The URL can be used to link to this page

Home My WebLink AboutX2016-2546 - PermitsCity of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - CIP ELEC MECH PLUM *X2016-2546* PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Job Address: 1 HOAG DR NB Description: COMM - TI 1400 SF "HR OPTIMATION" Legal Desc.: IRVINE SUB BLK 2 LOTS 169 & 170 POR OF LOTS & BLK 1 172 POR OF LOT Owner: Address: Phone: Applicant: Address: Phone: HOAG MEMORIAL HOSPITAL 1 HOAG DR NEWPORT BEACH, CA 92663 949-254-19 VARISCO ROBERT 19600 FAIRCHILD RD #295 IRVINE, CA 92612 949-679-6300 Code Edit : 2013 Type of Construction: II-A-SPR Occupancy Group: B Added /NewITI sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 3 No of Units : Bldg Height: Bldg Sprinklers: Flood Zone: 0 0 X Contractor: Address: Phone: Con State Lic: Lic Expire: Bus Lic: Lic Exp Date: SOUTH COUNTY CONTRACTORS 161 EXETER WAY #87 CORONA, CA 92882 949-205-6304 988175 11/30/2017 BT30048035 07/31/2017 Worker's Compensation Insurance Carrier: WC EXEMPT Policy No: (NO EMPLOYEES) Expire: Building Setbacks Use Zone: Rear: / Front: / Left: I Right: / Parking Spaces: 0 Architect: Address: Phone: Engineer: Address: COMB Permit : X2016-2546 Project No : 1756-2016 Issued Date : 11/28/2016," Inspection Area : 7 JORDAN STEPHEN C 4448 E HASTINGS AVE ORANGE, CA 92867 888-5805-0052 State Lic:C013586 Phone: State Lic: Designer: Address: Phone: Special Conditions: Fire Hazard Zone : N o 0 -o 0 o0 Construction Valuation: $150,000.00 Building Permit Fee: $1,324.00 Plan Check Fee: $1,151.88 Overtime Plan Ck: $0.00 Investigation Fee: Record Management: Energy Compliance: CA Seismic Safety : Disabled Access : Hazardous Mat Building Green Fee : $0.00 $60.00 $105.00 $0.00 $150.00 $0.00 $6.00 TOTAL FEE : $3,676.18 Excise Tax: Additional Fee : Grading Bonds Fee: Grading PC Consultant : Grading Permit Fee: Grading PC Fee: WQ Insp. Fee : Electrical %: Mechanical A: Plumbing %: $346.62 $272.35 $222.83 Plan Check Fee : $0.00 Planning Department - $0.00 Plan check Fee : $0.00 Fair Share: $0.00 SJH Trans : $0.00 In -lieu Housing Fee : $0.00 Public Works Department - $0.00 Park Dedication : $0.00 P/W Plan Check : $0.00 San Dist : $0.00 NMUSD Fee: $0.00 ?? $0.00 $0.00 $0.00 Fire Department Fire Inspection: Fire Plan Rev Demolition Fee Building Dept Adm General Service Refund Deposit Grading Bond: $1,648.52 Fee Due at Permit Issuance : $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $2,027.66 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: eS OWNER -BUILDER DECLARATION - I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Sgarp 7031.5.` By35fle.ss 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 t+nep erneit to file 3 Signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code or that he or she is exempt from licensure 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 rjotlnor44 than fi Mrlr ed dollars ($500). 5 I7as`owner of th, e property, or my employees with wages as their sole compensation, will do L) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Bdstn'e%5 and Prciesejpns 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 ifiotdvtments atg Tgt ilttended 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 iimprwed for the purpose of sale). CI, a5 owner 6f th@ s operty, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not �aap-IIply.tsa n owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). L3 I am exempt from licensure under the Contractors' State License Law for the following reason: By my snatura6alcwsaacknowledge 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 legally 'a S/dicture thaat I hate built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Codes av'gilable upon request when this application is submitted or at the following Web site:http://www.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 Section 7 ) of Division 3 of the Business and Professi. ; - Code and effect. License Class License No Date 7+ 1 14Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3T06 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 ance of the work for which this permit is issued. Policy No, ave 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. insurance carrier and policy number are: Carrier Policy Number Name of Agent ❑I certify that, in the performance of the work that, if I should become subject to fie workers' Signature of Applicant ($100,000), IN ADDITION TO THE of the Labor Code, for the My workers' compensation Expiration Date Phone # whic j' is permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree on provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. DECLARATION REGARD!! CONSTRUCTION LENDING AGENCY I hereby affirm under penaltof perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lenders Name Lender's Address By my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behal I have read this application and the information I have provided is correct I agree to comply with all applicab e city and county ordin nces an I authorize representatives of this city or county to ente ��bov A. • Signature of Property Owner or Authorized Agent, ACTION DATE BY Date 1I28/16n aws relating to building construction. d property for inspection purposes. �,II Print Property Owner's or Authorized Agent's Name .,�. a tF77 Cr. cre47-e—Dateel D'CLARATION OF COMPLIANCE WITH CODE OF FEDERAL EGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 FOR OFFICE USE ONLY PERMIT EXPIRED ❑ I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED DEPA PERMIT EXTENDED PERMIT FINAL CERTIFICATE OF OCCUPANCY ISSUED LVA-V1 QMD ESTOS NOTIFICATION IS NOTA SED DEMOLITION SIGNATURE: All required alarms, latches gates and fences which serve as part of a pool/spa barrier, shall be in place prior to approval to fill pool/spa & shall remain in place & be maintained for the life of the pool.