HomeMy WebLinkAboutF2008-0307 - PermitsCity of Newport Beach
Building Department
FIRE COMBO Permit No: F2008-0307
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 NB
Inspector Area:
OF LOT
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Owner: HOAG HOSPITAL FD&C
Address: 500 SUPERIOR #300
NEWPORT BEACH CA 92663
Phone: 949-764-4486
Applicant: SEYED/DETECTION LOGIC
Address: 7605 N SAN FERNANDO RD
BURBANK CA 91505
Phone: 818-683-1552
Code Edit : 2007
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories:
No of Units :
Flood Zone:
Bldg Sprinklers:
V-BSPR
E
0
0
1
0
Y
Description: RELOC FIRE ALARM SYS "CHILD CARE CTR" (EAST WING)
1536-2008 (ROOM 111,112 & 114)
Legal Description: IRVINE SUB BLK 2 LOTS 169 & 170 POR OF LOTS & BLK 1 172 POR
Contractor: DETECTION LOGIC INC
Address: 7605 N SAN FERNANDO RD
BURBANK CA 91505
Phone: 818-683-1552
Con State Lic
Lic Expire:
Bus Lic:
Lic Exp Date:
713099
10/31/2009
BT01072507
06/30/2009
Worker's Compensation Insurance
Carrier: NORTH RIVER INS
Policy No: 4086948258
Expire: 01/01/2009
Issued Date: 08/11/2008
Setback- Front:
Rear:
Left:
Right:
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
!NSPECTO� -
State Lic:
State Lic:
DETECTION LOGIC
760 SAN FERNANDO RD
BURBANK CA 91505
818-683-1552
Construction Valuation: $2,305.00
Building Overtime Plan Check :
Plan check Exten Fee:
Building Fire Plan Check Fee:
TOTAL FEE : $406.00
$0.00
$0.00
$130.00
FEES
Fire Plan Check Fee :
Fire Permit/Inspection Fee:
Records Management:
Investigation Fee:
Residential Issuance Fee
$130.00
$130.00
$16.00
$0.00
$0.00
Counter Review :
Zoning Plan Check Fee:
Plan Check Fee : $130.00 Fee Due at Permit Issuance : $276.00
$0.00
$0.00
$0.00
$0.00
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL :
OTHER DEPARTMENT:
• •
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• • • • • •/API VAL to ISSNE:
PERMIIT EXPIRES 180 DAYS AFT It (pSSUANCf• OR LAST MAW UJSPECTION
• • • • • • • • • •
•• • • • •• •
• • •ell• •
• •
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• •
OWNER -BUILDER DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LICENSE LAW FOR THE FOLLOWING REASON
DEMOLISH, OR REPAIRS
EPA R$ANY ST UCURE,ANDNS PRIOR TO ITS ISSUANCE, ALSO REQUIRES THCODE: ANY CITY OR COUNTY WHICHIE RES APPLICANT FOR SUCH PERMITA PERMIT TO CONSTRUCT,�TO FTEILE A SIGNED
PERMIT EXPIRED
DATE:
4
BY:
1
STATEMENT
WITH
ALLEGED
NOR
•
THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LICENSE LAW (CHAPTER 9 (COMMENCING
SEC. 7000) OF DIV. 3 OF THE BUSINESS AND PROFESSIONS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE
EXEMPTION. ANY VIOLATION OF SEC. 7031.5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF
MORE THAN FIVE HUNDRED DOLLARS ($500)'.
I, AS THE PROPERTY, MY EMPLOYEES WITH
PERMIT CANCELLED
TURE
NOT
THROUGH
THE
THAT
OWNER OF OR WAGES AS THEIR SOLE COMPENSATION, WILL 0D THE WORK, AND THE STRUC
IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES
APPLY TO N OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR
HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE. IF, HOWEVER,
BUILDING OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OF COMPLETION, THE OWNER -BUILDER WILL HAVE THE BURDEN OF PROVING
HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE.):
PERMIT EXTENSION
111
7044,
BUILDS
TRACTORS
1, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC.
BUSINESS AND PROFESSIONS CODE: THE CONSTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF THE PROPERTY WHO
OR IMPROVES THEREON, AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(S) LICENSED PURSUANT TO THE CON-
LICENSE LAW.).
FIRE PROTECTION
PERMIT FINAL
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I AM EXEMPT UNDER -SEC B & P.C. FOR THIS REASON
DATE
OWNER
FOR OFFICE USE ONLY
LICENSED•CONTRACTORS
I HEREBY
DIVISION
LICENSE
DECLARATION
AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER 9 (COMMENCING WITH SEC. 7000) OF
3 OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS IN FULL FORCT AND EFFECT.
CLASS C,/ ccit LICENSE NO. 1- 13 c gel
DATE
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1 a % /JCONTRACTOR N-t/'T/ Lo&
WORKERS'
I HEREBY
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OF
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ANCE
CARRIER
, 741 I
g l 1I
COMPENSATION DECLARATION
AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS:
1 HAVE AND WILL MAINTAIN A CERTIFICATE OF CONENT TO SELF -INSURE FOR WORKERS' COMPENSATION, AS PROVIDED FOR BY SEC 3700
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 SEC 3700 OF THE LABOR CODE, FOR THE PERFORM-
OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, MY WORKERS' COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE:
NU R /d p (u r,-R
POLICY NUMBER Ire $[? 1.1 6 2-5 II
(THIS
•
MANNER
SUBJECT
PROVISIONS./J
DATE;
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 PERSON IN ANY
SO AS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA, AND AGREE THAT IF I SHOULD BECOME
TO THE WORKERS' COMPENSATION PROVISIONS OF C. 37 0 OF THE LABOR CODE, I SHALL FORTHWITH COMPLY WITH THOSE
4 / it APPLICANT:
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 DOLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES
AS PROVIDED FOR IN SEC. 3706 OF THE LABOR CODE, INTEREST, AN] ATTORNEYS FEES.
CONSTRUCTION LENDING AGENCY
I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK
FOR WHICH THIS PERMIT IS ISSUED (SEC. 3097, CIVC).
LENDER'S NAME • • •••
• • • • •••
• •
LENDER'S ADDRESS • • • ••
• •
• • •
• • • �•I•
I CERTIFY THAT I HAVE READ THIS APPLCATION AND STATE THAT THE ABOVE INFORMATIOMIS CORRE•L I AyISEE TOCOMPLY V TH ALL CITY
AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION, AND HEREBY AUTHORIZE REPRE$ENTMIVES OF THIS
COUNTY TO ENTER UPON THE ABOVE -MENTIONED PROPERTY FOR INSPECTION PURPOSES.
PERMITTEE NAME (PRINT) E\) f A the e4. R •••• •
-••
SIGNATURE OF PERMITTEE - • : • • ']AVE 6•C '(l
• • •�ag
1/23/07 rev