HomeMy WebLinkAboutX2019-3808 - PermitsCity of Newport Beach - Building Division
' 100 Civic Center Drive, Newport Beach, CA 92660
i9 Permit Counter Phone (949)644-3288
v t Inspection Requests Phone (949)644-3255
Combination Type - CIP ELEC
IIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIII� II COMB Permit: X2019-3808
x 2 0 1 9 3 8 6 6 Project No: 2619-2019
Issued Date : 11/27/2019
Inspection Area : Tt •7
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 8:00 p.m. No work on Sundays or
Job Address: 1601 AVOCADO AVE NB
Description: COMM (2) ILLUMINATED WALL SIGNS "CITY OF HOPE"
Legal Desc.: P BK 192 PG 1 PAR 2
Owner:
CITY OF HOPE
Address:
1605 AVOCADO AVE
Overtime Plan Ck:
NEWPORT BEACH, CA 92660
Phone:
$0.00
Applicant:
FORSYTH DAVE
Address:
3411 LAKE CENTER DR
CA Seismic Safety:
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:
Construction Valuation: $3.500.00
Building Permit Fee:
$136.00
Plan Check Fee: $118.32
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management:
$0.00
Energy Compliance:
$0.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $330.92
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Contractor:
THIRD FLOOR NORTH CO
Address:
3411 LAKE CENTER DR
Bus Lic:
SANTA ANA CA 92704
Phone:
714-556.0990x117
Con State Lic:
656202
Lic Expire:
10/31/2020
Bus Lic:
BT00017538
Lic Exp Date:
10/31/2020
Worker's Compensation Insurance
Carrier:
EMPLOYEE SERV GROUP
Policy No:
WC62700071019SZ
Expire:
07/01/2020
Building Setbacks
Use Zone:
Excise Tax:
Additional Fee
Grading Bonds Fee:
Grading PC Consultant
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
Rear: /
Front: I
Left: I
Right: I
'arkina Spaces
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$35.60
$0.00
$0.00
Plan Check Fee
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
State Lic:
JACOB TONY
P.O. BOX 802050
SANTA CLARITA CA 91380 e - • • -
661.259-0700 State Lic:C-059022 •••
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om
LAI EVELYN
2110 MAIN ST STE 304
SANTA MONICA, CA 90405 c o 0 m¢ m
310-401-1330
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Special Conditions: ....
Planning Department -
Fire Department
Plan check Fee
$40.00
Fair Share :
$0.00
SJH Trans :
Fire Plan Rev
In -lieu Housing Fee
$0.00
Public Works Department -
Park Dedication :
$0.00
PM Plan Check :
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
$0.00 Fee Due at Permit Issuance : $330.92
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE: ` �v
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Fire Department
$40.00
Fire Inspection:-
$0.00
$0.00
Fire Plan Rev
$0.00
$0.00
Demolition Fee
$0.00
Building Dept Adm
$0.00
General Service
$0.00
Refund Deposit
$0.00
Grading Bond:
$0.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance : $330.92
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE: ` �v
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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).
❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) 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 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
im roved 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 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 exemptErom licensure under the Contractors' State License Law for the following reason:
By my signaturd MIMI 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 legally
a@I44 §Iucture tVt 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 Codepis evailable upon request when this application is submitted or at the following Web site:http://v w .leginfo.ca.gov/calaw.htmi.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I bereby affirm lAdgrpgnalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 Divisi 3 of the Business and Pro siorfs Code nd my license is in full force
end plect. License Ciass License No Date 2 Contractor Signat
VIIpRKERS' T.OtAPENSATION DECLARATION
f4g1lyG: FAILU9nO SECURE WORKERS' COMPENSATION COVERAGE Is UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINA PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSA=ION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
affirm upder pfinalty of perjury one of the following declarations:
......
e 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
ince of hhe work for which this permit is issued. Policy No.
and wfi'IA2intain 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
a carrier and policy number are:
Policy Number
Date
me of Agent f'none a
certify that, in the perfor l ante 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 worker compensation laws of California, and agree
I, if I should become su act to the r ers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions
.
nature of Applicant /097,tCivil
o !
CLARATION REGA DING CONSTRUCTION LENDING AGENCY
)reby affirm under p natty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section Code).
Ider'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 owners behalf.
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and counpp ordmancey and state laws relating to building construction.
I authorize representatives of this city or county tb enter the ove-identi ' party for inspection purposes.
nature of Prooertv Owner or Authorized AGent Print Property Owner's or Authorized Agent's Name aJ2 d D e \� 2 >• g
ACTION DATE BY DECLARATION 01 I/ REGULAT ONS PART061 OF IIT E 40ANDAQMD RULE CE WITH CODE OF RAL FOR OFFICE USE ONLY
PERMITEXPIRED�JdISUBMITTED ASBESTOS
PERMITCIINCELLED EPA
PERMITFINAL )-Y-11160 i BESTOS bTIFICATION IS
NOTOTT APPLICABLE
-TO
CERTIFICATE OCCUPANCY BSUED ' SIGNATURE:EOLITION r