HomeMy WebLinkAboutB2001-3744 - PermitsCity of Newport Beach
Building Department
CIP Permit No: B2001-3744
PO Box 1768 Newport Beach, Califomia 92658-8915 Permit Counter Telephone (949)644-3288 Inspection RequestsTelephone (949)644-3255
Job Address: 1 HOAG DR Floor:
Inspector Area: 7 Legal Desc:
Owner:
Address:
Phone:
Applicant:
Address:
Phone:
HOAG HOSPITAL
1 HOAG DR
NEWPORT BEACH CA 92663
714-897-1780
MC CLAIN ROOFING INC
12812 VALLEY VIEW STREET
SUITE 33
714-897-1780
Code Edition : 97
Type of Construction: 11.1 HR
Occupancy Group: 1-1.2
Added/New sq.ft. Bldg:
Added/New sq. ft. Garage:
No of Stories: 1
No of Units:
Issued:
Receipt #
Suite:
Bldg: 1
Contractor:
Address:
Phone:
Con State Lic
Lic Expire:
Bus Lic:
Lic Exp Date:
Description of Work: T/O B.U.R., INST B.R.0 IN ASPHALT 70 SQUARES MIN CLASS
MC CLAIN ROOF
12812 VALLEY VIEW STREET
SUITE 33
714-897-1780
625013
08/31/2003
BT98032874
04/30/2002
Workers' Compensation Insurance - -
Carrier: STATE COMP
Policy No: 285-0001873
Expire: 01/01/2002
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:
$14.000.00
$194.20
$0.00
$0.00
$0.00
$550.00
50.00
ZONING APPROtte: : • • • • •
•
.. • .
FIRE APPROVAL'
GRADING APPROVAL:
Microfilm: $0.50
Exdse Tax : $0.00
Pad* Ded: 50.00
SJH Trans: $0.00
San Dist: $0.00
Ca Seismic Safety: $0.00
Disabled Review: $0.00
(JAMES IRVINE SURGICAL CENTER)
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
State Lic:
State Lic:
FEES
Hazardous Mat:
Add Fire Dep HMQ:
Other Fee:
: • yfOTAL FEE :$744.70 TOTAL PAYMENT :50.00
•
•
$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: $744.70
HE K BY:
WORK M
OR THIS PERMIT 8
a\a-
$0.00
$0.00
$0.00
$0.00
$0.00
M THE DATE OF VALIDA
APPROVALS
.FOUNDATION:
ROUGH GRADE
DATE
BY
LINE & GRADE CERT/SETBACKS
ERECTION PADS
COMM TS
mkt Gov /tier-1
FOOTINGS
' \h
SLAB ON GRADE
FRAMING:
DECK SLAB
SUBFLOOR
ROOF & BUILDING HT
EXT. SHEAR/HOLD DOWNS
GENERAL FRAMING
FIREPLACE THROAT
OWNER -BUILDER DECLARATION
I HEREBY AFRRM UNDER PENALTY OF PERJURY THAT I MI EXEMPT FROM THE CCNTRACTORS
LMFNSE LAW FDR THE FDUQMNO REASON (SEC. 7011.5. BUSINESS NJD PROFESSIONS CODE: ANY CITY
ON COUNTY WHICH REQUIRES A PERMIT TO CONSTRICT, ALTER. IMPROVE, DEMOOSH, OR REPNR MIY
STRUCTURE, PRIOR TO ITS ISSUANCE. ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A
SIGNED STATEMENT THAT HE OR SHE 15 UCENSEO PURSUANT TO THE FROWSICNS OF ME
CONTRACTORS LICENSE LAW (CHAPTER 9 'COMMENCING WTH SEC. 7000) OF UV. 3I THE BUSINESS
AND PROFESSIONS COOED OR THAT HE OR SHE 15 EXEMPT THEREFROM AND THE BASIS FOR THE
ALLEGED EXEMPTION, ANY WOIAT ON OF SEC. 70315 BY NE APPJCIM FOR A PERMIT SUBJECTS THE
FPRIGNI TO A GAL PENALTY OF NOT MORE TWO FRE HUNDRED DOLLARS (ESN):
❑ I, AS CHIMER OF THE PROPERTY. OR MY EMPLOYEES WTH WAGES AS THEW SOLE
COWEISATION, VNL DO THE MARK. ND WE STRUCTURE IS NOT INTENDED OR CFFERED FOR SALE
'SEC. 7044, BUSINESS AND PROFESSIONS CODE THE CONTRACTORS UCDISE LAW W ES NOT APPLY TO
AN OWNER O PROPERTY WHO BUILDS OR IMPROVES THEREON, RAND MHO DOES SUCH WORK WNW)
OR HERSELF OR THROUGH N5 OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENT. ME
NOT INTENDED OR OFFERED FOR SALE. F, HOWEVER, THE BUILDING OR I1FROVEMENT IS SOLD WITHIN
ONE YEMI OF COMPLETION. THE O11NER-BUILDER BILL HAVE THE BURDEN OF PROVING THAT HE OR SHE
DO NOT BUILD OR ILIPIIOVE FOL TIE PURPOSE OF SHE.).
❑ I. AS OWNER OF THE PROPERTY. AM EXCUSABLY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7044, BUSINESS AND PROFESSIONS CODE: THE
CONTRACTORS UCENSF LAW DOES 10T APPLY TO AN OWNER OF THE PROPERTY INTO BUILDS OR
IMPROVES THEREON, AND Ma CONTRACTS FOR SUCH PROJECTS WTH A CONTRACTOpS) UCENSED
PURSUANT TO THE CONTRACTORS LICENSE LAW),
O I NA EXEMPT CINDER SEC. B.E P.G. FOR THIS REASON
DATE OWNER
INTERIOR & EXTERIOR
INSULATION
DRYWALL
SUSPENDED CEILING
SHOWER LATH
EXTERIOR LATH
SCRATCH (PLASTER) (2 DAY)
MASONRY PRE -GROUT
INCENSED CONTRACTORS DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I M1 I rsueen CANCER PROVISIONS OF
CHAPTER • (COMMENCING WTH SECTION 7000) OF OWSON 3 OF THE BUSINESS N0 PROFESSIONS
CODE, AND IFY UCENSE IS IN FULL FORCE AND EFFECT.
LICENSE CLASS
/j' j WC'
X rOR
WORKERS' SATION DECLARATION
/4TE'l HEREBY AFFIRM UMER PENALTY O PERJURY ONE OF THE FOLLOWING DECLARATIONS'.
I HAVE AND WILL MO NTNN A CERTIFICATE OF CONSENT TO SEFJNBNE FOR WORKERS'
COMPENSATION. AS PROWDEO FOR BY SECTION 370O OF THE LABOR CEDE, FOR THE
PERFORMANCE OF THE WORK FOR WOCH DNS PERMIT M ISSUED.
MISC. INSPECTIONS:
PERMIT EXTENSION
1ST EXP. LETTER
` nSRATt sEmidWTN
T 6T tR TIRE N lD AnD
0 5403
iteitiM.DES) TFA AS9ESEIS
NOT I F 1 Cana 10.
u
0
ASSEST0S
ai
1_04
OBI
h APPLIcat TO RM05 S
u.ya Alt
2ND EXP. LETTER
7
BUILDING FINAL
CERTIFICATE OF OCCUPANCY
HAVE AND RILL MAINTAIN WORKERS' COMPENSATION INSURANCE, AS REQUIRED BY
SECTION STUN Of THE (LIBOR CODE. FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS
PERMIT IS ISSUED. MY WORKERS COIIPOISATNW INNNAAKs CARRER AU0 POLICY
NUMBER ARE:
CAROB'
POLICY NUMBER
(THIS SECTION NEED NOT BE COMPLETED F THE PERMIT IS FOR ONE HUNDRED DOLLARS
(SIN)OR LESS).
I COMFY THAT W THE PERFORMANCE OF THE LARK FOR MACH THIS PERMIT IS ISSUED, I
SHALL L NOT EMPLOY ANY PERSON N NW &WI ER SO AS TO BECOLE SUBJECT TO THE
WORKERS COMPENSATION LAVA OF CALIFORNIA AND AGREE THAT F I SHOULD ECOE
SUBJECT TO WE WORKERS OatBENTTON PROVISIONS OF SECTION 3700 OF THE LABOR
TENTH COMPLY MTN WOO PROVISIONS.
C f• _
ARAM : FAILURE TO EECU •O EINSA OY CDVEFADE IS UMAAFUL, AND SHALL
SUILEGT_ AN EMPLOYEK 1eaE TIES NO CML FINES OF TO ONE HUNDRED THOUSAND
DODOLLLLARM�,,'($l00. 00). W •OOIIi�l 1� 09 tOYPOISATION. NAMES AS PROVIDED FOR N
ECTO17ST06 OF THE LPBO CSOE .AI10f.TOREYB FEES.
TENANT NAME:
TYPE OF BUSINESS USE:
$ 550
DATE 2 I 4D Z
TO: Linda Stvak-
REFUNDED
CONSTRUCTION LENDING AGBCY
ISIVISBY AFFIRM INTER PENALTY OF PBUURY THAT THERE IS A CONSTRUCTION (ENDNS AGENCY
FOSVENBTAIVINVO.FTHEEMM FOR WINCH TEM PERI•T�581fl SECGOT, M.G.).
• • • • • . • • •• •• • •
LENDERS WOE • - • • •
• • • •
•
LENOSTS ADORERS ••• • • •= � •• •• • i•
I CERTIFY THAT I HAVE READ THIS APWKAT)GM AND STATE THAT THE ABOVE INFORMATION IS
RARER. I MIME TO CORKY MIN ALL are AND COUNT ORENANCES AND STATE (AKA RELATING
TO BUILDING OIIATWCTI0N, N0 HEREBY AUTHORIZEIREPRESENTATVES OF THIS COUNTY TO ENTER
UPON THE ABOVianu Re P•GPYTY F�NBP INPOSES.
• •
• • • • • •
• •• • • •• • ,•.
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