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Home My WebLink AboutM2021-0066 - Permits�tD City of Newport Beach -Building Division 11111111111111111Illill E1111111111111111111111111111111 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 n � °Exr+,u4 Job Address: 20 BAY ISLAND Floor: Suite: Bldg: 0 Description of Work: R/R DECKING @ DOCK, GANGWAY AND PIER W/AZEK 1X6 COMPOSITE DECKING Inspector Area: 1 Legal Description: S TWP 6 RGE 10 SEC 34 Owner: GANNON DAN Address: 20 BAY ISLAND NEWPORT BEACH, CA 92661 Phone: State Lic: Applicant: SWIFT SLIP DOCK/PIER BUILDERS Address: 6351 INDUSTRY WAY WESTMINSTER CA 92683 Phone: 949-631-3121 Special Cond: Issued Date 09/24/2021 Contractor: SWIFT SLIP DOCK/PIER BUILDERS Address: 6351 INDUSTRY WAY WESTMINSTER CA 92683 Phone: 949-631-3121 Con State Lic:797052 Lic Expire: 07/31/2023 Bus Lic: BT01122734 Lic Exp Date: 11/30/2021 HARBOR Permit: M2021-0066 Project No : 2240-2021 Inspection Requests Phone (949)644-3255 •F ° . Engineer: Address: Phone: '°°° ° Designer: A s _ i Address: Phone: Longshoremen's and Harbor Workers' Compensation Declaration - Carrier : AMERICAN EQUIT Policy No: WC173816804 FEES Valuation: $19,000.00 Fire Inspection Fee: $0.00 $0.00 Inspection Fee: $314.00 Fire Plan Check Fee: $0.00 Plan Dep - Counter Review : $0.00 Plan Check Fee $329.00 Records Mangement: $6.00 Plan Dep - Zoning Plan Check: $0.00 OT Plan Check Fee: $0.00 Harbor Plan Check Fee: $61.00 Plan Dep - OverTime Plan Check: $0.00 Investigation Fee: $0.00 Building Green Fee : $1.00 TOTAL FEE : $711.00 Plan Check Fee: $0.00 Fee Due at permit Issuance: $711.00 PROCESSED BY: PUBLIC WORKS: _ � J _ / itJ V PLAN CHECK BY: APPROVAL TO ISSUE: OTHER DEPARTMENTS: FINAL INSPECTION: PERMIT EXPIRES 190 DAVSAFTER ISSUANCE OR LAST VALID INSPECTION o° B . ° 'NER-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) :tion 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 foi 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 an 'essions 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 oI 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, 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 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 o 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 not 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). J 1 am exeMIrt gi licensure under the Contractors' State License Law for the following reason: 3y my signaturmeelma 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 legalll dl.a.structure Ahat 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, Section 7044 of the Business an( Drofesgions CBQe;ig "available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.govlcalaw. html. Nunatyre of Proprty Owner or Authorized Agent Date •• I,ICEJNSED C;ONMCTOR'S DECLARATION 12jebv affirm drttler penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencin vy;� ec i 7 0) of Division 3 of the Bus' ess and f Si e, and my license is in full forc( and effect. Licertss•Class License No. Date �. Contractor Signature LONG6HOREMENI,S & HARBOR WORKERS' COMPENSATION DECLARA N 17 1141FANG: FAILURE 10 SECURE LONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES A D CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 9e OO'OB RT, IN ADDITION .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 penalty of perjury one of the following rations: . •• e - `• 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 ssuedMy workers' compensation insurance carrier and policy number are: Carrier ' Policy Number Expiration Date Name of Agent Phone # L7 1 certify that, in the performance of thework for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, an, agree that if I should becom ub to th rkers compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Sign re of Applicant Date' �� 7.1.)2) D LARATION REGARDING ONSTRUCTI 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 comp all applicable city and county ordinances and state laws relating to building construction. I authorize re esentati of th ty o county to enter the above -identified property for inspection purposes. Q L ,. �i�, Signature: Print Name: a IV ora (W Date: 6f �T �') ACTION DATE BY DECLARATION OF COMPLIANCE MTH CODEOF - FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 61 OF TITLE40 AND AQMDRULE 1403. PERMIT€XMREO ❑ I SUSMITTEDASBESTOS NOTIFICATION T0: ❑ EPA ❑ AQMD PERMITCANCELLED PERMITEXT€LADED ❑ ASBESTOS NOTIFICARONIS NOTAPPLICABLE TO PROPOSED DEMOLITION. PERMITFINAL ' 1 CERTIFICATEOF SIGNATURE:. OCCUPANCYISSUED