HomeMy WebLinkAboutB2005-3071 - PermitsCity of Newport Beach
Building Department BLDG Permit No: B2005-3071
PO Box 1768 Newport Beach, Califomia 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:
Applicant:
Address:
Phone:
HOAG MEMORIAL HOSPITAL
1 HOAG DR
NEWPORT BEACH CA 92663
949/764-4463
ASSI SECURITY INC
18001 COWAN AVE, STE A
IRVINE CA 92614
949/955-0244
Code Edit : 2001
Type of Construction:
Occupancy Group: U2
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories: 0
No of Units :
Bldg Height:
Bldg Sprinklers:
Flood Zone:
Issued:09/29/2005
Suite: Bldg: 1
Legal Description:
Contractor:
Address:
Phone:
Con State Lic:
Lic Expire:
Bus Lic:
Lic Exp Date:
Description of Work: INSTALL PKNG CONTROL GATES "DOLPHIN" PRKG STRUC
2346-2005 (PHASE 1)
IRVINE SUB BLK 2 LOTS 169 & 170 POR OF LOTS & BLK 1 172 POR
ASSI SECURITY
18001 COWAN SUITE A
IRVINE CA 92614
949/394-6604
683831
01/31/2006
BT99100104
07/31/2006
Worker's Compensation Insurance
Carrier: CLARENDON NATL INS
Policy No:
Expire:
Building Setbacks
01KR0027405
02/01/2006
Use Zone:
Parking Spaces:
Rear:
Front:
Left:
Right:
Architect:
Address:
Phone: State Lic:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
TAYLOR WILLIAM C
2220 UNIV DR #200
NEWPORT BEACH CA92660
714/574-1325 State Lic:S-000702
TAYLOR WILLIAM
2220 UNIVERSITY
NEWPORT BEACH CA92660
949/574-1325
Special Conditions:
Construction Valuation: $25,000.00
Building Permit Fee : $363.70
Plan Check Fee: $261.86
Investigation Fee: $0.00
Clean Up Deposit: $0.00 , ,
$0.00
Disabled Acess - $0.00
Demo Adm Fee: $0.00 -,
Fee Increased $0.00
Microfilm:
Excise Tax- Res:
Excise Tax- Com:
, Supplemental P/C:
"= Fair Share:
General Sery DMO
Refund DMO Dep
i'OTAL :, $1,024.54
$54.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
FEES
Haz Mat Disclosure:
CA Seismic Safety:
Other:
2900-5002
$0.00 Planning Dep--
$0.00 Plan Check: $0.00
Counter Rev.: $60.00
$284.980T Plan Check :
Public Works Plan Ck: $0.00
TOTAL PAYMENT : $546.84 TOTAL DUE : $477.70
Fire Dep - -
Plan Review:
Inspection:
$0.00
$0.00
PROCESSED BY:
PLANNING APPROVAL:
GRADING APPROVAL :
.,
OTHER DEPARTMENT:
PLAN CHECK BY:
APPROVAL TO ISSUE:
OA G i °
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 F0.LOWING 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 IS LICENSED PURSUANT TO THE PROVISIONS
OF THE CONTRACTORS LICENSE LAW (CHAPTER 9 (COMMENCING WITH SEC. 7000) OF OW. 3 OF THE
BUSINESS AND PROFESSIONS CODE)) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS
FOR THE ALLEGES) EXEMPTION. ANY VIOLATION OF SEC. 7031.5 BY ANY APPLICANT FOR A PERMIT
SUBJECTS THE APPLICANT TO A CALL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (S60O
❑ L AS OWNER OF THE PROPERTY. OR MY EMPLOYEES WITH WAGES AS THEIR SOLE
COMPENSATION, WILL DO THE WCRK AND THE STRUCTURE I5 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 OWNEREUILDER WILL HAVE THE
BURDEN OF PROVING THAT HE 0R SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE.).
❑ I. AS OWNER OF THE PROPERTY. AM EXCLUSIVELY CONTRACTING WITH 110ENSED
CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7044, BUSINESS AND PROFESSIONS COOS: 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:
FOUNDATION:
WATER QUALITY BMP'S
ROUGH GRADE
LINE & GRADE CERT/SETBACKS
ERECTION PADS
FOOTINGS
/b/7ldi/7/------
SLAB ON ( GRADE
FRAMING:
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 ICOMMENCNG WITH SECTION 7000) OF DIVISION 0 OF THE BUSINESS AND PROFESSIONS
CODE. AND MY LICENSE IS IN Full FORCE AND EFFECT.
LICENSE CLASS LID. NO.
INTERIOR & EXTERIOR
INSULATION
DRYWALL
C)—�%co$
SUSPENDED CEILING
DATE CONTRACTOR.. ✓�� %
/ `�
SHOWER LATH
_
WORKERS' COMPENSATION DEL. -A(ION
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'
C PENSATION, AS PROVIDED FOR BY SECTION 3700 OF THE LABOR CODE. FOR THE
PE ORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUE°.
H E AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE. AS REQUIRED BY
EXTERIOR LATH
SCRATCH (PLASTER) (2 DAY)
MASONRY PRE -GROUT
/./7/yG�
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
I5100)OR LESS).
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 ME
PERMIT EXTENSION
WORKERS' COMPENSATION LAWS OF CALIFORNIA. AND AGREE THAT IF 1 SHOULD BECOME
SUBJECT TO THE W'ORKERS'COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR
CODE. I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS.
WARNING. FAILURE TO, SECI'RE WORKERS COMP JISATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYE') TO CRIM'VAL PcNALTIES f ND CIVIL EWES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100.000), IN AJLT.0N TC TH2 COST OFCOMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR ,f002, IN 7 ERES M'D ATTORNEYS FEES
1ST EXP. LETTER
2ND EXP. LETTER
//��
BUILDING FINAL
/%�j
/� '
1 HEREBY AFFIRM CONSTRUCTIONUNDEPENALYOF yL LENDING AGENCYY THAT E IS A CONSTRUCTION LENDING
AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC.YNT,
CIV.C1. , , ,
LEnoER'S NaMEn_n�-' ,
CERTIFICATE OF OCCUPANCY
`
TENANT NAME:
OWNER/ BUILDER AGENT INFORMATION
NAME:
LENDERS M10RF$S,„_„' , ' . L._i
^.CE^.TIFY -.HAT 1 HAVE READ THIS AP: LICATIO.I AND STATE THAT THE ABOVE INFORMATION IS
CORRECT. 1 AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS
RELATING TO BUILDING CONSTRUCTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS CITY
T TER UPON THE ASOVE'MENTIONED PROPERTY FOR INSPECTION PURPOSES.
fiN"'))/!l
ADDRESS:
TYPE OF BUSINESS USE:
DRIVERS LIC. NO.
J
q
'%� „' , /^2 i,
I.N TI IMF nr PFRM,rTE — ATE
Shared Permits Dep\BldgPermit(Back)8/04
City of Newport Beach
Building Department ELECTRICAL Permit No: E2005-1802
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:
Inspector Area: 7 Code Edit: 2004
OF LOT
Owner: HOAG MEMORIAL HOSPITAL
Address: 1 HOAG DR
NEWPORT BEACH CA 92663
Phone: 949/764-4463
Issued Date: 09/29/2005
Processed By:
Suite
Description of Work: ELEC/PKNG CONTROL GATES "DOLPHIN STRUC"
B2005-3071 (PHASE 1)
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:
ASSI SECURITY
18001 COWAN SUITE A
IRVINE CA 92614
949/394-6604
683831
01/31/2006
BT99100104
07131/2006
Inspector Notes:
New Construction
Residential
Multi -Family. 0
1-2 Family: 0
Receptacle/Switch/Outlets
Receptacles/Outlets: 0
$0.00 Fixtures: 0
$0.00 Sep Circuits: 0
Service
0-600V up to 200A: 0 $0.00
0-600V over 200A: 0 $0.00
Over 600V or 1000A: 1 $107.00
Signs
Branch Circuit'
Each Add Circuit:
Time Clocks:
0
0
0
TOTAL: $197.25
FEES
Motors/Transformers (HP/KVA)
$0.00 0 to 1 HP/KW/KVA 4 $16.00
$0.00 1 to 10 HP/KW/KVA: 0 $0.00
$0.00 10 to 50 HP/KW/KVA: 0 $0.00
50 to 100 HP/KW/KVA: 0 $0.00
Over 100 HP/KW/KVA: 0 $0.00
$0.00
$0.00
$0.00
Piggy Back/remp Power. 0 $0.00
Temp Power Pole: 0 $0.00
PAYMENT:
$34.75 BALANCE:
Temp Underground:
Sub Panel:
Record Mgmt Fee:
Plan Check Fee:
Investigation Fee:
Issuance Fee:
Supplemental Fee:
$162.50
0 $0.00
1 $16.00
0 $0.00
0 $0.00
$0.50
$34.75
$0.00
$23.00
$0.00
D CONTRACTORS DECLARATION
eby affirm under penally of perjury that 1 am licensed under provisions of Chapter 9 (commencing with Sectierr7000) of Division 3 of the Business and Professions code,
my license is in full force and effect.
e No: 683831 Class: Date:
Contractor: ASSI SECURITY
WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations:
ave 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
h this permit is issued.
e and will maintain workers' compensation insurance, as required by Section 3700 of the labor code, for the performance of the work far which this permit is issued.
rkers' compensation insurance cam^r and pnlicy rumberis:
ARENDON NATL INS Polies nun•ber:01KR0027405
(This section need not be completed if the perrit is for are h rlrer ro" ars ($100) ar less.
I certify Nat in the performance of the work for which this permh' is 'sued, I shall not employ any person in any manner so as to become sub ect to the workers' compensation
laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 377 - - a•or wile, I s h a "'�^rir�• =N those provisi
Date: ^2 `,-0� Applicant Signature:
Warn g: Fa
($100,000), in addition to toe cast of :ompensrtion,darages as rrovid d frr m Section 370S of the
orkers' compensation coverage is unlawful...rid shad subject an errpl
Expire Date: 02/01/2006
mina •enalties and ciwl fines up to one hundred thousand dal
or code. interest, and , . - - . s fees.
1 hereby acknowledge that I have read ihis application; that the information given is cored; and that my authonzed agent of the owner. I agree t
comply vnth city and state laws regulating construction; and in doing the work authonzed thereby, no person will be employed in violation of the labor code of the , -te of
California relating to workm4tn' ompensaton insurance.
Permittee Name (Print)_
Signature of permittee:
"C`Ac( 1 / Q;1..u- L/l Address:
r2/ QC
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 AFTER ISSUANCE OR
LAST VALID INSPECTION.
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