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Home My WebLink AboutF2002-0421 - PermitsCity of Newport Beach Building Department FIREALRM Permit No: F2002-0421 PO Sox 1768/3300 Newport Blvd., Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288 Inspection RequestsTelephone (949)644-3255 Job Address: 1 HOAG DR Bldg: 1 Inspector Area:j/f Legal Desc.: Owner: Address: Phone: Applicant: Address: Phone: HOAG HOSPITAL 1 HAOG DR NEWPORT BEACH, CA 92663 BRIGGS ELECTRIC INC 16662 MILLIKAN AVE IRVINE CA 92714 949-863-9901 Edit Code: Type of Construction: Occupancy Group: Added /New sq.ft. Bldg : Added /New sq. ft. Garage: No of Stories. : No of Units : 2001 II.1 HR B 3 Floor: 1 Suite: Description of Work: FIRE ALARM T.I.II ST & 3RD FLOORS 2744-2002 Contractor: Address: Phone: Con. State Lic Lic Expire: Bus. Lic.: Lic Exp Date: BRIGGS ELECT 16662 MILLIKAN AVE IRVINE CA 92714 949.863-0901 297836 08/31/2003 GT01013033 12/31/2002 Workers' Compensation Insurance - - Carder US FIDELITY & GUARANTY Policy No: Expire: D123W000029 07101/2003 Issued Date: 12/1212002 Construction Valuation: $5,000.00 Fire Plan Check Fee : Fire Permit! Inspection Fee: Record Management : Issuance Fee : Investigation Fee: $108.00 $110.00 $22.50 $0.00 $0.00 Architect: Address: Phone: Engineer: Address: Phone: State Lic: State Lic: Designer: BRIGGS ELECTRIC INC Address: Phone: Special Conditions: T04 FEES $0.00 $0.00 TOTAL FEE : $240.50 TOTAL PAYMENT : $108.00 TOTAL DUE : $132.50 PROCESSED BY: ZONING AP0ROV AL: FIRE APPROVAL: OTHER DEPARTMENT: PLAN CHECK BY: APPROVAL TO ISSUE: WORT: MUST OE STARTED WITHIN A PERIOD OF 180 DAYS FROM THE DATE OF VALIDATION OR THIS PERMIT BECOMES NULL AND VOID. tyLc) 1- 115 dsI APPEQWILS DATE BY ., COMMENTS aNxeRem DERP C�ARATIQ _ ,- I HEREBY AFFIRM UNDER➢EAALiY OF PERJURY THAT I PIA EXEMPT FROM THE CONTRACTORS LICENSE LAW FOR THE FOLLOING REASON (SEC. 70315, BUSINESS AND PROFESSIONS: CODE: ANY CT' OR COUNTY WHICH REQUIRES A PERMIT TO CONSTRUCT, ALTER, IMPROVE, [WHOOSH, OR REPAIR ANY STRUCTURE PRIOR TO ITS ISSUANCE ALSO REQUIRES THE APPLICANT FOR SUCH •PERMIT TO FILE A O'LIAED'STATEMENT THAT HE ORSHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LICENSE LAW (CHAPTER 3 -COMMENCING WITH SEC 7000) OF OM 3 OF -THE BUSINESS AND PROFESSIONS CODE)) R THAT HE OR SHE 16 EXEMPT THEREFROM AND THE 8A616 FOR THE AUEGED.EKEMPTION ANY NOTATION OF SEC 7031.5 BY ANY APPUCANT FOR A PERMIT SUBJECTS THE APPLICANT TOA CML PENALTY OFNOT MORE TITAN FIVE HUNDRED DOLLARS(0800D: I, AS OWNER Of THE PROPERTY, OR MY EMPL0YRE6 NDTH WAGES AS THEIR SOLE COMPENSATION, WILL 00 THE WORK, AND THE STRUCTURE ISNOT INTEN[EO OROFFERED FOR SALE (SEC 7044. BUSINESS AND PROFESSIONS CODS THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS R IMPROVES THEREON. AND WHO DOES SUCH PARK MPPRROOVPEMENTSEARELNF OTRINTENDED HORIOS FFEREOERFOR SALE P[FO HOWEVERR HONED BUILDINGSUCH R IMPROVEMENT IS SOW WITHIN ONE YEAR OF COMPLETION, THE OVWJERAUILOER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE). I, AS OWNER OF THE PROPERTY. AM EXCLUSIVELY CONTRACTING WITH ,LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7044. BUSINESS AND PROFESSIONS CODE 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 ACONTRACTORIS) LICENSED PURSUANT TO THE CONTRACTORS LICENSE LAW.) TAM EXEMPT UNDER SEC SIP FOR THIS REASON ,,. _ _ FIR PF7biECTION .:iy ;(: UNDERGROUND ROUGH PIPE THRUST BLOCKS EXCAVAT[ON ' P. - - - UNDERGROUND PIPING FLASH - UNDERGROUND HYQI1Kj TEST pY UNDERGROUND/ i�FLOW APRV. r SPRINKLER,HkDRO TEST SPRINKI1€R FLOW TEST 1 SPRINKLER ROUGH PIPE STANDPIPE HYDRO TEST STANDPIPE FLOW TEST STANDPIPE ROUGH PIPE CHEM SYSTEM FUNCTION TEST CHEM SYSTEM APPROVAL DATE OWNER FIRE ALARM SYS/TEIy1 _ / F PERJURY T DECLARATION I HEREBY AFFIRM UNDER NSED OF PERJURY THAT I AM DECLARATION LICENSED PENALTY LLCENSED UNDER'PROVISONS Of CHAPTER 1 (COMMENCING WITH SECTION 7000) OF DI WSION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE'SIN FULL FORCE AND EFFECT. LIC. NO. ' ROUGH WIRING / �N/ (�✓/ UOA- SYSTEM FUNCTION TEST otic,br? kAiDex1t.1...Q'" CENTRAL STATION MONITOR /710 As O ;. .. /yLLCENSECTASS WORKERS' COUPE SATWN DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: 1 NAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO EELFANEURE FOR WORKERS' COMPENSATION, AS PROVIDED FOR BY SECTION 9700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED I HAVE ANN WLL MAINTAIN WORKERS' COMPENSATION INSURANCE. AS REQUIRED BY SECTION 37000F THE LABOR CODE, FOR THE PERFORMANCE [FINE WORK FOR WH[CH THIS PERMIT IS ISSUED, MY WORKERS' COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE / FIRE MISC. TANK REMOVAL _ _ _ TANK INSTALLATION/TEST TANK PIPING PRESSURE TEST MEDICAL GAS PIPING TEST CROSS CONNECTION TEST CARRIER MISC. INSPECTIONS: POLICY NUMBER (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED COLLARS (S100) OR LESSL I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. $ SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS BECOME SUBJECT TO THE WORKERS COMPENSATION LAWSTjf CAUFORNIA, AND E THAT IF I SH ECOME SUBJECT TO THE WORKERS COMPENSATION PROWS/ S SECTION3700 E LAJ30R I SH FORTHWITH COMPLY WITH THOSE ONS NG12 Dt M/PJICANT: 7,,,(((CO - WARNING' AAUP TO SECURE WORKER PENS.TION CM'- T S'IN M¢IIL, AND SHPiI SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND UML F.NELU • ONE HUH 9RED THOUSAND DOLLARS MI00,000), IN ADDITION TO THE COST OF COIIPEII 4TIOA, ARAGES AS YROVIOED FOR IN SECTION 37060F THE LABOR CODE INTEREST, AND ATTO^NE'^y^ F €S ' Y ,. CONSTRUCTION LENDING AGENCY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING I HEREBY AFFIRM UNDER PENALTY AGENCY FOR THE PERFORMANCE C' THE WORK FOR WHICH THIS PERMIT IS ISSUED (6EC3007, GVCA- ,. LENDERSNAME ' LENDER'S ADDRESS I CERTIFY THAT I HAVE REAL THIS APPUCATWN AND STATE THAT TnE ABOV _ INFORM' HON IS CORRECT. I AGREE T• COUNTY ORDINANCES AND STATE LAWS • PLY OATH ALL C R 'ND - - - - BY RELATING TO EUI • • . TRUCTION AN AUTHORIZE REPRESENTATIVES OF THIS '•"�+P�P.RyTY -_--- COUNTY TO- .+' �N EMOVE-MENU POORINSPECTONPtlPPB8E8. (VPERMITTEEy' (PRINH J/ /1 �� .1I FINAL l`T? ,}�1}I�� 1 - l�"1 " L`J'�(�7n f / FICNANIRFR PFRMF/F=F e "yid