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Home My WebLink AboutB2004-3266 - PermitsCity of Newport Beach Building Department PO Box 1768 Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288 BLDG Permit No: B2004-3266 Inspection RequestsTelephone (949)644-3255 Job Address: 1 HOAG DR Floor: Suite: Inspector Area: 7 Owner. HOAG MEM PRESBYTERIAN HOSP Address: 1 HOAG DR NEWPORT BEACH CA92658 Phone: 949-574-4488 Applicant: TAYLOR LINDA Address: 2220 UNIVERSITY DR NEWPORT BEACH CA92660 Phone: 949-574-1325 Code Edit : 2001 Type of Construction: Occupancy Group: U2 Added /New stilt. Bldg: Added /New sq. ft. Garage: 0 No of Stories: No of Units : Bldg Hgts : Issued:10/13/2004 Bldg: 1 Legal Description: Contractor: Address: Phone: Con State Lic: Lic Expire: Bus Lic: Lic Exp Date: MC CARTHY BUILDING CO 20401 SW BIRCH ST #300 77 SUITE300 /t1 949-760-5580 la ''11 411173 IW 08131/2005 BT00021561 03/31/2005 Worker's Compensation Insurance Carder Policy No: Expire: ARCH INSURANCE CO 51WC13594800 04/01/2005 Building Setbacks Rear: / Front: / Left: / Right / PC Use Zone: Parking Spaces: Description of Work: RET WALL 6' HI X 220 LF 2582-2004 - Architect: TAYLOR LINDA Address: 2220 UNIVERSITY DR NEWPORT BEACH CA92660 Phone: 949-574-1325 State Lic:C009828 Engineer: TAYLOR WILLIAM C Address: 2220 UNIV DR #200 NEWPORT BEACH CA 92660 Phone: 714/574-1325 State Lic:S-000702 Designer: Address: Phone: Special Conditions: Construction Valuation: $10,000.00 Building Permit Fee : Plan Check Fee: Investigation Fee: Clean Up Deposit: Disabled Acess Demo Adm Fee: Fee Increased $170.20 $122.54 $0.00 $0.00 $0.00 , $0,00 , $o_0o Microfilm: Excise Tax- Res: Excise Tax- Com: Supplemental P/C: Fair Share: General Sery DMO Refund DMO Dep $21.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 FEES Haz Mat Disclosure: CA Seismic Safety: Other: O.T. Public Works Plan Ck: TOTAL FEE : $625.64 TOTAL PAYMENT : $91.90 $0.00 Planning Dep-- $0.00 Plan Check: $220.00 Counter Rev.: $0.00 $91.90 OT Plan Check : $0.00 Fire Dep - - $0.00 Plan Review: $0.00 Inspection: $0.00 TOTAL DUE : $533.74 PROCESSED BY: PLANNINCAPPROVALS GRADING APPROVAL : OTHER DEPARTMENT: PLAN CHECK BY: APPROVAL TO ISSUE: 514 zat vl n 4- sr L PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. YY 33 APPROVALS DATE BY COMMENTS 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 PRIOR TO ITS ISSUANCE. ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STAT OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LICENSE LAW (CHAPTER 9 DING WITH SEC. 7000) OF DIV. 3 OF THE BUSINESS AND PROFESSIONS CODE)) OR THAT HE OR SHE IS MPT 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 HUNOREO DOLLARS ($500). T EMPLOYEES WRHWAGES AOFFESOL\ ❑ LASOWNER DO THE WORK. COMPENSATION,,USTWILL DO THE WESSIANDTHE: STRUCTURE ISNOT INTENDED OR DES NFOR SALE AND THE OW,ER OF PROPERTY WHO BUILS DCODE:PRES CONTRACTORSH.LICENSE LAWS SUCNOT WORI(APPLY HOWNER R FWHOBUILDSORIMPROVESEMPLOYEAND WAO THAT SUCH WORK TO HIMSELF OR HERSELF OR THROUGH HIS OF HER OWN EMPLOYEES. PROVIDED THAT L SUCH IMPROVEMENTSSSENOTINTENDED E ROFFEREDOMFORSALE.IF. WNE-BU.LHEBWLLIHA ET PR IS SOLD THIE ONE YEAR OF COMPLETION, OR I THE OWNER -BUILDER FOR -THE PUR WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE.). BURDEN ❑ I. AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACRNG WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT(SEC. 7044. BUSINESS AND PROFESSIONS CODE. THE CONTRACTORS LICENSE LAW GOES 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: FOUNDATION: WATER QUALITY BMP'S l /LL(i7 S v y ROUGH GRADE LINE & GRADE CERT/SETBACKS ERECTION PADS FOOTINGS / !/ /J�`1/ 1------ SLAB ON (GRADE FRAMINCJ`. DECK SLAB SUBFLOOR ROOF & BUILDING HT EXT. SHEAR/HOLD DOWNS GENERAL FRAMING FIREPLACE THROAT LICENSED CONTRACTORS DECLARATION I 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, Mc SECLASS TIC. NO. INTERIOR & EXTERIOR INSULATION DRYWALL � u �� DATE b(t'StOL CONTRACTOR �1'ICCFRTtt'j SUSPENDED CEILING 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' MPENSATI N, A5 PROVIDED FOR BY SECTION 3700 OF THE LABOR CODE. FOR THE SHOWER LATH EXTERIOR LATH SCRATCH (PLASTER) (2 DAY) MASONRY PRE -GROUT ORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. a AND WILL MAINTAIN WORKERS' COMPENSATOR INSURANCE. AS REQUIRED BY �� 1004- /f Qypr �.yy / �) /A�rr ` TION 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 MISC. INSPECTIONS: POLICY NUMBER (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 THIS PERMIT IS ISSUED, I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER 50 AS TO BECOME SUBJECT TO THE PERMIT EXTENSION WORKERS' COMPENSATION LAWS OF CALIFORNIA. AND AGREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF SECTOR 3700 OF THE LABOR CODE, I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. WARNING FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTI $5 AND CIVIL FIRES •110 TO ONE HUNDRED THOUSAND DOLLARS (3100.000). IN ADDITION TO THE COST OF POMPCNSATION. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTERNS'. `ND V TOFVEPS FEET 1ST EXP. LETTER 2ND EXP. LETTER BUILDING FINAL ,�L3 �� CONSTRUCiIObLLF',NUhVG'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. CIV.C.). LENDERS NAME ' ` ' CERTIFICATE OF OCCUPANCY OWNER/ BUILDER AGENT INFORMATION NAME: TENANT NAME: --, LENDER'S ADDRESS ' ' T -' J.- ' 1 CERTIFY THAT I HAIL, R`AD THIS AP"LIGGdl0, AND STATE TH'T THE /SO\ = INFCF'NATION IS CORRECT. I AGREE TO COMPLY WIT ( ALL CIA AND C LNTY CRDINANCE3 AND LTATE LAWS RELATING TO BUILDING CONSTRUCTION AND HEREBY AUTHORIZE REPRESENTATVES OF THIS CITY TO ENTERUPO�N THE ABOVE -MENTIONED PROPERTY FOR INSPECTION PURPOSES. )( .LR�ISIAlD CrELMf1i72:-..' ADDRESS: TYPE OF BUSINESS USE: - DRIVERS LIC. NO. ERMI E NAME (PRINT) ;� . ' bsifyi SIG,NATIIRF OF PFRMITTFF "ATE Shared\Permits Dep\BldgPermit(Back)8/04