HomeMy WebLinkAboutX2016-2001 - Permits�r City of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
N h Permit Count-� Phone (949)644-3288
Inspectfun Requests Phone (949)644-3255
�4rrou� Combination Type - BLDG ELEC
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
X 2 0 1 6 2
0 0 1
IICOMB Permit: X2016-2001
Project No : 1356-2016
Issued Date : 06116/2016
Inspection Area : 7
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST
VALID INSPECTION. ,n;,? y
y.
w,' 40
Job Address: 139 NEWPORT CENTER DR NB
Description: NEW ILLUM SIGN "LINCOLN";_
Legal Desc.:
�M
Owner: THE IRVINE
Address 550 NEWPORT CENTER DR
Contractor:
Address:
PROMOTION PLUS SIGN CO INC
21034 OSBORNE ST
Architect:
Address:
NEWPORT BEACH CA 92660
CANOGA PARK CA 91304
Phone:
Phone:
818-993.5406
Phone:
State Lie:
°ommo
Applicant: JACKSON DAWSON
Con State Lie:
853228
Engineer:
°
Address: 1 PARKLANE BLVD LITH FLR
Lie Expire:
01/3112017
Address:
DEERBORN MI 48123
Bus Lie:
BT30055126
Phone: 313-593.0690
Lie Exp Date:
05/31/2017
Phone:
State Lic:
° o
®® o
Code Edit : 2013
Worker's Compensation Insurance
Designer:
PROMOTION PLUS SIGN CO
e e
m °`®° ° ° °
Type of Construction:
Carrier:
CYPRESS INS
Address:
9420 BESEDA BLVD #250
Occupancy Group: U
Policy No:
PRWC706429
NORTHRIDGE CA 91324
occen
Added /New sq.ft. Bldg: 0
Expire:
04/01/2017
Phone:
818-993.5406
Added /New sq. ft. Garage: 0
No of Stories: 0
Building Setbacks
Rear: I
Special Conditions: AUTH FROM CONTRACTOR
° -
No of Units: 0
Front: I
FOR BILL DUNLAP TO SIGN
Bldg Height: 0
Left: I
FOR CONTR
Bldg Sprinklers:
Right: /
Flood Zone: X
Use Zone: Parking Spaces:
0
Fire Hazard Zone : N
Construction Valuation: $10,500.00
Building Permit Fee: $222.00
Excise Tax:
$0.00
Planning Department -
Fire Department
Plan Check Fee: $193.14
Additional Fee :
$0.00
Plan check Fee:
$37.50 Fire Inspection:
$0.00
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: $18.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee :
$0.00 Building Dept Adm
$0.00
Energy Compliance: $0.00
Grading PC Fee:
$0.00
Public Works Department -
General Service
$0.00
CA Seismic Safety: $0.00
WQ Insp. Fee:
$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 %:
$29.06
San Dist :
$0.00
Building Green Fee : $1.00
Mechanical %:
$0.00
NMUSD Fee:
$0.00
$0.00
Plumbing %:
$0.00
$0.00
TOTAL FEE: $500.70
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Plan Check Fee:
$0.00 Fee Due at Permit Issuance : $500.70
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 checkmark(s) I have placed.W't2ethe 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 U 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).
❑ 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 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 Codi3,•i§ available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
ignatuLe of Property'Owner or Authorized Agent Date �.
LlOfflED CQ'P(PRACTOR'S DECLARATION
I hereby affirm ende(•penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700 ) f Div Sion 3 of the Business and Professions Qoda, d Ice �SIn fu forc
andel%ct. Licence Class License No Date Contractor Signature A./2
t 0AkERS' COWJ3?,NSATION DECLARATION
WARNING• FAILURE TO SECl1RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000(, IN ADDITION TO THE
COSTOf COMPENSPTLO&DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I"vbyaffirm L:IdBgpEnalty of perjury one of the following declarations:
and will•maintain a certificate of consent to self -insure for workers' compensation, issued by the
Ice of the work for which this permit is issued. Policy No.
and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code,
carrieradotpolicy numberare:
• • • Policy Number
Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for
for the performance of the work for which this permit is issued. My workers'
Date
ne of Agent -i -none o
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
I, if I should become su ect OAS workers' co2mppe/Date
n/nssa on provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
natureCLARofAp,ION IRE nARDIN D fN CONSTRUCTION LENDGEN
:reby affirm under penalty of perjury that there is a construction Wding 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 county ordinances and state laws relating to building construction. ca le'-ouwI. I%� /�
I authorize representatives of this city or county nter the abov-identif d pro erty for inspection purposes. V 6
nature of Property Owner or Authorized Agent O.P /,Z Print Property Owner's or Authorized Agent's Name Date
ACTH DATF
fiv
OECLARATIONOFOOMPL&WCEWTTHCODEOF
KM MHdf Mk 4)MY
FEDERAL REGULATIONS PART 61 OF TITLE40AND
AOMORULE1403.
[.Vfi7 MTTrIh.ASNSTOS M717rICATION7Z):
❑ EPA
❑ AQMD
PFRMfTFXPfRFF)
PLER101TCANCELLED
P€XOTTE%TENDED
0 ASBESTOS NOAHCAIIOMIS NOT APPLICABLE TO
PROP05EDDEMOUThON-
PEWITrINAL /o 3-!G
CEAPFICAT£OF
51Lr'IYAf VitE:
OCCUPAIJC'Y'ISSUEO