HomeMy WebLinkAboutX2010-2559 - PermitsCity of Newport Beach
Building Department
PO Box 1768 Newport Beach, California 92658-8915
Combination Type - GIP/ PLUM/ / /
Permit Counter Telephone (949)644-3288
COMB Permit No: X2010-2559
PROJECT NUMBER: 1998-2010
Inspection Requests/Telephone (949)644-3255
Job Address: 1 HOAG DR NB
Description:INSTL ADA SHOWER @ CONFERENCE CENTER
Inspector Area: 7
OF LOT
Owner. HOAG HOSPITAL FD & C
Address: 500 SUPERIOR AVE #300
NEWPORT BEACH, CA 92663
Phone: 949-764-4464
Applicant:
Address:
Phone:
FOTHERINGHAM JUANITA
101 S KRAEMER BLVD #100
PLACENTIA CA 92870
714-496-4185
Code Edit :
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage
No of Stories:
No of Units :
Bldg Height:
Bldg Sprinklers:
Flood Zone:
Issued Date: 11/24/2010
2007
II-ASPR
B
0
0
3
0
0
Y
Legal Desc.:
IRVINE SUB BLK 2 LOTS 169 & 170 POR OF LOTS & BLK 1 172 POR
Contractor:
Address:
Phone:
Con State Lic:
Lic Expire:
Bus Lic:
Lic Exp Date:
PHILCO CONSTRUCTION INC
1762 N NEVILLE ST
ORANGE CA 92865
714-283-0604
764578
06/30/2011
BT03011002
03/31/2011
Worker's Compensation Insurance
Carrier: - EVEREST NAT INS
Policy No: 7600001642101
Expire: 04/01/2011
Building Setbacks Rear: I
Front: I
Left: /
Right: I
Use Zone:
Parking Spaces:
0
Architect:
Address:
Phone: State. Lie:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
State Lic:
FOTHERINGHAM JUANITA
101 S KRAEMER BL, #100
PLACENTIA CA 92870
714-496-4195
Special Conditions:
Fire Hazard Zone : N
INSPECTOR
Construction Valuation: $6 000.00
Building Permit Fee: $150.20
Plan Check Fee: $108.14
Overtime Plan Ck: $0.00
Investigation Fee: $0.00
Record Management: $14.45
Energy Compliance: $52.00
CA Seismic Safety : $0.00
Disabled Access : $77.00
Fee Increase. Fee. $0.00
Additional Fee : $0.00
Hazardous Mat: $14.40
Building Green Fee : $1.00
TOTAL FEE: $555$7
•
Solar System PC:
Excise Tax:
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee :
Electrical %:
Mechanical %:
Plumbing %:
••• ••••
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$0.00. - Planning Department -
$0.00 Plan check Fee :
Fair Share :
SJH Trans :
$0.00 In -lieu Housing Fee :
$0.00 Public Works Department -
$0.00 Park Dedication : $0.00
$0.00
$0.00
$18.78
•; • • PJan Check Fee :
• • •
P/W Plan Check :
San Dist :
NMUSD Fee:
$111.90
$0.00
$0.00
$0.00
$120.00
$0.00
$0.00
$0.00
Fire Department
Fire Inspection:
Fire Plan Rev
Demolition Fee
Building Dept Adm
General Service
Refund Deposit
Fee Due at Permit Issuance :
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$444.07
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
•• /AD • • •
'Q.3 • •
•• • •
• •
PUBLIC WORKS APPROVAL:
�b Y 1 PLAN CHECK BY:
.•• ••
•
• • • APPROVAL TO ISSUE:
••• ••. • •„pr1QI7•S.EJG I f7E 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
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) (Section 7031.5, Business 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 the permit to file a 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 not more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (j all of or U portions of the
work, and the structure is not intended or offered for sale (Section 7044, Business and Professions 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 improvements are not intended 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 improved for the
purpose of sale,.
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an 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).
❑ I am exempt from licensure under the Contractors' State License Law for the following reason:
By my signature below I acknowledge 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 sell a structure that I have 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 Code, is available 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
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of
of Division 3 of the Business and Professions Code, and my license is in full force,
been e lass . License No.
Date Contractor Signature
WO KE S' 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 (S100,030), IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
0 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 of the Labor Code, for the performance of the work for which this permit is
d
Date
No.
have and will maintain workers' compensation insurance, as required_ by. Section 3700 of the Labor Code, for the
mance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are:
nor Policy umber Expiration Date
Name of Agent Phone #
0 I certifythat, in the performance of th r r which this pemlit is issued, I shall not employany person in anymanner
so as to beome subje t to the workers' sotto ws of California, and agree that if f should become subject to the
workers' compensation sions of S de, I shall forthwith comply with those prgvisions
.z« �y5
Signature of Applicant Date X / / l/
DECLARATION REGARDIN CONSTRUCTION LENDING AGENCY
I hereby affirmunder penalty of perjury that there is a construction lending agency for the performance of the work for
is
sued this permit is (Section 3097,. Civil Code).
Lender's Name
ACTION
PERMIT EXPIRED
DATE:
BY:
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL
CERTIFICATE OF
OCCUPANCY ISSUED
DECLARATION OF COMPL ANCE WITH CODE OF FEDERAL
REGULATIONS PART 61 OF TITLE 40 AND AOMD RULE 1403.
❑ I SUBMITTED ASBESTOS NOTIFICATION TO:
0 EPA
❑ AOMD
ASBESTOS NOTIFIC
(commencing with Section 7000) OSED DEMOLITIONI
SIGNATURE: X
WPgY f9E"fi+*4mes rWn-vtl\.,-nLav i."1,9TM tW1PnAkMM M£%NPaas?n=M M'+4tWrvMeng4
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'
I have read this application and the information I have provided is e • •
•
I agree to comply with all applicable city and county ordinances t e relating to building construction. ' •
I authorize representatives of this city or county tq enter the a p pe r inspection purposes.
Signature of Property Owner or Authorized Agent /V\ /991ate • ••
�� r Print Property Owner's or Authorized Agent's Name: �G G
FOR OFFICE USE ONLY
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01/01/2009
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