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Home My WebLink Aboutm2019-0015 - PermitsCity of Newport Beach- Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII HARBOR Permit: M2019-0915_ a 100 Civic Center Drive, Newport Beach CA 92660 M 2 0 1 9 0 0 1 5 r Permit Counter Phone (949)644-3288 Project No : 0319-2019 - / n;. Exx,zx' Inspection Requests Phone (949)644-3255 - Job Address: 59 LINDA ISLE Floor: Suite: Bldg: 0 Description of Work: R/R (2) 14" SAVARE CONCRETE MARINA GUIDE PILE, LIKE FOR LIKE Inspector Area: 2 Legal Description: N TR 4003 LOT 59 Owslcr:. O'F6N2QR RICHARD Ak!naem°. Contractor: SWIFT SLIP DOCK/PIER BUILDERS- Engineer: PETROV PLAMEN - 59 L115DANSLE. Address: 6351 INDUSTRY. WAY Address: 28161 CASITAS.CT • NF.WVneRT BEACH, CA 92660 • Pklone:o0 0 WESTMINSTER CA 92683 LAGUNA NIGUEL CA 92677 Phone: `949-631-3121 Phone: 714-717-7542 'a o a • m State`Lic. :. C-066947 o •o • a war Applicant: JACQUELYN CHUNG Con State Lic:797052 Designer: Addness4 63A,1JN,[tUSTRYWY Lie Expire: 07/31/2019 - Address: a WESTMINSTER CA 92683 Bus Lie: BT01122734 Phone: ° 949-6313121 .« Lie Exp Date: 11/30/2019 Phone: m ® m Special Condi...... - .Longshoremen's and Harbor Workers' Compensation Declaration - • e e Carrier: AMERICAN LONGSHOR Issued Date 02/12/2019 Policy No: ALMA01662-01 Ex ire:12/37/2019' FEES Valuation, '$10,000.00 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 Fee: $0.00 Harbor Plan Check Fee: $131.00 Plan Dep - OverTime Plan Check: $0.00 Investigation fee: $0.00 Building Green Fee: $1.00 TOTAL FEE : $725.00 Plan Check Fee : $433.00 Fee Due at permit Issuance: $292.00 PROCESSED BY: „.D1 HARBOR RESOURCES: LANJ PLAN CHECK BY: P/ APPROVAL TO ISSUE - OTHER DEPARTMENTS: FINAL INSPECTION PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECRON 'YIYCR-OUILULR ULVL.IYRNIIVIY � .z > `I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated beloeoy-the creckmark(s) I have placed next to the applicable item(s) action 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 ant Aessions 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 I 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 7044, amass 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 thi 3rovements 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 e 3roved 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 nol ply 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). J I am exempt from licensure under the Contractors' State License Law for the following reason: y 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 legal) A 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 applicabl law, Section 7044 of the Business an rofessions Code, is available upon request when this application is submitted or at the following Web site:hffp://www.leginfo.ca.gov/calaw.htmi. ignature of Property Owner or Authorized Agent ate ..•. eeee ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencin ith q tion T of Division 3 of the Busi ess and rof sions • � •i�er se is in full forj nd effect. License Class License No. Date i L�. VV Contractor Signat .ON GSHORE E 'S & HARBOR WORKERS' COMPENSATION DECLARATI N TARN N AI R O ECURE LONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND C L FINES UP ONE HUNDRED THOUSAND DbWAM A DI 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 peq Ity of perjory•dht of the Tollewine nrl m}i / • e • , I h e and will maintain Longshoremen's and Harbor workers' compensation insurance, as required by Section 3700 of the Labor Code, for the perfdrrliahce of the work jqr %W0 this parmit.i, workers' compensation insurance carrier and policy number .are: • • e. I- Policy Number Expiration Date �� of Aged Phone # • • • sseee •e rtify that, in the perfo ante of the w or which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laV of California, ar that, if I should become subj ct to the wo a ens lion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. • • s �• `, ature of Applicant: �� DECLARATION REGARUNG GQN6T UCTION'LJNDING AGENCY V ! I hereby affirm under penalty of peury that therree�r0is 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 ea in of following: I am the property o r o horized to ac on the property owner's behalf. I have read this plication n e information I have provided is correct. - I agree to comp with all plic city and county ordinances and state laws relating to building construction. I authorize repr sentativ of is c r county to enter the above -identified property for inspection purposes. Signatur Print Name Date: ACT7ON ➢A BY DECLARA0M& COMPLIANCEiMTH'CODE &F FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 67 OF TITLE40AND AQMDRULE1403. ❑ ISUBMf7TEDASSESTOSN077FICA7IQNTO. ❑ EPA ❑ AQMD P€RMITEXPIRED PERMITCANC€UED - PERMITEXTENDED ❑ ASBESTOS NORFICARONIS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL %. CERTIFICATEOF SIGNATURE; '.000UPRldCY75SUED