HomeMy WebLinkAboutB2001-3543 - PermitsCity of Newport Beach
Building Department
3300 Newport Blvd - PO Box 1768 Newport Beach, California 92658-8915
BLDG Permit No:B2001-3543
Permit Counter Telephone (949)644-3288 Inspection RequestsTelephone (949)644-3255
Job Address: 1 HOAG DR Floor: Suite:
Inspector Area 7 Legal Descr:
Owner:
Address:
Phone:
Applicant:
Address:
Phone:
HOAG MEMORIAL HOSPITAL PRESBY
1 HOAG DR,BOX 6100
NEWPORT BEACH,CA92656-6100
949/646-8901
CUNNINGHAM MICK
2220 UNIVERSITY DR
NEWPORT BEACH CA
949-574-1325
Code Edition: 97
Type of Construction:
Occupancy Group:
AddedlNew sq.ft. Bldg:
Added/New sq. ft. Garage:
No of Stories:
No of Units :
Receipt Number:
SIGN
Bldg: 1
Contractor:
Address:
Phone:
Con State Lic:
Lic Expire:
Bus Lic:
Lic Exp Date:
Description of Work: INTERIOR/EXTERIOR SIGNAGE
SEE 6378-99
LETTERING CO
17822 GEORGETOWN LANE
HUNTINGTON BEACH CA 92647
7141848.5596
782512
08131/2002
Workers' Compensation Insurance - -
Canier: ZENITH INS CO
Policy No: z046818701
Expire: 01/11/2002
Building Setbacks Rear:
Front:
Left:
Right:
Use Zone:
Parking Spaces:
Construction Valuation: $60.000.00
Building Permit Fee :
Plan Check Fee:
Investigation Fee:
Clean Up Deposit:
Disabled Access:
PROCESSED BY:
PLANNING APPROVAL:
FIRE APPROVAL.
GRADING APPROVAL:
PUBLIC WORKS:
$581.00
$418.32
$0.00
$0.00
$0.00
Microfilm:
Excise Tax- Res.:
Excise Tax- Com.:
Supp1ental P/C:
Fair 2h'dre:
TQTIyLFEE : $1,053.47
$40.50
$0.00
$0.00
$0.00
$0.00
I
I
I
FEES
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
Sees
REGIER D RANDY
2220 UNIVERSITY DR
NEWPORT BEACH CA
949/574-1325 State Lic: CO23842
State Lic:
Hazardous Mat Disclosure:
CA Seismic Safety:
Fire Dep - Plan Review:
Fire Dep - Inspection:
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL PAYMENT : $418.32 TOTAL DUE : $635.15
OTHER DEPARTMENT:
PLAN CHECK BY:
APPROVAL TO ISSUE:
WORK MUST BE STARTED WITHIN A PERIOD OF 180 DAYS FROM THE DATE OF VALIDATION
OR THIS PERMIT BECOMES NULL -AND VOID.- -- - - - - — - - - - - _ _
Planning Dep - -
Plan Check:
Counter Rev.:
OverTime Plan Check Fee:
$0.00
$13.65
$0.00
0-19
APPROVALS
DATE
BY
COMMENTS
FOUNDATION:
ROUGH GRADE
LINE & GRADE CERT/SETBACKS
ERECTION PADS
FOOTINGS
SLAB ON GRADE
FRAMING:
DECK SLAB
SUBFLOOR
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)
OWNER•BUILDER DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY TWAT I AM EXEMPT FROM THE CONTRACTORS
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 OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE
CONTRACTORS LICENSE LAW (CHAPTER 9 (COMMENCING MTH SEC. 7000) OF DIV. 3 OF THE BUSINESS
AND PROFESSIONS COOED OR THAT HE OR SHE IS 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 (E500)
❑ 1, A8 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
(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 W THIN
ONE YEAR OF COMPLETION. THE OWNER -BUILDER VALI HAVE THE BURDEN OF PROVING THAT HE OR SHE
DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE.).
❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING VAIN LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7014. BUSINESS AND PROFESSIONS CODE: THE
.CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF THE PROPERTY WHO BUILDS OR
IMPROVES THEREON, AND WHO WI/TRACTS FOR SUCH PROJECTS WTH A CONTRACTOR(99 LICENSED
PURSUANT TO THE CONTRACTORS LICENSE LAW.).
❑ I AM EXEMPT UNDER SEC. B6 P.C. FOR THIS REASON
DATE OWNER
LICENSED CONTRACTORS DECLARATION
I HERESY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF
CHAPTER 9 (COMMENCING 1MTH BECTON 7000) OF UMSION 0 OF THE BUSINESS AND PROFESSIONS
CODE. AND MY LICENSE IS IN FULL FORCE AND EFFECT.
LICENSE CLA55 LIO NO .�`Yq-%/
pAjpA Cc'!lT !o -c) 1 CONTRA '..asa
WORKERS' COMPENSATION D -r ION
MASONRY PRE -GROUT
HEREBY AFFIRM UNDER PENALTY OF PERJURYONE OF THE FOLLOWING DECLARATIONS:
I HAVE AND WLL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS'
C MPENSATI N, AS PROVIDED FOR BY SECTION 3700 OF THE LABOR CODE, FOR THE
PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.
MISC. INSPECTIONS:
PERMIT EXTENSION
1ST EXP. LETTER
2ND EXP. LETTER
BUILDING FINAL
CERTIFICATE OF OCCUPANCY
TENANT NAME:
TYPE OF BUSINESS USE:
REFUNDED
DATE
TO:
I HAVE AND WLL MAINTAIN WORKERS' COMPENSATION INSURANCE. AS REQUIRED BY
SECTION 3700 OP THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS
PERMIT IS ISSUED, MY WORKERS' COMPENSATION INSURANCE CARRIER ANO POLICY
NUMBER ARE:
CARRIER
POLICY NUMBER
(TES SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS
00100)0R LESE).
CERTIFY THAT EN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I
SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO A8 TO BECOME SUBJECT TO THE
WORKERS' COMPENSATION LAWS OF CALIFORNIA, AND AGREE THAT IF I SHOULD BECOME
SUBJECT TO THE WORKERS' COMPENSATION PR SIGNS OF SECTOR OR
CODE I SHALL FORTHWITH COMPLY WITH THO ONB ii 11
1 c�\ MPLI
WARNING: Y.AILUFE TI BECJRE WORNER6' COMPENSA GE IS UNLAWFUL, AND SHALL
SUBJECT AN J'P',OYCR 1O (1RIMINAL PENALTIES AND MIL FINES UP TO ONE HUNDRED THOUSAND
COLLARS (-100,OP9), 1" ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3701TC HE.ASOR nIDE'FTEREST, AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENOING AGENCY
R THE PeRFOR. # ALE OF THL WORK. OR WHIN. L IS FEf J.LT IS ISSUED (SE0.309T
LLAOERs:DORESS
I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS
CORRECT. I AGREE TO COMPLY WTH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING
TO BUILDING CONSTRUCTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER
UPC.H :15_E If O E-51 T CNEO 'FCPER "Y e P INSPECTION PURPOSE&
*inNL s ov
✓ T61Y'NATUUIE4P PERMITIEE