HomeMy WebLinkAboutF2008-0157 - PermitsCity of Newport Beach
Building Department
PO Box 1768 Newport Beach, Califomia 92658-8915
FIRE COMBO Permit No: F2008-0157
Permit Counter Telephone (949)644-3288
Inspection Requests/Telephone (949)644-3255
Job Address: 1 HOAG DR NB.
Inspector Area: 9(t Z{ks,
OF LOT
Owner:
Address:
Phone:
Applicant:
Address:
Phone:
HOAG MEMORIAL HOSPITAL
500 SUPERIOR AVE STE 300
NEWPORT BEACH CA92663
949-764.4486
SEYED/DETECTION LOGIC
7605 N SAN FERNANDO RD
BURBANK CA 91505
818-683-1552
Code Edit : 2001
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories:
No ofUnits :.
Flood Zone:
Bldg Sprinklers:
VN,SPR
E3
0
0
1
0
N
Description: FIRE ALARM (B2005-1425) Co F . ce t4 1 c R
0887-2008
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:
DETECTION LOGIC INC
7605 N SAN FERNANDO RD
BURBANK CA 91505
818-683-1552
713099
10/31/2009
BT01072507
06/30/2008
Worker's Compensation Insurance
Carrier: NORTH RIVER INS
Policy No: 4086948258 .
Expire: 01/01/2009
Issued Date: 06/11 /2008
Setback- Front:
Rear:
Left:
Right:
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
State Lic:
State Lic:
DETECTION LOGIC
7605 N SAN FERNANDO RD
BURBANK CA 91505
818-683-1552
00
Construction Valuation: $95,995.00
Building Overtime Plan Check :
Plan check Exten Fee:
Building Fire Plan Check Fee:
TOTAL FEE : $1,748.37
$0.00
$0.00
$0.00
FEES
Fire Plan Check Fee :
Fire Permit/Inspection Fee:
Records Management:
Investigation Fee:
Residential Issuance Fee
Plan Check Fee : $131.90
$697.97
$969.40
$81.00
$0.00
$0.00
Counter Review :
Zoning Plan Check Fee:
$0.00
$0.00
$0.00
$0.00
Fee Due at Permit Issuance : $1,616.47
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL :
• •• • •-•
• • • •
• • •• •
• • • •
• ••
•
• • •
• • • •
• • • •
• • •
• • • •
•
• •
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
•PERIM? E=CPtRCS:80 Dr N¢ AFTER ISSUANCE OR LAST VALID INSPECTION
• • • • •• • •
• • • • • • •
• •• •• • • ••• ••
410>
OWNER -BUILDER DECLARATION
1 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 REPAIR ANY STRUCTURE, PRIOR TO ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED
PERMIT EXPIRED
DATE:
BY:
STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LICENSE LAW (CHAPTER 9 (COMMENCING
WITH SEC. 7000) OF DN. 3 OF THE BUSINESS AND PROFESSIONS CODE) OR THAT HE OR SHE IS 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 CIVIL PENALTY OF
NOR MORE THAN FIVE HUNDRED DOLLARS ($500):
PERMIT CANCELLED
TURE
I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL 00 THE WORK, AND THE STRUC-
IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES
TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR
NOT
THROUGH
THE
APPLY
HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE. IF, HOWEVER,
BUILDING OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OF COMPLETION. THE OWNER -BUILDER WILL HAVE THE BURDEN OF PROVING
PERMIT EXTENSION
THAT
•
7044,
BUILDS
HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE.):
I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC.
BUSINESS AND PROFESSIONS CODE: THE CONSTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF THE PROPERTY WHO
OR IMPROVES THEREON, AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(S) LICENSED PURSUANT TO THE CON-
FIRE PROTECTION
PERMIT FINAL
__ 11
"`23 OL)
O LI
�(yd
TRACTORS
•
LICENSE LAW.).
I AM EXEMPT UNDER SEC B. & P.C. FOR THIS REASON
DATE OWNER
FOR OFFICE USE ONLY
LICENSED CONTRACTORS DECLARATION
1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER 9 (COMMENCING WITH SEC. 7000) OF
DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS IN FULL FORCT AND EFFECT.
LICENSE CLASS LICENSE NO.
OATi%C 6 / Ill O$ CONTRACTO$YCGJ rt [: N /_I ' .-
WORKERS' COMPENSATION DECLARATION - l C r
I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS:
I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONENT TO SELF -INSURE FOR WORKERS' COMPENSATION, AS PROVIDED FOR BY SEC 3700
• HE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.
IVE AND WILL MAINTAIN WORKERS COMPENSATION INSURANCE, AS REQUIRED BY SEC 3700 OF THE LABOR CODE. FOR THE PERFORM -
AN ' OF 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, I SHALL NOT EMPLOY ANY PERSON IN ANY
MANNER 50 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, I SHALL FORTHWITH COMPLY WITH THOSE
PROVISIONS.
DATE' APPLICANT:
WARNING: FAILURE TO SECURE WORKFI3s COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CNIL 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 ATTORNEYS FEES.
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'S NAME
• • • •
LENDER'S ADDRESS • • •
•
• • • •
• • • • •
• • • •
• •
I CERTIFY THAT I HAVE READ THIS APPLCATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT, 1 AGREE TO COMPLY WON ALL
AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF
COUNTY TO ENTER UPON THE ABOVE -MENTIONED PROPERTY FOR INSPECTION PURPOSES.
•
PERMITTEE NAME (PRIN •
• •
CITY
THIS
• • •
•
•
•
• •
•
OF PERMITTE DAT
�
• •
•.
/SIGATURE
•
•
•••
• • • •
• • •• •• •
•
j
1/23/07 rev