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216 S STATE COLLEGESIGN PERMIT NO. SGN2021-00073 TYPE OFNew AttacPERMIhed CITY OF ANAHEIM New Attached to Structure Sign DATE: 613012021 JOB ADDRESS: 216 S STATE COLLEGE BLVD LEGAL DESCRIPTION: PERMIT APPLICANT: OWNER INFORMATION: NMC ANAHEIM LLC SANFORD D SIGAL TARZANA, CA 91356-3362 JOB DESCRIPTION VALUATION: 1,500.00 ItyJwiii'NJ BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 INSPECTION REQUEST LINE: (714) 765 - 4626 QUARTER SECTION: 113 CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION: TONY CHEN 2213 SASTRE AVE SOUTH EL MONTE, 91733 0000 CA Installation of (2) illuminated wall sign for "Georgie's Donuts." PROCESSED BY: MAL I nereoy amnn under penalty or perjury mat I am exempt from the Uonlrectors License Law for the following reason (Sec. 7031.5 Business and Professions Code: any city or county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to Its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractors License Law (Chapter 9)(commencing with Section 7000 of Division 3 of the Business and Protest Code) or that he is exempt therefrom 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 property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044 Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or Improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement is sold with one yearof completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale). I, as the owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044 Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contmctogs) licensed pursuant to the Contractors License Law). ❑ I am exempt under Sec. , B & P.C. for this reason: Date: Owner: under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Ey I have and will maintain workers compensation insurance, as required by Section 3700 of the Labor Code, or the performance of the work for which this permit is issued. My workers Compensation insurance carrier and policy are: Caller. EXEMPT Policy Number: This section need not be completed If t he permit Is for one hundred dollars ($100) or less. ❑ I certify that in the performance of the work for which this permit is issued. I shall not employ any person it any manner so as to become subject to the workers compensation laws of California, and agree that lf I should become subject to the workers compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. , Date: 6/30/2021 Applicant: WARNING: FAILURE TO SECURE WORKER'S -COMPENSATION COVERAGE IS UNLAWFUL, AND; 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 ATTORNEYS FEES. there is a construction lending agency for the performance of the work for which this permit is Lenders Information: I certify that I have read this application and state that the above information is comect. I agree to comply with all city ordinances and state laws relating to building construction, and hereby authorize represenfives of this city to enter upon the above mentioned property for Inspection purposes. v �i Date: 6/30/2021 Signet of Applicant or Agent The permit shall expire by limitation and become null and void if the building or work has not passed final inspectoin 365 days from the date of permit issunace. A new permit is required to commence or continue work. LICENSED TION I nereoy amnn under penalty or perjury mat I am licensed under provisions of chapter 9 (commencing with Section 7000) of Divsion 3 of the Business and Professions Code. Date: 6/30/2021 Contractor. NUMBER EXPIRATION DATE: BUS2019-02793 7131/2022 TYPE: C45 TYPE: BUS N tl l �. p s' La DATE--H3Q_ Tees— paIdro Fris ermIt: Total: 672.75