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HomeMy WebLinkAboutM2019-0079 - Permits�xLI, City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIII II HARBOR Permit: M2019-0079 c+ 100 Civic Center Drive, Newport Beach, CA 92660 M 2 0 1 9 0 0 7 9 p Project No : 2368-2019 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 NO CONSTRUCTION NOISE Job Address: 808 BAY AVE W Floor: Suite: Bldg: 0 Description of Work: SFR REINFORCE (E) SEA WALLW/TIE BACKS TO NEW DEADMAN Inspector Area: 1 Legal Description: N TR 884 LOT 35 Owner: JACKSON TODD Address: 18342 CHURCHILL LN VILL PARK CA 92861 Phone: 714.420-0377 State Lic: Applicant: SMITH BRAD Address: 425 30TH STREET NEWPORT BEACH CA 92663 Phone: 949-631-3682 Special Cond: Issued Date 01/30/2020 Valuation: $30,000.00 Inspection Fee: $297.00 Plan Check Fee $312.00 OT Plan Check Fee: $0.00 Investigation Fee: $0.00 Building Green Fee : $2.00 Contractor: ASSOCIATED PACIFIC CONST Address: 495 EMBARCADERO MORRO BAY CA 93442 Phone: 805-772-7472 C-066947 Con State Lic:394886 Lic Expire: 11/30/2020 Bus Lic: BT30062687 Lic Exp Date: 03/31/2020 Fire Inspection Fee: Fire Plan Check Fee: Records Mangement: Harbor Plan Check Fee: FEES $0.00 $0.00 $6.00 $135.00 a a Engineer: PETROV PLAMEN .... Address: 28161 CASITAS CT LAGUNA NIGUEL CA 92677 • ° •••� Phone: 714-717-7542 • ° . • ° •• ° Designer: ®.°• . . ••®°• Address: • Phone: I1 S ECTOFe.°jt •...°° Longshoremen's and Harbor Workers' Compensation Declaration Carrier: AMERICAN LONGSHORE MUTUAL Policy No: ALMA00765-071 USL& $0.00 Plan Dep - Counter Review: $0.00 Plan Dep - Zoning Plan Check: $0.00 Plan Dep - OverTime Plan Check: $0.00 11 TOTAL FEE : $752.00 Plan Check Fee : $447.00 Fee Due atpermit Issuance: $305.00 PROCESSED BY: /�1 � PUBLIC WORKS: o\ / \\— PLAN CHECK BY: l J I(�� APPROVAL TO ISSUE: / OTHER DEPARTMENTS: FINAL INSPECTION: PERMIT EXPIRES 180 DAYS AFTER 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(s) I have placed next to the applicable itom(s) 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 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 and 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 d0l'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 or U 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 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 will have the burden of proving that it was not built c 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 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 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 cov 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 applicable law, ifessions CAA Is- available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. nature of Propasl)rOwner or Authorized Agent Data 9CENSED CONTFACTOR'S DECLARATION JAgebq affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (a Rid effect. License -Class License No. Da' _GNGBHORE2vii a & HARBOR WORKERS' COMPENSATION DECLAI 6ARf1QJj:PFAILURSIO SECURE LONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION COVERAGE IS UI 110Q,000), IN ADDITIOM de THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 7705 leoiiarations: '.... 7000) of Division 3 of the Busine s and 9 Contractor Signature Bred by this permit, I cannot lel Section 7044 of the Business my license is in full , AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following 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 My , v"kers' compensation insurance carrier and policy number are: er - • • Policy Number Expiration Date s Vf Agent• Phone # I cer ifytlial,'in the pe ormance 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' compens tion laws of California, e that, if I should become ubject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. latureofApplicant: % ta. -3o-Zo21 :LARATION REGARbIN_G­C6WSTkaTION LENDING AGENCY I 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 c mply with all applicable city and county ordinances and state laws relating to buildin construction. I authorize representatives of this city r county ounty to enter the above -identified property for inspect' n purposes. ;innature: e _ Print Nam 5fJ(Zfr% �iOY` (f� Q Dat . -10 — 2© 2- 0 (ACTION A4TE BY DECLARATI NOFCOMPLIANCEWIFNCODEOF FEDERALR GLILATIONSPART6IOFTITLE40AND AOMO RULE 1403. SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD ❑ ASBESTOS NOTIFICATIONIS NOTAPPLICABLETO PROPOSEDDEMOLITION. 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