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HomeMy WebLinkAboutM2019-0009 - PermitsCity of Newport Beach - Building Division 1111111111111111111111111111111111111111111111111111111111 '. 100 Civic Center Drive, Newport Beach, CA 92660 M 2 0 1 9 0 0 0 9 Permit Counter Phone (949)644-3288 Job Address: 3904 CHANNEL PL Floor: Suite: Bldg: 0 Description of Work: SFR REINFORCE (E) SEAWALL, INSTALL TIE -BACKS & NEW CONCRETE DEADMAN Inspector Area: 1 Legal Description: Owner: 3900 CHANNEL PL #3,LLC Address: 15 CORPORATE PLAZA #G-1 NEPORT BEACH CA 92618 Phone: State Lie: Applicant: LINSDAY BRANDON Address: 151 KAJ AMUS DR #G-1 C ° o o C09111A IiM9SA CA 92626 ° Phdna °" 7147-754-040 m °°oomo 949/729-8082 0 Spadallftnd: IssgecLEXIte 03/$7J2019 0 O O 6 O VaYuat$n: oo $30,000.00 lApeeGcn Fee)' o` $287.00 Plan Check Fee, ° ° $302.00 OT Plan Check Fo©:° ° $0.00 Investigation Fee: $0.00 Building Green Fee : $2.00 Contractor: EKEDAL MASONRY & CONCRETE INC $0.00 Address: 220 NEWPORT CENTER DR #11-288 Address: Records Mangement: NEWPORT BEACH CA 92660 Plan Dep -Zoning Plan Check: $0.00 Phone: 949/729-8082 Phone: C-066947 Con State Lic:487590 Designer: Lie Expire: 02/28/2020 Address: Bus Lie: BT00005971 Lie Exp Date: 09/30/2019 Phone: HARBOR Permit: M2019-0009 Project No : 0193-2019 Inspection Requests Phone (949)644-3255 Engineer: PETROV PLAMEN 28161 CASITAS CT LAGUNA NIGUEL CA 92677 714-717-7542 ic L Longshoremen's and Harbor Workers' Compensation Declaration Carrier: EMPLOYEE SERVICE GROUP Policy No: 2246 FvnirA Fire Inspection Fee: $0.00 $0.00 Fire Plan Check Fee: $0.00 Plan Dep - Counter Review: $0.00 Records Mangement: $10.00 Plan Dep -Zoning Plan Check: $0.00 Harbor Plan Check Fee: $0.00 Plan Dep - OverTime Plan Check: $0.00 11 TOTAL FEE: $60``1.00 Plan Check Pee : $302.00 Fee Due at permit Issuance: $299.00 PROCESSED BY: Nt HARBOR RESOURCES: 1 PLAN CHECK BY: APPROVAL TO ISSUE: OTHER DEPARTMENTS: FINAL INSPECTION: _ PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION DECLARATION V 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(: ction 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 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 a fessions 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 more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 704, 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 t 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 roved 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 n 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, a structure that 1 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.html. 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 (commenci . ng with Section 7000) of Division 3 of the I nd effect. License Class License No. Date — Contractor Signal ONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION DECLA ON D�ARN�ING: FAILURE TO SECURE LONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL i0W001, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 7706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. and is in full 'ENALTIES AND CIVIL FINES UP T610NE HUNDRED THOUSAND I hereby affirm under penalty of perjury one of the 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 worktoc which this permit I. My workers' compensation insurance carrier and policy number are: : •.•• ••O°"° Policy Number Expiration Datq ... of Agent Phone# ..•.•. • ° ••0901) 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 Taws of Califpdrjlj that, if I should become subject to the wor compensation prove ns of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. • •; • ° ° „� iture of Applicant --4 �/ f • _ 1 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: : • ° ° ° .... 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 o his city or county t ent he above -identified property for inspection purposes. signature: Print Na /%� r 7P D t ACTION gAME :. BY DECLARATf MOFCO PUANCEH9THCODEOF FOR MICE USE ONLY FEDERAL REGULATIONSPART SI OFTI7L€40AND AOMD RULE 1403. . PERMITEXPIRED ❑ ISUBMITTEDASBESTOSNOIIFICATfONTO: ❑ EPA ❑ AQMD PERMITCANC€LLEO PERMITEXTENDED E3 ASBESTOS MOflRCAIIOMIS NOT APPLICABLE TO PROPOSEDDEMOUTION. PERMITFINAL I — ` _ rL C€RTIFICATEOF SIGNATURE: OCCUPANCYISSUED