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HomeMy WebLinkAboutM2018-0050 - PermitsCity of Newport Beach - Building Division *M2018-0050* o 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 P"axvnu**t* . Job Address: 120 BAY FRONT S Floor: Suite: Bldg: 0 Description of Work: SFR DOCK REPAIR (NO WORK IN HARBOR) Inspector Area: 2 Legal Description: BALBOA ISLAND RESUB SEC 1 BLK 1 LOT 6 Owner: CUPPS ARNE Contractor: Address: 120 BAY FRONT S Address: NEWPORT BEACH, CA 92662 Phone: State Lie: Applicant: SANTANIELLO JAMES Address: 3419 VIA LIDO Address: NEWPORT BEACH, CA 92663 Phone: 714-815-5097 Special Cond: Issued Date 06/27/2018 Phone: SANTANIELLO JAMES 3419 VIA LIDO #115 NEWPORT BEACH CA 92663 714-815-5097 Engineer: Address: Phone: HARBOR Permit: M2018-0050 Project No: 1534-2018 Inspection Requests Phone (949)644-3255 Con State Lic:361862 Designer: SANTANIELLO JAMES Lie Expire: 08/31/2018 Address: 3419 VIA LIDO Bus Lie: BT30035015 Fire Inspection Fee: NEWPORT BEACH, CA 92663 Lie Exp Date: 03/31/2019 Phone: 714-815-5097 seem m e ams• m emse omo ° e 7eav: a des ° ° .. m 00 o ° ° mso o m moo 000 m m o �m° Longshoremen's and Harbor Workers' Compensation Declaration - Carrier: WESCO Policy No: W WC3329846 TOTAL FEE : $679.00 Plan Check Fee $393.00 Fee Due at permit Issuance: $286.00 PROCESSED BY: PLAN CHECK BY: m�ie�YeDl3raL�� APPROVAL TO ISSUE: OTHER DEPARTMENTS: FINAL INSPECTION: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION FEES Valuation: $3,000.00 Fire Inspection Fee: $0.00 $0.00 Inspection Fee: $270.00 Fire Plan Check Fee: $0.00 Plan Dep - Counter Review: $0.00 Plan Check Fee $283.00 Records Mangement: $2.00 Plan Dep - Zoning Plan Check: $0.00 OT Plan Check Fee: $0.00 Harbor Plan Check Fee: $123.00 Plan Dep - OverTime Plan Check: $0.00 Investigation Fee: $0.00 Building Green Fee: $1.00 TOTAL FEE : $679.00 Plan Check Fee $393.00 Fee Due at permit Issuance: $286.00 PROCESSED BY: PLAN CHECK BY: m�ie�YeDl3raL�� APPROVAL TO ISSUE: OTHER DEPARTMENTS: FINAL INSPECTION: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION VNER-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) fiction 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 fo 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 ane ifessions 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 o 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 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 of property who, through employees' or personal effort, builds or improves the property, provided that the movements 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 o moved for the purpose of sale). 1, 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 exerpPt fl`& l 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 Iegall, ,a4uctute Ulat l.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 ani �fessfons Ccpe' jp.dvailable 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 IEpISED Cj7NTP4CTOR'S DECLARATION !rg¢y affirm uflCer penalty of perjury that I am licensed under provisions of Chapter 9 (com ci 'th Sec 7000) of Division 3 of the in s a Professio lbde, and my license is in full fore 1 e ct. License Dass License No. Date Contractor Signat NGBHORICAN'S & HARBOR WORKERS' COMPENSATION DECLA TI Stlii: FAILURE Tg SECURE LONGSHOREMEN'S a HAR13OR WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P N TIES A D CIVIL FINE UP TO ONE HUNDRED THOUSAND DOLLARS VAIN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I reby affirm under penalty of perjury one of the following Sara�jons: ...... .... 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 �wprkers' compensation insurance carrier and policy number are: Tiee:- Policy Number Expiration Date rP of Anent 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 we of California, that, if I should Coe subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. / iture of Appli n . Y -� LENDING AGENCY I herP0iaffirm 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). 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 a ation and the information I have provided is correct. I agree to .ply with II applicable oil);and county ordinances and state laws relating to building co struction. I author' a presents es of this c' r county to enter the above -identified property for inspection urposes. r,, ,�/�' Signature. Print Name:`yf�"t�✓ Ipy�`� Dat/ ACTTD DATE BY ECLARATIO Of COM ARrfil TRCLE40A FOR FICE OSE DNEY FEDERAL UL4TlONSPARTBf OFTfTLE40ANQ FE AQUORUL 1403. - PERMITEXIii i SUBIWTTEUASSESTOS NOTIFICATION T0: ❑ EPA P€RMITCANC€ICED PERMIT EXTENDED[3AQMD ❑ ASBESTOS NOTIRC4TIONIS NOT APPLICABLE TO PROPOSEDDEMOLITION. PERMITFINAL ( ( CER77FICATE OF SIGNATURE OCCUPANCYMgUED