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Home My WebLink AboutM2021-0018 - PermitsS,,,r.a4r City of Newport Beach -Building Division IIIIIIIIIIIIIIIIIII�IIIIIIIIIIII II o't 100 Civic Center Drive, Newport Beach, CA 9?660 M 2 0 2 1 0 0 1 8 .. a Permit Counter Phone (949)644-3288 •li]Ylll!,Zl Job Address: 642 VIA LIDO NORD Floor: Description of Work: R/R FLOATING DOCK Inspector Area: 2 Legal Description: N TR 907 LOT 58 Owner: CLEM CLARA Address: 642 VIA LIDO NORD NEWPORT BEACH, CA 92663 Phone: State Lic: Applicant: MORALES MARISSA Address: 6351 INDUSTRY WY WESTMINSTER CA 92683 Phone: 949-631-3121 Special Cond: Issued Date 03123/2021 Valuation: $22,000.00 Inspection Fee: $308.00 Plan Check Fee $322.00 OT Plan Check Fee: $0.00 Investigation Fee: $0.00 Building Green Fee : $1.00 TOTAL FEE: $775.00 Suite: Bldg: 0 Contractor: SWIFT SLIP DOCKIPIER BUILDERS Address: 6351 INDUSTRY WAY WESTMINSTER CA 92683 Phone: 949-631-3121 C-066947 Con State Lic:797052 Lic Expire: 07131/2021 Bus Lic: BT01122734 Lic Exp Date: 11/30/2021 Fire Inspection Fee: Fire Plan Check Fee: Records Mangement: Harbor Plan Check Fee: Plan Check Fee HARBOR Permit: M2021-0018 Project No : 0633-2021 Inspection Requests Phone (949)644-3255 Q Engineer: PETROV PLAMEN 0 Address: 28161 CASITAS CT LAGUNA NIGUEL CA 9261z Phone: 714-717-7542 V7� Designer: �-A Address: Phone: Q 0 Longshoremen's and Harbor Workers' OC4�ensation ration - Carrier: AMERICAN EQUIT i Policy No: WC173816804 in Expire: 12/3112021 FEES $0.00� $0.00 Plan Dep -Counter Review : $8.00 Plan Dep - Zoning Plan Checka1 sdm $136.00 Plan Dep - OverTime Plan Check: $0.00 $0.00 Fee Due at permit Issuance : $775.00 PROCESSED BY:y ��L— PUBLIC WORKS: PLAN CHECK BY: _ APPROVAL TO ISSUE: OTHER DEPARTMENTS: 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 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 fc 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 any Cessions 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 c 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 th 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 c 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 no 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 lei I 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 Ifessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/colaw.htmi. nature 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 (c m ncing with Se t' 7000) of Division 3 of the Business d'Pi'0 �,, i de, a d lic oense is in full fora nd effect. License Class License No. Dale G Contractor Signature ONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION DECLA I N A.RNING: FAILURE TO SECURE LONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP O NDRED THOUSAND DOLLARS IR0,000), 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 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 My workers' compensation insurance carrier and policy number are: r Policy Number Expiration Date of Agent Phone # I certify that, in the perform he work r ich th 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 su c[ to the e c p satio provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. pure of Appt' I -ARATION REG DI G NS CTION LE G 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 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 city and county ordinances and state laws relating to building construction. I authorize represgRtgriNs of this city ty to enter the above -identified property for inspection purposes. Sianature: 11 r\ Print Name:\ M a ki ssa /Mm I Date 'AcTl911%' V OA_r)" BY Utt-LAMAI1ViV Wr LVMVL/AIVLL MIH LVULVf FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE 1403. - PERMIT EXPIRED ❑ ISUBM[TTEDASBESTOS NOTIFICATION' O: ❑ EPA ❑ AOMD ASBESTOS NOT APPLICABLE TO PROPOSED DEMOLITION. PERMITCANCELLEO PERMIT EXTENDED PERMIT FINAL ^v�S CERTIFICATEOF SIGNATURE: OCCUPANCYISSUED