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Home My WebLink AboutF2006-0019 - PermitsCity of Ne PO Bo port Beach Building Department FIRE COMBO Permit No: F2006-0019 768 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 Inspector Areay'ffj j OF LOT Owner: Address: Phone: Applicant: Address: Phone: HOAG MEMORIAL HOSPITAL 1 HOAG DR NEWPORT BEACH CA 92658 Suite: Description of Work: FIRE/(2) DEVICES SOUTH PARKING SRUCTURE 0084-2006 Legal Description: IRVINE SUB BLK 2 LOTS 169 & 170 POR OF LOTS & BLK 1 172 POR Contractor: Address: Phone: TECHNICAL MAINTENANCE & INSTALLATION INC. 1625 W COLLINS AVE ORANGE CA 92867 719-997-3955 Code Edit : 2001 Type of Construction: I-FR, SPR Occupancy Group: S4 Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 0 Flood Zone: X Bldg Sprinklers: Y TECHNICAL MAINTENANCE & INSTALLATION INC Architect: 1625 W COLLINS AVENUE Address: ORANGE CA 92867 714-997-3955 Phone: Con State Lic: Lic Expire: 02/28/2008 Bus Lic: Lic Exp Date: Worker's Compensation Insurance Carrier: STATE COMP Policy No: 808-0000202 Expire: 01/01/2007 Issued Date: 03/31/2006 Setback- Front: Rear: Left: Right: 718842 Address: Phone: Designer: Address: Phone: Special Conditions: INSPECTOR State Lic: Engineer: State Lic: Construction Valuation: $1,200.00 Building Overtime Plan Check : Plan check Exten Fee: FEES $0.00 Fire Plan Check Fee : $0.00 Fire Permit/Inspection Fee: Records Management: Investigation Fee: Residential Issuance Fee $122.00 $122.00 $15.00 $0.00 $0.00 TO AL FEE : $259.00 TOTAL PAYMENT : $122.00 TOTAL DUE : $137.00 Counter Review : Zoning Plan Check Fee: $0.00 $0.00 $0.00 $0.00 PROCESSED BY: ZONING APPROVAL : FIRE APPROVAL : OTHER DEPARTMENT PLAN CHECKED BY:: APPROVAL TO ISSUE: r_ b. 1 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION APPROVALS DATE BY COMMENTS 'OWNER -BUILDER DECLARATION 1 HEREBY AFFIRM UNDER NALTY OF PERJURY THAT 1 AM EXEMPT FROM THE wiITRACTMS LICENSE LAW FOR THE FOLLROING REASON (SEC. 7031.5. BUSINESS AND PROFESSIONS COOS: ANY CITY OR COUNTY:WHICH RE IRES A PERMIT TO CONSTRUCT. ALTER. IMPROVE, DEMOLISH, OR REPAIR ANY STRUCTURE, P TO ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STA NENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LICEN LAW (CHAPTER B (COMMENCING WITH SEC. 7000) OF 01V. 3 0F THE BUSINESS AND PROFESSIONS E)) OR THAT HE OR SHE 15 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 IVIL PENALTY OF NOT MORE THAN FIVE HUNDRED °WARS($500):. I. AS OWNER OF E PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SCIE FIRE PROTECTION UNDERGROUND ROUGH PIPE THRUST BLOCKS EXCAVATION UNDERGROUND PIPING FLUSH UNDERGROUND HYDRO TEST UNDERGROUND/BACKFLOW APRV. COMPENSATION. WILL OO THE WORK. AND THE STRUCTURE 18 NOT INTENDED OR OFFERED FOR SALE (SEC. 1044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW 00E3 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 TWIT HE OR SHE 010 NOT BUBO OR IMPROVE FOR THE PURPOSE OF SALE ). 1, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC T044. BUSINESS AND PROFESSIONS COOS: THE CONTRACTORS LICENSE LAW 00ES NOT APPLY TO AN OWNER OF THE PROPERTY WHO BUILDS OR IMPROVES THEREON. AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(S) LICENSER PURSUANT TO THE CONHucraRS LICENSE LAW.). I AM EXEMPT UNDER SEC. B3 P.C. FOR THIS REASON SPRINKLER HYDRO TEST SPRINKLER FLOW TEST SPRINKLER ROUGH PIPE STANDPIPE HYDRO TEST STANDPIPE FLOW TEST STANDPIPE ROUGH PIPE CHEM SYSTEM FUNCTION TEST CHEM SYSTEM APPROVAL DATE OWNER, CO2 SYSTEM APPROVAL FM 200 FUNCTION I IBPN5FD r'ONTR A rrnpG DFOI ARATION 1 HEREBY AFFIRM UNDER PENALLY 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 GLASS LIC. NO. DRY CHEM SYS FUNCTION TEST DRY CHEN SYS FUNCTION APRV. HALON SYS FUNCTION TEST Te 3 -13jCTO HALON SYS FUNCTION APPROVAL WORKERS' COMPEN ATION DECLA T I HEREBY AFFIRM UNDER PENALTY OF PER RY 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 WORK FOR WHICH HOOD SYSTEM APPROVAL DOCK PROTECTION ROUGH DOCK PROTECTION HYDRO DOCK PROTECTION FLOW FIRE ALARM SYSTEM SECT( N 3700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE THIS PERMIT 15 ISSUED, MY WORKERS' COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE. CARRIER ROUGH WIRING SYSTEM FUNCTION TEST 091 (O AADtAiAJS POLICY NUMBER CENTRAL STATION MONITOR 1 U HIS Ste Hun Neeu NV St CUMHLe I50 0- I HL HLNml 1 IS km UNe nun OH0O DOLLARS (7100) OR LESS). I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT 15155UE0.1 SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE FIRE MISC. V/ORK_RS 001JPEN5A-ION LAWS OF CALIFORNIA. AND AGREE THAT IF I S'HOtILO BECOME SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR CODE, I SHALL FORgTHHWITH COM WITH THOSE PROVISIONS APPLICANT: wife t'�/' 64 A TANK REMOVAL TANK INSTALLATION/TEST PN WARNING FAILURE TO SEGURL'VC IKERS' to'1PEY: ;Tier CO' GE IS UNLA 'L, AND SHALL SUBJECT AN EMPLOYER TCCRIM.NAL PENALTIES AND JIVI 1) $ UP TO ONE HU RED THOUSAND COLLARS 37706 OFOTHE LABOR 0000„Iry ERIN A0011,0Al AO ;SA ESLALost NP ATTORNEYS FEES. AGES AS PROVIDE() FOH w _ TANK PIPING PRESSURE I EST FUEL MODIFICATION 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, CIV.C). , LENDER, RIME o 0 I HER _ LENDER'S APORF55-`_ I CEBE.Y THAI '1 HAVE READ TJIS APPLICATION A.NSTATE SAT O.E ABOVE INFORMATION IS CORRECT. 1 AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES ANO STATE LAWS RELATING TO WILDING CONSTRUCTION. AN0 HEREBY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE -MENTIONED PROPERTY FOR INSPECTION PURPOSES. FINAL gIarlglaD WV/a 7 �+s� 5� � ` G` IGNA RF OFP MITTEE °)� / Forms)NIEEire Pen111lDat11