HomeMy WebLinkAboutM2019-0083 - Permits,�� City of Newport Beach - Building Division II�IIIIII�IIIIIIIIIII�IIIIIIIIIIIIIII�II II HARBOR Permit: M2019-0083
100 Civic Center Drive, Newport Beach, CA 92660 2 0 1 9 0 0 8 3 Project No: 2593-2019
. =,� Permit Counter Phone (949)644-3288
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°�rr,.as*` Inspection Requests Phone (949)644-3255
NO CONSTRUCTION NOISE
Bldg: 0
Description of Work: SFR REPAIR EXISTING SEAWALL
o Address: 2100 BALBOA BLVD E Floor: Suite:
InspectorArea: 7` .•••••
Legal Description: P BK 1 F1
PG 4 uS.Vt
�i applicable:
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Owner: BAY HOUSE 100 LLC Co tractor: SS ATF
IC CODS HIJ% QAeY:0�oARr1N'AO D o ° • • ° ® ° ° ° ° °
Address: 2021 E BALB A A res 9 Address: 23 ORCHARD 250 M
NEWPORT B C CA926 ROB 2 LAKE FORES CA 630 °°®•Phone: p O WClO ••
h e: 49-206-9929 .....
State Lic. S-00 ° • • °
b'C • • • s
Applicant: SHAVER PAU C c Designer: ��- • ° ° °
Address: 30900 RANCH VI D E 2 E / Address: t i • °
NEWPORT B CH A 26 L 0 8'
Phone: 949-581-2888 ILi Date: / /20 Phone: ;rt.
Special Cond: "" �dre Work Is' Gf�pensation Declaration -
Scan
1 a °�� } a � � , arr� N LO GS�RE MUTUAL
Issued Date 01/16/2020 ° t �+§ PqI' y No: ALMA00765- / &
a ` T re : 10/01 /2020
FEES o
Valuation: $ 30,053.00 Fire Inspection Fee: $0.00 _ $0.00
Inspection Fee: Fire Fire Plan Check Fee: .___---$0.00 -"--"—Plan Dep - Counter iew $0.00
Plan Check Fee T2.00' Records Mangement: $6.00 Plan Dep - Zoning �hec $0.00
OT Plan Check Fee: $0.00 Harbor Plan Check Fee: . $135.00 Plan Dep - OPlan Check $0.00
Investigation Fee:
Building Green Fee:x "`s""' �_^�•_.._. . _ -
TOTAL FEE : $756.00 Plan Check Fee: $447.00 Fee Due at permit Issuance: $309.00
PROCESSED BY: `��r�//� ^^ PUBLIC WORKS:
PLAN CHECK BY: �l JC APPROVAL TO ISSUE:
OTHER DEPARTMENTS:
FINAL INSPECTION:
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPEC77ON
ER -BUILDER
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`che Busigess a
fessions Code) or that he or she is exempt from Iicensure 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).
1, 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 I
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).
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 r
Iy to an owner ojptoperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
•.... •
1 am -exempt from Iicensure under the Contractors' State License Law for the following reason:
Try signature be646&knowledge 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 legs
a strpcture that I haJb built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I unders a ica aw, Section 7044 of the Business e
le5�iorts Code, is available upon request when this applicAtion is c ih 'Hod. �af.3h. _:..� _._- �!n.eca.gov!calaw.html. ,
iature of Propedy{Qw ' = Date
i� �ON If applicable:
i;
Ions o apter 9 (comme 'ng with Section 7000 of Div' n V�i Busi �,, - I nd my license is in full
License No. Date - 0 o tr cN�tl� _
:NING: F2MLURE;O$50E ON4PHOREMEPS 6 HAR WORKER PE O GE IS U SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND IL E7 up
TO ONE HUNDRED THOUSAND DOLLARS
f,0001, IN ADDITIO%w1{a TY COS OF COMP TIC
AMAGES ID F S ON 6 THE R COOE�µ7ERE ,,AgTTORNEY'S FEES I herehv air und':. penalty of perjury one of the following
�afa�10p5: ,y... lV YV"VFrr -
*I have and 'fit6 � intai men's an Harbor workers' compensation insurance, as required by Section 3700 of the Labor Code, for the p or -�ce of the work for which this permit is
led. My prk compensation insurance carrier and polic are:
rier its P c r _piration Date
ne of Agent_ PI} e #
i
I certify that th p m he t 1t is isle , sh o any person in any manner so as to become subject to th wor compensation laws of California, ane
:e that, if I should' 'eco e u orkers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions x
(nature of App11, n "g
I hereby affinti un r p _ I y elju tPtavtftere Is &' corQW6dti6rrlbnding agency forth--d"pd-ftormance of the work for which this -'permit is issued (Secti§n 31
Civil Code).
Len'�ler's a ,. Lender's,((yt 0s K otc31 M i
By my signature tielo I certffy to eacM`4ii'ttf-e`(foliarromg:'-' 1 „�
I am the property owne or authorized to act on the property owner's behalf. I`
I have read this y witca l 4l, iicibi information I have provided is correct. __ __
I agreeiz comply with ail of
county to enter th aboces ve-identified
ed en a"f-Tsws relating t i building c�poses. �� ; s
I authorize�preserltativ'�s of this city or county to enter the above-idenfified property for inspection urposes
signature: P.rint Name: Date: 6 - Z
ACT70N
DATE
BY
DECLARATION F COMPILANCE MTH CODE OF
FOR OFFIC USE ONLY
FEDERRALRE LATIONSPART61OFTITLE40AND
IN
PERMIT EXPIREI
Z
J
-`
❑ SUBM17TED ASBESTOS NOTIFICATION TO::
❑ EPA
❑ AQMD
PERMITCANCELLED
PERMIT EXTENDED
❑ ASBESTOS NORFICAUONIS NOTAPPLICABLE TO
PROPOSED DEMOLITION,
PERMIT FINAL
CERTIFICATE OF
SIGNATURE.
OCCUPANCYISSUED