HomeMy WebLinkAboutX2008-2315 - PermitsCity of Newport Beach
Building Department COMB Permit No: X2008-2315
PO Box 1768 Newport Beach, California 92658-8915
Permit Counter Telephone (949)644-3288
Combination Type - BLDG/ ELEC/ / /
Inspection RequestsrTelephane (949)644-3255
Job Address: 1 HOAG DR NB
Inspector Area: 7
OF LOT
Project :
Legal Desc.:
Owner: HOAG HOSPITAL FD & C
Address: 500 SUPERIOR AVE #300
NEWPORT BEACH CA 92663
Phone: 949-765-4486
Applicant: PS SERVICES INC
Address: 28250 E GRETTA LN
ANAHEIM CA 92806
Phone: 714-721-9514
Code Edit : 2007
Type of Construction:
Occupancy Group: U
Added /New sq.ft. Bldg: 0
Added /New sq. ft. Garage: 0
No of Stories: 0
No of Units : 0
Bldg Height: 0
Bldg Sprinklers:
Flood Zone:
Issued Date: 12/09/2008
Construction Valuation: $5 500.00
Building Permit Fee:
Plan Check Fee:
Overtime Plan Ck:
Investigatin Fee:
Record Management
Energy Compliance:
CA Seismic Safety :
Disabled Access :
Fee Increase: Fee:
Additional Fee :
Hazardous Mat :
$127.60
$91.87
$0.00
$0.00
$24.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL FEE : $397.8 •
PROCESSED BY:
ZONING APPROVAL: •
GRADING APPROVAL:
••
• •
Description: (3) WALL (1) DIRECTIONAL SIGN
2057-2008 2057-2008
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:
P S SERVICES INC
2820 E GRETTA LANE
ANAHEIM CA 92806
714-721-9462
614676
10/31/2010
BT30017294
10/31/2009
Worker's Compensation Insurance
Carrier: DELOS INSURANCE
Policy No: 01DKRM1203364
Expire: 04/01/2009
Building Setbacks Rear: /
Front: /
Left /
Right: /
Use Zone: PC-38
Parking Spaces: 0
San Dist :
Excise Tax:
NMUSD Fee:
Grading Permit Fee:
Grading PC Fee:
WO Insp. Fee :
Electrical %:
Mechanical %:
Plumbing %:
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FEES
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
State Lic:
YAKOB GHJAN
3336 AQUA DULCE CANYON RD #103
AQUA DULCE CA 91390
661-268-8899 State Lic:C-053791
P S SERVICES INC
2820 E GRETTA LANE
ANAHEIM CA92806
714-721-9462
Special Conditions:
Fire Hazard Zone : N
$0.00 Planning Department-
$0.00 Plan check Fee : $37.50
$0.00 Fair Share : $0.00
SJH Trans : $0.00
$0.00
$0.00
$0.00
$8.93
$0.00
$0.00
• ••
•• • • • • • ••
Public Works Department -
Park Dedication : $0.00
P/W Plan Check : $105.00
Plan Check Fee : $91.87
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
Fire Department
Fire Inspection:
Fire Plan Rev
Demolition Fee
Building Dept Adm
General Service
Refund Deposit
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Fee Due at Permit Issuance : $305.76
Th
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
OWNER -BUILDER DECLARATION
1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LICENSE LAW FOR HE FOLLOWING REASON
(SEC. 7031.5, BUSINESS AND PROFESSIONS CODE: ANY CITY OR COUNTY WHICH REQUIRES A PERMIT TO CONSTRUCT, ALTER, IMPROVE,
PERMIT EXPIRED
DATE:
BY:
DEMOLISH, OR REPAIR ANY STRUCTURE, PRIOR TO ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED
STATEMENT
WITH
ALLEGED
.
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
MORE THAN FIVE HUNDRED DOLLARS ($500): EXEMPTION.5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF
NOR MORE
PERMIT CANCELLED
I,
TURE
NOT
THROUGH
THE
AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL 00 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 AN 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
PERMIT EXTENSION
■
I,
BUSINESS
IMPROVES
THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE.):
AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7044,
AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF THE PROPERTYWHO BUILDS OR
THEREON AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(S) LICENSED PURSUANT TO THE CONTRACTORS
PERMIT FINAL
12: \G'��
■
I AM
LICENSE LAW.).
EXEMPT UNDER SEC , 8.8 P.C. FOR THIS REASON
CERTIFICATE OF OCCUPANCY
DATE OWNER
TENANT NAME
LICENSED CONTRACTORS DECLARATION
1 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.
TYPE OF BUSINESS
LICENSE CLASS LICENSE NO.
XJ( gATE l 1 B b ]XONTRACTOR P S :52w(w - A, uA.
FOR OFFICE USE ONLY
1I't'L.
' WORKERS' COMPENSATION DECLARATION
1 HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS:
I AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, AS PROVIDED FOR BY SEC 3700
LABOR CODE, FOR HE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.
I HAVE NO WILL MAINTAIN WORKERS' COMPENSATION INSURANCE, AS REQUIRED BY SEC 3700 OF THE LABOR CODE, FOR THE PERFORM -
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 WORK FOR WHICH THIS PERMIT IS ISSUED, 1 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, 1 SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS.
DATE; 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, AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
1 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'S NAME
• • • • • 000 •
•
LENDER'S ADDRESS
• • • • • • • •
• • • • •• • • •
•
I CERTIFY THAT I HAVE READ THIS APPLICATION 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
• • • • • • • • • •
•
IS CITY TO ENTER UPON THE ABOVE -MENTIONED PROPERTY FOR INSPECTION PURPOSES.
ITTEE NAME (PRINT) OC.HAI� -N v 0NKC B t ND,A
n
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*NATURE OF PERMITTEE
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CI
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