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Home My WebLink AboutM2019-0011 - PermitsCity of Newport Beach eBuiiding.DeW,s, fr IIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII HARBOR Permit: M2019-0011 a 100 Civic Center Drive, Newport Beach•CA 94660 • • ° Project No: 0224-2019 Permit Counter Phone (949)644-3288 .eo ••• •ee oe• oe Inspection Requests Phone (949)644-3255 Job Address: 219 EVENING STAR LN Floor: Suite: Bldg: 0 Description of Work: REPAIR/UPGRADE BULKHEAD Inspector Area: 3 Legal Description: N TR 4224 LOT 139 Owner: JONES JR. CLIFTON S Contractor: ASSOCIATED PACIFIC CONST Engineer: PETROV PLAMEN Address: 219 EVENING STAR LN Address: 495 EMBARCADERO Address: 28161 CASITAS CT NEWPORT BEACH CA949-456-0685 MORRO BAY CA 93442 LAGUNA NIGUEL CA 92677 Phone: Phone: 805-772-7472 Phone: 714-717-7542 State Lie: C-066947 Applicant: JONES JR. CLIFTON S Con State Lic:394886 Designer: Address: 219 EVENING STAR LN Lie Expire: 11/30/2020 Address: NEWPORT BEACH CA949-456-0685 Bus Lie: BT30062687 Phone: 949-456-0685 Lie Exp Date: 03/31/2020 Phone: Special Cond: Longshoremen's and Harbor Workers' Compensation Declaration -', Carrier: AMERICAN LONGSHORE MUTUAL Issued Date 05/01/2019 Policy No: ALMA00765-07/ USL& Expire : 10/01/2019 FEES Valuation: $40,000.00 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: $0.00 Plan Dep - Zoning Plan Check: $0,00 OT Plan Check Fee: $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 : $722.00 Plan Check Fee : $433.00 Fee Due at permit Issuance: $289.00 PROCESSED BY: PLAN CHECK BY: HARBOR RESOURCES: Lw APPROVAL TO ISSUE: OTHER DEPARTMENTS: FINAL INSPECTION: PERMIT EXPIRES 180 DAYSAFTER ISSUANCE OR LAST VALID INSPECTION INER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the rase n(sf Qldj;a�pcl be%w bathe checkmark(s) I have 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, impsotte.geInolisis, & ril any structure, prior to its 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 (Chapter 94c 0 orr&ropncing with Section 7000) of Division 3 of the 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). , •� I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of rP) pcitionaP of :he fork, and'tTIp stricture is not intended or offered for sale (Section 7044, iness and Professions Code: The Contractors' State License Law does not apply to an owner of propertyw o, ttt}ough employeep•' dt pe Kwnal 6I'fort, 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 oneSkal`0f compI4jpn'ttle OwnerTBu:d (r will have the burden of proving that it was not built D 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 not 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 I a structure that I have built as an owner -builder if it has not been constructed in its entirely by licensed contractors. I understand that a copy of the applicable law, Section ifessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.govlcalaw.html. nature of Property Owner or Authorized Agent Date ICENSED CONTRACTOR'S DECLARATION Limit, I cannot lei of the Business hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (com encing with Section 7000) of Division 3 of the Busttnne s and Profess' and my license is in full force rd effect. License Class License No. Date (YDS ^ I — � 1 �f Contractor Signaturel�---- ONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION DECLARATfON— ARNING: FAILURE TO SECURE LONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 71b0 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 following 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 My workers' compensation insurance carrier and policy number are: Policy Number Expiration Date gent 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 provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Iture of Applicant l{ oat C1 AGENCY I hereby affirm under penally 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). Lenders Name Lender'sAddress By 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 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 or county to enter the above -identified property for inspection purposes. iianature:\S _C (_ Print Name./ �Oi264 im�,Al Dater ACTION DATE BY ULULH rl V1Y VV 4V1V11'LLN1Nl.L 1.111 LULL N, I.. V1111C WJ C L'..I FEDERAL REGULATIONS PART 61 OFTITLE40AND AQMD RULE 1403. PERMITEXPIRED 0 t SUBMITTEDASBESTOS NOTIFICATION TO: 0 EPA 0 AQMD PERMITCANC€LEEP PERMITEXTENDED OOPOSEDBEMQ ASBESTOS TOTIONISNOTAPPI.iCABL.ETO N. PERMITFINAL _23--1S ZYL CERTIFICAT€OF SIGNATURE: OCCUPANCYISSUED