HomeMy WebLinkAboutB9906933 - PermitsCity of Newport Beach
Building Department
Deng, 2g3-75Ldj
CIP Permit No: B9906933
PO Box 1768 Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3238/3289 Inspection RequestsTelephone (949)644-3255
1t Address: 1 HOAG DR
InspectorpeSS: Nrk7
Owner:
Address:
Phone:
Applicant:
Address:
Phone:
Floor: Suite: Bldg: 1
HOAG MEMORIAL HOSPITAL PRESSY
1 HOAG DR,BOX 6130
NEWPORT BEACH,CA92658-6100
94911146-8901
REGIER 0 RANDY
2220 UNIVERSITY DR
NEWPORT BEACH CA
949/574-1325
Cade Edition :
Type of Construction:
Occupancy Group:
Added/Neva sq.ft. Bldg:
Added/New sq. ft. Garage
No of Stories:
No of Units:
97
ISP
S3/S4
177,673
6
Legal Des:::
Contractor:
Address:
Phone:
Con State Lic
Lic Expire:
Bus Lic:
Lic Exp Date:
Description of Work: 6 STORY PARKING STRUCTURE 177.623 SF
pc 6378-99 BLDG 8
MC C:.RTHY BR
100 BAYVIEW CIRCLE SUITE 3000
NEWPORT BEACH CA 92660
949/854-8383
411173
08/31/2001
BT00021561
03/31/2001
Workers' Compensation Insurance - -
Carrier: ST PAUL FIRE
Policy No: WVK8500121
Expire: 04/01/2001
Building Setbacks Rear:
Front:
Left:
Right:
Use Zone:
Parking Spaces:
Construction Valuation: $8,028.560.00
Building Permit Fee: $20,289.70 Micrc`.':rn: $260.00
Plan Check Fee: $14,608.58 Excise Tax : $0.00
Supplemental: $0.00 Park Ded: $0.00
Investigation Fee: $0.0G SJH Trans: $0.00
Clean Up Deposit: $5,000.00 San Dist: $0.00
Energy Compliance: $0.00 Ca Seismic Safety:$1.686.00
Fair Share: 53.00 Disabled Review: $254.00
TOTAL FEE :$65,224.29
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
REGIER D RANDY
2220 UNIVERSITY DR
NEWPORT BEACH CA
949/574-1325 State Lic: CO23842
oaeetot
GAINES HODGE C
320 N HALSTED ST #200
PASADENA, CA 91107
626/351-8881 State Lic: 8-001034
Special Conditions:
FEES
Hazardous Mat:
Add Fire Dep HMQ:
Other Fee:
TOTAL PAYMENT :$19.753.96
$0.00
$0.00
$702.02 3 yP%
Aa #'I Pao•Fre
Fire Department:
Plan Review Fee: $8,115.8t
Inspection Fee: $14,202.79
Planning Department:
Counter Review : $0.
Zoning Plan Check: $10 .32
OverTime Plan Check Fee: •0.00
TOTAL DUE: $45,470.33
PROCE.SIED BY:_
ZONING APPROVAL:
TIRE APPROVAL :
GRADING APPROVAL:
OTHER DEPARTMENT:
PLAN CHECK BY:
APPROVAL TO ISSUE:
n
AAle-
L
WORK MUST BE STARTED WITH A PERIOD OF /80 DAYS FRO ficaTh6A01 F..WF?J yri L B EACH
OR THIS PERMIT BECOMES NULL AND VOID.
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COMM
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City of Newport Beach
PO Box 1768 Newport Beach, California 92658-8915
Building Department
Permit Counter Telephone (949)644-3288/3289
GRADING Permit No: G9905322
Inspection RequestsTelephone (949)644-3255
Job Address: 1 HOAG DR Floor: Suite:
Inspector Area:7
Owner.
Address:
Phone:
Applicant:
Address:
Phone:
Bldg: 1
Edit Code : 97 Legal Desc.:
HOAG MEMORIAL HOSPITAL PRESBY
1 HOAG DR,BOX 6100
NEWPORT BEACH,CA92658-6100
949/6468901
REGIER D RANDY
2220 UNIVERSITY DR
NEWPORT BEACH CA
949/574.1325
Geo. Tech. Engr.:
Address:
Phone:
State Lic:
Valuation:
Yardage FILL:
Yardage CUT:
LAW CRANDALL
200 CITADEL DR
LOS ANGELES,CA 90040-1554
323/889-5300
100000
0
0
Contractor:
Address:
Phone:
Con. State Lic. :
Lic Expire:
Bus. Lic.:
Lic. Exp Date:
Cartier:
Policy No:
Expire:
FARROW LESS
17151 NEWHOPE ST, STE 108
FOUNTAIN VALLEY, CA 92728
714/424-0151
765529
07/31/2001
BT20060151
05/31/2001
Workers' Compensation
STATE FUND INS
229-020117
01/01/2001
Description of Work: PRECISE GRADING PHASE I (NO EXCAVATION)
GRADING (B/B/eses) BLDG 8
l.311-11
Inspector
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Insurance - -
Address:
Phone:
REGIER D RANDY
2220 UNIVERSITY DR
NEWPORT BEACH CA
949/574-1325
Designer:
State Lic: CO23842
State Lic:
Special Conditions: AUTHORIZATION LETTER ON
FILE FOR JOHN VANDERLANS
TO SIGN FOR CONTRACTOR
FEES
GRADING
Plan Check Fee:
Permit Fee:
Investigation Fee :
Planning Dept -
Counter Review:
Planning Check:
PROCESSED BY:
PLANNING:
TRAFFIC:
SUBDIVISION:
S570.25
51,140.50
S0.00
$0.00
$0.00
DRAINAGE
Plan Check Fee:
Permit Fee:
Investigation Fee:
Planning Dept -
Counter Review:
Planning Chedk:
OTAL FEE : S2.710.75
G.z
OTHERS
50.00 Clean Up Deposit -
S0.00 GRADING :
S0.00 DRAINAGE:
Fair Share :
S0.00 SJH Trans Corridor :
$0.00 Park Ded Fee :
TOTAL PAYMENT : S2.606.75
51,000.00
S0.00
S0.00
$0.00
$0.00
TOTAL DUE : S104.00
OTHERS
Microfilm :
Other Fee:
Other Fee:
Other Fee:
Other Fee:
Other Fee:
50.00
S0.00
S0.00
S0.00
S0.00
$0.00
BE STRATED WITHIN A PERIOD OF 180 DAYS FROM THE DATE OF VALIDATION
• HIS PERMIT BECOMES NULL AND VOID.
-Tafi- 917 2en. 72
APPROVALS
DATE
By
COMMENTS
PREGRADE MELTING
1' -pp 490 ,fee> e7E7.0 /sae,
GRADING INSPE ic.)N 1
AREA DRAINS
ROUGH GRADE kP')P.
ROUGH GRADE APH2OVA:
PREPAVING MEE.
CURB AND GUTI t"<
°vit.; a<,•noii.r)CP ETCLAPV4TON
4'Skartgogara
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PAVEMENT SUBCP,Atj; 4.
AGGREGATE E.:
FLATVVORK
Avoid/Sao ad,"
izsarApraure orittStrievA-
STORM DRAIN
L leCNSr:L1 CONifini ORS oFCLARATICN
CATCH BASIN
EROSION CCM '
OTHER
PRECISE
VtrullyUrr; GONIPIrNi$7,7:0N OULAPATION
— — —„ — —
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GR,LJNK:4sL
DOCUMENTS
FINAL GRADING REIPOR)
CERTIFICATE TYPE NAM ENGR FIRM RECEIVED I3'
FINAL
ROUGH GRADE PEPCK-1
:JAM'''. S., • I !I'. gr,-) — _
FINAL GRADING REPOP r
-r
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SLAB ELEVATION CEP IIFICA FE" j- CONSTRUCrsom LENDING ACFNCY
CIVIL CERTIFICATE
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REFUNDED
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Pti..+TiNG '0 ...3..141,4440
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City of Newport Beach
Building Dbpartment GRADING Permit No: G2000-0257
PO Box 1768 Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288(3289
Inspection RequeslsTelephone (949)544-3255
Job Address: 1 HOAG DR Floor:
Inspector Area 7 Code Edit: 97
Owner:
Address:
Phone:
Applicant:
Address:
Phone:
Suite: Bldg: 1
Legal Desc.:
HOAG MEMORIAL HOSPITAL PRESBY
1 HOAG DR,BOX 6100
NEWPORT BEACH,CA92658-6100
949/646-8901
REGIER D RANDY
2220 UNIVERSITY DR
NEWPORT BEACH CA
949/574-1325
Geo. Tech. Engr.: LAW CRANDALL
Address: 200 CITADEL OR
LOS ANGELES CA 90040
Phone: 323/889.5300
State Lic:
Valuation:
Yardage FILL:
Yardage CUT:
340000
0
19540
GRADING
Plan Check Fee:
Permit Fee:
Investigation Fee :
Planning Dept -
Counter Review :
Planning Check:
PROCESSED BY:
PLANNING:
TRAFFIC:
SUBDIVISION:
$2,008.75
$4,017.50
$0.00
$0.00
$26.33
Contractor:
Address:
Phone:
Con. State Lic.
Lic Expire:
Bus. Lic.:
Lic. Exp Date:
Carrier:
Policy No:
Expire:
DRAINAG
Plan Check Fee:
Permit Fee:
Investigation Fee:
Planning Dept -
Counter Review:
Planning Check:
TOTAL FEE : $9.552.84
FARROW LESS
17151 NEWHOPE ST, STE 108
FOUNTAIN VALLEY, CA 92728
714/424-0151
765529
0713112001
BT20060151
05/31/2001
Description of Work: PRECISE GRADING, PHASE II
SEE 6378-99
/aup
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Workers' Compensation Insurance - -
STATE FUND INS Address:
229-020117
01/01/2001
Phone:
REGIER D RANDY
2220 UNIVERSITY OR
NEWPORT BEACH CA
949/574-1325
Designer
Special Conditions:
�G EES
$0.
$0.0
'$0.00
State Lic:CO23842
State Lic:
OTHERS
Clean Up Deposit -
GRADING :
DRAINAGE:
F-'r Share :
SJ Trans Corridor:
Ded Fee
AYMENT : $0.00
OTHER DEPARTMENT:
PLAN CHECK BY:
APPROVAL TO ISSUE:
$3,500.00
$0.00
$0.00
$0.00
$0.00
TOTAL DUE : $9.552.84
OTHERS
Microfilm :
Other Fee:
Other Fee:
Other Fee:
Other Fee:
Other Fee:
Yu
$0.26
$0.00
$0.00
$0.00
$0.00
$0.00
WORK MUST BE S7 RATED WITHIN A PERIOD OF 180 DAYS FROM THE DATE OF VALIDATION
OR THIS PERMIT BECOMES NULL AND VOID. - - - -
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City of Newport Beach
PO Box 1768 Newport Beach, California 92658-8915
•
Building Department
ELECTRICAL Permit No: E9906060
Permit Counter Telephone (949)644-3288/3289 Inspection RequestsTelephone (949)644-3255
Job Address:1 HOAG DR Bldg: 1 Floor: Suite:
Inspector Ave:
Owner.
Address:
Phone:
Processed By:
8
Code Edlt: 96 Legal Desc.:
HOAG MEMORIAL HOSPITAL PRESBY
1 HOAG DR,BOX 6100
NEWPORT BEACH,CA92658$100
949/646-8901
Contractor:
Address:
Phone:
Con. State Lic. :
Lic Expire:
Bus. Lic.:
Lic. Exp Date:
BRiGGS ELECTRIC INC
16662 MILLIKAN AVENUE
IRVINE CA
949/863-9901
297836
08/31/2001
BT00003629
12/31/2000
FEE ��SCo el!' okixiao/le Ayi9A e
Description of Work:
ELECTRIC/6 STORY PARKING STRUCTURE
ELECTRIC (B99069331 BLDG 8
IN*PECTOR NOTES:
Inspector
New Construction
Residential,
Multi -Family 0 $0.00
1-2 Family 0 $0.00
Service
0 to 600V up to 200A
0 to 600V over 200A
Over 600A/1,000A
O $0.00
O $0.00
1 $87.30
Receptacle/Switch/Outlets
Recep/Outlets 3 $2.70
Fixtures 302$173.10
Sep Circuit 0 $0.00
Slans
Branch Circuit 0 $0.00
each Add Circuit 0 $0.00
TOTAL: S547.07 PAYMENT: $94.63
Motors/Transformers IHP/KVAI
0 to 1 HP/KIN/KVA
1 to 10 HP/KW/KVA
10 to 50 HP/KW/KVA
50 to 100 HP/KW/KVA
over 100 HP/KW/KVA
Other
Time Clocks
0
0
2
2
0
g/24/oo le }lig a PK`C
Pao cc, w c 4,,; pp' irk
am.) A4e
$0.00
$0.00
$36.00
$70.00
$0.00
0 $0.00
Temp Power Pole
Temp Underground
Sub Panel
Investigation Fee
Plan Check
Issuance
7z%44 ✓1,F.
oohs 0 $0.00
4 $52.80
O $0.00
O $0.00
BALANCE: S452.44
$0.00
$105.47
$19.70
kICENSED CONTRACTORS DECLARATIOf
_I hereby afem under penalty of perjury that I am licensed under provbbns of Chapter 9 (commencing with Section 7000) of Dvision 3 of the Business and Pro
and my lcense is in fullface and effect.
License Na 24fl3& Clmc CadMetor. {jtrdr5 SUCT01C INC
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 far by Section 3700 of the labor r
of the work fa which this permit is Issued.
I hove and will maintain workers' compensation insurance. as required by Section 3700 of the labor code. for the performance of the
My workers compensation insurance carrier and polity numbers is:
Carder: EEDANCE NANONAL Talky number: NWA014770301 Expke: 07/01/2001
This section need not be completed if the permit is for one hundred dollars ($100) or less.
I certify that in the performance of the work fa which this permit Is issued, I shall not employ any person
of California. and agree that R 1 should become subject to the workers' compensation provisions of Section 370
Date: Cr - ar'/p Applicant Signature: y ✓.s .
n9CW Warning: Failure 10 secure workers' e workecompensation coverage is unlawful, and shall subject an employer to airunnf penalfies ail fines up to one hundred
ons code.
Approvals
HOb381UOdM3N 30 ,1951 nding Electrode
ode. for
work for
the performance
/ whichIthb-permiris issued."
become s bled to the worker compensation burs
faamith comply with those provisions.
($100.0001, In addifion to the cost of compensaliondamages as provided for in Section 3706 of the labor code. interest, and attorney's fees.
I hereby acknowledge that I have read this application; that the information given Is correct: and that I am the owner, a duly authorized agent of the owner. I agree to
comply with clty and state laws regulating construction: and In doing the work authorized thereby, no person will be employed in violation of the labor code of the state of
California relating to workmen's canoe rpdfraq insurance.
Permittee Name (Print)
Signature of permittee:
Address:
Date: C • -3 Co
Underground
Inspector/Date
Underslab/Floor
Rough Conduit Walls /d r119
i n
Rough Wiring Ceilings /4
Hough Service
Temp Power
Utility Co. Notified
Final
WORK MUST BE STARTED WITHIN A PERIOD OF 180
DAYS FROM THE DATE OF VALIDATION OR THI$
PERMIT BECOMES NULL AND VOID..
Ca41 fr defielhieeetes 76 i'fat neifL
37 24
Co�-E C 3/c/ y/11
d/V/zi ere »7/}„- ant 07 c't
r,
City of Newport Beach
Building Department
MECHANICAL Permit No:
PO Box 1768/3300 Newport Blvd., Newport Beach, Califomia 92658-891 Permit Counter Telephone (949)644-3288 Inspection RequestsTelephone
H2O01-0447
(949)644-3255
Jan Address: 1 HOAG DR
Inspepor Area: 7
Owner:
Add
P
Iss
Processed By:
HVAC Items
Furnaces
up to 100 au/ r 0 $0.00
over 100k Btu r 0 $0.00
Wa11/Floor Heaters 0 $0.00
Heat Pumps & Packaae Units
Bldg:
Code Edit: 97
1 Floor:
ORIAL HOSPITAL PRESBY
,BOX 6100
EACH,CA92658-6100
up to 100k Btu/hr
up to 500k Btu/hr
up to 1M Btu/hr
up to 1.7SM Btu/hr
over 1.75M Btu/hr
2 $21.90
0 $0.00
0 $0.00
0 $0.00
0 $0.00
Suite:
Legal Desc.:
Description of Work: MECH/PKNG STRUCT
B9906933
Contractor: CONTROL AIR CONDITIONING CORPORATION
Address: 2301 NO GLASSELL STREET
ORANGE CA
Phone: 714.283-8100
Con. State Lic.: 369439
LIc Expire: 02/28/2003
Bus. Lie.: BT00002088
Lic. Exp Date: 07/31/2001
FEES
Boilers & Compressors
up to 3HP
over 3HP to 15HP
over 15HP to 30HP
over 30HP to 50HP
over 50HP
�sc Its s a
Fire Dampers
Gas in
Metal Fireplace
ICBO App.S-
O $0.00
O $0.00
O $0.00
O $0.00
O $0.00
0 $0.00
0 $0.00
0 $0.00
TOTAL: S54.16 PAYMENT : S0.00
INSPECTOR NOTES
Inspector
Ventilation
Bathroom Pan
Exhaust Pan
Attic Pan
Down -Draft Fan
Residential Hood
Commercial Hood
Repair/Alter/Add
Air Handling Units
up to 10k cfm
over 10k cfm
BALANCE: 554.16
O $0.00
1 $5.45
0 $0.00
0 $0.00
o $0.00
O $0.00
O $0.00
O $0.00
O $0.00
g aMnn under penalty of perjury that I am licensed under provisions of Chapter 1(commencing with Section 7000) of Division 3 of the business and professions code,
rmg license Is in hill force and effect.
No: 369439 liana: de: Contractor: QONTROL AIR CONDITIONING CORPORATION
WORKERS' CCMPENSABON DECLARATION: I hereby dfem under pertly of peflury one of the following declarations:
I have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by Section 3700 of the labor code, for the performance of the work
for which thls penult Is Issued.
_I have and will maintain workers' compensation insurance. as required by Section 3700 of the labor code, for the perfomunce of the work for which this permit is Issued.
My worker's compensation Insure bee cagier and peke number is :
Carder RE0LAN0jNSijRANr CO' slcy)undbe:• y/Cl5220182000 Expire : swot/toot
(This section need not tb cojn10%tlq if ILA permit Is for one hundred dollars ($100 or les
I certify that In the performance oelee work fog•hkk Mls penult Is Issued, : shall not employ any person In any
of and qay t I{ 1 should become subject to the workers' compensation provisions of Secti
ant: /.ly ul pplicanl Signatu-e:
• • • • • • • • • • • ••• • • •
Warning: Falliesto ecure wartime' coppematien coyyrayela mpwfut and shall subject an employer to criminal penal and civil fines up to one hundred
thousand dotIartr(SAe,000), In lddltlosto the cos•of eongertatAn,dsmages as provided for In Section 3706 of the labor code, interest, and attorneys fees.
• •• •• • • ••• • • ••
I hereby acknowledge that I have read ttls application; ital the IMmornation given Is correct; and that I am the owner, or duly authorized agent of the owner. I agree to
comply with city and state laws regulating construction and In doing the work authorized thereby, no person will be employed In violation of the labor code of the state of
California relating to workmen's compensation insurance.
workers' compensation laws
rthwlth comply with those provisions.
Permittee -;Print; •7 " y • n A---- Address : /
gnature of perthitt�4: ' ' ate: .5// /4
VAV Box
Other
o $0.00
$0.00
$0.00
Record Management Fee: $0.27
Investigation fee $0.00
Plan Check S6.84
Issuance $19.70
supplemental Fee $0.00
Approval@
Underslab/Floor
HVAC/Hood - Rough
Fireplace -Rough
Gas Test
Fireplace - Final
HVAC/Hood - Final
Insoector/Date
WORK MUST BE STARTED WITHIN A PERIOD OF 180
DAYS FROM THE DATE OF VALIDATION OR THIS
PERMIT BECOMES NULL AND VOID.
City of Newport Beach
Building Department
PLUMBING Permit No: P2002-0451
PO Box 1768/3300 Newport Blvd., Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288 Inspection RequestsTelephone (949)644-3255
Job Address:1 HOAG DR Bldg: 1 Floor:
Inspector Area: 1 Code Edit: 97
Owner: HOAG MEMORIAL HOSPITAL PRESBY
Address: 1 HOAG DR,BOX 6100
NEWPORT BEACH,CA92658.6100
Phone: 949/646-6901
Issued Date: ONIOMOOZ��
Processed By.
Suite:
Legal Desc.:
Contractor:
Address:
Phone:
Con. State Lic. :
Lic Expire:
Bus. Lic.:
Lic. Exp Date:
MURRAY COMPANY
2919 E VICTORIA STREET
RANCHO DOMINGUEZ CA
310/637-1500
162382
10/31/2003
BT98035832
07/31/2002
Bathroom Fixtures
Toilet 0
Bidet 0
Urinal 0
Bath Tub 0
Shower Stall 0
Wash Basin 0
Hydro -Mass Tub 0
Floor Sink 0
$0.00
$0.00
50.00
30.00
50.00
50.00
50.00
50.00
Yelp CONTRACTORS DECLARATION
Floor Drain
Kitchen Fixtures
Kitchen Sink:
Garbage Dlap
Bar Sink
Vegetable Sink
Ice Maker
Dishwasher
Lndry/Trap
18 $143.10
0
0
0
0
a
0
0
$0.00
50.00
50.00
50.00
50.00
50.00
50.00
TOTAL: S199.83
FEES
Description of Work: PLUMBING/6 STY PARKING STRUCTURE
1
IpISPECTOR NOTES
L die. ,. C/rNi or.., 5 /%C
"zit, r/iGrAT7
Regulator 0 $0.00
Lawn Sprinkler 0 $0.00
Pam
Water Piping 0 50.00
Water Softener 0 $0.00
Water Heater 0 $0.00
Gas up to 4 outlets 0 50.00
Gas over 4 outlets 0 50.00
Backflow up to 2" 0 50.00
PAYMENT: 10.00
Backfiow over 2" 0
Hose Bibb 0
Drinking Fountain 0
Roof Drain 0
Grease Trap 0
Grease Interceptor 0
P-Trap 0
Other
BALANCE: S199.83
arum under penalty of pertW that tom licensee under provcbns of Chapter 9 (commendrq wtth Secton 70031 of Division 3 of the Bushes and Professions code.
my tense k in he face and effect.
License Na IAR1Nr Claw
DS.:X 11 /t0 0z
Cankacbr :Mann COMPANY
WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations:
_I have and MN maintain a certificate of consent to self -Insure for workers' compensation, as provided fa by Section 3700 of the labs code. for the perfomance of the work
for whlck this permit Is Issued.
I have and will maintain waken' compensation Insurance, as required by Section 3700 of the labor code. fa the performance of the wak for which this permit c issued.
My workers' campensaton Insurance canter and poky number is:
Carier. ST?Milt IN% Paley number. rikOMORY EWk•:Mal/=
(This section need not be completed halite pe rrnR islttine hundred dollars ($100) or less.
I cef fy flat in the pedartance or the soak IOr4Ch Rat l enrd&s clued.• shah nol employ any person In any ma
a Ca arsd !/ I G_ a >jmgacj to ltp wOnk• • • Appron t signature
or secgen 3 h comply with tra:e provisions.
Oats: a• • • •.• AppNeaMllgh•hx•• %� �/ '
become sublecl to the worker' compensation laws
Waning: Pak" to secure worker canpensafon coverage Is unlawful. and shall subiect an employer to alminol penalties and chi C up to one hundred
thousand dollars ($100,000), In addition tote cast& ogrRgpnsaiotidareages os govir dram h Section 3706 a the labor code, interest, and attorneys fees.
• • • • • • • • • • • • • •
I hereby ocknowAedge thal I havelea% this appiliatbra Ihet theMnf&rnalioM c51 1: and that I am the owner. Of duty autha tied agent of the ovner. I ogee to
comply with city and state laws ragulatkg caretrsktlon: 8nd In darg the soak autha ted thereby, no person w11 be emQlayed In vblatbn of the later code of the state of
ria relaN toweldin) 29/19 r //crest I � n �a°
Permittee Name (Print) i /. • t-. 3 Address : l/�/ //,L Y//(y/1//_/rr
Signature of permittee•`/,�� l Date: 7 L f��/O' �i
$0.00
50.00
50.00
50.00
50.00
50.00
50.00
$0.00
50.00
Sewer
Sewer 0 50.00
Sewer Alter/Repair 0 50.00
Sewer Abandon 0 50.00
Record Management Fee: 30.50
Investigation $0.00
Plan Check 535.78
Issuance 520.45
Supplemental Fee 50.00
Morov63
Soil Pipe (ground)
Sewer
Water Pipe (ground)
Gas Pips (ground)
Plumbing (rough)
Gas Pipe (rough)
Water Heater
Gas PSI Test
Gas Co Notified
Final
Inspector/Date
WORK MIST BE STARTED WITHIN A PMt10D OF 180
DAYS FROM THE DATE OF VALIDATION ORIHI£
PERMIT BECOMES NULL AND VOID.
(9-0I-Cogaco
City of Newport Beach
PO Box 1768 Newport Beach. Califomia 92658-8915
Building Department
Permit Counter Telephone (949)644-3288/3289
PLUMBING Permit No: P2000-0807
Inspection RequestsTelephone (949)644-3255
Job Address:l HOAG DR Bldg: 1
Floor: Suite:
Inspector Area'f Code Edit: 97
Owner:
Address:
Phone:
Processed By:
HOAG MEMORIAL HOSPITAL PRESBY
1 HOAG DR,BOX 6100
NEWPORT BEACH,CA92658-6100
949/646.8901
Legal Desc.:
Contractor:
Address:
Phone:
Con. State Lic. :
Lic Expire:
Bus. Lic.:
Lic. Exp Date:
MURRAY COMPANY
2919 E VICTORIA STREET
RANCHO DOMINGUEZ CA 90221
310/637-1500
162382
10/31/2001
Bathroom Fixtures
Toilet 0
Bidet
Urinal
Bath Tub
Shower Stall
Wash Basin
Hydro -Mass Tub
Floor Sink
0
0
0
0
0
0
0
$0.00
$0.00
$0.o0
$0.00
$0.00
$0.00
$0.00
$0.00
Floor Drain
Kitchen Fixtures
Kitchen Sink:
Garbage Dlsp
Bar Sink
Vegetable Sink
Ice Maker
Dishwasher
LndrylTrap
0 $0.00
o $0.00
0 $0.00
O $0.00
O $0.00
O $0.00
O $0.00
O $0.00
FEES
Regulator 0 $0.00
Lawn Sprinkler 0 $0.00
Misc
Water Piping 0 $0.00
Water Softener 0 $0.00
Water Heater 0 $0.00
Gas up to 4 outlets 0 $0.00
Gas over 4 outlets 0 $0.00
Backflow up to 2" 0 $0.00
TOTAL: 5151.25 PAYMENT: 50.00
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of tsivis'on 3 of
and my license b in full face and effect.
License Na 142342 Clan: Date: la ((0 - Or) Carlbaeler: MURRAY COMPAN
WORKERS' COMPENSATION DECLARATION: 1 hereby affirm under penally of perjury one of the following declarations:
I have and will maintain n cerl&bate of consent to self -insure for workers' compensation, as provided for by Section 3700
for whici this permit Is Issued.
I have and will maintain workers' compensation insurance, as requied by Section 3700 of the labor cede, fa the pe fornanc
My workers compensation Insurance carrier and policy number Is:
Caster: UDCO CASDAITY CO Poky number. W11S1]Y23 Expire:Qf[Q1/2gR,1
(This section need not be completed if the permit is for one hundred dollars ($100) or less.
I certify that h the performance of the wak for which this permit is issued, I shall not employ any person'In any manner
of Califs is and agree that If I should become subject to the workers compensation provisions of Se�liop 3 r r of the I � a -shall fat' comply with those provisions.
Dale: (a - 1 CO ' OM' U Applicant signature :j\Jyl
Description of Work: SITE SEWER LINE/STORM DRAINS
SEE 6378A9
JNSPECTOR NOTES:
r;e
1214/
7.(I foo L{A1�[^I/�'�ry4 �.A�I/t /&4iv1 OAdfa t .- chew
Or/(��a�"l/ ta r\�y�,rnoLed OAb
ine-
Backflow over 2" 0 $0.00
Hose Bibb 0 $0.00
Drinking Fountain 0 $0.00
Roof Drain 0 $0.00
Grease Trap 0 $0.00
Grease Interceptor 0 $0.00
P-Trap 0 $0.00
Other
STOR R 1 $52.90
Warning: failure to secure waken compensation coverage is unlawful. and shall suryect an employer to criminal penalties and civil fines up to one hundred
thousand dollars 1$100.0001, in addition to the cost of compensotion,damages as provided for in Section 3706 of the labor code. interest, and attomey's fees.
I hereby acknowledge Mot I have read this application: that the information given Wit; and that I am the owner. or duly abthor¢ed agent of the owner. I agree to
comply with city and state laws regulating construction; and In doing the . work authorized thereby. no person will be employed in violation of the labor code of the state of
SIT-
Callfanb relating to workmen's cons nation insurance
Permittee Name (Print) RA1n
Signature of permittee:
Add ss
Date: 6 ' 1
Inspector
SEWAGE LN 1 $52.90
Sewer
Sewer 0 $0.00
Sewer Alter/Repair 0 $0.00
Sewer Abandon 0 $0.00
Investigation
Plan Check
Issuance
$0.00
$26.45
$19.00
Approvals
Soil Pipe (ground)
Sewer
Water Pipe (ground)
Gas Pipe (ground)
Plumbing (rough)
Gas Pipe (rough)
Water Heater
Gas PSI Test
Gas Co Notified
Final
WORK MUST BE STARTED WRHIWA PERIOD OF I80
DAYS FROM THE DATE OF VALIDATON OR THIS
PERMIT BECOMES NULL AND VOID.
Inspector/Date
•
l6 E- Ova iA�Z%
City of Newport Beach
PO Box 1768 Newport Beach, Califomia 92658-8915
Building Department
PLUMBING Permit No: P2000-0928
Permit Counter Telephone (949)644-3288/3289 Inspection RequestsTelephone (949)644-3255
Job Address:
1 HOAG DR Bldg: 1
Inspector Area:
Owner.
Address:
Phone:
Processed By:
Floor: Suite:
8 Code Edit: 97
HOAG MEMORIAL HOSPITAL PRESBY
1 HOAG DR,BOX 8100
NEWPORT BFEACH,CA92658-6100
949/646-8901
Legal Desc.:
Description of Work: SITE SEWER LINE/STORM DRAINS (PHASE 111
SEE 6378-99 (P2000-0807)
Contractor: MURRAY COMPANY;
Address: 2919 E VICTORIA STREET
RANCHO DOMINGUEZ CA 90221
Phone: 310/637-1500
Con. State Lic.: 162382
Lic Expire: 10/31/2001
Bus. Lic.:
Lic. Exp Date:
Bathroom Fixtures
Toilet 0 $0.00
Bidet 0 $0.00
Urinal 0 $0.00
Bath Tub 0 $0.00
Shower Stall 0 $0.00
Wash Basin 0 $0.00
Hydro -Mass Tub 0 $0.00
Floor Sink 0 10.00
CONTRACTORS DECLARATION
Floor Drain
Kitchen Fixtures
Kitchen Sink:
Garbage Dlsp
Bar Sink
Vegetable Sink
Ica Maker
Dishwasher
Lndry/Trap
0 $0.00
O $0.00
0 $0.00
O $0.00
O $0.00
O $0.00
O $0.00
O $0.00
FEES
Regulator
Lawn Sprinkler
Misc
Water Piping
Water Softener
Water Heater
Gas up toSo�s
Gas over 4 outletls
Backflow up to 2!'
INSPECTOR NOTES:
in%m D/L 37o 4* C//L/6 /.tea C Q,w a"
44j f'�,/V*L(,{- 13 j
/6//<b c.,4 4fef -d a e thAe
0 $0.00
0 $0.00
0
0
0
0
0
0
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL: $137.55 IjAYMENT: S0.@0 BALANCE:
eby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7003) of Div
nd my Scense a in full force and effect. �i ��`
License No: 1673e2 Clan: Date: �U ( Contracts:
WORKERS' COMPENSATION DECLARATION: I hereby affrrn under penally of perjury one of the fdlowirlg declarations:
_I have and will maintain a certificate of consent to self -Insure for workers' compensation. as provided for by Section 370D of
far whlck thls permit Is Issued.
I have and will maintain workers compensation Insurance, as required by Section 3700 of the labor code. for the performance
My workers compensation Insurance curler and poky number Is:
Cr... IILICO CASUALTY CQ' Paltry number: W141772a Ewlra: 34/01/700t
(This section need not be completed if the permit is for one hundred dollars ($100) or less.
certify that in the performance of the work for which the permit Is Issued, I shall not employ any person In any manner so as to become subject th y - compensation laws
of Califanla, d agree that If I shoId become subject to the workers compensation provisions of Sec 3700 of the Ia . I shal forthwith ... sNth those provisions.
Dare: �� - I � l 1 Applicant Signature •
Backflow over 2" 0
Hose Bibb 0
Drinking Fountain 0
Roof Drain 0
Grease Trap 0
Grease Interceptor 0
P-Trap 0
Oth
which the
Warning: failure to secure workers' compensafion coverage is unlawful, and shall subject an employer to criminal penalties and Civil fines up to one hundred
thousand dollars I$100A00), in addibn to the cost of compensation,danages as provided for in Section 3706 of the labor code. Interest. and enamel's feet
I hereby acknowledge that I have read this application: that the information given is correct; and that I am the owner, or duly authorized agent of the owner. I a ree to
comply with dry and state laws regulating construction; and in doing the work authorized thereby, no person will be employed In violation of the labor code of t slate of
California relating to workmen's compensation Insurance.
Permittee Name (Print) /Al D^�'( Address :
Signature of permittee: Date: 7" 7-) 3-06
1
30.00 STORMDRN 1 $52.90
$0.00 Sewer
$0.00 Sewer 0 $0.00
$0.00 Sewer Alter/Repair 0 $0.00
$0.00 Sewer Abandon 0 $0.00
$0.00
$0.00 Investigation
Plan Check
$52.90 Issuance
Sewer
Water Pipe (ground)
Gas Pipe (ground)
Plumbing (rough)
Gas Pipe (rough)
Water Heater
Gas PSI Test
Gas Co Notified
Final
$0.00
$26.45
$5.30
P%36 /n10
WORK MUST BE STARTED WITHIN A PE D OF 180
DAYS FROM THE DATE OF VALIDATION OR THIS
PERMIT BECOMES NULL AND VOID.
f P-- k-A5i(a{ w-ii k44. , I2/7ai