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Home My WebLink AboutM2021-0084 - Permits (3)City of Newport Beach - Building Division 'M2021--0084* HARBOR Permit: M2021-0084 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 3023-2021 Permit Counter Phone (949)644-3288 n a S. �� 1r" . ACT Cj'FI tL! Inspection Requests Phone (949)644-3255 i..S' � Job Address: 2676 BAY SHORE DR Floor: Suite: Bldg: 0 - Description of Work: SFR REBUILD SEAWALL, INSTALL NEW TIE -BACKS AND DEADMEN C Inspector Area: 2 Legal Description: IRVINE SUB LOT 171 BLK 64 FOR OF LOT M •'� Owner: LANGSON JACK Contractor: ASSOCIATED PACIFIC CONST/JAIME Engineer: PETROV PLAMEN Address: 5100 CAMPUS DR STE 300 Address: 495 EMBARCADERO Address: 28161 CASITAS CT NEWPORT BEACH, CA 92660 MORRO BAY CA 93442 LAGUNA NIGUEL CA 92677 Phone: Phone: 805-772-7472 Phone: 714-717-7542 Q State Lic: C-066947 M z Applicant: SMITH SUZETTE Con State Lic:394886 Designer: z Address: 3654 SACREMENTO ST Lic Expire: 11/30/2022 Address: SAN FRANSISCO, CA 94118 Bus Lic BT30047194 (1) Phone: 415-440-4480 Lic Exp Date: 05/31/2022 Phone: M Special Cond Issued Date 02/1112022 Longshoremen's and Harbor Workers' Compensation Declaration - Carrier : AMERICAN LONGSHORE MUTUAL ASSN Policy No: 2020010391755Y Expire : 10/01/2022 FEES Valuation: $65,000.00 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: $8.00 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 : $3.00 TOTAL FEE : $715.00 Plan Check Fee : $390.00 Fee Due at permit Issuance : $325.00 PROCESSED BY: 3:5 PLAN CHECK BY: ✓ L_ PUBLIC WORKS: APPROVAL TO ISSUE: OTHER DEPARTMENTS: SE( FINAL INSPECTION: _ PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION 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 appli:,dble L.;-a(s) iection 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 IS 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( 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 o of 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, usiness and P-cfccsions 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 thI --ycvhments are nnf 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 nproved 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 pp',y 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 • I am exempt from licensure under the Contractors' State License Law for the following reason: roy signatulP hPlnyi 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 Iegall, ell 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 an, '(ofessions Cod-,, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm1. 't3nature of Prrpert? Owner or Authorized Agent Date {LDNSED CONTRACTOR'S DECLARATION Lcroby affirm unclerpenalty of perjury that I am licensed under provisions of Chapter 9 (comrpVcing with Section 7000) of Division 3 of the Business and Professlopiecod r(d my ' ense is in full force nd effect. License Class License No. Date )C.. Z—t /— ZZ Contractor Signature .ONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION DECLARATION 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 �100,0001, 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 of 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 My workers' compensation insurance carrier and policy number are: Policy Number Expiration Date Anent � I, Phone # I certify that, in the performance of the work for that, if I should become subject to the workers' ge_ Iture of Applicant: V LARATION REGARDING 9hmit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 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 comply with all applicable and ty ordinances and state laws relating to building construction. I authorize representati/vees oft or my to enter the above -identified property for inspection purposes. Signature: x // PrintName:?< WleoV- ele<<T�/ l %7—y Dat K2-/!_ Za ACTION DATE By DECLARATION OFCOMPLIANCE KITH CODE OF FOR OFFICE USE ONLY FEDERAL REGULATIONS PART 6f OF TITL.E40 AND AQMD RULE 1403. PERMIT EXPIRED — ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMITCANCELLED PERMITEXTENDED ❑ ASBESTOS NOTIFICATIONIS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMIT FINAL L CERTIFICATEOF SIGNATURE: OCCUPANCYISSUEl