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X2019-0426 - Permits
City of Newport Beach- Building Division COMB Permit: X2019-0426 $152.00 Plan Check Fee: $132.24 Overtime Plan Ck: IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII Investigation Fee: $0.00 Record Management: $16.00 Energy Compliance:. $56.00 CA Seismic Safety: $0.00 Disabled Access: $0.00 Hazardous Mat n' 100 Civic Center Drive, Newport Beach CA 92660 X 2 0 1 9 0 4 2 6 Project No : 0307-2019 - jy ti Permit Counter Phone (949)6443288 $0.00 $19.90 San Dist: Inspection Requests Phone (949)644-3255 $0.00 NMUSD Feer -$0.00 $0.00 Issued Date : fn4irex > Combination Type - BLDG ELEC :2019 Area Inspection Area 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 6:00 p.m. No work on Sundays or Holidays .•... Job Address: 2601 W COAST HWY NB - Description: COMM 1LLUM CHNL LETTER WALL SIGN, REFACE EXTG CABINETS, NON-ILLUM LETTERS @ REAR, (2) SETS OF LETTERS ON EXTG POLE, REFACE EXTG CABINET "MAMAVS" Legal Desc.: TR 919 LOTH NWLY 50 FT SELY 1300 FT - oc000 ; °.,, • ° . Owner: MOSNAYEDI MIKE Contractor PROMOTIONAL SIGNS UNLIMITED Architect: ° o • ° " Address: $6 DEEP SEA Address: 3301 S SUSAN ST Address: ... NEWPORT. BEACH CA 92657 SANTA ANA CA 92704. ° C•�O o°c Phone: Phone 714-540-5454 Phone: State Lie: ; •--..�., ° Applicant:. CHRISTIE RICHARD Con State Lica. 636512 Engineer. , •.. o" Address: 3301 S. SUSAN ST Lie Expire: 01/3112020 Address: SANTA ANA CA 92704 Bus Lie: BT30066071 Phone 714-540-5454 Lie Exp Date: 0212912020 Phone: State Lie: e o ..... Code Edit: 2016 Worker's Compensation Insurance Designer: GILBERT JASON 0 °. m o. ° . • ®n Type of Construction: barrier. INS CO OF THE WEST Address: 3301 S SUSAN ST Occupancy Group: U Policy No:. WSD50013180 SANTA ANA CA 92704 Added /New sq.ft. Bldg: 0 Expire: 0 410112 01 9 Phone: 714.540.5454 Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear: I Special Conditions: No of Units :. 0 Front: Bldg Height:.. 0 Left: Bldg Sprinklers: Right: Construction Valuation: 94.300.00 Building Permit Fee: $152.00 Plan Check Fee: $132.24 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $16.00 Energy Compliance:. $56.00 CA Seismic Safety: $0.00 Disabled Access: $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00: TOTAL FEE: $417.14 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant: Grading Permit Fee: Grading PC Fee: - WOlnsp.Fee: Electrical %: Mechanical %: Plumbing %: $0.00 Planning Department - $0.00 Plan check Fee $0.00 $0.00 Fair Share $0.00 $0.00 SJH Trans $0.00 - In -lieu Housing Fee: $0.00 $0.00. Public Works Department- $0.00 Park Dedication:. $0.00 $0.00 P/W Plan Check: $0.00 $19.90 San Dist: $0.00 $0.00 NMUSD Feer -$0.00 $0.00 Plan Check Fee $237.50 Fee Due at Permit Issuance : $179.64 PUBLIC WORKS APPROVAL: PLAN CHECK BY: Gil\• APPROVAL TO ISSUE: 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 Plan Check Fee $237.50 Fee Due at Permit Issuance : $179.64 PUBLIC WORKS APPROVAL: PLAN CHECK BY: Gil\• APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION I hereby affirm under penaltyof 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) action 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 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 of the Business and Ifessions 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 more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044, ainess 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 )rovements%Vgot 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 )roved for theopurpose of sale). ,C as owner oftlte property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not ;If to an o'Wner 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: 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 legal e structut9 M'af Chave 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 �Wesions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. gature of t roporty Owner or Authorized Agent Date 'PINSED C©RTIZACTOR'S DECLARATION /) 'reby affirm ufider penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 ) of ivision 3 of the Business anTe Se, �Rd my license is in full force I etfect. Li(rpp% lass License No Date 'Z Contractor Sig; E--' `� )RKERS' COMPENSATION DECLARATION IARNING: FAILU$$E Tg SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO 399MF COMPEN64NON, 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: DOLLARS ($100,000), IN ADDITION TO I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th ormance of the work for which this permit is issued. Policy No. raOvper e and will maintain workers' compensation insurance, as required by Section 3700of the Labor Code, for the performance of the for which this pt is issued. My workers' compensatioi ce carrier and policy number are: 'ier 1�$ , (_. codes l/V�'—S'Z' Policy Number V Expiration Date —f �'Z-c:�'�G of Agent certify that, in the pert firmance 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' mpensation laws of California, and agre I, if I should becomes bj_ecctt tlQ the <ers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. nature of Applicant \ Dat—/ CLARATION REGA DING CONSTRUCTION LENDING AGENCY )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). 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 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 coun ordinan s and state laws relating to building construction. I authorize representatives of this city or county t1enter the a I tified-proplin for inspection purposes. �� - , 4 .7 / i ACTION PERMIT EXPIRED DATE BY DECLARATION OF p REGULATIONS PART O61 OF ILT E 40 AND QMD RULECE WITH CODE OF FOR OFFICE USE ONLY NOTIFICATION TO I PERMITFINAL I -k -A-\1 �BESTOS OTIF CATION IS NOT APPLICABLE TO CERTIFICATE OF OPr75gDD N - -C OCCUPANCVISSUED SIGNATURE: _/