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HomeMy WebLinkAboutM2021-0076 - Permitstyg,N.r Uy R. a 7 'rc�rhw8v City of Newport Beach - Building Division 11�1111 11111111111111111111111111111111111111111111111 100 Civic Center Drive, Newport Beach, CA 92660 M 2 0 2 1 0 0 7 6 Permit Counter Phone (949)644-3288 Job Address: 411 EDGEWATER PL Floor: Suite: Bldg: 0 Description of Work: SFR REPAIR OF FASCIA BOARDS AROUND PERIMETER OF PATIO AND CATWALK Inspector Area: 1 Legal Description: BALBOA BAYSIDE TR LOT 9 BLK 2 ALL -INC BET SAME & HIGH TIDE LINE - Owner: BEDROSIAN JANICE Contractor: APEX DIVING & MARINE SERV Address: 411 EDGEWATER AVE E Address: 15061 SHERMAN WAY STE J NEWPORT BEACH, CA 92661 VAN NUYS, CA 91405 Phone: Phone: 818-7B7-1794 State Lic: Applicant: BEDROSIAN JANICE Address: 411 EDGEWATER AVE E NEWPORT BEACH, CA 92661 Phone: 949-548-9999 Special Cond: HIGH DENISTY, LIQUEFACTION Declaration - AREA Issued Date 121D6/2021 2_;, Valuation: $1,400.00 Inspection Fee: $314.00 Plan Check Fee $329.00 OT Plan Check Fee: $0.00 Investigation Fee: $0.00 Building Green Fee : $1.00 TOTAL FEE : $723.00 PROCESSED BY: PLAN CHECK BY: Con State Lic:1006937 Lic Expire: 08/31/2023 Bus.Lic: BT30059290 Lic Exp Date: 05/3112022 HARBOR Permit: M2021-0076 Project No : 2850-2021 VInspection Requests Phone (949)644-3255 o P1_ F lb cc Engineer. LU Address: 0— Phone: Designer: DWAIN Address: 150601 SHERMAN WAY #J VAN NUYS CA 91405 Phone: 949-590-9966 Longshoremen's and Harbor Workers' Compensation Carrier: LONGSHORMAN'S/W.C. Policy No: 9216743-19 Exoire : 08/2412022 Fire Inspection Fee: $0.00 $0.00 Fire Plan Check Fee: $0.00 Plan Dep - Counter Review: $0.00 Records Mangement: $18.00 Plan Dep - Zoning Plan Check: $0.00 Harbor Plan Check Fee: $61.00 Plan Dep - OverTime Plan Check: $0.00 Plan Check Fee : $390.00 PURUC WORKS'. APPROVAL TO If OTHER. DEPARTMENTS: FINAL INSPECTION : _ PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR -LAST VALID INSPECTION Fee Due at permit Issuance : $333.00 ILDER 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) 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 an( 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 o 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 thl 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). 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 le 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, 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 gns hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (c king with Section 7000) of Division 3 of the Buto sde, and my license is in full force nd effect. License Class License No. Dat T— - 2'z- ^ Z Contractor Signature .ONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION DECLA AT N f - IARNING: FAILURE TO SECURE LONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 1100,0001, 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 I have perw-1-11-11aintain 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 I. My w rs' co hsa 'on "nsurance terrier nd policy number are: r olicy Number Expiration Date of Agent r Phone # 1 certify that, in the performance of th 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 laws of California, an that, if I should become sub' t s' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. rture of Applicant:N / / Y 1� �;�� Date[ 17--2!7,,Z� -ARATION REGARDING CONSTRt1CTION LENDING AGENCY I hereby affirm under penalty of perjuly4hat-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 thisapplication and he information I have provided is correct. I agree to c mpl I c Is city and county ordinances and state laws relating to building construction. I authorizer pr iv o i city or county to enter the above -identified property for inspection purposes. ,1 Signature. Print Nam ��t� v t 0y Date: ACTION DATE BY DECLARATIO O OMPLIANCE WITH CODE OF FOR OFF& WEONL FEDERAL REGULATIONS PART 67 OF TITLE 40 AND Ar MDkLLE IQ;. PERA4ITEXPIRED D I SUBMITTED ASBESTOS WOTIFI( ATION TO: - C EPA ❑ AQMD PERMITCANCELLED PERMIT EXTENDED ❑ ASBESTOS NOT7FICATIONISNOTAPPLICABLETO PROPOSED DEMOLITION. PERMIT FINAL CERT7FICATEOF SIGNATURE: - OCCUPANCYISSUED