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Home My WebLink AboutM2023-0005 - Permitsp�aEWPORT City of Newport Beach A Community Development Department- Building Division - y 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-3288 U s Inspection Requests Phone: (949) 644-3255 C4C�FO0.N`P newportbeachca.gov/inspections IIII I I II I III II II II IIII II Harbor Permit : M2O23-0005 Plan Check No : PC2023-0114 Work Class: New Issued Date: Inspection Area : 1 Zj PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. t+�/ Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday 8:00 a.m. to 6:00 p.m. No work on Su� or Holidays. V� Job Address : 1120 BAY AVE W Legal Desc : N TR 626 BLK 4 LOT 6 k ¢V� Description: SFR R/R 2 CONCRETE PILES. RE -DECK FLOATING DOCK & PIER Owner: Address Phone GARY BUNTMANN Contractor: SWIFT SLIP DOCK/PIER BUILDERS Architect : lb 410 17TH, 1010 DENVER, CO 80202 Applicant: MARISSA MORALES Address: 6351 INDUSTRY WAY WESTMINSTER, 92683 Phone: (949) 631-3121 Code Edition : Type of Construction Occupancy Groups: Building Setbacks Flood Zone Use Zone : 2022 U Front: 5, Front: 25, Side: 3, Side: 3 AE, 8 FT; X R-1 - Single -Unit Residential Processed By: SPECIAL CONDITIONS: SA Address : 6351 INDUSTRY WAY WESTMINSTER, CA 92683 Phone: (949)631-3121 Con State Lic : 797052 Lic Expire : 07/31/2023 Bus Lic: BT01122734 Bus Lic Expire : 11/30/2023 The Longshore and Harbor Workers' Insurance Carrier: GREAT AMERICAN ALLIANCE INS CO Policy No: WC173816805 Policy Expire: 12/31/2023 Fire Sprinklers : NO Fire Hazard Zone : NO Address : Phone: State Lic Engineer: PETROVPLAMEN Address: 28161 CASITAS CT LAGUNA NIGUEL, CA 92677 Phone : (714) 717-7542 Designer: Address Phone: Construction Valuation : $46,000.00 OWNER -BUILDER DECLARATION I hereby afBml under penally 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) Section 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 for io permit to file a signed statement thathe 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 'rofessions 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 of of more than five hundred dollars ($500). 1, as owner of the property, at my employees with wages as their sole compensation, will do U all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, nosiness 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 nprovements are not intended or offered for sale. If, however, the building or improvement is sold within oneyear of completion, the Owner -Builder will have the burden of proving that it was not built or n roved for the purpose of sole). 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 poly 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 I am exempt from licensure under the Contractors' State License Law for the following reason: ly my signature below f 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 legall, all 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 And 'rofessions Code, is available upon request when this application Is submitted or at the following Web site:htip:l/www.leginfo.ca.gov/calaw.html. signature of Property Owner or Authorized Agent Date _, .ICENSED CONTRACTOR'S DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 000 of D sic, 3 of the Business and P essl C and ice se is in full force nd effect. License Class License No D 'Z t Contractor Signal UORKERS' COMPENSATION DECLARATION 'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (6100,000), IN ADDITION TO THE OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, Me ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to .self -insure for workers' compensation, issued by the Director of industrial Relations as provided for by Section 3700 of the Labor Code, for ih Wormance of the work for which this permit is issued. Policy No. have and Will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' wmpensatioi ranee carrier and policy number are: Policy. Number of Agent Date -1I certifythat, in the performance 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' compensation laws of California, and agre Tat, if I should benaect f. w ors' c ens n proviq si ofSectian 3700 of the Labor Code, f shall forthwith comply with those provisions. j tignature of Appli\/`-� 21 115 Z31ECLARATiON RONSTR� TI . G AGENCY f hereby affirm under penalty of erjuryth there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Enders Name Lender's Address ly 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 comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or cou o o -id ' led progeny for inspection purposes. p� MOO - l y c _ 11 5 F nanahlra of Prnnerty Owner or Authorf7ad An y Print PmoArty Ownnr's nr Authorized Anent's NanA/ V v 1 - Lev J Date Z- I (J 1 ACTION I DATE BY ` t (bECLARATION OF COMPLIANCE RRTH CODE OF FEDERAL FOR OFFICE USE ONLY Wit j REGULATIONS PART 61 OF TITLE. 40 AND AOMD RULE 1403 PERMI FEXPIREO t,S3ESTOo . J JTI FI,.ATION 7U PERMIT EXTENDED LIAQINO PERMITFINAL 'L ASBESTOS NOTIFICATION IS NOT ARPLICABLE Tb CFRON ATEOP RRORDSEDOEMOLITION OCCUPANCY ISSUEp_ SIGNATURE`