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Home My WebLink AboutX2021-1715 - Permits��Mrr4 City of Newport Beach - Building Division q T 100 Civic Center Drive, Newport Beach, CA 92660 s Y Permit Counter Phone 949 644-3288 Inspection Requests Phone (949)644-3255 Combination Type - BLDG ELEC IIIIIIIIIIIIIIIIIIIIIIIIIIII II X 2 0 2 1 1 7 1 5 fo 4P COMB Permit: X2021-1715 Project NO : 1502-2021 Issued Date : Inspection Arearea :2021 7 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0711412024 OR PERMIT WILL 3E INVALID 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 H lidays Jab Address: 330 OLD NEWPORT BLVD NB Description: COMM ILLUM SIGNS (3) "KECK MEDICINE OF USC" Legal Desc.: Owner: ADVANCED MEDICAL PROPERTIES LLC Contractor: VISIBLE GRAPHICS Architect: Address: 320 SUPERIOR AVE #250 Address: 9736 ETON AVE Address: NEWPORT BEACH CA 92663 CHATSWORTH CA 91311 Phone: Phone: 818-787-0477 Phone: State Lic: Applicant: ZAMORANO CRIS Con State Lic: 745555 Engineer: Address: 9736 ETON AVE Lic Expire: 07/31/2022 Address: CHATSWORTH CA 91311 Bus Lic: BT30075209 Phone: 8181402-5447 Lic Exp Date: 05/31/2022 Phone: State Lic: I Code Edit : 2019 Worker's Compensation Insurance Designer: ZAMORANO CRIS Type of Construction: Carrier: COMPWEST INS CO Address: 9736 ETON AVE Occupancy Group: U Policy No: WCV5900022 CHATSWORTH CA 91311 Added /New sq.ft. Bldg: 0 Expire: 05/12/2022 Phone: Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear: / Special Conditions: No of Units : 0 Front: / Bldg Height: 0 Left: I Bldg Sprinklers: Right: / Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Min Construction Valuation: $20 000.00 Building Permit Fee: $419.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $364.53 Additional Fee : $0.00 Plan check Fee: $52.00 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: $0.00 Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00 Energy Compliance: $61.00 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 PM Plan Check : $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $54.85 San Dist: $0.00 Building Green Fee : $1.00 Mechanical W $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $952.38 Plan Check Fee: $416.53 Fee Due at Permit Issuance : $535.85 PROCESSED BY: _ _ -_ PUBLIC WORKS APPROVAL: 1 ZONING APPROVAL: ��/' PLAN CHECK BY: GRADING APPROVAL: __.__ APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION 1 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 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, pdorto 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 L) 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). ❑ 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 legaily 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 under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Pr�fgssons Code, and my a se is in full force and effect. License Class License No Date / y — Z ( Contractor Signaturi�i[ WORKERS' COMPENSATION DECLARATION NARNING: 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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, 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: 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 Tnance 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, for the performance of the work for which this permit is issued. My workers' carrier and policy number are: Policy Number is of Agent certify that, in the performance of the work for which this if I should become subject to the workers' compensatio re of Applicant Date is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and ag ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �reby affirm under penalty of perjury that there is a construct) 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 county ordinances and state laws re ting to building construction. I authorize representatives of this city or county to enter rty fo enter the above -identified op r inspection purposes. l o a - nature of Prooertv Owner or Authorized Auena -/V��/�i� —Print Property Owner's or Authorized Aqent's Name 0 ryr 5_O i /J ACTION 1 DATE BY DECLARATION OF COMPLIANCE&YITH CODE OF FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE illog FOR OFFICE USE ONLY PERMIT EXPIRED U I SUBMITTED ASBESTOS NOTIFICATION TO - PERMITCANCELLED EPA PERMIT EXTENDED QM D PERMITFINAL CERTIFICATE OF OCCUPANCY ISSUED _ / i S C ASBESTOS NOTIFICATION IS NOTAPPLICABLE TO PROPOSED DEMOLITION SIGNATURE: