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Home My WebLink AboutM2019-0013 - Permits,Pit ye of N41wp?rt Beach -Building Division ��IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII �� HARBOR Permit: M2019-0013 o, m 106 Livid Cent9r OnQee Ne�pQrt Beach, CA 92660 M 2 0 1 9 0 0 1 3 Project NO : 0317-2019 PejmQCguQteQPQonp (949J644-3288 Valuation: $30,000.00 I w4 s�wT�u' Inspection Requests Phone (949)644-3255 Inspection Fee: $287.00 Fire Plan Check Fee: •. ®•B' m•m 00m 0•m mm Plan Dep - Counter Review: $0.00 Plan Check Fee $302.00 Records Mangement: Job Address: 1704 BAY FRONT S Floor: Suite: Bldg: 0 Plan Dep -Zoning Plan Check: $0.00 Description of Work: R/R (2) EXISTING 4' WIDE T -PILE & PIER LIKE FOR LIKE $0.00 Harbor Plan Check Fee: Inspector Area: 2 Plan Dep - OverTime Plan Check: $0.00 Legal Description: BALBOA ISLAND SEC 5 LOT 4 BLK 3(AND ELY 12.7 FT LOT 3 BILK 3 $0.00 Owner: HURRAY PATRICIA L Contractor: 'SWIFT SLIP DOCK/PIER BUILDERS Engineer: PETROV PLAMEN Address: 1704 BAY FRONT S Address: 6351 INDUSTRY WAY Address: 28161 CASITAS CT NEWPORT BEACH, CA 92662 WESTMINSTER CA 92683 LAGUNA NIGUEL CA 92677 Phone: Phone: 949-6313121 Phone: 714-717-7542 State Lie: C-066947 Fee Due at permit Issuance: $293.00 Applicant: JACQUELYN CHUNG Con State Li¢797052 Designer: +, � Address: 6351 INDUSTRY WY Lie Expire: 07/31/2019 Address:, r WESTMINSTER CA 92683 Bus Lie: BT01122734 Phone: 949-631-3121 Lie Exp Date: 11/30/2019 Phone: ;1 a Special Cond: Longshoremen's and Harbor Workers'. Compensation Declaration - Carrier: AMERICAN LONGSHOR Issued Date: 02/12/2019 Policy No: ALMA01662-01 PROCESSED BY: HARBOR RESOURCES: L�li PLAN CHECK BY: APPROVAL TO ISSUE: OTHER DEPARTMENTS: FINAL INSPECTION: PERMIT EXPIRES 180 DAYSAETER ISSUANCE OR LAST VALID INSPECTION tx ire:3uavzu1v FEES. Valuation: $30,000.00 Fire Inspection Fee: $0.00 $0.00 Inspection Fee: $287.00 Fire Plan Check Fee: $0.00 Plan Dep - Counter Review: $0.00 Plan Check Fee $302.00 Records Mangement: $4.00 Plan Dep -Zoning Plan Check: $0.00 OT Plan Check Feer $0.00 Harbor Plan Check Fee: $131.00 Plan Dep - OverTime Plan Check: $0.00 Investigation Fee: $0.00 Building Green Fee: $2.00 TOTAL FEE : $726.00 Plan Check Fee : $433.00 Fee Due at permit Issuance: $293.00 PROCESSED BY: HARBOR RESOURCES: L�li PLAN CHECK BY: APPROVAL TO ISSUE: OTHER DEPARTMENTS: FINAL INSPECTION: PERMIT EXPIRES 180 DAYSAETER ISSUANCE OR LAST VALID INSPECTION FNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(e) f fiave:placed next to•the*applicable item(s) :tion 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, dric'to Rg i*u$nce 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 Beitirfi TOSO) Af,Divillipfl 34 jhe Business ani 'essions 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 to a civil penalty c more than five hundred dollars ($500). 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions of the work, and the structure4s not.intendebor offered for sale19grction 7044, iness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effolj, talildC br iplplovIes the property, pcowded that th, rovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder wlll1have the burd&r of roving thtt ittva$ 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 doesnol 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 im 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 ifessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm nature of Property Owner or Authorized Agent ICENSED CONTRACTOR'S DECLARATION herebyaffirm under penalty of perjury that I am licensed under provisions of Chapter 9 com ci It ti f Division 3 of the usi ass nd rofr P Y P 1 rY P P ( r g, �T,=QQQ%J� nd effect. License Class License No. Date // �yv tr !! Contractor Signa u OMGSHOREMN'S 8 HARBOR WORKERS' COMPENSATION DECLARATION A INC: FAIrL,URE SECURE LONGSHOREMEN'S a HARBOR WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTI AND CIVIL 10 ttDD1Tl TO THE _,COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND AT FEES. I bare affirm ur I covered by this permit, I cannot lel law, Section 7044 of the Business Date Jins , and my license is in full f S UP TO ONE HUNDRED THOUSAND DOLL penalty of perjury one of the follov eve nd will maintain Longshoremen's and Harbor workers' compensation insurance, as required by Section 3700 of the Labor Code, f r theIefformance of the work for which this permit My workers' compensation insurance carrier and policy number are: Policy Number Expiration Date ent Phone # Ify that, ina performa 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, ' I should b ome subject a worker ' cosmpe�+ Sation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ^/ ofAppliD nt: ✓ /ei�.�,! IZ-24,6 I hereby affirm under Lender's Na By my signature below, I I am the property I have read th' applicati I agree to co ply with �l I authorizer presents as LENDING AGENCY of pery that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ii Lender'sAddress toI of the following: Drifed to act on the property owner's behalf. the information I have provided is correct. ble city and county ordinances and state laws relating to building constru tion. city or county to enter he above -identified property for inspection purpo as. __ Print Name: 2. 12—' L ®t� ACFlON I /ikiTF I BY II FEnERAL TI 11DECLARAON PART 610€TITLOMPUANCE WITH E40AND ' J EOFFOR OFFICE USE ONLY AQMD RULE 1403 f SUBUTTEDASBESTOS NOTI€]CATION TO: ❑ EPA ❑ AQMD ❑ ASBESTOS NO7fRCATIONIS NOT APPLICABLE TO PROPOS€OD€MOLITICIM SIGNATURE: