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Home My WebLink AboutF2017-0623 - Permitswnas City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIII II FIRE Permit: F2017-0623 _ 100 Civic Center Drive, Newport Beach, CA: 92660 F 2 0 1 7 0 6 2 3 Project No : 2598-2017 E Permit Counter Phone (949)644-3288 '�4rrnw""xb Inspection Requests Phone (949)644-3255 -Job Address: 717 LIDO PARK DR N13 Description: COMM DOCK FIRE SERVICE RPDA & POTABLE BACKFLOW, FIRE HYDRANT Inspector Area: FIRE Legal Description: SEC 28 T.6 R 10 AND SEC 33 T 6 R 10 20.98 AC IN SECS Owner: CURCI MICHAEL Contractor: BELLINGHAM MARINE IND INC Architect: Address: 717 LIDO PARK DR Address: SPARLING LANE C " Address: NEWPORT BEACH CA 82663 Phone: 949-673-1060 Phone: DIXON CA 956208810 �rQ 707-678-2385. C y ` Phone: ° mm e.m• State Lie: . ..-�. Applicant: MASSABKI FRED -Con State Lie: 442499 Engineer: m•e• m---- o o MASON RANDY HOWARD e Address: 7755 CENTER AVE tic Expire: 07/31/2019 Address: 7755 CENTER AVE #1060 HUNTINGTON BEACH CA 92647 Bus Lie: BT01101867 HUNTNGTN BEACH CA 92647 Phone: 657.227-7457:. Lie Exp Date:: .09/30/2019 Phone: 657-227-7454. State Lie: C-030569Y m . o ° z. a • o Code Edit: 2016" Worker's Compensation Insurance Designer: • • t • aA m ® ° Type of Construction: .Carrier: ALASKA NATIONAL INS CO Address: ... Occupancy Group: U Policy No: 17KWD32133 Added /New sq.Bldg: 0 Expire: 11115/2018 Phone:o ft Added /New sq: ft: Garage: 0 - m ° m Y4 ,� m o No of Stories: 0 Issued Date: 11/14/2018 Special Conditions: No of Units : 0 'Setback- Front - - Flood Zone: - Rear. 'I Bldg Sprinklers: N Left: Right -... FEES - Construction Valuation: - $40,000.00 BuildingPC Fee: $0.00 - Fire Residential Alarm PC Fee: $0.00 Records Management: $0.00 Building Overtime PC Fee: $0.00 Planning Counter Review: $0.00 Building Extention Fee : $0.00 Planning Zoning PC Fee : '$0.00 - Building investigation Fee: $0.00 $0.00 Fire Plan Check Fee: - $327.00. Public Works PC Fee: $0.00 $0.00 Fire Permit Fee : $417.00 Public Works Traffic Plan Check Fee; $0.00 Building Permit Feer `.$0.00 TOTAL FEE : $1,020.000 Plan Check Fee: $276.00 Fee Due at Permit Issuance : $744.00 PROCESSED BY: �l ^` �' '� :.OTHER DEPARTMENT: ,f�A pJ ZONING APPROVAL: PLAN CHECKED BY:: o FIRE APPROVAL..: `�-.,F' APPROVAL TO ISSUE: L PERMIT EXPIRES 180 DAYS. AFTER ISSUANCE OR LAST VALID INSPECTION OWNER -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) (Section 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 the 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 and Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption.: Any violation of Section 7031.5 by any applicant for a permit subjects the applicant toa civil penalty of not more than five hundred dollars ($500). ❑ I, as owner of the property, or my. employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered 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 improvesthe property, provided that the improvements 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 or improved 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 not apply 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: By my signature belo%l 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 sell a structureRfidelipve 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 and Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.govicalaw.htmi. :S'iahhi a of Propartybwner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION herippy affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing wit actio 000) f Division 3 of the Busin sand Profession ode, and my license is in full force and effect. Licansa Class •�•••: License No Date �� Contractor Sig tura � WORKERS' 9CgPENSATION DECLARATION ..... WARNING'. FAILURE T06000RE WORKERS' COMPENSATION COVERAGE I5 UNLAWFUL, AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000), IN ADDITION TO THE t037•d'F COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LASORCODE, INTEREST, AND ATTORNEY'S FEES. i dtbrtbf affirm ugder penalty of perjury one of the following declarations: 0 I have and•will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th drf&Once of the work for which this permit is issued. Policy No. ... . . ve and wiM rrtalntain 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' compensatiol msuran carrier and policy number are: - Carrier Policy Number Expiration Date is of Agent certify that, in the p� , if I should become lature of Applicant,) ice of the work for which this permit is issued, I shall not employ any person in any manner soas to become subje to the to W#Iworkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those prgvisiorjs. hereby affirm under enally of perjury that there is a construction lending agency for the performance of the work for which this permit is ender's Name Lender's Address ly 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 coRnt I agree to. comply with all applicable city and county'ordinance;pond la I authorize representatives of this city or county t e,�I W thel 97;1e( ACTION PERMITRNAL CERTIFICATE OF OGCUPANGYISSUED DATE y I BY Is relating to building construction. property for inspection purposes. Print Propertv Owner FEDEPAL ❑ I SUBMfTFEDASBESTOS NOTIFICATION TO:- ❑ EPA ❑ AQMD ❑ ASBESTOS NOTIRCARONIS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE:: , Civil Code). laws of California, and