HomeMy WebLinkAboutB2005-1425 - PermitsCity of Newport Beach Building Department
CIP Permit No: B2005-1425
PO Box 1768 Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288 Inspection Requests/Telephone (949)644-3255
Job Address: 1
Inspector Area: 7
OF LOT
HOAG DR Bldg:1 Floor:
Owner: HOAG MEMORIAL HOSPITAL
Address: 301 N NEWPORT BLVD
ORANGE CA 92869
Phone:
Applicant: LADOWICZ ELISABETH
Address: 1424 FOURTH ST, STE 403
SANTA MONICA CA 90401
Phone: 310/394-3500
Code Edit : 2001
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:.
No of Stories:
No of Units :
Bldg Sprinklers:
Flood Zone:
Issued Date: 04/24/2006
V - N SPR
E3
11890
N
1
Y
Suite: Description of Work: ONE STORY CHILD CARE CENTER BLDG 11890 SF
1108-2005
Legal Description: IRVINE SUB BLK 2 LOTS 169 & 170 POR OF LOTS & BLK 1 172 POR
Contractor: WILLIAMS SCOTSMAN INC
Address: 9400 GALENA ST
RIVERSIDE CA 92509
Phone: 951/360-7999
Con State Lic: 606382
Lic Expire: 11/30/2006
Bus Lic:
Lic Exp Date:
Worker's Compensation Insurance
Carrier: ZURICH AMERICAN INS
Policy No: WC298356005
Expire: 04/01/2007
Building Setbacks Rear:
Front:
Left:
Right:
Use Zone:
Parking Spaces:
PC
Architect:
Address:
Phone:
LADOWICZ ELISABETH
1424 FOURTH ST, STE 403
SANTA MONICA CA 90401
310/394-3500 State Lic:CO22692
Engineer: DAY KEVIN C
Address: 12808 SOUTH 600 EAST
DRAPER UT 84020
Phone: 804/571-9877 State Lic:C-047204
Designer:
Address:
Phone:
Special Conditions:
rvnra Ane Arr•rtVU •"
CITY INSPECTION FOR FON
ONLY -STATE APPROVED
STRUCTURE
Construction Valuation: $2,800,000.00
Building Permit Fee :$10,518.50
Plan Check Fee: $7,280.64
Supplemental: $0.00
Investigation Fee: $0.00
Energy Compliance: $311.00
Fair Share: • • $0.00
• • •
•
• • •
• •
•
• PROCES$Ep in, •••••
• • • • ••
•••
ZONING AtW RI*AL: • • •
GRADING APPROVAL :
• •• ••
• • •
• • •
• • •
• • •
•••••
•
• ••
• •
• •
•••
• • •
•
••
•
Record Mgmt: $142.50
Excise Tax: 52,496.90
Park Dedication: $0.00
SJH Trans: $0.00
San Dist: $12,484.50
CA Seismic Safety: $588.00
Disabled Accestts/, $545.00
TOTAL FEE : 444,849.70
•
•
•
•
••
FEES
Hazardous Mat: $23.00
Add Fire Dep HMQ: $0.00
Other Fee: $196.00
Planning Department
Counter Rev: $0.00
Zoning Plan Ck: $220.00
OT Plan Ck Fee: $0.00
Fire Department
Fire Inspection Fee:
Fire Plan Review
TOTAL PAYMENT : $10,192.90 TOTAL DUE : $34,656.80
PLAN CHECK BY:
APPROVAL TO ISSUE:
PERMIITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
$7,078.40
$2,912.26
O j- 00 -1-7
APPROVALS
DATE
BY
COMMENTS
FOUNDATION:
WATER QUALITY BMP'S
ROUGH GRADE
LINE & GRADE CERT/SETBACKS
g-n - PRtcsSE c?LRnLW% Fen.
THs5C`PEam�ts owvirt (ito7-
'LeeV-g J
ERECTION PADS
FOOTINGS
SLAB ON (GRADE
FRAMING:
DECK SLAB
SUBFLOOR
ROOF & BUILDING HT
EXT. SHEAR/HOLD DOWNS
GENERAL FRAMING
FIREPLACE THROAT
OWNER -BUILDER DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I 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 FOP, SUCH
PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS
OF THE CONTRACTORS LICENSE LAW (CHAPTER 9 (COMMENCING WITH SEC. 7000) OF DIV. 3 OF THE
BUSINESS AND PROFESSIONS CODE)) OR THAT HE DR SHE IS EXEMPT THEREFROM ANO THE BASIS
FOR THE ALLEGED EXEMPTION. ANY VIOLATION OF SEC. 70315 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 THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE
(SEC. 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY
TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK
HIMSELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH
IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE IF, HOWEVER. THE BUILDING OR
IMPROVEMENT IS SOLO 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 Nil F.).
❑ I, 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.).
OWNER'S NAME: DATE'.
INTERIOR & EXTERIOR
INSULATION
DRYWALL
SUSPENDED CEILING
SHOWER LATH
EXTERIOR LATH
SCRATCH (PLASTER) (2 DAY)
MASONRY PRE -GROUT
LICENSED CONTRACTORS DECLARATION
1 HEREBY 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, AND MY LICENSE IS IN FULL FORCE AND EFFECT.
LICENSE CLASS �/
DATE/ey/Z%/DCON
WORKERS' COMPENSATION
CLA ION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS:
I HAVE ANO WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS'
C MPENSATION, AS PROVIDED FOR BY SECTION 3700 OF THE LABOR CODE, FOR THE
PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.
MISC. INSPECTIONS:
PERMIT EXTENSION
1ST EXP. LETTER
2ND EXP. LETTER
BUILDING FINAL
CERTIFICATE OF OCCUPANCY
TENANT NAME:
TYPE OF BUSINESS USE:
NAME:
OWNER / BUILDER AGENT INFORMATION
ADDRESS:
1 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 ARE:
CARRIER
POLICY NUMBER
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS
($100) OR LESS).
I CERTIFY THAT IN THE PERFORMANCE OF THE WOW( FOR WHICH THIS PERMIT 15 ISSUED. I
SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE
WORKERS' COMPENSATION LAWS OF CALIFORNIA. AND AGREE THAT IF I SHOULD BECOME
SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR
CODE, I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS.
WARNING: FAILURE TO SECURE WORKERS C MPEI�SATI�UNLAWFUL COVERAGE IS AND SHALL
SUBJECT AN EMPLOYER TO CRIMIN 17nLTT$ AFD1 CSIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100.000), IN ADDITION TOTHE ^CSb OF DDMPENSA/IO1. DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, IN•BR•ST,•I A•TOgNEY'tFEES.
CONSTROGT�PL LEADING 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 15 ISSUED (SEC.3097,
CIV-0.T. ••• •
•
LENDER'S NAME • •• •• • • • •
LENDERSADDRES\: • ° • • • •••• •• ••:• • •
I CERTIFY THAT I 'MVE•REt' SFI2,,PMEIt<4TION ANDITAltoTHAT THE •9O'REYINFORMATION 15
CORRECT. I AGA! TO CSIPLY VTTH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS
RELATING TO BUILDING CONSTRUCTION. AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS CITY
TO ENTER UPON THE ABOVE -MENTIONED PROPERTY FOR INSPECTION PURPOSES.
4• •
• • • •
Shared\Permits Dep\BldgPermit(Back)8/04
DRIVERS LIC. NO.
City of Newport Beach
Building Department COMB Permit No: X2007-0361
PO Box 1768 Newport Beach, California 92658-8915
Combination Type - GRAD,
Permit Counter Telephone (949)644-3288 Inspection Requests/Telephone (949)644-3255
Job Address: 1 HOAG DR NB
Inspector Area: 7
OF LOT
Owner:
Address:
Phone:
Applicant:
Address:
Phone:
HOAG MEMORIAL HOSPITAL
301 N NEWPORT BLVD
ORANGE CA 92869
LADOWICZ ELISABETH
1424 FOURTH ST, STE 403
SANTA MONICA CA 90401
310/394-3500
Code Edit : 2001
Type of Construction: V-N SPR
Occupancy Group: E-3
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 1
No of Units: 0
Bldg Height: 0
Bldg Sprinklers:
Flood Zone:
Issued Date: 02/2012007
0
0
Project :
Legal Desc.:
Description: PRECISE GRADING FOR CHILD CARE CENTER
1108-2005 62005-1425
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:
WILLIAMS SCOTSMAN INC
9400 GALENA ST
RIVERSIDE CA 92509
951/360-7999
606382
11/30/2008
BT30014664
04/24/2007
Worker's Compensation Insurance
Carder: ZURICH AMERICAN INS
Policy No: WC298356005
Expire: 04/01/2007
Building Setbacks Rear. /
Front: /
Left: 1
Right 1
Use Zone:
Parking Spaces:
0
Architect: LADOWICZ ELISABETH
Address: 1424 FOURTH ST, STE 403
SANTAMONICACA 90401
Phone: 310/394.3500 State Lic:CO22692
Engineer: MARSTON MARIE
Address: 3151 AIRWAY AVE, STE S-2
COSTA MESA CA 92826
Phone: 714/966-9060 State LieC-038798
Designer:
Address:
Phone:
Special Conditions:
,kpFC
�aR
Construction Valuation:
Building Permit Fee :
Plan Check Fee:
Overtime Plan Ck:
00
$0.00
$0.00
$0.00
Record Management: $8.50
Energy Compliance: $0.00
CA Seismic Safety : $0.00
Disabled Across : $0.00
Fee Increase: Fee: $0.00
Additional Fee : $0.00
Hazardous Mat: $0.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
San Dist :
Excise Tax:
NMUSD Fee:
Grading Permit Fee:
Grading PC Fee:
WQ Insp. Fee :
Electrical %:
Mechanical %:
Plumbing %:
FEES
$0.00 Planning Department -
$0.00 Plan check Fee : $0.00
$0.00 Fair Share : $0.00
SJH Trans : $0.00
$584.00
$292.00
$0.00
$0.00
$0.00
$0.00
Public Works Department -
Park Dedication : $0.00
PM/ Plan Check : $0.00
• ••• ••• .. •
TOTAL FEE : $884.50 :TOTAL. PAYMENT ::$0.0p : TOTAL DUE : $884.50
• • • • . . . • • • •
• • • • • •••
11���PUBLIC WORKS APPROVAL:
• • ��-•'••PL•:'N CHOCK BY:
• • • • • • • •
: .• •• : 4PQRo41.'ro ISSUE:
PERMITS EXPIRE 180 DAYS AFTER ISS&4NCE OR LAST VALID INSPECTION.
Fire Department
Fire Inspection:
Fire Plan Rev
Demolition Fee
Building Dept Adm
General Service
Refund Deposit
W
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
R6)1, WI3
ACTION
DATE:
BY:
OWNER -BUILDER DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE CONTRACTORS LICENSE LAW FOR THE FOLLOWING REASON
(SEC. 7031.5, BUSINESS AND PROFESSIONS CODE: ANY CITY OR COUNTY WHICH REQUIRES A PERMIT TO CONSTRUCT, ALTER, IMPROVE,
PERMIT EXPIRED
DEMOLISH, OR REPAIR ANY STRUCTURE, PRIOR TO ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED
PERMIT CANCELLED
STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LICENSE LAW (CHAPTER 9 (COMMENCING
WITH SEC. 7000) OF DIV. 3 OF THE BUSINESS AND PROFESSIONS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE
ALLEGED EXEMPTION. ANY VIOLATION OF SEC.70315 BY ANY APPLICANT FORA PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF
NOR MORE THAN FIVE HUNDRED DOLLARS ($S00):
I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUC-
TURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES
NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR
THROUGH HIS OR HER OWN EMPLOYEES. PROVIDED THAT SUCH 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
OR IMPROVE FOR THE PURPOSE
..
PERMIT EXTENDED
PERMIT FINAL
8 - s-.p g
U[� ' -
■ THAT HE OR SHE DID NOT BUILD OF SALE.):
I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7044,
BUSINESS AND PROFESSIONS CODE; THE CONTRACTORS LICENSE LAIN 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
CERTIFICATE OF
OCCUPANCY ISSUED
LICENSE LAW.).
•
I AM EXEMPT UNDER SEC B. & PC. FOR THIS RFA•ON
DATE OWNER
LICENSED CONTRACTORS DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER 9 (COMMENCING WRH SEC. 7000) OF
DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS IN FULL FORCE AND EFFECT,
LICENSE CLASS LICENSE NO.
TENANT NAME
TYPE OF BUSINESS
2- 2o- 07 CONTRAC R W:\\) R'M C. Wti-T.-,
FOR OFFICE USE ONLY
WORKERS' COMPENSATION DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS:
WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, AS PROVIDED FOR BY SEC 3700
LABOR CODE, FOR THE�ERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.
If
` AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE, AS REQUIRED BY SEC 3700 OF THE LABOR CODE. FOR THE PERFORM-
•CE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, MY WORKERS' COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE:
CARRIER
POLICY NUMBER
❑ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMR IS FOR ONE HUNDRED DOLLARS ($100) OR LESS).
I CERTIFY THAT IN PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I SHALL NOT EMPLOY ANY PERSON IN ANY MAN-
NER soAs TO B ME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA. AND AGREE THAT IF I SHOULD BECOME SUBJECT
TO THE WO ' COMPENSATION PROVISIONS O5_Y .3700 OF THE LABOR ,C!]Q�LSHALL FOR COMPLY WITH THOSE PROVISIONS.
�TE' 2 ` Z CR APPLICANT: C�. 'L.P'
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION C OVERAGE IS UNLAWFUL, A ND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES
AS PROVIDED FOR IN SEC. 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
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 ISSUED (SEC. 3091. CIV.C).
LENDER'S NAME
• • • ••• ••• •
• • • • • • •
LENDER'S ADDRESS •• • • • • • • • •
• • • • • • • • • • •
I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS &ORRECT, 1 AeREE_1D COMPL WI AL
CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION!' Ant HEREBY AU 1t NIZEREPRESEITTATIVE OF
THIS CITY TO ENTER UPON THEEABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. ` melt— .
PERMRTEE.IPAB/E (PRINT) \. J F !'1 LJlYRIVE (�1 `‘ 1 • • • •
SIGNATURE $?E EE • • • • 40
_
City of Newport Beach
Building Department BLDG Permit No: B2005-2324
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
OF LOT
Owner:
Address:
Phone:
HOAG MEMORIAL HOSPITAL
1 HOAG DR
NEWPORT BEACH CA 92660
Applicant: LADOWICZ ELISABETH
Address: 1424 FOURTH ST, STE 403
SANTA MONICA CA 90401
Phone: 310/394-3500
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:04/24/2006
0
0
Suite: Bldg: 1 Description of Work: TRASH ENCLOSURE
1108-2005
Legal Description: 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:
Worker's Compen
Carrier:
Policy No:
Expire:
WILLIAMS SCOTSMAN INC
9400 GALENA ST
RIVERSIDE CA 92509
951/360-7999
606382
11/30/2006
sation Insurance
ZURICH AMERICAN INS
WC298356005
04/01/2007
Building Setbacks
Use Zone:
Parking Spaces:
Rear: /
Front: /
Left: /
Right: /
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
LADOWICZ ELISABETH
1424 FOURTH ST, STE 403
SANTA MONICA CA 90401
310/394-3500 State Lic:CO22692
DAY KEVIN C
12808 SOUTH 600 EAST
DRAPER UT 84020
804/571-9877
Special Conditions:
State Lic:C-047204
Construction Valuation: $5.000.00
Building Permit Fee : $105.70
Plan Check Fee: $76.10
Investigation Fee: $0.00
Clean Up Deposit: $0.00
Disabled Acess .• .
•. $0.00
Demo Adm Fee: • . .w60.(Q1 ,
Fee Increased ,j4.gl
: ••.
•• •• •
• :-- . •..
•
PROCESS . �Ell.SY: .• :•: • ••••
••••• • • • • i
•
PLANNING APPROVAL:
GRADING APPROV4L:•• ••
• • • •
• • • •
•
40
••• •
•.
• • •
• • •
•• • •.
• • •
• • • .•
Microfilm:
Excise Tax- Res:
Excise Tax- Corn:
Supplemental P/C:
Fair Share:
General Sery DMO
Refund DMO Dep
TOTAL FEE : fi£ •.55
$0.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
FEES
Haz Mat Disclosure: $0.00
CA Seismic Safety: $0.00
Other:
$0.00
Public Works Plan Ck: $0.00
TOTAL PAYMENT : $76.10
TOTAL DUE : $110.45
OTHER DEPARTMENT:
PLAN CHECK BY:
APPROVAL TO ISSUE:
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LASTVALID INSPECTION.
Planning Dep - -
Plan Check:
Counter Rev.:
OT Plan Check :
Fire Dep - -
Plan Review.
Inspection:
$0.00
$0.00
$0.00
$0.00
$0.00
ho\- 55-74 7
APPROVALS DATE
BY
COMMENTS
FOUNDATION:
WATER QUALITY BMP'S
ROUGH GRADE
LINE & GRADE CERT/SETBACKS
ERECTION PADS
FOOTINGS
SLAB ON ( GRADE
FRAMING:
DECK SLAB
SUBFLOOR
ROOF & BUILDING HT
EXT. SHEAR/HOLD DOWNS
GENERAL FRAMING
FIREPLACE THROAT
INTERIOR & EXTERIOR
INSULATION
DRYWALL
SUSPENDED CEILING
SHOWER LATH
EXTERIOR LATH
SCRATCH (PLASTER) (2 DAY)
MASONRY PRE -GROUT
MISC. INSPECTIONS:
OWNER -BUILDER DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I 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 15 LICENSED PURSUANT TO THE PROVISIONS
OF THE CONTRACTORS UCENSE LAW (CHAPTER 9 (COMMENCING WITH SEC. 7000) OF DIV. 3 OF THE
BUSINESS AND PROFESSIONS CODE)) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS
FOR THE ALLEGED EXEMPTION. ANY VIOLATION OF SEC. 7031.5 BY ANY APPLICANT FOR A PERMIT
SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (5500):
❑ I, AS OWNER OF THE PROPERTY. OR MY EMPLOYEES WITH WAGES AS THEIR SOLE
COMPENSATOR. WILL DO THE WORK. AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE
(SEC. 7044. BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY
TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK
HIMSELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES. PROVIDED THAT SUCH
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 HE OR SHE 010 NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE.).
❑ I. 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 ME CONTRACTORS LICENSE LAW.).
OWNERS NAME: DATE:
LICENSED CONTRACTORS DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF
CHAPTER 9 (COMMENCING WITH SECTOR 7000) OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS
CODE, AND MY LICENSE 15 IN FULL FORCE AND EFFECT.
LICENSE CLASS �LIC. N
DATE-'y!`Z/ hie CONTRA
Aee
PERMIT EXTENSION
1ST EXP. LETTER
2ND EXP. LETTER
BUILDING FINAL
CERTIFICATE OF OCCUPANCY
'3-1tief
TENANT NAME:
TYPE OF BUSINESS USE:
Shared\Permits Dep\BldgPermit(Back)8/04
NAME:
OWNER / BUILDER AGENT INFORMATION
ADDRESS:
DRIVERS LIC. NO.
WORKERS' COMPENSATION DE ' RAT
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 WORK FOR WHICH THIS PERMIT 15 ISSUED.
I HAVE AND WILL MAINTAIN WORKERS COMPENSATION INSURANCE, AS REQUIRED BY
SECTION 3700 OF THE LABOR CODE, FOR ME PERFORMANCE OF THE WORK FOR WHICH
THIS PERMIT IS ISSUED. MY WORKERS COMPENSATION INSURANCE CARRIER AND POLICY
NUMBER ARE'.
CARRIER
POLICY NUMBER
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT 15 FOR ONE HUNDRED DOLLARS
(5100) OR LESS).
I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I
SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE
WORKERS' COMPENSATION LAWS OF CAUFORNIA. AND AGREE THAT IF I SHOULD BECOME
SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR
CODE. I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS.
WARNING: FAILURE TO SECURE WORKERS' C PZNSA ON Cj! ERAGE 15 UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL P�IA,L•f;5 GIRL NINES •P TO ONE HUNDRED THOUSAND
DO 1 ARS (5100.000), IN ADDITION TO TH4COST•OFICOMRIENSATIONfDAMAGES A5 PROVIDED FOR IN
SECTION 3706 Of THE LABOR CODE. INTERt* A NDI HO4 NEY'S FEM.
CONSTRUCtIO&LLaNDING 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 ISSUED (SEC.3097,
GV CJ. ••• •
•
LENDERS NAME •� •• �a • •• • • •
. •••• •
LENDERS ADDRESS - • • • . .
I CERTIFY THAT I HAVEORE.0 IRIS RP�F(CATIWTAND STAB TH.•T THE ASO* IIIFaRMATION IS
CORRECT. I AGREE b•COMPLT WITH ALL OTY AND COUNTY ORDINANCES AND STATE LAWS
RELATING TO BUILDING CONSTRUCTION. MC HEREBY AUTHORIZE REPRESENTATIVES OF THIS CITY
TO ENTER UPON THE ABOVE -MENTIONED PROPERTY FOR INSPECTION PURPOSES.
•• •
• • • •
• • •
M• • •• ••
•
y ea
City of Newport Beach
Building Department COMB Permit No: X2007-1588
PO Box 1768 Newport Beach, California 92658-8915
Combination Type - BLDG/
Permit Counter Telephone (949)644-3288 Inspection Requests/Telephone (949)644-3255
Job Address: 1 HOAG DR NB
Inspector Area: 7
OF LOT
Owner:
Address:
Phone:
HOAG MEMORIAL HOSPITAL
301 N NEWPORT BLVD
ORANGE CA 92869
Applicant: WILLIAMS SCOTSMAN INC
Address: 9400 GALENA ST
RIVERSIDE CA 92509
Phone: 951/360-7999
Code Edit : 2001
Type of Construction:
Occupancy Group: U-2
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories:
No of Units :
Bldg Height:
Bldg Sprinklers:
Flood Zone:
Issued Date: 07/03/2007
0
0
0
0
0
Project :
Legal Desc.:
Description: BLOCK WALL 6' x 525 LF & GLASS 0/BLOCK 6' x 140 LF
1108-2005 SEE 1108-2005
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:
Worker's Compensat
Carrier:
Policy No:
Expire:
Building Setbacks
Use Zone:
Parking Spaces:
WILLIAMS SCOTSMAN INC
9400 GALENA ST
RIVERSIDE CA 92509
951/360-7999
606382
11/30/2008
BT30014664
04/30/2008
ion Insurance
ZURICH AMERICAN INS
WC298356006
04/01/2008
Rear: /
Front: /
Left: /
Right: /
0
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
LADOWICZ ELISABETH
1424 FOURTH ST, STE 403
SANTA MONICA CA 90401
310/394-3500 State Lic:CO22692
DAY KEVIN C
12808 SOUTH 600 EAST
DRAPER UT 84020
804/571-9877 State Lic:C-047204
Special Conditions:
InaI Euiu,
Construction Valuation: $99,000.00
Building Permit Fee: $990.10
Plan Check Fee: $712.87
Overtime Plan Ck: $0.00
Investigatin Fee: $0.00
Record Management : $0.50
Energy Compliance: $0.00
CA Seismic Safety : $0.00
Disabled Access : $0.00
Fee Increase: Fee: $0.00
Additional Fee : $0.00
Hazardous Mat: $0.00
•
• •
• •
•
• •
•
San Dist :
Excise Tax:
NMUSD Fee:
Grading Permit Fee:
Grading PC Fee:
WO Insp. Fee:
Electrical %:
Mechanical %:
Plumbing %:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL FEE : $1,743.47
FEES
Planning Department -
Plan check Fee :
Fair Share :
SJH Trans :
$40.00
$0.00
$0.00
Public Works Department -
Park Dedication : $0.00
PNV Plan Check : $0.00
Fire Department
Fire Inspection:
Fire Plan Rev
Demolition Fee
Building Dept Adm
General Service
Refund Deposit
TOTAL PAYMENT : $0.00 TOTAL DUE : $1,743.47
$0.00
$0.00
$0.00
$0.00
$0.00
50.00
$0.00
. •
PROCESSED BY: • • • • •
ZONING APPROVAL:•• •• •• ••
GRADING APP5OVAk: • •
••• ••
17\--
•
CiPERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
t4 (i34j7
i
OWNER -BUILDER DECLARATION
I HEREBYAFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LICENSE LAW FOR THE FOLLOWING REASON
DEMOLISH, OR RC. 7031.5, EPAIR ANY STRUCTUAND SIONS CODE: ANY CITY OR RE. PRIOR TO ITSISSUANCE,USO REQUIRESNTY WHICH THEAES A PERMIT TO PPLICANT FOR SUCH PERMICT, T IT TO FIE A SIGNED
STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LICENSE LAW (CHAPTER 9 (COMMENCING
WITH SEC. 7000) OF DN. 3 OF THE BUSINESS AND PROFESSIONS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE
ALLEGED EXEMPTION. ANY VIOLATION OF SEC. 7031.5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CNIL PENALTY OF
1111 NOR MORE THAN FIVE HUNDRED DOLLARS ($500):
1 AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUC-
TURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES
NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR
THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH 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
MITHAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE.):
I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7044,
ACTION
DATE:
BY:
PERMIT EXPIRED
PERMIT CANCELLED
PERMIT EXTENDED
PERMIT FINAL
-1 -vp�
1
W1
�O�
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 AM EXEMPT UNDER SEC B. & PAFOR THIS REASON
CERTIFICATE OF
OCCUPANCY ISSUED
GATE OWNER
LICENSED CONTRACTORS DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER 9 (COMMENCING WITH SEC. 7000) OF
DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS IN FULL FORCE AND EFFECT.
uCLASS LICENSE NO.
TENANT NAME
TYPE OF BUSINESS
� 7>3) (r2 CTORLt77.
FOR OFFICE USE ONLY
• •
•• • ••• •• � •• •
• •
:• • � • . • • • • :. •••
:•• ••• ••• •
-•� "it ••= 1 •
ORKERS' COMPENSATIO DECLARATION
■ I HEREBY AFFIRM UNDER PENALTY F PERJURY ONE OF THE FOLLOWING DECLARATIONS:
1 HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, AS PROVIDED FOR BY SEC 3700
OF THE LABOR CODE, FOR THFPERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.
LI
I HAVE AND WILL MAINTAIN WORKFYS' COMPENSATION INSURANCE, AS REQUIRED BY SEC 3700 OF THE LABOR CODE. FOR THE PERFORM
ANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, MY WORKERS' COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE
CARRIER
POLICY NUMBER
■ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS MOO) OR LESS).
I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I SHALL NOT EMPLOY ANY PERSON IN ANY MAN-
NER SO AS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA. AND AGREE THAT IF I SHOULD BECOME SUBJECT
TO THE WORKERS' COMPENSATION PROVISIONS OF SEC. 3700 OF THE LABOR CODE I HALL FORTHWITH COMPLY WITH THOSE PROVISIONS.
7) 3) 07
WATE•
qR(,CANT:
RNING: FAILURE TO SECURE'W KERS' COMPENSATION COVERAGE IS UNLAWFUL. AND S HALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES
AS PROVIDED FOR IN SEC. 3706 OF THE LABOR CODE. INTEREST, AND ATTORNEYS FEES.
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 ISSUED (SEC. 3097, CN.C).
LENDER'S NAME
ENDERS ADDRESS
I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITH ALL
CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION. AND HEREBY AUTHORIZE REPRESENTATIVES OF
THIS CITY TO ENTER UPON THE ABOVEMENTIONED PROPERTY FOR INSPECTION PURPOSES.
`
( T) �F.f}I3 y AL- �-rr
,AERMITTEE NAME PRIN
NATURE OF PERMITTEE 7)3%(%�T.
• • • •••
•i ••• •
City of Newport Beach
Building Department ELECTRICAL Permit No: E2005-0798
PO Box 1768 Newport Beach, California 92656-8915 Permit Counter Telephone (949)644-3288 Inspection Requests/Telephone (949)644-3255
Job Address: 1 HOAG DR Bldg: 1 Floor:
Inspector Area: 7
OF LOT
Owner: HOAG MEMORIAL HOSPITAL
Address: 1 HOAG DR
NEWPORT BEACH CA 92860
Phone:
Issued Date: 04/24/2006
Processed By:
Suite:
Description of Work: ELEC/ONE STORY CHILD CARE CENTER BLDG
62005-1425
Legal Description: 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:
WILLIAMS SCOTSMAN INC
9400 GALENA ST
RIVERSIDE CA 92509
951/360-7999
606362
11/30/2006
Inspector Notes:
New Construction
Residential
Multi -Family: 0 $0.00
1-2 Family: 0 $0.00
Service
0-600V up to 200A: 0 $0.00
0-600V over 200A: 0 $0.00
Over 600V or 1000A: 0 $0.00
Receptacle/Switch/Outlets
Receptacles/Outlets: 80
Fixtures: 140
Sep Circuits: 0
Low Voltage 0
Signs
Branch Circuit: 0
Each Add Circuit: 0
Time Clocks: 0
TOTAL: $224.75
$81.00
$100.00
$0.00
$0.00
$.0.00
$0.00
$0.00
FEES
Motors/Transformers (HP/KVA)
0 to 1 HP/KW/KVA:
1 to 10 HP/KW/KVA:
10 to 50 HP/KW fKVA'.
50 to 100 HP/KW/KVA:
Over 100 HP/KW/KVA:
Piggy Back/Temp Power:
Temp Power Pole:
PAYMENT:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$40.25 BALANCE:
Temp Underground:
Sub Panel:
Record Mgmt Fee:
Plan Check Fee:
Investigation Fee:
Issuance Fee:
Supplemental Fee:
$184.50
0
0
0
0
$0.00
$0.00
$0.00
$0.00
$0.50
$40.25
$0.00
$23.00
$0.00
irf*A
111:11KERS' 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 wonters' 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 3700 of the labor code. for the performance of the work for which this pemit is issued.
My workers' compensation insurance carrier and policy number is:
Carrier: ZURICH AMERICAN INS Policy number:WC298356005
(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 for which this permit is issued, I shall not employ any perso so as to became subject t0 •t • • • ' •ionsa'eafion •
laws of California and a ee that if I should become subject to the workers' compensation provisi of Section f�rhe Igp9r . • = shall f• W dhply Bath tri se pi60�sions.
-
SED CONTRACTORS DECLARATION
ereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions code,
d my license is in full force and effect.
e No: 606382 Class: - Date: Contractor: WILLIAMS SCOTSMAN INC
Date:
Code Edit: 2004
Applicant Signature: '
WarNn•failure o secure workers' compensation coverage Is unlawful, and shall sublets an employer lpenalt. = nd civil firs up tip one hyndred •usisanydollars. • •
($100,000), in addition to the cost of compensation,damages as provided for in Section 3706 of the labor code, inter- -, and attomers Wes* • • • • •
•••
I hereby acknowledge that I have read this application; that the information given is correct: and that I am the comer, or duly authorizes jgeat ofsihepwger. •yagr•e to • • • •
comply with city and state laws regulating construction: and in doing the work authorized thereby, no person will be employed in vlo6gon of Ilk labortode oflhe state of • •
California relating to workmen's cornnppeensation insurance.
f 1
F. 4;1Dace: o3iost&Toa
Pemhittee Name (Print)
Signature of permittee:
64,491 . i Address:
Date. . bra •
•
• • •• •• •• •• •
•• ••• • • a• ••
Approvals
Grounding Electrode
Underground
Under Slab/Floor
Rough Conduit Walls
Rough Wiring Ceilings
Rough Sevice
Temp Power
•
•• • Utility Company Notified
• • • • Final
• ••
Inspector/Date
PERMITS EXPIRE 180 DAYS AHBR ISSUANCE OR
LAST VALID INSPECTION.
•
City of Newport Beach
Building Department MECHANICAL Permit No: H2005-0454
PO Box 1768 Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288 Inspection Requests/Telephone (949)644-3255
Job Address: 1 HOAG DR Bldg:1 Floor. Suite:
Inspector Area:7
OF LOT
Owner:
Address:
Code Edit : 2001
HOAG MEMORIAL HOSPITAL
1 HOAG DR
NEWPORT BEACH CA 92
Phone:
Issued Date 04/24/2006
Processed By:
Contractor:
Address:
Phone:
Con State Lic:
Lic Expire:
Bus Lic:
Lic Exp Date:
Legal Description:
aif
Description of Work: MECH/ONE STORY CHILD CARE CENTER BLDG
B2005-1425
IRVINE SUB BLK 2 LOTS 169 & 170 POR OF LOTS & BLK 1 172 POR
WILLIAMS SCOTSMAN INC
9400 GALENA ST
RIVERSIDE CA 92509
951 /360-7999
606382
11/30/2006
Inspector Notes:
HVAC Items
Fumaces
Up to 100K BTU/hr. 0 $0.00
Over 100K BTU/hr. 0 $0.00
Wall/Floor Heaters: 0 $0.00
Heat Pumps & Package Units
Up to 100K BTU/hr. 11 $143.00
Over 500K BT Whr: 0 $0.00
Up to 1 M BTU/hr: 0 $0.00
Up to 1.75M BTU/hr: 0 $0.00
Over 1.75M BTU/hr: 0 $0.00
Up to 3HP:
>3 HP to 15 HP:
>15 HP to 30 HP:
>30 HP to 50 HP
>50 HP:
Air Handling Units
up to 10K CFM:
Over 10K CFM:
VAV Box:
Boilers & Compressors
0 $0.00
0 $0.00
0 $0.00
0 $0.00
0 $0.00
11
0
0
$99.00
$0.00
$D.00
TOTAL: $389.75
FEES
Ventilation
Bathroom Fan:
Exhaust Fan:
Attic Fan:
Down -Draft Fan:
Residential Hood:
Comm. Hood:
Repair/Alter/Add:
PAYMENT:
Misc
7 $42.00 Fire Dampers:
0 $0.00 Gas Line:
0 $0.00 Metal Fireplace:
0 $0.00 ICBO App.#:
O $0.00
1 $9.00
O $0.00
$73.25 BALANCE:
0
0
0
Soso
$0.00
$o.00
$316.50
Other
$0.00
$0.00
Record Mgmt Fee: $0.50
Investigation: $0.00
Plan Check: $73.25
Issuance: $23.00
Supplemental Fee: $0.00
OanN ED CONTRACTORS DECLARATION
hereby affirm under penally of penury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions code,
d my license is in full force and effect.
License No: 806382 Class:
Date: Conti
: WILLIAMS SCOTSMAN INC
WORKERS' COMPENSATION DECLARATION: 1 hereby affirm under penalty of penury one of the following declarations:
- 1 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 this permit is issued.
I have and will maintain workers' compensation insurance, as required by Section 3700 of the labor code. for the pMormance of the work for which ml5Iemisls issue.
My workers' compensation insurance carrier and policy number is: • • • • • • • •
Carrier: ZURICH AMERICAN INS Policy number:WC298356005
effl :Qgalt2007
(This section need not be completed if the permit is for one hundred dollars ($100) or less.
• • • •• • •
I certify that in the perfonrance of the work for which this pemit is issued, I shall not employ any person In any manner so es to become suttee( to Ihelt6dters comlfensat?oii
laws of Califorpl4, and ree that 1 I should become subject to the workers' compensation provis' s of of the labor code. I I with comply with those provisions.
�z
Date:
Applicant Signatu / �S , 4- • •.. • • • • •
•
Waming: Failure to secure workers' compensation coverage is unlawful, and shall subject ana oyes! coral and dF1'lles�p t4 on: htsdredtllwsaMillars•• ••• • •
(S100,000), in addition to the cost of compensation,dannges as provided for in Section 3706 of the r code, interest, and aaomh4ees • • • • • • • • • • •
• • • • •' • • • • • •• • ••
• • •
I hereby acknowledge that I have read this application; that the information given is correct: and that I am the comer, or duly authorized agent of the owner. I agree to
comply with city and state laws regulating construction; and in doing the work authorized thereby, no person will be employed in violation of the labor code of the state of
California relating to workmen's compensation insurance.
Permlttee Name (Print) '
Signature of permittee: 1/(
Address:
6• ••• •••• ••• ••• ••
• I$ • • ••
• •
/ !,� •
.
•
Date.•__ I .�7' ��i •••
Approvals
Underslab/Floor
HVAC/Hood-Rough
Fireplace -Rough
Gas Test
Fireplace -final
HVAC/Hood-Final
Inspector/Date
$- S-0?-C;-{,qie:.
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR
LAST VALID INSPECTION.
ho\-551/4-7
Job Address: 1
Inspector Area: 7
OF LOT
Owner:
Address:
City of Newport Beach
Building Department PLUMBING Permit No: P2005-0646
PO Box 1768 Newport Beach, California 92658-8915
Permit Counter Telephone (949)644-3288 Inspection Requests/Telephone (949)644-3255
HOAG DR Bldg: 1 Floor Suite: Description of Work:PLUM/ONE STORY CHILD CARE CENTER BLDG
B2005-1425
Code Edit 2001 Legal Description: IRVINE SUB BLK 2 LOTS 169 & 170 POR OF LOTS & BLK 1 172 POR
HOAG MEMORIAL HOSPITAL
1 HOAG DR
NEWPORT BEACH CA 92660
Contractor: WILLIAMS SCOTSMAN INC
Address: 9400 GALENA ST
RIVERSIDE CA 92509
Phone: r. Phone: 951/360-7999
Con State Lic: 606382
Issued Date: 04/24/2006 / ) Lic Expire: 11/30/2006
Bus Lic:
Processed By: LY` / Lic Exp Date:
Inspector Notes:
9p
Bathroom Fixtures Kitchen Fixtures
Toilet: 15 $135.00 Kitchen Sink: 9 $81.00
Bidet 0 $0.00 Garbage Disp: 3 $27.00
Urinal 0 $0.00 Bar Sink: 4 $36.00
Bath Tub: 0 $0.00 Vegetable Sink: 0 $0.00
Shower Stall: 1 $9.00 Ice Maker: 1 $9.00
Wash Basin: 15 $135.00 Dishwasher: 3 $27.00
Hydro -Mass Tub: 0 $0.00 Lndry/Trap: 2 $18.00
Floor Sink: 1 $9.00 Regulator: 0 $0.00
Floor Drain. 7 $63.00 Lawn Sprinkler: 1 $13.00
FEES
Misc. Misc.
Water Piping: 0 $0.00 Roof Drain: 10 $90.00
Water Softener: 1 $10.00 Grease Trap: 0 $0.00
Water Heater. $20.00 Grease Interceptor: 0 $0.00
Gas up to 4 outlets: $0.00 P-Trap: 0 $0.00
Gas over 4 outlets: $0.00 Sewer
Backflow up to 2": $0.00 Sewer 1 $22.00
Backflow over 7: $0.00 Sewer Alter/Repair: 0 $0.00
Hose Bibb: $54.00 Sewer Abandon: 0 $0.00
Drinking Fountain: $0.00
TOTAL: $971.00 PAYMENT:
$189.50 BALANCE:
Other
$0.00
$0.00
Record Mgmt Fee: $0.50
Investigation: $0.00
Plan Check: $189.50
Issuance: $23.00
Supplemental Fee: $0.00
$781.50
NSED CONTRACTORS DECLARATION
eqy 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 torce and effect.
No: 606382 Class: Date: Contractor: WILLIAMS SCOTSMAN 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 work 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 perfonrence of the work for whirl Rd5 permit ittissye1t •
My workers' compensation insurance caner and policy number is:
Carrier: ZURICH AMERICAN INS Policy number:WC298356005 ExpImm: 0fe1J 307•
(This section need not be completed if the perrrit is for one hundred dollars ($100) or less. • laws of should become subject to the workers' cornpensation provisions of ion code, I shall forth • •
I certify That in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation
y with those proBsions.
California, and agree t
1 if 1
are workers'
dNon to the cost of
Date:
Failure
Applicant Signature :
Warning: compensation coverage is unlawful, and shall subject an emp
($100,000), in compensatlon,damages as provided for in Section 3706 of the labor co
• • •
• • •
fine• upeo Ale Plum/fed tllbusand=IAI=rs •
, interest, a . - omeystets. •• • : : e• • • • • •
•• • • •
1 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 Me 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 slate of
California relating to workmen's compensation insurance. • •
Pemnitlee Name (Print)
Signature of permitlee:
/• Address:
rd-
ate
• • • • • • •
• • • •
•
•
• •
•
• •
• •
Approvals
Soll Pipe (ground)
Sewer
Water Pipe (ground)
Gas Pipe (ground)
Plumbing (rough)
Gas Pipe (rough)
• Water Heater
• Gas PSI Test
Gas Co Notified
Final
Inspector/Date
7•C-a'7- ce41
.y- 0,- %o
3•'z-O? •
r-1.1'oT'retie'
8-a off • bc3^
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE
OR LAST VAID INSPECTION
?1oLSS-741