HomeMy WebLinkAboutXC2023-0271 - Permits�EWPoRr City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: XC2023-0271
Community Development Department- Building Division X C 2 0 2 3 0 2 7 1
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-1733
Permit Counter Phone: (949) 718-1888 Issued Date : 07/1912023
te r. x newportbeachce.gov/civic Final Date:
C9G/F00.��P Combination Type - Permit Status: Issued
Work Class - Other Inspection Area: 7
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE
NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS
Job Address: 3990 WESTERLY PL Legal Desc : P BK 39 PG 18 PAR 3
Description: COMM NON-ILLUM FOAM SIGN "PERRICONE FARMS'
Owner: OW-ABERDEEN WESTERLY OWNER LLC
Address : 2727 LBJ FREEWAY, 806
DALLAS, TX 75234
Phone:
(657)261-8894
Applicant:
ADIMPACT CORPORATE SIGNAGE
Address :
15445 RED HILL AVE, A
TUSTIN, CA 92780
Phone:
(949)476-0015
Owner/Builder :
Address :
Phone
Code Edition : 2022
Type of Construction : V-B
Occupancy Groups: U
Bldg Height :
Building Setbacks
Flood Zone
Use Zone :
X
PC - Newport Place
PROCESSED BY: C
SPECIAL CONDITIONS:
Contractor: ADIMPACT CORPORATE SIGNAGE
Address : 15445 RED HILL AVE, A
TUSTIN, CA 92780
Phone:
(949)476-0015
Con State Lic
: 490124
Lic Expire :
06/30/2024
Bus Lic:
BT30074271
Bus Lic Expire : 02/28/2024
Workers' Compensation Insurance
Carrier: TRAVELERS PROPERTY CASUALTY
COMPANY OF AMERICA
Policy No: UB7J022083
W. C. Expire : 10/1/2023
Fire Sprinklers : NO
Fire Hazard Zone : NO
No of Units : 0
No of Stories
Architect
Address
Phone: 1 •1
State Lic
Engineer:
Address
Phone :
Designer: AZAD GOLSHANI
Address : 15445 RED HILL AVE, A.
TUSTIN, CA 92780
Phone: (714)315-7811 „
Construction Valuation : $1,500.00
Added/New/TI sq. ft. Bldg : 0
Alteration sq. ft. Bldg :
Added/New sq. ft. Garage: 0
TOTAL sq. ft. : 0
OWNER. -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reascn(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
is permit to file a signedstatement that he or she is licensed pursuant to the previsions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
rofessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.6 by any applicant for a permit subjects the applicant to a civil penalty of
of more than five hundred dollars ($500).
11, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
',usiness 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
nprovements 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 bull! or
Itproved for the purpose of sale),
1 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
poly 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 I am exempt from licensure under the Contractors' State License Law for the following reason:
ly 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
ell 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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http:l/www.teginfo.ca.govlcalaw.htmt,
lignature of Property Owner or Authorized Agent Date
ACENSED CONTRACTOR'S DECLARATION //
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commanding with ction 7000) of Division 3 of the"Quy{ less and Profess' rS5 e, snit my license is In full force
no effect. License Class License No t /9-_ ConJty'�\ctor Signaiule
VORKERS' ComrENSATION DECLARATION
IFRNING: FAILURE TC S_2l'RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS t41t00.0001. IN ADDITION TO THE
CS": ]^ ",`MPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3T05 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
i 1 nave and will-rointa'rn 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
gEformance of the work for which this permit is issued. Policy No.
hpvs and will maintcin 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'
'rance carrier E^d policy number are:
Tler Policy Number Expiration Date
re of Agent Phone #
dflnfy [hat, In hP pr+rformanp a of the work for which this permit is issued, shell not employ any person in any mender so as to become subject to the workers' q(�mpensation laws of California, and agree
t, 'f h OWd ecoTo sqt •t'to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with Ihoss provisions. /V,.(�`
nature pullcant � Data
CLAR Ti0 RFF�,Y DI O GONSTRUC'i'tON LENDING AGENCY
Ireby a#flrm rider analty of perjury that thsre is a construction lending agency for the performance of he 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 ordina and state laws relating to building construction.
I authorize representatives of this city or unty toe it ove•1 ed property for inspectlon purposes.
nature of Pro. ern Owner or Authorized Age Print Pro l erty Owner's or Authorized A enf's �z Ci " r^
TION DATE. BY D CLARAT*N OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITI E 40 AND AQMD RULE
1403
RMiT EXPIRED I LJ I suaNuTTED ASBESTOS NOTIFICATION TO
PERMIT EXTENDED
PER'NHTFINAL=1^Z'!-Z ASt7E5i05 NOTiFICA PION IS NOT APPLICABLE t0
CERTIFICATE OF PROPOSED DEMOLITION
OCCUPANCY ISSUED SIGNATURE: