The URL can be used to link to this page

Home My WebLink AboutB2001-0105 - PermitsCity of Newport Beach Building Department CIP Permit No: B2001-0105 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: Suite: HOAG MEMORIAL HOSPITAL ONE HOAG DR BOX 6100 NEWPORT BEACH CA 92658-6100 949-574-4488 CHARTIER DAVID 296 REDONDO AVE LONG BEACH CA 90803 562/987-4666 Code Edition : Type of Construction: Occupancy Group: Added/New sq.ft. Bldg: Added/New sq. ft. Garage No of Stories: No of Units: Issued: Receipt # Bldg: 1 Legal Desc: Contractor: Address: Phone: Con State Lic: Lic Expire: Bus Lic: Lic Exp Date: MILES & KELLE 1102 E VALENCIA DR FULLERTON CA 714-773-9272 312206 02/28/2003 BT00018695 12/31/2001 97 - Workers' Compensation Insurance - - Carrier: STATE COMP B Policy No: 046-0009197 525-TI Expire: 01/01/2002 1 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: PROCESSED BY: ZONING APPROVAL: - - FIRE APPRO'vA',: GRADING APPROVAL: PUBLIC WORKS: $39.000.00 $416.90 $300.17 $0.00 $0.00 $750.00 $0.00 $0.0 Microfilm: $13.41 Excise Tax : $0.00 Park Ded: $0.00 SJH Trans: - $0.00 San Dist: $0.00 Ca Seismic Safety: $0.00 Disabled Review: $32.80 TOTAL FEE -:$1,972.03 tior Description of Work: TENANT IMPROVEMENT (HEALTH INST) 0125-2001 Architect: Address: Phone: Engineer: Address: Phone: Designer: Address: Phone: CHARTIER DAVID 296 REDONDO AVE LONG BEACH CA 90803 562/987-4666 State Lic: C015736 Special Conditions: Inspector State Lic: FEES Hazardous Mat: Add Fire Dep HMQ: Other Fee: TOTAL PAYMENT:$420.24 $19.70 $0.00 $0.00 Fire Department: Plan Review Fee: Inspection Fee: Planning -Department: Counter Review : Zoning Plan Check: OverTime Plan Check Fee: TOTAL DUE:$1,551.79. - - OTHER DEPARTMENT: PLAN CHECK BY: PPR• VAL TO ISSU WORK MUST BE STARTED WI OR THIS PERMIT BECOMES $120.07 $291.83 $0.00 $27.15 $0.00 PERIOD a F 180 DAYS FROM THE DATE OF VALIDATION L AND VOID. VC-i3c6319 APPROVALS FOUNDATION: R7L��`N GRADE LIE'$. GR-.'DEOER,I:ETBACKS t RE;, CN PADS --- 'O Ll TYPE OF BUSINESS USE: BATE BY COMMENTS DECLARATION OF -COMPLIANCE WITH -:- CODE "-0F°'FEDERAL REGULATIONS" PART -61-OF TITLE 40 AND -AGS._.... -- ERE 1403. 0 I S ANITTED ASBESTOS ..._.- `SIGHATUR REFUNDED DATE-_.7 ZZ-O‘ --:_ TO:.11 P CS. E C .1�� OWNER- E JiLOER Dt t i AiIO`; F L _ illDLR. or uALlY 4 PERJURY_ A P ExEr FIRGM ALEC COIL NrIGIEr0 . "t R 1 L G-_vAIN R ON L JcSNEEF ANS IRO SEL:GN O] AN £ I LI J^1 .JIHOISMI r I EI CGNES1CUSAL.L1L lr v OF r. F REPAIR P 4Y Sr1 , Or TR 1E2 E-ARL z _O IRPCGCFC. 'IL A'CPLICANI; <J� _ ,AtL , i_1 ' II LO' OLt _ H _.',l ZO r. :OE < ipNLR! _OR _ C IO- C . p :;� J I.Ga> END GCOFESSICISG RYE SHE .a i_FI ,CM EC OF; :SCOFF CrElos: 1CFIE PAIFEASIAPri S4LIGE -GLIArRe I rACJILEI PEN ROE 1 14 F CrirrEISCIS. o. TO SE C.NPFR _F' I Ul:W. aJns > ... -,\�. i.-CIf1LL}�,rya[S- .1 •=Nib fTr PrF;a, ; o- =_IEEY AFFII GENE! _ ..R THE. 6 :LTC rua G v ut ..:Ilia <F:E'CRISATENSP SCION REF 'A5 "FC,. IRE.'" FY \RE1SS JOPF APO prRI i.l HER: THIF R..: 2 T IRS -HE E F THoi.E5ANr ch--oR Jr,, ES opo -Cs& E 10 0C`YLLY 79Iii AcE Olu.„N00S WILDING _ONSI U OA. AND II£I bY PLCrrIGICZE1 1 ;'d;rll IIS r'ER L JE. THE ALIOVE NENI ZONED TA :Ir FOR c ROE FURPOSEST'c City of Newport Beach Building Department ELECTRICAL Permit No: E2001-0060 PO Box 1768/3300 Newport Blvd, Newport Beach, Califomia 92658-8915 Permit Counter Telephone (949)644-3288 Inspection RequestsTelephone (949)644-3255 ;lean Job Address:1 HOAG DR Bldg: 1 Floor: Inspector Area: 7 Code Edit: 96 Owner. HOAG MEMORIAL HOSPITAL Suite: Legal Desc.: Contractor: Description of Work: ELEC/TI 62001-0105 INSPECTOR NOTES: MILES & KELLEY CONSTRUCTION COMPANY INC Address: 0 ' OAG DR : OX 6100 EWPORT BEAI H CA92658-6100 Phone: 949-574-4488 Receipt #: Process By: Address: 1102 E VALENCIA DR FULLERTON CA Phone: 714-773-9272 Con. State Lic.: 312206 Lic Expire: 02/28/2003 Bus. Lic.: BT00018695 Lic. Exp Date: 12/31/2001 FEE New Co structior$/ Resider Multi -Family 1-2 Fam ly Service 0 to 600V up to 200A 0 to 600V over 200A Over 600A/1,000A Receatacte/SW itch/Outlets Recep/outlets 22 $19.70 0 $0.00 Fixtures 14 $13.02 0 $0.00 Sep Circuit 0 $0.00 Sians O $0.00 Branch Circuit 0 $0.00 O $0.00 each Add Circuit 0 $0.00 O $0.00 Time Clocks 0 $0.00 NTRACTORS DECLARATION &fen 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, my license is in fullforce and effect. License No: 31/206 Class: Contractor: MILES & KELLEY CONSTRUCTION COMPANY INC Motors/Transformers (HP/KVA) 0 to 1 HP/KW/KVA 1 to 10 HP/KW/KVA 10 to 50 HP/KW/KVA 50 to 100 HP/KW/KVA over 100 HP/KW/KVA Piggy Back / Temp Power TOTAL: $60.87, PAYMENT: $8.18 Temp Power Pole 0 $0.00 $0.00 Temp Underground 0 $0.00 $0.00 Sub Panel 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 Record ManagmeM Fee : $0.27 Investigation Fee $0.00 $0.00 Plan Check $8.18 Issuance $19.70 Supplemental Fee $0.00 BALANCE: $52.69 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 far workers compensation. as provided for by Section 3700 of the labor code, for the performance of the work for which this permit is issued. I have and will maintain workers compensation insurance, as required by Section 3/00 of the labor code. for the performance of the work for which this permit is issued. My workers compensation insurance carrier and policy numbers is: Carder:- STATE COMP Policy number 946-0009197 Expke :01/01/2001 - - - - This section need not be completed if the-pemtit is for one hundred dollars ($100) or less. I certify that in the performance of the wsk for wych9his Perris is issued. I shall not employ any pers. In any manner so as 1 become subject to the workers compensation laws of California, and agree that d I should become snblecf to thr w kU-' compensation provisions of Section 37t _ � labor code. ha forthwith con -ply with those provisions. ale: _ Ir r-- al r Applicant Sign T re: r Warning: failure to secure workers compensation covernpe is unlawful, cod seta Subject on employer to cnmutal penalties and civil tines up to one hundred ($100,0001, in addition to th; c s: cf comFensotibn,damage- as pro ridLd Kr in Section 3706 of the labor code, interest, and attorneys fees. is I hereby acknowledge tt it I hove read this application: that the information given is correct: and that I am the owner, or duly authorized agent of the owner. I agree to comply with city and slate 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 workmens compensation insurance. •eBer11 ee Name (Print) Cy'�✓ Si of permittee: Address : try —f/—O 3 l� Approvals Grounding Electrode Underground Underslab/Floor Rough Conduit Walls Rough Wiring Ceilings Rough Service Temp Power Utility Co. Notified Final Insoector/Date 7/ d 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: P2001-0052 PO Box 1768/3300 Newport Blvd., Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288 Inspection RequestsTelephone (949)644-3255 Job Address:3 HOAG DR Bldg: 1 Floor: Inspector Area: 7 Code Edit: 97 Owner. Address: Phone: Issued : Processed By: HOAG MEMORIAL HOSPITAL ONE HOA r ' BOX 6100 NE '%'TBE HCA926586100 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 2 $15.30 Hydro -Mass Tub 0 $0.00 Floor Sink 0 $0.00 NTRACTORS DECLARATION Floor Drain Kitchen Fixtures Kitchen Sink: Garbage Disp Bar Sink Vegetable Sink Ice Maker Dishwasher Lndryffrap Suite: Legal nest? Contractor: Address: Phone: Con. State Lic. : Lic Expire: Bus. Lic.: Lic. Exp Date: O $0.00 O $0.00 O $0.00 O $0.00 O $0.00 O $0.00 O $0.00 0 $0.00 TOTAL: $43.91 Description of Work: PLUM/TI B2001-0105 INSPECTOR NOTES: MILES 8 KELLEY CONSTRUCTION COMPANY INC 1102 E VALENCIA DR FULLERTON CA 714-773-9272 312206 02/28/2003 BT00018695 12/31/2001 FEES /papector Regulator 0 $0.00 Lawn Sprinkler 0 $0.00 Misc Water Piping 1 $3.85 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 PAYMENT: $4.79 Backflow over 2" 0 Hose Bibb 0 Drinking Fountain 0 Roof Drain 0 Grease Trap 0 Grease Interceptor 0 P-Trap 0 Other BALANCE: $39.12 y 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, my license is in full force and effect. nse No: 312206 Class: Contractor : MILES 6 KELLEY CONSTRUCTION COMPANY INC WORKERS COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: - - I have and wilt maintain a certificate of consent to self -insure far workers' compensation. as provided for by Section 3700 of the labor code. for the performance of the work for whick this permit is issued. _I have and will maintain workers' compensation insurance, as required by Section 3700 of the labor code. for the performance of the work for which this permit k issued. My workers' compensation insurance carrier and policy number is: Carrier: STATE COMP Policy number: 046-0009197 Explre :01/01/2002 (This section need not be completed it the permit is for one hundred dollars ($1.1) or less. I certify that in th rformonce of the w¢k)ar W Ich fr. its (icrr iif is issued. I shall not employ any person %-n , anner so s become subject to the workers' compensation lows of mlo, and Gar a that 1 I should tiscone Zbieci toSbe,riorkers compensat of Sectip' ' PI of the la code. I shall forthwith comply with those provisions. ate: 14 O C Applicant Signehire : �� \ 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 ($100,000). in addition to the cost of compensatiian.darrages o:povided for in Section 3706 of the labor code, interest. and attorneys fees. r r- I hereby acknowledge the.' I kY.'b read fj iis opr4catlon; the' ihs irr arrf atIcn glsPbn is correct: and that I am the owner, or duly authorized agent of the owner. I agree to comply with city and staff -laws regulatric corcfraction: and inraping the work ¢ athodzed thereby. no person will be employed In violation of the labor code of the state of Califorrspselotng to wo/ merit come: on Insurance. ee Nam (Print) aU� Cr-,✓ Address: �- -d ure of permittee: � .�� `t"j< D� 1� i $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Sewer Sewer 0 $0.00 Sewer Alter/Repair 0 $0.00 Sewer Abandon 0 $0.00 Record Management Fee: $0.27 Investigation $0.00 Plan Check $4.79 $0.00 Issuance $19.70 Supplemental Fee $0.00 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 7�di��g6 WORK MUST BE STARTED WITHIN A PE OF 180 DAYS FROM THE DATE OF VALIDATION OR THIS PERMIT BECOMES NULL AND VOID. -30(0 3 l9 City of Newport Beach Building Department MECHANICAL Permit No: H2001-0035 PO Box 1768/3300 Newport Blvd., Newport Beach, California 92658-891 Permit Counter Telephone (949)644-3288 Inspection RequestsTelephone (949)644-3255 Job Address: 1 HOAG DR Bldg: 1 Inspector Area: 7 Code Edit: 97 Owner: Address: HOAG MEMORIAL HOSPITAL ONE HOAG DR BOX 6100 OR EACH CA 92658-6100 Phone: / 949-574-44 Issued Proce HVAC Items Furnaces up to 100tu/hr 0 $0.00 over 100k Btu/hr 0 Wall/Floor Heaters 0 $0.00 Heat Pumps & Package Units up to look Btu/hr 0 $0.00 up to 500k Btu/hr up to 1M Btu/hr up to 1.75M Btu/hr over 1.75M Btu/hr $0.00 D $0.00 O $0.00 O $0.00 O $0.00 TRACTORS DECLARATION Floor: Suite: Legal Desc.: Contractor: Address:_. Phone: Con. State Lic. : Lic Expire: Bus. Lic.: Lic. Exp Date: Boilers & Compressors up to 3HP over 3HP to 15HP over 15HP to 30HP over 30HP to 50HP over 50HP Misc Items Fire Dampers Gas Line Metal Fireplace ICBO App.#- Description of Work: MECH/TI B2001-0105 MILES & KELLEY CONSTRUCTION COMPANY INC 1102 E VALENCIA DR INSPECTOR NOTES Inspector FULLERTON CA , /'�//a/ ce 714-773-9272 312206 02/28/2003 BT00018695 12/31/2001 O $0.00 O $0.00 O $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 O $0.00 FEES TOTAL: $33.66 PAYMENT : $2.74 ,Pucnr /0* (,4) Ventilation Bathroom Fan Exhaust Fan Attic Fan Down -Draft Fan Residential Hood Commercial Hood Repair/Alter/Add Air Handling Units up to 10k cfm over 10k cfm BALANCE: $30.92 O $0.00 0 $0.00 O $0.00 0 $0.00 O $0.00 O $0.00 1 $10.95 O $0.00 O $0.00 y affirm under penalty of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the business and professions code, A my license Is In full force and effect. Lie No: 312206 Class: Contractor:- MILES B KELLEY CONSTRUCTION COMPANY 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 for by Section 3700 of the labor code, for the performance of the wart for which this permit Is issued. I have and will maintain workers' compensation Insurance, as required by Section 3700 of the labor code, for the performance of the work for which this permit Is Issued. My workers compensation Insurance carrier and policy number Is : Cantor: STATE COMP Policy nu: Y_er: ' 046-L009167 Expire: 01101/2002 (This section need not be complet d if th. Del mit is for one hundred dollars ($100 or less). I certify that in the performance of Lie work f r wh ^.h his permit is issued, I shall not employ any pars in any manner so ss become subject to the workers' compensation laws of Cali agree that If I shook. necon re subject to the workers' compensation provisions of 5 0 of the la ate: - - - _ _ .__-APP rsignatwe: Warning: Failure to secure warkeL,' c:.mpal3ation caverafe Is unlawfil, anJ shall subject an employerto criminal penalties and civil fines up to one hundred thousand dollars sIC0,000); in addlrion to the cost recom,.en:at&.n,oamages as provided for in Section 3706 of the labor code, interest, and attorneys lees. 1 hereby acknowledgr thr t I have r-aJ this aaplicatior; that the Inforiation uiven is correct; and that I am the owner, or duly authorized agent of the owner. 1 agree to comply with clty anJ statu 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 /Cayce relating to workmen's compensation insurance. ,! Permittee Name (Print).._ , rf.k.!.k 4' ^�/ Address : ode, I shall forthwith comply with those provisions.. Si e of permiffse:` 7(-6 VAV Box Other Record Management Fee: Investigation fee Plan Check Issuance Supplemental Fee Approvals U nderslab/Floor HVAC/Hood - Rough Fireplace -Rough Gas Test - - Fireplace - Final HVAC/Hood - Final. 0 $0.00 $0.00 $0.00 $0.27 $0.00 $2.74 $19.70 $0.00 Inspector/Date 0.2fr,764 WORK MUST BE STARTED WITHIN A PERIOD OF 180 DAYS FROM THE DATE OF VALIDATION OR THIS PERMIT BECOMES NULL AND VOID.