The URL can be used to link to this page

Home My WebLink AboutX2019-3809 - Permitsf$h'p City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 H.. m Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - BLDG ELEC IIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIII II COMB Permit: X2019-3809 x 2 0 1 9 3 8 0 9 Project No : 2619-2019 Issued Date : 11/27/2019 Inspection Area :$I'j PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m, No work on Sundays or Holidays Job Address: 1601 AVOCADO AVE NB Description: COMM (1) MONUMENT SIGN "CITY OF HOPE" Le at g Desc • P BK 192 PG 1 PAR 2 .. FORSYTH DAVE Address: 3411 LAKE CENTER DR Owner: CITY OF HOPE Contractor: Architect: IA Address: 1605 AVOCADO AVE Address: Address: . 020° Hazardous Mat NEWPORT BEACH, CA 92660 Building Green Fee : m Phone: NMUSD Fee: Phone: Phone: State Lie: 0 ° m � o•eooc. mee • o Applicant: FORSYTH DAVE Address: 3411 LAKE CENTER DR Record Management: SANTA ANA, CA 92704 Phone: 714-218-8100 Code Edit: 2016 Type of Construction: Occupancy Group: U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 0 No of Units : 0 Bldg Height: 0 Bldg Sprinklers: Flood Zone: Building Permit Fee: $166.00 Plan Check Fee: $146.16 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $18.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $436.40 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Con State Lie: Lie Expire: Bus Lie: Lie Exp Date: Worker's Compensation Insurance Carrier: Policy No: Expire: Building Setbacks Excise Tax: Additional Fee: Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: I Front: / Left: / Right: / 3arkina Soaces $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $21.99 $0.00 $0.00 Plan Check Fee Engineer: JACOB TONY ° ¢ Address: P.O. BOX 802050 c SANTA CLARITA CA 91380 e e e Phone: 661-259-0700 State LIc:C-059022 Designer: LAI EVELYN Address: 2110 MAIN ST STE 304 SANTA MONICA, CA 90405 Phone: 310-401-1330 Special Conditions Planning Department - Fire Department Plan check Fee Fire Inspection: Fair Share Fire Plan Rev SJH Trans Demolition Fee _ In -lieu Housing Fee: Building Dept Adm Public Works Department - Park Dedication : $0.00 P/W Plan Check : $41.25 San Dist: $0.00 NMUSD Fee: $0.00 $0.00 Fee Due at Permit Issuance PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVALTO.ISSUE: eo n ooa o e ° em•oo mm o mmmoa ¢ cooeoa 0 m a e o 00000m ¢ n CGf000 o co 0 0 o e o 0000 e000 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $436.40 Fire Department $40.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: $0.00 Fee Due at Permit Issuance PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVALTO.ISSUE: eo n ooa o e ° em•oo mm o mmmoa ¢ cooeoa 0 m a e o 00000m ¢ n CGf000 o co 0 0 o e o 0000 e000 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $436.40 OWNER -BUILDER 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) (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 the 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 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 `) all of or U 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 personal 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). ❑ 1, 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 apply t0 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 belowj 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 legal sell a structure that Ilhave 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 fallowing Web site:http://www.leginfo.ca.gov/calaw.htmi. $tgmtlq of Prg)f g,Qwner or Authorized Agent Date LICEIIISED CONTRACTOR'S DECLARATION Chd9rgWaffirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 0) o Division 3 of the Business and Prof sions Code, d my license is in full force and effect. License 61ess License No Date \\ 1 T Contractor Signature SVOBK£RS' COAAPLNSATION DECLARATION MWII�LLG: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUFJORED THOUSAND DOLLARS ($100,000), IN ADDITION TO T POMPE4---MON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. �rQtly affirm uncLer penalty of perjury one of the following declarations: 0010 •I halve and vrilll 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 Cade, for formance Age war% for which this permit is issued. Policy No. 0000 L4iwv2 and %Will %air;ain 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' compensa'' ur ce carrierliand4policy number are: Policy Number of Agent Date ]I certify that, in the pert rmance 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 iat, if I should becomes ject to the wo ers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Iignature of Applicant Date 1T��9 IECLARATION REG DING CONSTRUCTION LENDING AGENCY hereby affirm under enalty 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). ender's 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 count ordinances and state laws relating to building construction. I authorize representatives of this city or county t enter thea ve-identified property for inspection purposes. Signature of Property Owner or Authorized Agent Print Property Owner's or Authorized Ag ACTION DATE BY DECLARAT ON OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGU IONS PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA PERMIT EXTENDED QMD PERMIT FINAL 5- -,Z 6Zd RESTOS NOTIFICATION IS NO APPLICAE CERTIFICATE OF PROPO DEr OLITION OCCUPANCYISSUED SIGNATURIE a✓2