HomeMy WebLinkAboutX2009-1036 - PermitsCity of Newport Beach
Building Department
PO Box 1768 Newport Beach, Califomia 92658-8915
Permit Counter Telephone (949)644-3288
Combination Type - BLDG/ GRAD/ / /
COMB Permit No: X2009-1036
Inspection Requests/Telephone (949)644-3255
Job Address: 1 HOAG DR NB
Inspector Area: 7
OF LOT
Owner: HOAG HOSPITAL FD & C
Address: 500 SUPERIOR AVE #300
NEWPORT BEACH CA92663
Phone: 949-764-4486
Applicant: RABBEN WILLIAM
Address: 833 DOVER DR #9
NEWPORT BEACH CA 92663
Phone: 949-548-3459
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: 01/19/2010
2007
V-B
U
0
0
0
0
0
N
Construction Valuation: $50.000.00
Building Permit Fee: $660.00
Plan Check Fee: $475.20
Overtime Plan Ck: $0.00
Investigation Fee: $0.00
Record Management : $130.00
Energy Compliance: $0.00
CA Seismic Safety : $0.00
Disabled Access : $0.00
Fee Increase. Fee' $19.70
Additional Fee : $0.00
Hazardous Mat : $0.00
Building Green Fee : • $2.00 , •, ,
Tb1'AL FEE : 0,7
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PROCESSED BY:
ZONING APPROVAL: •
GRADING APPROVAL:
•
•
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•
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Project :
Legal Desc.:
Description: INSTL WALL 25 LF X 11'7" MAX HI @ LOWER CAMPUS SLOPE
0819-2009 0819-2009 (SOUND WALL)
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:
DEB CONSTRUCTION INC
2230 E WINSTON ROAD
ANAHEIM CA 92806
714-632-6680
372419
03/31/2011
BT30028854
08/31 /2010
Worker's Compensation Insurance
Carrier: TRAVELERS IDEMNITY
Policy No: DTEUB9072C1109
Expire: 01/01/2010
Building Setbacks Rear: /
Front: /
Left: /
Right: /
Use Zone:
Parking Spaces: 0
Solar System PC:
Excise Tax:
FEES
$0.00
$0.00
Grading Permit Fee: $740.00
Grading PC Fee: $3,240.00
WO Insp. Fee : $0.00
Electrical %:
Mechanical %:
Plumbing %:
•. •
• •
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• •
PER
$0.00
$0.00
$0.00
Plan Check Fee :
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
State Lic:
HALLADAY DANA STANLEY
391 N MAIN ST #205
CORONA CA 92880
951-278-9700 State Lic:C-034751
HERMAN DANIEL
833 DOVER DR #9
NEWPORT BEACH CA 92663
949-548-3459
Special Conditions:
Fire Hazard Zone : N
Planning Department -
Plan check Fee : $357.00
Fair Share : $0.00
SJH Trans : $0.00
Public Works Department -
Park Dedication : $0.00
P/W Plan Check :
San Dist :
NMUSD Fee:
$2,570.24
$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 :
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
XPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTIO
$0.00
$95.04
$0.00
$0.00
$0.00
$0.00
$0.00
$3,148.70
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 chhedcmark(s) I have placed next to the applicable items) (Section 7031.5, Business and Professions
ssuacealso or usaticarepermit construct,
demolish. or
prior
issuance, thepplican�the prmitto e ased statement that sis licensed pursuant the
pprroovisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 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 ( ) all of of portions of the
work, and the structure is not Intended or offered for sale (Section 7044, Business and Professions Code: ThO e 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 proertrtyy 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 Ucense
❑ 1 am exempt fromlicensure under. the Contractors' State License. Law for the following reason:
By my signature below I acknowledge that, except for my personal residence in which 1 must have resided for at least one year
prior to completion of the improvements covered by this rmit, 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:f/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 7000)
of Division 3 of the Business and Professions Code, and my license is in full force and effect.
Jicense Class License No.
$ate I- St. sae )`ontractorSignaturef
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE I8 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO
CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (S100,000), I1 ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and willmaintain 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
t
No.
have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the
ance of the work for which this penult is Issued. My workers' compensation Insurance carrier and policy number are:
per Policy Number Expiration. Date
Name of Agent Phone #
❑ I certify that, In the performance of the work for which this permit Is lssued,.I shall not employ any person In any manner
so as to become subject t0 the workers' compensation laws of California, and agree that If I should' become subject to the
workers' compensation provisions of Section 3700 of the Labor Code, l shall forthwith comply with those provisions.
Signature of Applicant - Date
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY •
I hereby affirm under penalty of perjury that there Is a construction lending agency for the performance of the work for
which this permit is iseued (Section.3097, Civil Code).
Lender's Name '
Lender's Address
By my signature below, I certify to each of the following;
1 am the property owner or authorized to act on the.property owner's behalf..
I have read this application and the:Infornation I ha : p
I agree to comply with all applicable city and county
I authorizerepresentatives of this city or county to
ature of Property Owner or Authorized Agent
%
rim roperty Owner's or Authorized Agent's Name: j rert �TTtc✓!w+-T
laws relating to building construction.
roperty for inspection purposes.
70 1- (R-Zola
ACTION
DATE:
BY:
PERMIT EXPIRED
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 AQMD RULE 1403.
❑ I SUBMITTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
SIGNATURE:
FOR OFFICE USE ONLY
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1/01/2009
HALLADAY & MIM MACK, INC.
201 E. Yorba Linda Boulevard
Placentia, CA 92870-3418
714 993-4500 Phone
714 993-6837 Fax
DATE:
FIELD VERIFICATION MEMO
ATTN: _�r�ste��0C
REFERENCE
PROJECT:
Line & Grade
Project Name / Tract No. COGe4\\es*1S nk 1._)Q`11
Location / Address i-k o q -1`'��OS
Permit No.
I hereby state that the following has been verified for line and grade and found to be within substantial
compliance with the approved plans as of the date of this verification.
ITEM VERIFIED: C_�� ci(e A \r 044ri1 t tj'C- `Ca r v+^S 4cc r
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S gnature
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Print Name
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MO5CS000420M 5/05