HomeMy WebLinkAboutX2021-2319 - Permits�w'r4
City of Newport Beach - Building Division
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100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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Inspection Requests Phone (949)644-3255
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Combination Type - BLDG ELEC
*X2021-2319*
COMB Permit: X2021-2319
Project No: 2005-2021
Issued Date : 08/31/2021
Inspection Area : 7
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 08/31/2024 OR PERMI ,
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 i
Job Address:
957 NEWPORT CENTER DR NB
Description:
COMM ILLUM SIGN "COREPOWER YOGA"
Legal Desc.:
P BK 221 PG 30 PAR 6
Owner:
IRVINE CO Contractor:
EMPIRE SIGN & CRANE SERVICE INC Architect:
Address:
550 NEWPORT CENTER OR Address:
22816 COVE VIEW ST Address:
NEWPORT BEACH, CA 92660
CANYON LAKE CA 92587
Phone:
949322-8079 Phone:
818.920-1067 Phone: State Lic:
Applicant:
ANNA WEBER/ EMPIRE SIGN & CRANE SERVICE INC
Con State Lic: 833106 Engineer:
Address:
22816 COVE VIEW ST Lic Expire:
02/28/2022 Address:
CANYON LAKE CA 92587 Bus Lic:
BT30051229
Phone:
949-720-3160 Lic Exp Date:
08/31/2022 Phone: State Lic:
Code Edit : 0
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:
Construction Valuation: $2,450.00
Building Permit Fee: $130.00
Plan Check Fee: $113.10
Overtime Plan Ck:
$0.00
Investigation Fee:
$0.00
Record Management :
$12.00
Energy Compliance:
$61.00
CA Seismic Safety:
$0.00
Disabled Access :
$0.00
Hazardous Mat
$0.00
Building Green Fee :
$1.00
TOTAL FEE : $386.12
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Worker's Compensation Insurance
Carrier: STATE FUND
Policy No: 9132563
Expire: 05/14/2022
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 W
Plumbina %:
Rear: /
Front: /
Left: /
Right: I
irking Spa
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$17.02
$0.00
$0.00
0
Designer:
MANDEVILLE SIGN
Address:
676 GEORGE WASHINGTON HWY
LINCOLN, RI 02865-4255
Phone:
401-334-9100
Special Conditions
Fire
Planning Department -
Plan check Fee
Fair Share
SJH Trans
In -lieu Housing Fee:
Public Works Department -
Park Dedication :
$0.00
PAN Plan Check :
$0.00
San Dist:
$0.00
NMUSD Fee:
$0.00
Fire Department
$52.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
Plan Check Fee : $0.00 Fee Due at Permit Issuance:
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
INVALID
0
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$386.12
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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 ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner-Builderwill have the burden of proving that it was not built or
improved for the purpose of sale).
❑ 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason:
By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot lega11,
sell a structure thatl have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
Professions Codb,iS jayffilable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm].
Wptuje of Property Owner or Authorized Agent Date
LICENSED C09TUCTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 Division 3 of the Business and Profession ode, and my license is in full force
a$d ttfill& Licens9 Class C- V License No S 43 1 Oa Date 11 to-L.Contractor Signature��
WORKERS' d)PAPENSATION DECLARATION
VAARNBIO: FAILURE TO SMURE 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
CQ.ST Q F.COMPENSA V10 N,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
he affirm under penalty of perjury one of the following declarations:
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
Ice of tjl0 wp%for which this permit is issued. Policy No.
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' compensa
carrie6jr4r4icy number are:
Policy Number 61/ 3'1,5*to 3 Expiration Date
Agent
certify that, in the performance of the work forwhich 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
, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
of
Date/�I�-r-r1z1
:reby 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)
lder'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 laws relating to building construction.
I authorize representatives of this city or county-t bove-identified property for inspection purposes.
__...-_ _1 r,-___.....,...__. n-- - Z..r o.,. %i n-narla .,r n„rh, ri7en A�eM'Q Nd Mm fly/ A A ",JJ e
j DATE B DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
,r, 2 REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
F EXPIRED I ❑ I SUBMITTED ASBESTOS NOTI FICATION TO
PERMITFINAL LJASBESTOS NOTIFICATION IS NOT APPLICABLE TO
CERTIFICATE OF PROPOSED DEMOLITION
OCCUPANCY ISSUED SIGNATURE:
Date