HomeMy WebLinkAboutM2018-0079 - Permits (2)IIII III VIII VIII ILII ILII IIIIIMIII IIIIIaflI III I'I 4 ° °c a
City of Newport Beach -Building Division HARBOR Permit: M2018-0079
100 Civic Center Drive Newport Beach, CA 92660 M 2 0 1• B 0 0 7 9 Project No: 2969-2018
Permit Counter Phone .(949)644-3288.
Inspection Requests Phone (949)644-3255
4
Job Address: 341 BAYSIDE DR Floor: Suite: Bldg: 0
Description of Work: COMM-RECONFIGUATION OF EXTG FLOATING DOCK AT SLIP TO INCREASE WIDTH FOR NEW PEDESTRIAN GANGWAY
2969-2018
Inspector Area; 7
Legal Description: SEC 26 T 6 R 10 RECTANGULAR LOT IN SW1/4
Owner: IRVINE COMPANY Contractor: BELLINGHAM MARINE IND INC Engineer: FUNSTON CRAIG S
Address: 111 INNOVATION Address: 8810 SPARLING LANE ' Address: 1601 F STREET
IRVINE CA 92617 - DIXON CA 95620 BELLINGHAM WA 98225
Phone: Phone: 707-678-2385 Phone: 360-715-0121 -
State Lie: S-004876
Applicant: POKHREL USMITA Con State Lic:442499 Designer. 1
aS[ 1s: IIF!
Address: 8810 SPARLING LN Lie Expire: 07/31/2019 Address: ✓ 1 1 ,
DIXON CA 92640 Bus Lie: BT01101867 g
Phone: 707-761-4192 Lie Exp Date: 0 913 0/201 9 Phone:
Special Cond: Longshoremen's and Harbor Workers' Compensation Declaration
Carrier: ALASKA NATIONAL INS CO
Issued Date 04/22/2018 Policy No: 18KWD32133
Expire : 11/15/2019
FEES
Valuation: $193,000.00 Fire Inspection Fee: $0.00 $0.00
Inspection Fee: $287.00 Fire Plan Check Fee: $182.00 Plan Dep - Counter Review: $0.00
Plan Check Fee $302.00 Records Mangement: $42.00 Plan Dep -Zoning Plan Check: $0.00
OT Plan Check Fee: $0.00 Harbor Plan Check Fee: $0.00 Plan Dep - OverTime Plan Check: $0.00
Investigation fee:$0.00
Building Green Fee: $8.00
TOTAL FEE : $821.00 Plan Check Fee ` $484.00 Fee Due at permit Issuance: $337.00
PROCESSED BY: HARBOR RESOURCES: GW
PLAN CHECK BY:\ APPROVAL TO ISSUE;
OTHER DEPARTMENTS: Y
FINAL INSPECTION
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
p tl PV' • O -•• 11!
fNER-BUILDER DECLARATION • '.• : .
I hereby affirm under penalty of perjury that I am exempt fro%the Contractors' State LictenSe41w for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable'Item(s)
otion 7031.5, Business and Professions Code: Any city or cont: th4 rrequire: 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 pIlfrauant*o the provjsir ns of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business ani
fessions Code) or that he or she is exempt from licensure andfjie basis for itle 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 compent9tion, fill dc: all of or (_).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 oiproperty 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 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).
I am exempt from licensure 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 lei
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
(fessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
nature 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 (cD ncingg W With Section 7000) of Division 3 of the Busl e s and Profess) n de, and my license is in full
nd effect. License Class License No. Dat `F Contractor Signaturte�
ONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION DECLAIWItDN
A`RNING: FAILURE TO SECURE LONGSHOREMEN'S a HARBOR WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOL
1k%0001,_ 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 follc
1 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
of Agent 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 become subject to the workers' compensation pro talons of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Iture of AoDitcant: e 1 % . m
LENDING AGENCY
I hereby affirm 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, Civil Code).
Lender's Name Lender'sAddress
By my signature below, I certify to each of the following:
1 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 orcountyto enter the above -identified property for inspection
� purposes.
Signatury1;4 Nalp ZL
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ACTION DATE
BY
DECLARATIONNOFC MPLfANCEIVITHCOM07
FOR OFFICE USE ONCY
FEDERAL REGULATIONS PART 61 OFTITLE40AND
AQMD RULE 1403.
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P€RMiT EXPIRED
I SUBMITTED ASBESTOS N07IF[CATION TO:
❑ EPA
❑ AQMD
P€RMITCANCELLED
P€RA41T EXTENDED
E3 ASBESTOS M07IRCA770NIS NOT APPLICABLE TO
PROPOSEDDEMOLITfON
PERMITFiNAt $. �'
CERTIFICATEOF
OCCUPANCYISSUED
SIGNATURE: