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Home My WebLink AboutX2019-1199 - Permits1Y1 City of Newport Beach - Building Division *X20191199* uonsrrucnon vamanon: COMB Permit: X2019-1199 100 Civic Center Drive, Newport Beach, CA 92660 Project No: 0862-2019 r 'r 6 Permit Counter Phone (949)644-3288 Building Permit Fee: $136.00 Inspection Requests Phone (949)644-3255 ' Planning Department - �, Combination Type - BLDG ELEC Issued Date : 04/16/2019 firrv� Additional Fee: $0.00. Inspection Area : 7 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. $10.010 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: 1240 BISON AVE NB Grading Bonds Fee: $0.00 Fair Share: Descriptions COMM - (2) ILLUM SIGNS ON EXTG MONUMENT "CHEVRON" Fire Plan Rev. $0.00 Legal Desc.: N TR 12309 LOT 6 Investigation Fee: $0.00 Grading PC Consultant: Owner: IRVINE CO Contractor. SIGN DESIGNS, INC Architect A Address: .550 NEWPORT CENTER DR Address: 204 CAMPUS WAY Address:' Record Management: NEWPORT BEACH, CA 92660 MODESTO. CA 95350 $0.00 In -lieu Housing Fee: Phone: Phone: 209.5244484 Phone: State Lie: Applicant: TUNG GREGORY Con State Lie: 268001 Engineer. Grading PC Fee: Address: 204 CAMPUS WAY.. Lie Expire: 05/3112019: Address: General Service MODESTO CA 95350 Bus Lie: BT30066924 - • • m m Phone: 415-378-9620 - Lie Exp Date:. 04/3012020 Phone: State Lic; Code Edit : 2016 Worker's Compensation Insurance Designer: TUNG GREGORY .... a ..... Type of Construction: Carrier: INS CO OF THE WEST Address: 204 CAMPUS WAY 0000 Occupancy Group: U Policy No: WSA502970303 MODESTO CA 95350 Added /New sq.ft. Bldg: 0 Expire: 04101/2020 Phone: 415-378.9620 m . 00° Added/New sq. ft. Garage: 0 Hazardous Mat $0.00 X0000• °° °°° No of Stories: 0 Building Setbacks Rear: I Special Conditions: eoom No of Units: 0 Front./ - . m Bldg Height: 0 Left: / $0.00. •• • mo®.°a Bldg Sprinklers: Right: /. $0.00 Flood Zone: Use Zone: Parkins Soaces' 0 Fire Hazard 7nne - N o m o o uonsrrucnon vamanon: aa.ouu.uu Building Permit Fee: $136.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $118.32 Additional Fee: $0.00. Plan check Fee : $40.00 Fire Inspection: $10.010 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: $4.00 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 CASeismic Safety: $0.00 WQ Insp. Feer $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 %: $17.80 San Dist: $0.00 Building Green Fee : Mechanical %: $0.00. NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL LE$373.12 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $373.12 PROCESSED BY: PUBLIC WORKS APPR AL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: 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 checkmark(s) I have placed next to the applicable iterris) (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). 111, 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 improved for the purpose of sale). 111, 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 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.htmi. 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 70 of ivisi n 3 of the Business and Pro ss' 'R,finH°force and effect. License Class License No Da Contractor Signature WORKERS' COjj;*fjJSATION DECLARATION NAA�2ylgjJ &FQLURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIM AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($160,000), IN ADDITION TO THE COST b �QMPENSAI A.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. her,ebyipffirm under pAlilty of perjury one of the following declarations: I haft 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 once of the.Wark for which this permit is issued. Policy No. ha 6 and will Wpipjain 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 'nsut carrier Sn0pVolii�ty number Pare: i -�wfST W 4pc-!j�CR{~ Cf � Policy Number LAOA67-R PExpiration DetSo M4RJ8P4gent Zl 3certi% that, in t;ie 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 agre Ihat7If T would beepone s0 'ect to the wor Is' a ion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ..0 i .)() of r647a19 Signature of Applic2flf %� / � ate hereby affirm under penalty of perjurythat there I`s construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code) ender's Name I Lender's Address ly 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 county ordinances and state laws relating to building construction. I authorize representatives of Lmjy4Q an property for inspection purposes. /� lianature of ProDBrtv Own or Authorized ADen _ Print Property Owners or Authorized Agent's Name.[_.) 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