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Home My WebLink AboutX2019-0602 - PermitsCity of Newport Beach- Building Division OG CO 0 0 0.... CC 100 Civic Center Drive, Newport 6eacji, C1 9e660 Permit Counter Phone(9464-3281 • • Inspection Rett@ett Ph8n/(9$9)t44-325t•° Combination Type - BLDG �P IIIIHI II1I IIIIIIII 111II IIIII V COMB Permit : X2019-0602 Project No : 0431-2019 Issued Date : 02/25/2019 Inspection Area :7 • • • ° ° • • : PERL$TS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Contraction Hororsp Sunday oi;ridgy%: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: 1 HOAG DR Ne Description:. COMM SIGN, INSTALL NEW MONUMENT SIGN & (1) WALL SIGN -PICKUP FAMILY NEUROSCIENCES INSTITUTE, REMOVE (1) (E) SIGN Legal Desc.: IRVINE SUB BLK 2 LOTS 169 & 170 POR OF LOTS & BLK 1 172. POR OF. LOT Owner: Address: HOAG MEMORIAL HOSPITAL 1 HOAG DR NEWPORT BEACH, CA 92663 Phone: Applicant: BATT GARRICK Address: 111 W DRYER RD #F SANTA ANA CA 92707 Phone: 714-641-0064 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: Contractor. Address: Phone: Con State Lic:. Lic Expire: Bus Lic: Lie Exp Date:. SIGN SPECIALISTS 111 W. DYER RD#F SANTA ANA CA 92707 714-641-0064 988048 10/31/2019 BT30042506 03/31/2019 Worker's Compensation Insurance. Carrier: CYPRESS INS CO Policy No: SIWC927363 Expire: 08/25/2019 Building Setbacks Use Zone: Rear: / Front: I Left: / Right: /. Parking Spaces: Architect: Address; Phone: Engineer: Address: Phone: Designer: Address: Phone: State Lic: SULLAWAY MICHAEL 10815 RANCHO BERNARDO RD SAN DIEGO CA 92127 858-335-7606 State Lic:C-048588 Special Conditions: LANDSLIDE AREA Fire Hazard Zone : N Construction Valuation: $24,000.00 Building Permit Fee:. $456.00 Plan Check Fee:. $396.72 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 : $934.97 Excise Tax: Additional Fee : Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee : Electrical %: Mechanical%: Plumbing %: $0.00 Planning Department - $0.00 Plan check Fee : $0.00 Fair Share: $0.00 SJH Trans: $0.00. In -lieu Housing Fee . $0.00 Public Works Department - $0.00 Park Dedication : $0.00 PN4Plan Check : $41.25 San Dist : $0.00 NMUSD Fee: $0.00 Plan Check Fee : $40.00 $0.00 $0.00 $0.00 Fire Department Fire Inspection: Fire Plan Rev Demolition Fee Building Dept Adm General Service Refund Deposit Grading Bond: $396.72. Fee Due at Permit Issuance : $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $538.25 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE:.. 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 clecksriark(s):1 hay4 plead ndxt 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 ally Gtructl re;prilar jo its i;stlanct, 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 (ccThtmeltctng with Section W000)c4 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 struc&ue is nig intenaod or pf?ejed,fbisale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or pedonajeffolt, baijpst4 imrrotes thg 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 Owr*fpugte will have theturde . ofpre Virg that it was not built or improved 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 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). ❑ 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 legally 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 underseprovisions of Chapter 9 (commencing with Section 7000) of Divisionf the Business and Pr slops Code,.aBd rgy,license is in full force and effect. License Class License No Date Contractor Si natu WORKERS' COMPENSATION DECLARATION WARNING: 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 (6100,000), IN ADDrnON 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 declarations: I 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 the e rmance 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' compensation ins nce carrier and policy number are: arrier Policy Number Expiration Date Name of Agent Phone # ❑l certify that, in the performance 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 agree that, if I should become suthorkera' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant DECLARATION REGARDING CONSTRUCTION LENDING 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 Code). Lender's Name Lender's Address 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 wi h all applicable city and county o dinanc nd s ate laws relating to building construction. I authorize representatives of this city or county to e,�� r �hG a e-i� I f ' roperty for inspection purposes. Signature of Property Owner or Authorized Agents 1 �'. Print Property Owner's or Authorized Agent's Nam D ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 FOR OFFICE USE ONLY f if Date 2i274? PERMIT EXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED ❑EPA PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCY ISSUED Z4-/p ❑AQMD ❑ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION SIGNATURE: