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Home My WebLink AboutG2004-0061 - PermitsCity of Newport Beach Building Department GRADING Permit No: G2004-0061 PO Box 1768 Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288 Inspection Requests/Telephone (949)644-3255 Job Address: 1 HOAG DR Bldg:1 Floor: Suite: Inspector Area: 7 Code Edit : 2001 Owner. HOAG MEM HOSP RINELLA NEAL Address: 1 HOAG DR NEWPORT BEACH CA 92658 Phone: 949-574.4467 Applicant: RINELLA NEAL Address: 2220 UNIVERSITY DR NEWPORT BEACH CA92660 Phone: 949-574-1325 Geo Tech. Engineer. Address: Phone: Valuation: Yardage FILL: Yardage CUT: MACTEC 200 CITADEL DR LOS ANGELES CA 90040 $0.00 0 0 Legal Description: Contractor: MILES & KELLEY CONSTRUCTION COMPANY INC Address: 1102 E VALENCIA DRIVE FULLERTON CA 92831 Phone: 714-773-9272 Con State Uc:312206 Lic Expire: 02/28/2005 Bus Lic: 6T00018695 Lic Exp Date: 12/31/2005 Worker's Compensation Insurance Carrier. STATE COMP Policy No: 1679210 Expire: 01/01/2006 Issued Date: 01/12/2005 Address: Phone: Engineer: Address: Phone: Designer: Address: Phone: /r Description of Work: PRECISE GRADING/COMM ADDN 780 SF'<-) B2004-0289 '3,, l, 7 f7 Architect: 2220 UNIVERSITY DR NEWPORT BEACH CA92660 949-574-1325 State Lic: CO21102 TAYLOR WILLIAM C 2220 UNIV DR #200 NEWPORT BEACH CA 92660 714/574-1323 State Lic: 5-000702 Special Conditions: Grading Permit: Y Plan Check: $254.00 Permit Fee: $508.00 WQ Inspection Fee: $0.00 Investigation Fee: $0.00 Fee Increase: $22.96 WQ Plan Review Fee: $0.00 PROCESSED BY: PLANNING: TRAFFIC: SUBDIVISION TOTAL FEE : $785.46 FEES Drainage Permit: N SJH Trans Corridor:: Park Dedication: Records Management: Fair Share: $0.00 $0.00 $0.50 $0.00 $0.00 $0.00 TOTAL PAYMENT : $0.00 TOTAL DUE : $785.46 Other DEPARTMENT: PLAN CHECK BY: APPROVAL TO ISSUE: Planning Department Counter Rev: Zoning Plan Ck: PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION 9oab R9 $0.00 50.00 APPROVALS DATE BY COMMENTS WATER QUALITY BMP'S PREGRADE MEETING GRADING INSPECTION (ZA-- se-r/m084 .X,n7e— AREA DRAINS ROUGH GRADE REPORT APPROVED ROUGH GRADE APPROVAL PREPAVING MEETING CURB AND GUTTER PAVEMENT SUBGRADE AGGREGATE BASE FLATWORK OWNER -BUILDER DECLARATION HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LICENSE LAW FOR THE FOLLOWING REASON (SEC. 7031.5. BUSINESS AND PROFESSIONS COO£: ANY CITY OR COUNTY WHICH REQUIRES A PERMIT TO CONSTRUCT, ALTER, IMPROVE, DEMOLISH, Oa. REPAIR ANY STRUCTURE. PRIOR TO ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LICENSE LAW (CHAPTER 9 (COMMENCING WITH SEC. 70001 OF DIV. 3 OF THE BUSINESS AND PROFESSIONS CODE)) OR THAT HE OR SHE I5 EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMPTION. ANY VIOLATION OF SEC. 70315 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (5500): ❑ 1. AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL 00 THE WORK. AND THE STRUCTURE I5 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 SOLO WITHIN ONE YEAR OF COMPLETION, THE OWNER -BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE 110 NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE.). ▪ 1. AS 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 THE PROPERTY WHO BUILDS OR IMPROVES THEREON. AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(5) LICENSED PURSUANT TO THE CONTRACTORS LICENSE LAW). ❑ I AM EXEMPT UNDER SEC. Rb PO FOR THIS REASON GATE OWNER STORM DRAIN CATCH BASIN EROSION CONTROL LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM LICENSED UNDER PROVISIONS OF CHAPTER 9 /COMMENCING WITH SECTION 7009) OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE. AND MY LICENSE IS IN FULL FORCE AND EFFECT. LICENSE CLASS F�v1.L DATE 7 \L V5 OTHER PRECISE GRADING INSPECTION DOCUMENTS FINAL GRADING REPORT APPROVED FINAL LTC. NO. CONTRACTOR WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS'. 'HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' C MPEN^ATI N, AS PROVIDED FOR BY SECTION 3700 OF THE LABOR COOE, FOR THE no PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSSUED. itI 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 COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: CERTIFICATE TYPE F A E OF NGR. FIRM RECEIVED BY ROUGH GRADE REPORT FINAL GRADING REPORT CIVIL CERTIFICATE CARRIER POLICY NUMBER (1 HIS 5LV I TUN NGLU NU I tlL CUM✓LLI LU 11- I Mt 12HMI I I51UH UNL HUNUHLU U0LLAHS (0100) OR LESS). I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I 5H LL NOT EMPLOY ANY PERSON IN ANY MANNER 50 A5 TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA, AND AGREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS' COMPENSATION PROVI IONS `� SECTION 37d.I OF THE LABOR CODE. I SHALL FORTHWITH COMPLY WITH THOSE PR SAD DATE 1—\1-1 APPLICANT. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, Nd1 SHALL SUBJECT AN EMPLOYER TO CRIMINAL P9'ALT'ES AF D CIVI_ . INES UP TO ONE HUNDRED THOUSAND DOLLARS (5100YC), IN ADDITION Tr THE COS: OF L ORI ENSA,ION, DAMAGES AS PROVIDED FOR IN SFCTCN 37060F THE LABOR CODE. .NTER-ST, AND ATTORNEYS FEES SLAB ELEVATION CERTIFICATE (FEMA: REVISED 11/6/03 CONSRSUC70'I LEKOIN3 AGLNCY I HEREBY AFFIRM UNDER PENAL I Y OF PERJURY THAT THERE 15 A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC.3013). CIV.CJ. LENDERS NAME - LENOER'SAODREHS I CERTIFY THAT 1 IAV_ RLA0 :HIS APILICATION r010 STATE THAT THE IBOL'E IF°ONMAt ION IS CORRECT. I AGREE TO COMPLI WNH ALI CITY AND COUMY ORDINANCES A::D STATE LAWS RELATING TO B(ILBMG CONSTRUCTION. AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TOE UPON THE ABOVE MENTIONED PROPERTY FOR INSPECTION PURPOSES. up Q rotc.o Ate PENM111LE'9�L, TNT) L n SIONNADRF PN1 7 Ii[! r-Q.-0s