions Col The Contractors' State License Law does not
y to an Owner of property who builds or improve; thereon, and who contracts forthe projects with a licensed Contractor pursuant to the Contractors' State License Law).
U I am exempt from Ilcensuna under the Contractors' State License Law for the following reason:
By my signature below I acknowledge that, except for my personal residence In which I must have resided for at least one year pr or to completion of the improvements covered by
set 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 Taw Section
Professions Code. is available upon request when this application is submitted or at the following Web site:http:lfwww.leginfD.ca.gov/caaw_Il
Slgra W re of Property Owner or Autholzed Agent Date
�rrrt, I cannot le
of the Business
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury That I am licensedunder provisions of Chapter 9 (con�ryt�acing with section 7000) of. Division 3 ofthe Bus ad Profession Code, and my license is in full force
and effect. License Class License fro. Date j� 2! ;7 p, Contractor Signatures
LONG SHOREM1i BTS & HARBOR WORKERS' COMPENSATION DECLARATION —
WARN'l FAILURF TO rE.0 RE LONGSYOREIVENIS8 HARBORWORKERS'COMPENSATION COVERAGE IS UN.L FUL,AND SHALL SUBJECT" EMPLOYER TO CRIMINAL PENALitES AND CIVIL FINES UP TO ON HUNDRED THOU SAND DOLLARS
01100,D(L I, IN AD JITUII Tu THE COST OF CONIPEN SATION, DAMAGES AS PROVIDED FUR N SECTION SPoS OF THE LABOR CODE,, INTEREST, AND ATTORNEY'S FEES. I hereby affimn udder penalty .of perjury one of the following
I have and will m..aintam 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
My workers' compensation insurance Gamier and policy number are:
Pokey Number Expiration Date
Anent Phone #
I certify that, in the performance of the work forw hick this permit is issued, I shall not employ any person in any manner so as to become subject to theworkers' compensation law sof
that IT I should become subject to the wakens' compensation provisions of Section 3700 of the Labor Code, I Shall font lth Comply With those provisions.
Irure ofPppl'caril \/ 0
Dat�7. f Si'�
LENDING AGENCY
I hereby Tft.T.I under penalty of perjury that there Is a. construction lending agency forthe performance of the work forwhieh this permit. is issued (Section 3097
Lender's Name LenaersAddress
By my signature below., I. certifyto each of the following:.
I am the property owner or authorized to act on the property owners behalf.
I have read this application and the ihformation I have provided is correct.
I agree to comply w Lin all applicable city and county ordinances and slate laws relating to building construction.
I authorze representatives of�this city or county to enterthe above -identified property for inspection purposes.
Signature: ;,se
V v \ Print Nairl (',`��a,��p
CivH Code).
ACTION
DATE
BY
ram., ...«,4..— -,."
FEDERAL REGULATIONS PART 610E MILE 40AND
AQMD RULE 1403,
❑ f SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERMIT EY'PVREO
PERM? CANCELLED
PERMIT EXTENDED
SSEDT EMOU T ON 7/ON IS N OT APPLlGABLETO
PERA41T FINAL
CERTIFFCATEOF
OCCUPANCY ISSUED
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