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Home My WebLink AboutB2002-2188 - PermitsCity of Newport Beach Building Department CIP Permit No: B2002-2188 PO Box 1768 Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288 Inspection RequestsTelephone (949)644-3255 Job Address' 1 HOAG DR Floor: Suite: Inspector Area: 7 Legal Desc: Owner: Address: Phone: Applicant: Address: Phone: HOAG MEMORIAL HOSPITAL 1 HOAG DR NEWPORT BEACH CA 92660 949-574-4477 GUTIERREZ HOWELL 4850 BARRANCA #203 IRVINE CA 92604 9491552-2061 Code Edition Type of Construction: Occupancy Group: AddedlNew sq.fl. Bldg: Added/New sq. ft, Garage: No of Stories: No of Units: Bldg: 1 Contractor: O W N ERIBL D R Address: Phone: Con Stale Lic: Lic Expire: Bus Lic: Lic Exp Date: 97 Workers' Compensation Insurance -- II-1HR Carrier: B Policy No: Expire: 4 Issued: 1212312002 Receipt # Building Setbacks Rear: Front: Left: Right: Use Zone: Parking Spaces: Construction Valuation: Building Permit Fee: Plan Check Fee: Supplemental: Investigation Fee: Clean Up Deposit: Energy Compliance: Fair Share: $20,000.00 $262.30 $188.86 $0.00 $0.00 $0.00 $0.00 $0.00 PROCESSED BY: ZONING APP PP1'AL: FIRE APPROVAL: GRADING APPROVAL: PUBLIC WORKS: Microfilm: $21.50 Excise Tax : $0.00 Park Ded: $0.00 SJH Trans: $0.00 San Dist: $0.00 Ca Seismic Safety: $0.00 Disabled Review: $50.00 Description of Work: PLATFORM FOR PDU UNIT IN SUPPORT SVCS BLDG 1784-2002 Architect: Address: Phone: Engineer: Address: Phone: Designer: Address: Phone: WOOD III JACK F 4850 BARRANCA #203 IRVINE CA 92604 949-552-2061 State Lic: C015130 State Lic: Special Conditions: LETTER OF AUTH ATTACHED TO PLANS FOR RANDY PERRY TO SIGN ASOIB PC FEES Hazardous Mat: Add Fire Dep HMQ: Other Fee: TOTAL FEE :$820.90 TOTAL PAYMENT :$264.40 $0.00 Fire Department: $0.00 Plan Review Fee: $0.00 Inspection Fee: Planning Department: Counter Review Zoning Plan Check: OverTime Plan Check Fee: TOTAL DUE: $556.50 $75.54 $183.61 $0.00 $27.02 $0.00 OTHER DEPARTMENT: PLAN CHECK BY: APPROVAL TO ISSUE: 1Q1A5t_f fj7414 WORK MUST BE STARTED WITH A PERIOD OF 180 DAYS FROM THE DATE OF VALIDATION OR THIS PERMIT BECOMES NULL AND VOID. APPROVALS I DATE FOUNDATION ROUGHGRAPF. LINE & GRADE CERT/SETBACKS ERECTION PADS FOOTINGS SLAB ON AIDE ---/ FRAMING: ECK SLAB 9�94JSUBFLOOR 'ROOF & BUILDING HT EXT. SHEAR/HOLD DOWNS GENERAL FRAMING FIREPLACE THROAT INTERIOR & EXTERIOR INSULATION DRYWALL SUSPENDED CEILING SHOWER LATH EXTERIOR LATH SCRATCH (PLASTER) (2 DAY) MASONRY PRE -GROUT MIer{NSPECTIONS: PERMIT EXTENSION_ 1ST EXP. LETTER 2ND EXP. LETTER BUILDING FINAL CERTIFICATE OF OCCUPANCY TENANT NAME: 3Y� TYPE OF BUSINESS USE: COMMENTS $ - - --- REFUNDED DATE TO: OWNER -BUILDER DECLARATION 1 HEREBY AFFIRM°UNDER. PENALTY OF PERJURYTHAT I AM EXEMPT FROM THE CONTRACTORS 1 LICENSE LAW FOR THE FOLLOWING REASON(SEC 7031S. BIISINESSAND PROFESSIONS CCOE ANY CITY Z Ga. C W NTY WHICH REQUIRES A PERMIT TO CONSTRUCT. ALTER, IMPROVE. DEMOLISH. Oil -REPAIR ANY STRUCTURE, PRIOR TO TS ISSUANCE. ALSO REQUIRES THE APPLICANT FOR SUCH PERMIF TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF CONTRACTORS LICENSE LAW (CHAPTER 9 (COMMENCING WITH SEC. ]CW) OF DIV.3 OF THE BUSINESS AND PROFESSIONS CODE)) OR THAT HE OR SHE I8 EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMPTION. ANY VIOLATION OF SEC. 7031.5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (SEW: OWNER OF THE PROPERTY. OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION. WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE )y. (SEG90N. BUSINESS AND PROFESSIONS CORE THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON AND WHO DOES SUCH WORK HIMSELF F2 OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEESPROYIDEQTHAT SUCH IMPROVEMENTS APE `NOTINTENDED OR OFFERED FOR SALE. IF HOWEVER, THE bUILD1NG'OR'IMPROVEMENT IS SOLD WITHIN ONE YEAR OF COMPLETION. THE OWNER BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SFIE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE.)._ S (KJ_ I, A8 OWNER OF THE PROPERTY. AM EXCLUSIVELY CONTRACTING WITH LICENSED I� CONTRACTORS. TO CONSTRUCT THE PROJECT (SEC 7044BUSINESS. AND: PROFESSIONS CODE' THE a§ 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(S) LICENSED PURSUANT TO THE CONTRACTORS LICENSE LAW.).'. `1 I ALI EXEMPT UNDER SEC DATE / .At 13/0t-,--.'OWNER 8PC FOR THIS REASON LICENSED CONTRACTORS DECLARATI(SG I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT -I AM LICENSED UNDER PROVISIONS OF p CHAPTER 9 (COMMENCING WITH SECTION MOO) OF DIVISION S OF THE BUSINESS. AND PROFESSIONS CARE ANU MY LICENSE IS W FULL FORCE AND EFFECT LICENSE CLASS LTC. NO RATE 7 CONTRACTOR Y WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS ''. - I I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELDINSLIRE FOR WORKERS' —COMPENSATION. AS PROVIDED FOR BY SECTION 3700 OF THE LABOR LODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I 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, CARRIER POLICY NUMBER (THIS.SECTION NEED NOT HE OOMPLE I ED IF THE PLHMH IS FOR ONE HUNDRED DOLIAHS �. (590O) OR LESS). ' I CERTIFY THAT 1N THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT 19ISSUER. I FF ...SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE 1, WORKERS' COMPENSATION LAWS OF CALIFORNIA, AND AGREE THAT IF I SHOULD BECOME 1) SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF SECTION 3ICC OF THE LABOR CODE.I SHALL FORTHWITH COMPLY WRH THOSE PROVISIONS. 4 DATE _ __... APPI R, WARNING. FAILURE TO SECURE WD..KES CC. /FENUTNN CO'ERAGE 15 UNLAWFUL. AND SHALL 'e ( SUBJECT AN EMPLOYER TO CRIIAINAL PEIVAQIE. AND CIVIL FINE UP TO ONE HUNDRED THOUSAND 5 �. DOLLARS ISI00.000). IN AMNION TO THE O')SI 0, COMPENSATON. DAMAGES AS PROVIDED FOR IN I, C SECTION 3706 OF THE LABOR COD£. INTE3FS. AHD /ITT/WNEYK FEES. CONSTRUCTION LENDING AGENCY 3 IHEREBY AFFIRM UNDER PENALTY OF PEHIUHY THAI THEHL IS A CONS (ROC FION LENDING AGENCY -' 1 FOR THE PERFORMA'J,TE OF NEWOF.: FOR L.( H THIS F F951035 VEOISF: 1097 CN :. LENDER'S NAME • i LENDER'S ADORES. ' 1 1 CIIITIFY THAT HAVE READ THIS L CITY AND COUNTY STATE THAT THE ASTATOVE MFWS RELATING U TOMFCT I AGO S TO COMPLY INRH ALL CI 3180EREP ESENIANOES AND FTHIS CLAWSOUNTY RELATING r 5y TO BUILDING A CANS GROW. AND HEREBY AUTHi E REPRESENTATIVES OF THIS COUNN TO ENTER UPON THE aBO �MENTI NE'O C3PF'i-Y 0 F P iroN URPOSFS. X if6y tea/2y t_ PERMHTEE PRINT) City of Newport Beach Building Department ELECTRICAL Permit No: E2002-1184 PO Box 1768/3300 Newport Blvd, Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288 Inspection RequestsTelephone (949)644-3255 Job Address: 1 HOAG DR Inspector Area: 7 Owner: Address: Phone: Issued Date: Processed By: Bldg: 1 Floor. Suite: Code Edit: 96 Legal Desc.: HOAG MEMORIAL HOSPITAL 1 HOAG DR NEWPORT BEACH CA 92660 9491645-8600 12123/2002 f 4w Contractor: Address: Phone: Con. State Lic. : Lic Expire: Bus. Lic.: Lic. Exp Date: OWNERIBLDR New Construction Residential Multi -Family 1-2 Family Service 0 to 600V up to 200A 0 to 600V over 200A Over 600V/or1,000A 0 $0.00 O $0.00 Receptacle/Switch/Outlets Recep/Outlets 0 $0.00 Fixtures 0 $0.00 Sep Circuit 0 $0.00 Signs O $0.00 Branch Circuit 0 $0.00 0 $0.00 each Add Circuit 0 $0.00 0 $0.00 Time Clocks 0 $0.00 FEE Description of Work: ELECTRICALIPDU UNIT B2002-2188 INSPECTOR NOTES: n 0 Motors/Transformers (HPIKVAA 0 to 1 HPIKW/KVA 1 to 10 HP/KW/KVA 10 to 50 HP/KW/KVA 50 to 100 HP/KW/KVA over 100 HPIKW/KVA Piggy Back !Temp Power TOTAL: $92.20 PAYMENT: $14.25 Temp Power Pole 0 $0.00 0 $0.00 Temp Underground 0 $0.00 O $0.00 Sub Panel 0 $0.00 O $0.00 0 $0.00 O $0.00 0 $0.00 1 $57.00 Record Managment Fee : $0.50 Investigation Fee $0.00 O $0.00 Plan Check $14.25 Issuance $20A5 Supplemental Fee $0.00 BALANCE: $77.95 LICENSED CONTRACTORS DECLARATION hereby affirm under penally of perjury That I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions code, and my license is in Iullforce and effect. license No: Class: Canhoclor_ WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to seif-insure for workers' compensation, as provided for by Section 3700 of the labor code, for the performance of the work for which This penrit Is issued. I 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 caner and policy numbers is: Confer: Poky number: Expire: This section need not be completed if the permit is for one hundred dollars ($100) or less. I ccrhty that in the performance of the work for which this permit is issued, t shall not employ any person in any manner so as to become subject to the workers compensation laws of California, and agree That if I should became subject to the workers' compensation provision of Section 3700 of the labor code, I shall forthwith corrpty with those provisions. Date: Applicant Signature, Warning: Failure to secure workerscompensation coverage is unlawful, and shall subject an employer to cnirinal penalties and civil fines up to one hundred (S100,000), in addition to the cost el cornpensation.daneges as provided for in Sedi on 3706 of the labor code, interest, and attorneys fees. I hereby acknowledge that I have read this application; that the information given is correct: and that I am the owner, or duly authorized agent of the owner. I agree to comply with city and state laws regulating construction; and in doing the work authonzed thereby, no person wi II be employed in violation of the labor code of the slate of California relating to workmen's compensatio nee. ` Permittee Name (Print) 1- /'iDy ,PzY Address : Signature of permittee: � Date: 21 /2/ 5/OZ Approvals Grounding Electrode Underground UnderslablFloor Rough Conduit Walls Rough Wiring Ceilings Rough Service Temp Power Utility Co. Notified Final Inspector/Date WORK MUST BE STARTED WITHIN A PERIOD OF 180 DAYS FROM THE DATE OF VALIDATION OR THIS PERMIT BECOMES NULL AND VOID.. CITY OF NEWPORT BEACH P.O. BOX 1768, NEWPORT BEACH, CA 92658-8915 OWNER -BUILDER VERIFICATION (HSC 19831) Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. (Read information on Page 2 prior to completion of this form.) 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) 'tc . 2. I (have/have not) v E signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Eg*Cre el(Ec1 Y ic, I.JCL Address (G662, 04(0414:4‘.-' AVE • City�',e%vC Phone9y9-863-'7?of Contractors License No. 3Tolo I%c33 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address Phone City Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK Signed: -war Property Owner: 4.109O /{ prig C Date: /2r23/a (f\ot6-93) 3300 Newport Boulevard, Newport Beach .-.... ....�L_✓ur un v1114111 `nJG--LDO7U� An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified on the application. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. - For. more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure -an "owner -builder" building permit, erroneously implying that the property owner- r5 proy'iding his or her own labor and material personally. Building permits are not: required to be signed by property owners unless they are per,`or,mi=ng their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N Street, Sac:arer.to, California 95814 - Please fill out and return this owner -builder verification form so that we can confirm -that you are aware of these matters. The building permit will not be issuad--until the verification is returned.