HomeMy WebLinkAboutM2024-0003 - Permitse��Wf>oRr. City of Newport Beach
D e Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 718-1888
C9<�ORN`P newportbeachca.gov/civic
Work Class - Other
II1111111111111111111111111111111111111111111111111111111111Harbor Permit :M2024-0003
Plan Check No : PC2024-0127
Issued Date : 02/08/2024
Final Date:
Permit Status: Issued
Inspection Area : 2
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 : 506 VIA LIDO NORD Legal Desc : N TR 907 BLK LOT 494
Description: SFR R/R DECKING AT (E) DOCK, PIER, AND GANGWAY
Owner: GERALD PHARRIS
Address: 306 VIA LIDO NORD NEWPORT BEACH, CA
92663
Phone: (949)3B3-5678
Applicant: CHANTELE BOYETT
Address : 1024 LAKE ST HUNTINGTON BEACH,
92648
Phone : (562) 592-1357
Contractor
Address
Phone :
Con State Lie
Lie Expire
CA Bus Lie:
SOUTH SHORE MARINE Architect:
CONSTRUCTION INC
19051 GOLDENWEST ST, 106-119
HUNTINGTON BEACH, CA 92648
(562) 592-1357
1082069
10/31 /2025
BT30076917
Bus Lie Expire : 10/31/2024
The Longshore and Harbor Workers' Insurance
Carrier: NEW YORK MARINE & GEN INSURANCE CO
Policy No : WC202100023269
Policy Expire : 11/3/2024
Code Edition : 2022 Fire Sprinklers : NO
Type of Construction : Fire Hazard Zone ; NO
Occupancy Groups: U
Building Setbacks : Front: 4, Front: 10, Side: 3, Side: 3
Flood Zone : AE, B FT; X
Use Zone : R-1 - Single -Unit
- Residential _
Processed By:
Address
Phone :
State Lie
Engineer:
Address
Phone:
Designer: MAX ZAYV JACKSON
Address: 19051 GOLDEN WEST ST,
HUNTINGTON BEACH, CA 92648
Phone: (714)732-6127
Construction Valuation : $55,920.00
NO CONS s RUC .a I I N WORK
SPECIAL CONDITIONS: ON SAT URDA S
106-119
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I:am exempt fromthe ContractorsState License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable item(s)
(Section 7031,5. Business and Professbns Code: Any city or county that requires a penmitto construct, after, improve, demolish, or repair any structure, pnortc, Is issuance, also requires the applicant fc
the permit to file a. signed statement that he or she is licensed pursuantto the provisions of the Contractors' State License Law (Chapter9 (commencing with Section 7000) of Division 3 of the Business an
Professions Code) or that he or she isexempt from rensure and the basis for the alleged exemption. Any violation of Section 70315 by any appl[cant for -a permit subjects the applicant to a civil penalty a
not more than five huhLeo dollars (S500).
❑ 1, as owner of the property, army employees with wages as their sole compensation.. will. do (_) ail of or ( 7 portions ottne work, and the structure is not intended or oriered 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 ntended or offered for sale. if, however, the building or improvement Issold wilhin one year of completion,. the Owner -Builder will have the burden of proving that it was not built o
Erroved for the purpose or sale)
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the protect (Section 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or 1mprDVes thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors` State' License Law).
LJ I am exempt from li'censure underthe Contractors' State License Law for the following reason.
By my signature below I ackmow, ledge that, except for my personal residence in which I must have resided for at least one year pnorta completion of the Improvements covered by thus permit, I cannot le
sell a structure that I have built man owner -builder if R has hot been constructed r its entirety by licensed contractors. I understandthat a copy of the apple able Faw, Section 7044 of the Business
Professions Code, is available upon request when this application is submitted or at the folow Rig Web Ste:http:INrww.leginfo.ca.govtcalaw html.
Signakire of Property Owner or Authorized Agent
Date
;ED CONTRACTOR'S DECLARATION
affirm under penalty of perjury that I am licensed under provisions of Chapterg (comme mgi with Section 7000) of Division 3 of the Bus a and Professions Code, and Fly license is in full fore
:t_ License Cass License No De[e �. I _ >L Contractor Signature r
HOREMEN'S 8. HARBOR WORKERS' COMPENSATION DECLAR.ii
FAH.URr. TO -EJURE LONGSHOREIY£N'S 9 HARBOR WORKERS` COWERSATION COVERAGE IS UNLAWFUL., AND. MALL SUBJECTAN'. EWLOVER TO CR MNAL EE IALTIES AND CIVIL FINES VETO ONE HUNDRED. THOUSAND DOLLARS
IN ADDITION Pr THE COST OF COWEN SATION, DAMAGES AS MOVIDED FORM SECTION �% OF THE LABOR CODE, INTEREST, AND ATLORNEPS FEES. I hereby affirm under penalty of perjury one of the following
ons
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
Mr workers' compensation insurance carrier and policy number are:
Ex piration
none #
I certify that, In the performance of the work forwhic h this permit is issued, I shall not ern ploy any person in any manner so as to become subject to the workers' compensation lawsof California,
ae that. I I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code. I shall forthwith comply with those provisions.
na`ure of l.ppi;4ant: , /)
LE.CL-ARAMON
LENDING
I hereby a.f,l I under penalty of perjury thatthere is a. construction lending agency forthe performance of the work for which this permit. is issued (Section 3097, Civil Code).
Lender's Name LendersAddiess
By mysignature' betow, 1 certifyto each of the following:
I am the property owner or authorized to act on the property owners behaff.
I have read this application and the information I have provided is correct.
I agree to Comply With all applicable city arid county ordinances and state laws relating to building construction.
I authorize representatives of this city or county toenter'the above -identified property for inspection purposes.
Signature:
PATE I BY
PERM l T EY.PIREO
PE""✓A C,VVELLED
PERMIT FINAL
CEFZT! FICA TE nF
OCC+JPANCV i5SJED
Print Name:
rt utlfAL HLUULAI IONS FART (it OF T17LE40 AND
AQMD RULE 1403.
❑ I SUBM17TE& ASBESTOS N077FICATION TO:
❑ EPA
❑ AQMD
MI -ASBESTOS N071 HCA710NIS NOT APPLICABLE TO
%�