HomeMy WebLinkAboutB2001-1102 - Permits_EXPIREDBLDG Permit No: B2001-1102
City of Newport Beach
Building Department
3300 Newport Blvd - 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:
Inspector Area 7
Owner:
Address:
Phone:
Applicant:
Address:
Phone:
HOAG MEMORIAL HOSPITAL
1 HOAG OR
NEWPORT BEACH CA 92663
949/574-488
Code Edition:
Type of Construction:
Occupancy Group:
Added/New sq.ft. Bldg:
Added/New sq. ft. Garage:
No of Stories: 0
No of Units :
Receipt Number:
97
Construction Valuation: 810.000.00
Building Permit Fee :
Plan Check Fee:
Investigation Fee:
Clean Up Deposit:
Disabled Access:
$143.60
$103.39
$0.00
$200.00
$32.80
PROCESSED BY:'•. : •
• • •• ••-
• ••
PLANNING APPROVAL; •
FIRE'4PRde%Ae
,. 0 • •
• • • • . ••
GRASING APPROVAL:
• • • • •�,
Suite:
•
Bldg: 1
Legal Descr:
Contractor:
Address:
Phone:
Con State Lic
Lic Expire:
Bus Lic:
Lic Exp Date:
WATSON INVES
18182 SERRANO AVENUE
VILLA PARK CA
714/974$121
436023
03/31/2003
BT98038807
10/31/2001
Workers' Compensation Insurance
Carrier: STATE FUND
Policy No: 229-0019928
Expire: 01/01/2002
Building Setbacks Rear. /
Front /
L
Use Zone:
Parking Spa
Microfilm:
Excise Tax- Res
Excise Tax-
Suppleme . . I P/C:
Falr Sh
T • AL FEE : ;637.14
•
PUBLIC WORIJR!•• •• �•:
• •• • •
•• •
••
••
••••••
••• ••
• • •
•
•• ••
•.
•.• ••
$2.37
$0.00
$0.00
$0.00
$0.00
FEES
Description of Work: REMOVE DOOR FROM ENCL STAIRWAY IN PRKNG STRUC
0901-2001
itect:
dress:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
440
LIEBKE RAY
1340 REYNOLDS AVE
IRVINE CA 92614
State Lic: C006433
Special Conditions:
State Lic:
Hazardous Mat Disclosure:
CA Seismic Safety
Fire Dep - Plan Review:
Fire Dep - Inspection:
$0.00
$0.00
$0.00
$41.36
$100.52
TOTAL PAYMENT : S144.75 TOTAL DUE : $492.39
OTHER DEPARTMENT.
PLAN CHECK BY:
APPROVAL TO ISSUE;
Planning Dep - -
Plan Check:
Counter Rev.:
OverTime Plan Check Fee:
6-ecv eiegt..,
$0.00
$13.10
=0.00
WORK MUST BE STARTED WITHIN A PERIOD OF 180 DAYS FROM THE DATE OF VALIDATION
OR THIS PERMIT BECOMES NULL AND VOID.
APPROVALS
FOUNDATION:
ROUGH GRADE
DATE
BY
COMMENTS
LINE & GRADE CERT/SETBACKS
ERECTION PADS
FOOTINGS
SLAB ON GRADE
DECK SLAB
FRAMING:
SUBFLOOR
ROOF & BUILDING HT
EXT. SHEAR/HOLD DOWNS
GENERAL FRAMING
INSULATION
DRYWALL
SUSPENDED CEILING
PLASTERING:
INTERIOR LATH
EXTERIOR LATH
SCRATCH (2 DAY)
MASONRY
FOOTING
PRE -GROUT
FIREPLACE
MISC. INSPECTIONS:
PERMIT EXTENSION
1ST EXP. LETTER
a
1
J
fei/
2ND EXP. LETTER
PERMIT EXPIRED
PERMIT CANCELED
FINAL
CERTIFICATE OF OCCUPANCY
$ 2)0
DATE 2- 1 0
TO: I-bn fYVJrlovLaf
rorC2L-Led sar-spy r
OWNER -BUILDER DECLARATION
I HEREBY AFFIRM UNOER PENALTY OF PERJURY THAT 1 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 91COMMENCING WITH SEC. 70001 OF DI'J 3 OF THE
BUSINESS AND PROFESSIONS COCE)1 OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS
FOR THE ALLEGED EXEMPTION ANY VIOLATION OF SEC. 70315 BY ANY APPLICANT EOM A PERMIT
SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS j$500I.
0I, A5 OWNER OF THE PROPERTY. OR MY EMPLOYEES WITH WAGES A5 THEIR SOLE
COMPENSATION. WILL 00 THE WORK. AND THE STRUCTURE 15 NOT INTENDED OR OFFERED FOR SALE
ISEC )OM. BUSINESS AND PROFESSIONS CODE. THE CONTRACTORS LICENSE LAW DOES NOT APPLY
TO OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON AND WHO DOES SUCH WORK
H ELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES. PROVIDED THAT SUCH
PROVEMENTS ME NOT INTENDED OR OFFERED FOR SALE. IF. HOWEVER. THE BUILDING OR
IMPROVEMENT 15 SOLD WITHIN ONE YEAR OF COMPLETION. THE OWNER.BUILDER WILL HAVE THE
BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE.1
0 1, AS OWNER OF THE PROPERTY. AM EXCLUSIVELY CONTRACTING WITH LICENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (SEC 7044 BUSINESS AND PROFESSIONS CODE THE
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'I
C AM EXEMPT UNDER SEC _._.. __. _.._. Bd PC. FOR THIS REASON
LICENSED CONTRACTORS DECLARATION
I HEREBY AFFIRM UNDER PENALTY 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 FULL FORCE AND EFFECT
LICENSE CLA55 ,_,..... ........._. LIC NO..
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 SELF -INSURE FOR WORKERS'
COMPENSATION AS PROVIDED FOR 6Y SECTION 3700 OF THE LABOR COOS, FOR THE
PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED
1 HAVE ANO WILL MAINTAIN WORKERS' COMPENSATION INSURANCE AS REQUIRED BY
SECTION 3700 OF THE LABOR CODE. FOR THE PERFORMANCE OF THE WORK FOR NYIICH
THIS PERMIT 15 ISSUED MY WORKERS' COMPENSATION INSURANCE CARRIER AND POLICY
NUMBER ARE _Si
CARRIER _`T1UTAO_
POLICY NUMBER
RHIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS
15100) OR LESS).
'CERTIFY THAT IN THE PERFORM/WCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,'
SHALL NOT EMPLOY ANY PERSON IN ANY MANNER 50 AS TO BECOME SUBJECT TO THE
WORKERS' COMPENSATION LAWS OF CALIFORNIA, AND AGREE THAT IF 15HOULD BECOME
SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF SECTION 3700 OF THE
LABOR COOS 1 SHALL FORTHWITH COMPLY WITH THOSE PRONI
$IONS.
E 4Q
DATE' \ O7 ♦ ___ APPLICANT 1? ^ •W
WARNING. FAILURE TO SECURE WORKS '•Ct1MI NSARON CM•ERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PWALTIES •11D C¢IL LINES BP TO OE HUNDRED TIKKI5NC
DOLLARS (5100.000), IN ADDITION TO THESIS'S' ORDOCMQENSA DAMAGES AS PROVIDED FOR IN
SECTION 3THE OF THE LABOR CODE. INN ST.t eATIORNE S S.
CONSTRUCTcN LENOBkO AOE�CY
I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONLsTRUCTIOM LENDING
AGENCY FOR THE 7V 29MANCE OF THE WORK FOR WHICH THIS PERMIT S ISSUED (SEC.3091,
•
CN.C.). • • • • • ••• ••• • •
LOOMS/AM __.•—• • •• i__._. • • • • ! •• __
LENOER'SADDFESS • • • • •__J-�•_•-r• ••�
I CERTIFY THAT I HAVE READ THISAPPl1CITION AFACTATE MAT fif fly? IVORMATION IB
COMECT. I AGREE TO COMPLY WITH ALL CITY NO COUNTY ORDINANCES AND STATE LAWS
RELATING TO MRDOC CONSTRUCRON, AND HERESY AUTIORIZE REPRESENTATIVES Of THE
COUNTY TO ENTER UPON THE AVIMIAEjf!O EO PROPERTY FOR INSPECTION FINMSES.
• • • .•• •• •• •
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