HomeMy WebLinkAboutXC2022-1952 - PermitsCity of Newport Beach
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Community Development Department - Building Division
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100 Civic Center Drive, Newport Beach, CA 92660
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Permit Counter Phone: (949) 644-3288
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Inspection Requests Phone: (949) 644-3255
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newportbeachca.gov/inspections
Combination Type - ELEC
Work Class - New
IIII I I II I II I III II I I II COMB Permit : XC2O22-1952
Plan Check
eo : PC2022-2320
I
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 : 2865 COAST HWY E Legal Desc : N TR 323 BLK F LOT 6 TR 323 LOT 6 BLK F AND CORONA DEL MAR L OTS 1/3/5
Description: REPLACE (E) SIGN FACE "CDM URGENT CARE"
Owner: MOZAYENI ABDUL TR
Address: 450 NEWPORT CENTER DR STE490
NEWPORT BEACH, CA 92660
Phone:
Applicant: RAYMONDCHANG
Address : 18021 SKY PARK Cl, J
IRVINE, CA 92614
Phone : (949) 398-6500
Owner/Builder :
Address :
Phone :
Contractor :
YRZ SIGNS
Address :
25991 DUNDEE DR
LAKE FOREST, CA 92630
Phone :
(949) 672-8028
Con State Lic
: 1064372
Lic Expire :
03/31/2024
Bus Lic :
BT30079838
Bus Lic Expire : 10/31/2023
Workers' Compensation Insurance
Carrier:
Policy No : EXEMPT
W. C. Expire:
Code Edition : 2019 Fire Sprinklers : NO
Type of Construction : III -A Fire Hazard Zone : NO
Occupancy Groups : B No of Units : 1
Bldg Height : No of Stories :
Building Setbacks :
Flood Zone : X
Use Zone: CC - Commercial Corridor
PROCESSED BY:
SPECIAL CONDITIONS:
Architect
Address:
0N�
Phone:
State Lic
Address :
Address es A
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Phone
Designer: RAYMONDCHANG
Address : 18021 SKY PARK CI, J
IRVINE, CA 92614
Phone: (949)398-6500
Construction Valuation : $5,820.00
Added/New/TI sq. ft. Bldg
Alteration sq. ft. Bldg :
Added/New sq. ft. Garage: 0
TOTAL sq. ft. Bldg : 0
OWNER -BUILDER DECLARATION
I hareby of ine under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable Item($)
'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
he permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' Stale License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
3rofesslons Code) or that he or she is exempt from licensors and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant i o a civil penalty of
not more than five hundred dollars ($500).
1, 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,
31,SIneSS 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
mprovements 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
mprovod for the purpose of sale).
D I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Stale License Law does not
apply to an owner of property who builds or improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
D I am exempt from licensors under the Contractors' Stale License Law for the following reason.
3y my signature below l 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],
sell a structure that I have built as an owner -builder if it has not been constructed in its ontirsty, 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:li'w r.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 Sao tioY11)o 3 e Business and Prof ns , an Icens is In full force
and effect. License Class License No Ded Contractor Signature
✓PORKERS' COMPENSATION DECLARATION
NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRININAL PE TIES A CIVIL FINES UP To ONE HUNORE1 T O DOLLARS 1$10U;000I IN AD're" To THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
El
affirm under penalty of perjury one of the following declarations:
El I have and will maintain a certificate of ccnsent 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
performance of the work for which this permit is issued. Policy No.
have 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'
ranee carrier and policy number are:
e of Agent
Artify that, in th p rformance of
if I should bei Wsubject to(the
Policy Number
Date
this permit is issued. I shall not employ any person in any manner so as to become subject to the
envisions o Section 3700 of the Labor Code, I shall forthwith comply with those provisions,
nature of Applican , ,, _ _ ual
CLARATION FMG RDING CO 9TRU;Z; tl ING AGENCY
!reby affirm under penalty of perj th are is a construction lending agency for the performance of the work for which this permit is issued (Section 3097,
rder 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 19ve provided is correct.
I agree to comply with all applicable city and w ordin css and slats i lei' building construction.
( authorize representatives of this city or coon nt h and
!f openy for inspection purposes.
nature of Prooertv Owner or Authorized Aoanl tab Print Property Owner's or Authorized Agent's Name Inc
AC71ON DATE BY ° d �ECLA�.i l f f P'COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
7 F�ijt IONS PART 61 OF TITLE An AND AONID RULF.
PERM T c F RED LI I SUBMITTED ASBFSTOS NOTIFICATION TO / �y
PERMIT CANCELLEO —.... I _..0EPA _ �.I'✓"t- MY S, y'L CCT^^Ii(C�/ L
PEnWEKTEN)EJ
PERMIT FINAL CASBESTOSNOIiFICAIIONISNOT APPLICABLE TO D//1 -t.
CERTfFfCATf Of / I PROPOSED DEMOLITION
OCCUPANC SSUED _ j SIGNATURE:
laws of California, and
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