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Home My WebLink AboutB2000-3905 - PermitsCity of Newport Beach PO Box 1768 Newport Beach, Califomia 92658-8915 Building Department CIP Permit No: B2000-3905 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 HOSPITAL 1 HOAG DR NEWPORT BEACH CA 949-574-4488 LIEBKE STEVE 1340 REYNOLDS AVE #115 IRVINE CA 949-752-5052 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 # 97 Suite: 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 02128/2003 BT00018695 12/31/2001 Workers' Compensation Insurance - - Carner: STATE COMP Policy No: 046-0009197 Expire: 01/01/2002 Building Setbacks Rear: Front: Left: Right: Use Zone: Parking Spaces Construction Valuation: $145,000.00 Building Permit Fee: $966.00 Plan Check Fee:.. 8695.52 Supplemental: $0.00 Investigation Fee: $0.00 Clean Up Deposit-- $1,100.00 Energy Compliance: $0.00 Fair Share: $0.00 PROCESSED BY: ZONING APPROVAL: FIRE APPROVAL: GRADING APPROVAL: PUBLIC WORKS: Microfilm: $48.75 Excise Tax: $0.00 _. Park Ded: $0.00 SJH Trans: $0.00 SanDist:------$0.00--- Ca Seismic Safety: $0.00 Disabled Review: $116.00 TOTAL FEE :$3,470.34 - Description of Work: TEMP OFFICE TRAILERS (2) IN PARKING AREA & 3141-2000 ON TOP OF PKNG STRUCT. Architect: Address: Phone: Engineer: Address: Phone: Designer: Address: Phone: Special Conditions: Inspector State Lic: State Lic: FEES - - - Hazardous Mat: Add Fire Dep HMQ:: Other Fee: TOTAL PAYMENT :$507.28 ---OTHER DEPARTMEN PLAN CHECK APPROVAL WORK MUST BE STA ORTHIS PERMIT BE $19.70 $0.00 80.00 Fire Department: _. Plan Review Fee: Inspection Fee: Planning Department: Counter -Review :- - - Zoning Plan Check: OverTime Plan Check Fee: TOTAL DUE: $2,963.06 Ae ES NULL AND VOID. $144.94 $352.28 $0.00- $27.15 $0.00 H A PERIOD OF 180 DAYS FROM THE DATE OF VALIDATION APPROVALS FOUNDATION:-___ ROUGH GRADE LINE & GRADE CERT/SETBACKS ERECTION PADS - 44FOOTINGS $SLAB ON GRADE DECK SLAB i51UBFLCOR IROOF & B1J ! CIING HT { i SHEAR/HOLD DOWNS 9GE.NER'\L FRAMING ort 1)i:ATION S .SP"ENDED CEILING PLASTEHING INTE -TFRIOR LATH "ATCH A SO'<1HY IFL)OTING. - ROUT RE, L ACE:1. INSPECTIONS: PEE t .T EX { ENSION -1ST EXP. LETTER.. 2ND EXP. LETTER PE MIT--Gr.PIRcDm,,,- ...,, ..... ,PERMIT CANCELED $F_INAL.___ CERTIFICATE OF OCCUPANCY TENANT NAME: TYPE OF. BUSINESS USE: - DATE COMMENTS TO: l l \\ p4a* { __its __. Vs iv n,0A ct' t31 OWNER -BUILDER DECLARATION JNOER PElu iY °PIPER:JURY:THAI I AM EXEMPT- FROM IHE C 1N Ac10005 LiCENS P I L LL'.VIN I A r EC S N'SS Al 1µ I C'O U ENT, q 1 OR C iHN1Y MICA- RECT_IIR J ML T CONSTRUCT P L 5I rC E,-0 1 1 OR I5 E1:.IH N -9 RUC I'LIPL ENT-COR CO, OS ISOITANELAALSO „RECUIRLS THEPLITE C J U x PT:cc:M:1iMELT 0NELSTATEMENT HA POP SMIE„L OETISED pcpccqy".0 THE L,-CGF 0 111 , TENTETt HS LICENSE_LAW !CHAP TS 9 OSUMMENCINC,1 fL _GJ! OT JW t 0, I . SINESS ANT) L ON_ CO OR THAT HE J-<Nr E IO EXLMPT TICAINEICOONI p IIE CASES LNIEISAiLLEtr AxEmPnciN. ANv AT ITN OP 0:345 SA' ANY AEC': )N I 3 EETOO ECTS111EAH11 A I'Y0 A CIVIL PENAL),CPM1 3LrOAII TOE1 N RED -DO_ -A. .... C AS OWNER CH T,... PROPERTY. OR MY TOITEOYEES PIT wAoEs A :THEP SODE 5 4FRE PAN, IJN CO ME WORK 'J ODE:oo TH TURE -S 'NTRECEOOS 1S LAW DO S OT .8A__ -h PAN, ER _AND EPROFESSIONS'LOS OE 'A C 11 THEREON C]EI .VIEOC J TO AN C ER_ HER PROPERTY FOR: } 4J �ILHI' OR 'IA 'O '.cITAFA ANC] .<R PROMPTED < L' ER_ HERSELF N OM _TECCE0THROUGH :IG 7_R1- R 'OWN E)SPLI YL PRO.Ti.E- 1A SUS I- ` .Fw.Fa5?0TS I NOT NT > r� OR .CF3c h SALE') O u:oo TFE )RoolpooE a.fi.. T . f.. 1-15 3 ONE_ TSAR :C 1 ICA,THE NO 1 JT:POSE V f CN ^E::1; 1P, .E 'E OR f I01) C8L c: 4_. CONTRACTING 3 C t I A ONEI OF f1. F4.. IT, AM 1.' :,.I1LY ,ANTRPO_I NTSIO 11 -:1 - -S O P Y - 1 t .. (SEE IOE M1 WHO CODE-- 4,) i0 NOT A Oa le-UFT E PROPERTY F Irr I, •R 3 -.AWOCONTRACTS: _R'J....I oar»,)oc9oTVI H 4 CONTRACTORCONTRACTOROTI I ICENTNED { :THE COOTEECTORS Lice‘sr; Law O3 T1 'C'6:1)K ED CONTRACTORS DECLARATION -FL5Y WHOM: P 6Y OT PA4,Vh I NV II:TENSED CNJ RAC Oh' C) CI IAP I ETT P (COMM! NO _ .. ,. MN .A1) CF DiVIPION J 03 TIM 6IJSINEES AND PR 4 5,N,.. �L CLi vciu REFUNDED WORMERS' CST`APENSATASN DECLARATION ",E FOLLOWINC JEC AJOTTIONS' ST NTT r A HAINTNIt A reEREIEICATEOP CONIEET- "iC TELT INSuPEFCTTORKEINS CO+PEN-SIr Id. AS PR 1 Ca. NYSEL1 IGN 3:C'v E 11 . TTODE EC' . I E T P_E:T ANE or T-F PNOPC FOR OLITICI I CHIS PCP..' .. SECTION ONCIT HI T. IC P F"G.F FCC THE -AINNINENEE J__.'.'/Cn GF THIS NOIMIT I,. , 1.)ED MY . R. II :MTV J, J INSURANCE F OIRRIEP AND POLICY NUM:5ER AR5- - Tty OECTICHII JNO) PEST)I 211 5 PORONE ,21J'4DRED DEN r yl<S 5141 R CEP:MEM:THAT iN Tr IT I 1 E OR1 .,O= TPF:O K CC THI R.AT IC ISOEr.T ? , -41 L , 3T stop or 13 o,pn IN TN J ER CO " FC 'TIT S'J 'HE. WORKERE COMPENSATION A ACT OF C 1I ) R A AND .R F H O F Si 4 4.1 T4 J Y: 1 A. I-P I AMC: F T C H, s k- "�R+1C00F f LFc r r f4:IYW H o n 7IF i N- `.JP F E Ci SFR COMPENSATIONCOVERAGE S U I NPUI V 5 i" K. AM EMT) 0 .PN Ne 'S l0 l r.F ES IJP_ p 9N I NCPSCI HOIEFA rJ-- i C'IEARS 1110N f .'0)0_0 11 S-AFL ^CATION.LH DAMAGES: FDFOPc,S SECTION - OF' T EE 11T .: T-c ND ATTORNEY ;OS : UC'DNS7dU TIDY LENDING AGENGY - --- -- HEREBY n-EIPAI IJNPCIER REJ 1' OW 4EIT,URA' {HERE CONSTRIECTITEN L \^GINS TG'Nr FORT.Fi <rtnhElNCE r r ..<.., .F wi..11,74.4 THIS PERMIT IS ISSUE_ C.2C:7,_ LJT, 1Y1H3 HAW 'AD rIII, A.,P(3.h fv.IAL'i'(IA I b E4( JE fNi<AW I ION 18 C`RRCGf= -I AGREE TO: COMPLY OrITH AV -a151M> o0ri LHD RELATING :IC BULL SG cows. r1UCrow AND HEkLO" ACM DR3E REPRESENTATIVES OF THIS COUNT) IO-ENERU✓UN rH. A_1U'J`_YAL NEC,PROPERMC FOP INSTED )\PURP0S5 -- City of Newport Beach PO Box 1768 Newport Beach, California 92658-8915 Building Department CIP PermijrNo: B2001-2396 Permit Counter Telephone (949)644-3288 Inspection RequestsTelephorfe (949)644-3255 Job Address:1 HOAG DR Floor: Suite: Bldg: 1 Inspector Area: 7 Owner: Address: Phone: Applicant: Address: Phone: HOAG HOSPITAL 1 HOAG DR NEWPORT BEACH CA 92660 949-574-4488 Legal Desc: Contractor: Address: Phone: MILES & KELLEY CONSTRUCTION COMPANY INC 1102 E VALENCIA DR Lic Expire: FULLERTON CA Bus Lic: 714-773-9272 Lic Exp Date: Code Edition Type of Construction: Occupancy Group: Added/New sq.ft. Bldg: Added/New sq. ft. Garage: No of Stories: 1 No of Units: Issued: Receipt # 97 VN B MILES & KELLE 1102 E VALENCIA DR FULLERTON CA 714-773-9272 Con State Lic: 02/28/2003 BT00018695 12/31/2001 Workers' Compensation Insurance - - Carrier: STATE COMP Policy No: 046-0009197 Expire: 01/01/2002 Building Setbacks Rear: Front Left: Right: Use Zone: Parking Spaces: Construction Valuation: $0.00 Building Permit Fee: Plan Check Fee: Supplemental: Investigation Fee: Clean Up Deposit: Energy Compliance: Fair Share: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Microfilm: Exdse Tax: Park Ded: SJH Trans: San Dist: Ca Seismic Safety: Disabled Review: $0.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL FEE :$1.120.95 FEES Description of Work: TEMP OFFICE TRLR (#1 ONLY) IN PRKNG AREA 3141-2000 ON TOP OF PKNG STRUCT. Architect: Address: Phone: 312206 Address: Phone: Designer: Address: Phone: Engineer: /gsfleas State Lic: State Lic: Special Conditions: REFER TO B2000-3905 FOR PRIOR INSPECTIONS. Hazardous Mat: Add Fire Dep HMQ: Other Fee: TOTAL PAYMENT :50.00 $0.00 $0.00 $1,120.45 (O, l00 C#D) Fire Department: Plan Review Fee: Inspection Fee: Planning Department: Counter Review : Zoning Plan Check: OverTime Plan Check Fee: TOTAL DUE:;1.120.95 $0.00 $0.00 $0.00 $0.00 $0.00 PROCESSED BY: ZONING APPROVAL: ••• ... • • ••••• ••, • •• ••4 • ••• FIREAPIOtOI/Uit • GRADING APPROVAL: • ••• • pUBLIC WORK*: • •• • • • • • • • •• • • • • • • • • • •• • •• • • •• •• DTHER DEPARTMENT: PLAN CHECK BY: APPROVAL TO ISSUE: Pirc WORK MUST BE STARTED WITH A PERIOD OF 180 DAYS FROM THE DATE OF VALIDATION OR THIS PERMIT BECOMES NULL AND VOID. APPROVALS 1 DATE BY FOUNDATION: COMMENTS ROUGH GRADE LINE & GRADE CERT/SETBACKS ERECTION PADS FOOTINGS utaotdb2,-- SLAB ON GRADE FRAMING. /0A, 0.ifeed4A. 9 Cc.- DECK SLAB SUBFLOOR ROOF & BUILDING HT EXT. SHEAR/HOLD DOWNS fredia.0 ste-c-1 f4'ft<sk cXD GENERAL FRAMING FIREPLACE THROAT OWNER -BUILDER DECLARATION CFREEEM UNDER PENAI 3V OFEAUPY TAT 21.1 EREWN "HON THE CONTRACIOFT. LICENSE LAW TOR iE FINRLOWPCI PHANTA, tsEr. 7,, ON/ TIES:: CHO P132E25IRINN tOCE At. • .:1 NOIROHwI.CH •Tt WITTEN A 'NEM' I: CitrictiN At tortiNNE. 0EE313.1p11 END 1. FE:if HCITTTIS NTT El IF, to OR -.HE EXEYHT 71E:4::. HON ANT; CIF SADA PIN 12* HIE ,,PIA E"AIAT 11, RCP, PENAL E, CP !COMORE "HAN FIVE HUNORE NCO: I MIS 1111021: 0 I A, OWN,N. Cr THE: 2120212 l 21 OH m. MO OHEE Wort ,NA. IT N 'TIENT CONIFENSATHP: %HILL Ott THE FRRI: ANC T, E iTEHOOTIPTE ISNOT INTENDED ON OFFERED FON SATE letti REEHEDE ANE, THOECTEHONS COI IE: • A DWI RAC', AS I NW COE, NCI ARP% , Ea/. C/T TKITO,K, OD DP 1EN !EWE EON:CHEFS ITRO.EIKO. Ton NON .opiiHATEMENEN APE NOE INTENDED RH: orrEPED FOR 24.1E IF Nowt Ess 'hiPNED,,,ALEIE DE NOCE 07TLEN ONE FEAT, CP 041OIETI0N THE OWITER Putift:EIT ART HAVE THE 81.17,0E5050EC3TTC, THAT I IE OR ETIE 00 MOE BUILD CP ITARPOWE FOR THE PUTTIHRE WE spa 0 OF THE EFDAPEPOI E CDIEHAI,LN CONERLDN,,c E•rD EEEA'EL,; OCINTRIOTOTTS CHNSTHUO, OK! FROjEC, (EEE 07,44. EINCINEEP .Nr, PROT ESEENTIC COLE 'HE 'TON FAIRTNPN OCEHNE. • AVE DOES HOT APPL,",0 AN OEN5SE0 OF ,HE PROFEEIH WHO ED.I. 02 DN PORELEAET THE CONTRACTORS L !CENDE LAW 4-4E0E7 LAZIER SEE OCT OINHICH INTERIOR & EXTERIOR INSULATION DRYWALL SUSPENDED CEILING SHOWER LATH EXTERIOR LATH SCRATCH (PLASTER) (2 DAY) LICENSED CONTRACTORS DECLARATION ,nHAr.TER ,ECEED. 117312A, ,CE ON A OE THE Tit:WNES ATTU 11,101e2.SINNT. 2--‘ "31 c.r:7.67;;DH kt.W. E krtLy WORKERSCOMPENSATION DECLARATION i HIEFF, AEC HE 'EDER EED,10 0, DF,W0F• ONE CE' 'HE %Eh LANEND DAMAN/CONS MASONRY PRE -GROUT MISC. INSPECTIONS: PERMIT EXTENSION 1ST EXR, LETTER 2ND EXP. LETTER BUILDING FINAL CERTIFICATE OF OCCUPANCY TENANT NAME: TYPE OF BUSINESS USE: ILEA PEEN!, IDEHIND 0? W022ERA COMPFNEA' C;+: . ..ELWANDE , ACTT RC; IC, TATiRIER CHEZ NEWRY: NEEL NCI DE COMPEL••LO Et0,ED NNE EIJNUHI.X. THOLLFT.o. TITEIN OP IES21 Cf-REP V mar THE ITEKHOHNATT: I OF !PIE WORK FOR WTI, it S. ES DEENDEE!,)EcED WORKERS' COMFrNEA4i .129 AAP% OF CALIFORNIA. ANU AC;Ri F. I RAE IF 1 RI CY ND SEC•NATE SNB.ECT TO -NIL HPINIKENN CCENEENSATON FRC, 513214 OF ANe,-rie 003,HE LADEN: CDOE • WiAL, F ONINWIEN 00210 wr14..71.:55E '"IGNE N E WAPNiNC. FA, 317, 30393)349 WOCIKERS' 120FITCHSTYTTTI NETTER ,,,, E IS L421t.1151,:il AND CHAU. SUEELC, »2 ELPLEWEH 30 CRIANNAL PEnt”, C.LESDNODIO NI PO ONE HONLAIED APHLWAND EEO, DAN DACCDF THE LAIEOR CODE ,NTEREODE AN0AtiVrfeltki.P4 CONSTRUerial tEptupt.,:, recz • IEREL'S FENC 2)2I0E2PEN,,IT CJV PERiON't 'NW NENE IR ACONSTRUCTION LENONE, AWENDN F4 P H E P 011•0FE21FReiiSS2:1EEC ONO ::::••t••••l 1: :e:. AESI•• - • • • • • DERIVE THAiti THIW-R11.10.WI1N ANNill: 114T THEW-614i INIPPMATTON 12 NCH:IEEE !AGREE COVEN" WINK ALLIICIET APAIIDEIHNO, (tc• NrogckE, ALMLNITATETPATS RELATING 'TO BOIT:NINO NONRINICTION. ANN HEREBY NEERELHETNAINER.CE TFI.# 4.:O01ETT TO ENEEH 'WON THE ABNNEWTENT (NEC RENNETEHTT FOR !N9U CONN RUPPCISEE • • • • City of Newport Beath Building Department PO Box 1768/3300 Newport Blvd, Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288 ELECTRICAL Permit No: E2001-0769 Inspection RequestsTelephone (949)644-3255 Job Addr9,:1 HOAG DR Inspector Area: 7 Owner: Address: Phone: Receipt Processe HOAG HOSPITAL Bldg: 1 Floor Suite: Code Edit: 96 New Construction Residential Multi -Family 1-2 Family Service 0 to 600V up to 200A 0 to 600V over 200A Over 600A/1,000A CH CA 92660 Legal Desc.: Contractor: Address: Description of Work: ELEC/TEMP TRAILER B20003905 INSPECTOR NOTES: MILES & KELLEY CONSTRUCTION COMPANY INC Phone: Con. State Lic. : Lic Expire: Bus. Lic.: Lic. Exp Date: Receptacle/Switch/Outlets Recep/Outiets 0 $0.00 $0.00 Fixtures 0 $0.00 $0.00 Sep Circuit 0 $0.00 Signs O $0.00 Branch Circuit 0 $0.00 1 $45.35 each Add Circuit 0 $0.00 O $0.00 Time Clocks 0 $0.00 TOTAL: $76.66 RACTORS DECLARATION 1102 E VALENCIA DR FULLERTON CA 714-773-9272 312206 02/28/2003 BT00018695 12/31/2001 FEE 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 PAYMENT: $11.34 Temp Power Pole 0 $0.00 Temp Underground 0 $0.00 Sub Panel 0 $0.00 0 $0.00 0 $0.00 Record Managment Fee: Investigation Fee $0.00 Plan Check Issuance Supplemental Fee BALANCE: $65.32 her$ affirm under penalty of penury that I am licensed under provisions of Chapter 9 (commenting with Section 7000) of Division 3 of the Business and Professions code, icense is in fullforce and effect. No:312206 Class: Conhactor MILES & KELLEY CONSTRUCTION COMPANY INC WORKERS' COMPENSATION DECLARATION I hereby offrm under penalty of perjury one of the following declarations: I have and MlI 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 far 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 perm) is issued. My workers' compensation insurance carrier and policy nuntlrers Is: Carrier STATE COMP Policy number: 046-0009197 Expire :01/01/2002 This section need not be completed if the permit is for one hundred dollars ($100) or less. I certify performance in the perfoence of the work for which-thisr+arml )s issued, !shall not employ any person in an er as to become subj- the workers' compensation laws of Calitania, and agree 1 d I should became t.ibjed to (he worker -CI corpensation provisions of Section 1 - ,ar code, I shall v. comply with those provisions. Applicant nlow aming:F3iliae to secure wakers'compensalion coverage is unlawful, anti shall subject a an employer to canna]penalties and civil fin = up to one hundred ($100,000). In addition to the cost of corrpensation,daneges as pFnNQ4 for in Section 37O9 01 the labor code, interest, and attorneys fees. t I hereby acknowAedge that I ha+e load thi6 applic3h¢ i that Ere inforrre con givEn iS,conect,' aid that I am the owner, or duly authorized agent of the owner. I agree to comply with city and state la* rejulabn[mnstrtct 4o and in doirg thu wtrk author/bed Ihelaby, no person will be employed in violation of the labor code of the state of Calif aya-ialating to workmen;= mnpe.isation insurance. Permittee NNfime (Print) j tfstare of permittee: am\/ Address : >_ 't ✓�--� % ate: Co .6 -c I Approvals Grounding Electrode Underground *.Z Underslab/Floor Rough Conduit Walls Rough Wiring Ceilings Rough Service Temp Power Utility Co. Notified Final Inspector $0.00 $0.00 $0.00 $0.00 $000 $0.27 $0.00 $11.34 $19.70 $0.00 Inspector/Date WORK MUST BE STARTED WITHIN A PERIOD OF 180 DAYS FROM THE DATE OF VALIDATION OR THIS PERMIT BECOMES NULL AND VOID. . W45 ) Vals