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Home My WebLink AboutX2019-0964 - Permits_J �, City of Newport Beach - Building Division o* _ 100 Civic Center Drive, Newport Beach, CA 92660 N Permit Counter Phone (949)644-3288 ' '.. Inspection Requests Phone (949)644-3255 r,�° : " Combination Type - BLDG ELEC •®e. oe llllullllzlll�llll]IIIIji�RIIIIIPII'llll II m e o• o 0 0 "c •se' e s e oee oe 0 ooe e eoe e COMB Permit: X2019-0964 Project No 0662-2019 Issued Date: 0 410 512 01 9 Inspection Area : 7 Construction Valuation: $2,000.00 PERMITS EXPIRE 180 oil* RPIiERI NCSO L 7 ,#CID INSPECTION. Construction Hours: Monday -Friday 7:00 a.m. to 6:30 p.m. and Saturday From 8.100 p4h. to 6:00 p.m. No work on Sundays or Holidays Job Address: 133 NEWPORT CENTER DR NB - Building Permit Fee: $104.00 Description: COMM ILLUMINATED CHNL LTR WALL SIGN" BACK) DI LATTE" - Planning Department - Legal Desc.: Fire Department Owner: IRVINE CO Contractor: T D I SIGNS Architect: $0.00 Address: 550 NEWPORT CENTER DR Address: 1419 SEABRIGHT AVE Address: Fire Inspection: NEWPORT BEACH, CA 92660 - LONG BEACH CA 90813 - Grading Bonds Fee: Phone: Phone: 562-436-5168 Phone: State Lic:. Applicant: GANS MELISSA Con State Lic: 809989 Engineer: $0.00 Address: 13158 ARCTIC CIRCLE Lic Expire: 02129/2020 Address: SANTAFE SPRINGS CA 90670 Bus Lic: BT30062816 Record Management: Phone:. 562-436-5188 Lic Exp Date: 0 413 012 01 9 Phone: State Lic Code Edit : 2016 Worker's Compensation Insurance Designer. $0.00 Type of Construction: Carrier: AMERICAN FAMILY HOME .Address: $0.00 Occupancy Group: U Policy No: 4EA5WC000062900 General Service _ Added /New sq.ft. Bldg: 0 Expire: 11/1212019 Phone: $0.00 Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear.. I Special Conditions: Refund Deposit No of Units : 0 Front: I $0.00 Bldg Height: 0 Left: Y $0.00 Bldg Sprinklers: Right: I Hazardous Mat t; Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N $0.00 Construction Valuation: $2,000.00 Building Permit Fee: $104.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $90.48 Additional Fee: $0.00 Plan check Fee : $40.00 Fire Inspection: $0.00 Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev $0.00 Investigation Fee: $0.00 Grading PC Consultant : $0.00 SJH Trans : $0.00 Demolition Fee Record Management: $6.00 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 Energy Compliance: $56.00 Grading PC Fee: $0.00 Public Works Department - General Service $0.00 CA Seismic Safety: $0.00 WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $0.00 P/W Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $13.61 San Dist: $0.00 Building Green Fee : $1.00 Mechanical %: $0.00. NMUSD Fee: $0.00 $0.00 Plumbing %: - $0.00 $0.00 11 TOTAL FEE: $311A Plan Check Fee: $192.81 Fee Due at Permit Issuance : $118.28 PROCESSED BY: PUBLIC WORKS APPROVAL: ZONING APPROVAL:PLANCHECK BY: A. %, GRADING APPROVAL: APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION •• ••• I hereby affirm under penally of perjury that I am exempt from the Contractors' 9tate•L1cejlsi Lg0for jh'e reaaon(s) indicated below by the checkmark(s) I have placed next to the applicable items) (Section 7031.5, Business and Professions Code: Any city or county that require! aper #t to constr`ICt, AltpT, ipiDwve, 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 pros idiA 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 compenitatiojl•w�l do•("J �I c>1' os (_d portionaof 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 owrfer of Qrot)erty &ITd, 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 ftsovehent is sold within one-year of0completion, the Owner -Builder will have the burden of proving that it was not built or im 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 not ap 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: 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 legall, 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://www.leginfo.ca.gov/calaw.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 7 00) of Division 3 of the Business and Pro a to Cod , and ense Is in full force and effect. License Class �. Y ,r License No 10 Contractor Signatu �(�ti WORKERS' COMPENSATION DECLARATION NARNING: 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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: 5I 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 th 3 ormance of the work for which this permit is issued. Policy No. �I ave 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' compensatiol ns ante carrier and policy number are: Tier ASK T�rJ $�J 2P.+JCL �0 -Policy Number 4E A'J Wl 6d°O 6a�coQ Expiration Date l -' )6f - q' Vame of Agent In ii'(..4 44C. Phone # (ff11) V 6 9-1 & dim :11 certify that, in the performan 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 ogre :hat, if I should become ct to the workers' cpe ation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. signature of Applican Z t/1/'`-- Date DECLARATION REGWtlblNI3 CONSTRUCTION 1ENDING AGENCY hereby affirm under penalty of perjury that ther 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 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 l9ws relating to building construction. I authorize representatives of this city or coun;LtgA V; t4 above-IdeANd property for inspection purposes. Owner's or Authorized Aaent's Name ACTIONDATE BY REGULATIONS OF COMPLIANCE LIANCE 4TH CODE OF RUDERAL FOR OFFICE USE ONLY I PERMITEXPIRED i i 1 L-IISUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED EPA PERMITFINALJ.1•%�/7, I�- V ASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATEOF Y PROPOSED DEMOLITION OCCUPANCYISSUED SIGNATURE: