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Home My WebLink AboutM2022-0031 - Permits�E.PoRT City of Newport Beach IIII I I II I II I II II IIII I I II Harbor Permit: M2022-0031 �� -a @ Community Development Department- Building Division -- 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2022-1995 ~ Permit Counter Phone: (949) 644-3288 Work Class :Other c P Inspection Requests Phone: (949) 644-3255 Issued Date : 09/19/2022 CC opN� newportbeachca.gov/inspections Inspection Area :2 0 t PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. --a 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 Sundays or Holidays. 1 -1 Job Address : 44D HARBOR ISLAND DR Legal Desc : N TR 3867 BLK LOT 42 Description: SFR R/R FLOATING DOCK, GANGWAY, 3 PILES. Owner: EDWARDCONTRERAS Contractor: SWIFT SLIP DOCK/PIER BUILDERS Architect: Address : 2110 E WINSTON RD ANAHEIM, CA 92806 Address : 6351 INDUSTRY WAY WESTMINSTER, Address : '�- CA 92683 Phone: Phone: (949)631-3121 Phone: Con State Lie : 797052 State Lie Applicant: MARISSA MORALES Lie Expire: 07/3112023 Address : 6351 INDUSTRY WAY INDUSTRY WAY Bus Lie: BT01122734 Engineer : PETROV PLAMEN WESTMINSTER, 92683 Phone: (949) 631-3121 Bus Lie Expire : 11/30/2022 Address : 28161 CASITAS CT LAGUNA NIGUEL, CA 92677 The Longshore and Harbor Workers' Insurance Phone: (714) 717-7542 Carrier: GREAT AMERICAN ALLIANCE INS CO Policy No : WC173816805 Designer Policy Expire : 11/3012022 Address Phone: Code Edition : 2019 Fire Sprinklers : NO Construction Valuation : $67,000.00 Type of Construction : Fire Hazard Zone : NO Occupancy Groups: U Building Setbacks : Front: 10, Front: 18, Side: 4, Side: 4 Flood Zone : AE, 8 FT; X Use Zone : R-1 - Single -Unit Residential Processed By: SPECIAL CONDITIONS: ` OWNER -BUILDER DECLARATION I hereby affirm 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 Inc permit to file a signed statement that he or she is liconsod pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions 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 not 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 (_) portions of the work, and the structure is not: intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personet effort, builds or improves the property, provided that the improvements 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 or Improved for the purpose of sale). D 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 w5LI a 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). 1 am exempt from licensure under the Contractors' State License Law for the following reason. By 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 Iegalll sell 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 Professions Code, is available upon request when this application Is submitted or at the following Web site:http:liwww.leginfo.ca.govlcalaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section ) of D'€v€ u e 3 of the Business and Profs ns d y I' arise is in full force and effect License Class License No Date la Z Contractor Signature NORKERS' COMPENSATION DECLARATION NANNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TO ONE HUNDRED THOUSAND DOLLARS IStOD,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION a706 OF THE LABOR CODE, INTEREST, ANDATTORNEY's FEES. hereby affirm under penalty of perjury one of the following declarations: 1 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 in latfornri 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' Tanee carrier and policy number are: Policy Number Expiration Date to of Agent _ 11 certify that, in the dormanee of the work hick 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 becom u ecl 1 works in nsa l pr ' ions or Section 3700 of the Labor Code, I shall Forthwith comply With those previsions. ignalure of Applicant _, Dat/. vC! �-V Zz IECLARATION REGA ING _ R CTIO L ING AGENCY 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 30- , Cl it Code). enders Name Lender's Address _ y 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. j I have read this y applicationila and the icily an Lien I have provided a correct. M� n 5�� Dyact I� `(_I agree to comply with ail applicable City and unty nrdi noes and st ws relating to building construction. I authorize representatives of this city or counI tp a er the o 1 ntifi erj>!-fpr inspection purposes.,t ,,.G SZ, irmalure of PrODKIV Owner or Authorized Agent �( . Print Prooertv Owner's or Authorized Adept's Name j1/ ACTION DATE I BY / 159CLARATION OF COMPLIANCE WITH CODE OF FEDERAL ( FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND ACHVID RULE. PERMIT EXPIRED I / I I I UI SURMITTFD ASBESTOS NOTIFICATION TO CERTIION I5 NOT APPLICABLE TO FICATE OF / /1 �1 PROPOSED DEMOLITION OCCUPANCY ISSUED �1 V SIGNATURE: