Loading...
HomeMy WebLinkAbout1 Hoag DrCity of Newport Beach Building Department P.O. Box 1768 Newport Beach, CA 92658-8915 Permit Counter Phone No. (714) 644.3288/3289 I HEREBY AFFIRM UNDER PENALTY OP PERJURY THAT 1 AM EXEMPT FROTH THE COHMCTO0S OCENSE LAW FOR THE FClLOWING REASON (SEC. 1ID15. BUSINESS AND PROFESSIONS CODE: ANY CRY On COJIIIY 1YIIICHI REQUIRES A PERMIT 10 CONSTRUCT. AUER. IMPROVE. DEMCLISH. OR REPAIR ANY STRUCTURE. PFICH 10 ITS ISSUANCE. ALSO REGU.RES THE APPUCPlIT FOR SUCH PERMIT 10 FILE A SGIED STATEMENT HAT Hff 00 SHE IS LICENSED PURSUNIT T011E PIOVISJONS OF DE WN1R4C1005 LICENSE LAW (01AP1E11 9 ICOI.UAENCING WEN SECTIOI ETD) OF OMSION 3 OF THE BUSINESS AND PROFESSIONS CODE) On THAT TIE OR SHE 15 EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMPIKtI ANY VIOLAION OF SECTION 70315 BY MIY APRMJJR FORA PEN.W SIAECLS II IE APPLCAN17D A CIVA PENALTY OF NOT MORE TIAN FIVE HUNDRED OPIATE MOO) ) I i I. ASCYYBNER OF 111E PROPERTY. On MY ERROYCESWmI WAGES AS THEW `A1I'CUM- PENSATIOII. VML 00 THE WOW AND TIE STRUCTURE IS NOT IMINOED OR OFFERED FOR SALE (SEC. 1044. BUSINESS AND PROFESSIONS CODE: THE COINIRACTORS LICENSE LAW CONTRACTOR: ECM NOT APPLY 10 AN O'MEWHO R OF PROPERTY BIRDS On IMPROVES HI EFEC . AND VOO DOES SUET WOOK HD,CFI F OR HERSELF OR THROUGH HIS On HER OWN EMPLOYEES. PROVIDED THAT SUCH IMPFOVEMEMS ARE NOT WENDED On OFFERED FOR SALES. HoW ADDRESS: EVER. THE BUIU::G OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OF COMPLETION. THE OVRNER BUILVER WILL HAVE TIE BURDEN OF PICRIC THAT IE OR sate DID NOT BAD ON IMPROVER-.!11l4E PURPOSE OF SALE) En rin, I� QN][I I . L AS OerEI OF TEE PROPERTY. AIM EXCLUSIVELY OLYIHACTPG WITH Li -CREED CON- STATE �u.A g4.i IRAMDRS TO CONSTRUCT THE PROJEC1 (SEC 704. BUSINESS AND PROFESSIONS CODE: LIC 1�[D ( �!_7P_9^ IIIE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWIER OF A PROPERTY INTO S. L'. -. BUILDS OF1 IMPROVES HEREUL AND WC CO UTACIS FOR SUCH MI0ECIS WRII A IU4 ARCHITECT: R(S) LICENSED PURSUANT TO THE CONIRICTOFIS LICENSE LAW I. p�4EElE! I I AU EXEMPT WIDER SEC. 13 8P C. Fon THIS REASON ADDRESS: AL �7 TMCTO PHONE: BUILDING PERMIT LICENSED CONTRACTORS DECLARATION BLDG: 1 FLOOR: +4 :.. SUITE: OWNER: _-WIAE'9T9ORIAn SOEt'IIaL " ' ADDRESS: t ROAD a: F.D. Ong 610E NEVPDR' EEACE CA C7fcq CCCSL ;HIES K 1E4 i AECEIEALD ATE A ----- — —_ LIC. NO.: ENGINEER: ADDRESS: THEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS POr ROBE S5SIONSCODE. MD I YUCENSE ISNCING WWI ION ROB FORCE A DIVISION OF THE BUSINESS AID LJC. NO.: EICREE CLase—L'_Rf-11F---UC __��-�/1 n _ te#W APPLICANT: DATE �' s=�_�. __ -__- APPLICANT: 'oC>D�T WORKERS' COMPENSATION DECLARATION ADDRESS: I HEREBY AFFIRM UNDERPENALIY OF PEPSJRY ONE OF TIE FOLLOAVG DECLARATONS'. HAVE AND WILSELF-INSUREN A CEMIFICATE OF CONLEN1 TO SELF -INSURE FOR WORK. SIGNATURE OF _I ERB COL.IPENSATON. AS PROVIDED FOR BY SECTION IIW O TIE UBOn CEDE. FOR APPLICANT 1HE PERFORMANCE OF 111E WORK FOR WHICH RAS REFIRE IS ISSUED. _ �DAVE AND WALL MAR! WORKERS COMPENSATION INSURANCE. AS RECOPIED BY SECTION 3E0 OF 1HE LABOR CODE. FOR HIE PERF . MIICE OF THE WON< FOR PERIAT IS SUED. LIT WORKERS' COMPENSAIKYI V3IJRANCE CARDER ADPOLICY NUMBER GAMIER - r,nLIA^P RR: SFC110N NEED W1 BE COAPLLreo TIER41WITISFOR OEHUNDRED DOL- IA115 ,S101ICa LESS). I CUM) Y HAT iN THE PERFORMANCE OF THE WORD( FOR WROI THIS PEEWIT 15 ISSUED I SHALL NOT EMPLOY AM POISON el ANY MANA'EN 50 AS TO BECOME SUB JEST 10 THE WCRKE PS' CLMIPENSA110N LAWS OF CA FORMA AND AGREE TNT IF I SHOULD BECOME SUBJECT 10 THE WORKERS' COMPENSATION PROVISIORSOF SCION 3700 OF THE LABOR CODE. I SHALL FOR 111 Rouni Y WITH THOSE. SPOTS DATE _ - _ __ _. _ _ APRIC WARNING FAILURE TO SECTME WORKERS' COMPENSATION COVERAGE IS 1, AWFU-. AND SAL SUBJECT AN EMPLOYER TO CRIMO)ML PENALTIES AND CTRL ELVES UP 10 ONE HUN- DRED 1110USNND DOLLARS (SIC0.000). PI ADDITION TO TIE COST OF COMPENSATION. RUA AGES AS PROVIDED FOCI W SECTION 3706 OF 11E MOOR CODE. INTEREST. AND ATTORNEYS FEES CONSTRUCTION LENDING AGENCY I HEI EBY AFFIRM UNDER PENALTY OF PEIAJIIY THAT THERE IS A CONSTRUCTION LEND RIG AGENCY FOR THE PERFORMANCE OF 1HE WOW FOR WHICH THIS PEBII.T IS ISSUED (SEC 3717.CN C) LENDERS HAAE____. _ _— -- --- --_ LENDERS ADDRESS_ I CERTIFY THAT I HAVE READ THIS APPLICATXIN AID STATE THAT TIE ABOVE I FO(M- TONLSCORRECT IAGREE IO COMPLY WITH ALL CRY AND COUNTY CIOCNARCES MD STATE TIVES LAWS TILS COCCNDY 10 ENTER ELATING 10 UPON THE MENE-MEM CONS1RUCTION. Nil TONED RAIEHI FCC FCC tN4CIONEREBY AMTIORIZE A Pun. POSES !RUNE CA 91yn4 DESIf5E?. ERGHALD • T^rTrr ri O1Ln. TIT ..... ..... .... . TEE)) Flaal :SOME 11J: _J. t._ '1W :Pr' - °LI.aC.._,EI. FEE .. _ ELEg-72 ._'CS:. 1 .: v'rr^r..Y .•.-t_ c^1Y'T: v_ 6.. _.. �1C L.t J L_..-.. 11 K r_N SEIEKE SAFETY ) II%ED EETIEV FEE 1 R_, i-J DIETS HIT.fs::''1 iLu p. •N ,_VC..?L I1 RUIN FEE 1 'V FIFE DEFT:IESEECnI.P FEE 4 ` ; ^,RATANS:CM: ER OE?'-•� FEE d1•7/Vl . ... .IM..1 J. L. _.II_�. .�R t..: 1:C. (:f eI. yrn ,i!L41i! nr^YIF FEES PHONE: PHONE: NEIVPO RT BUS LC: INSP AREA: Sa0101:1a1 Permit No. B9701150 Inspection Requests Phone No. 714) 644-3255 DESCRIPTION OF WORK: t CONST: TYPE OF •- :•'OCC' COTETIU:T0N. ^ GROUP: • STONES. ADDED I NEN •-:: 3 ADDED 1 NEW 50. FT BLDG. SC,7, SO. FT. GAR. NO. OF USE PARKING UNITS: ZONE: SPACES: REED BLDG FRONT REAR LEFT SEIBACKS LEGAL DESCRIPTION. ?US. LIE LIS iA( 714 Win ailb rt c•,xrs. "won /arr Mai n.,#) -4C. PROCESSED BY: FIRE APPROVAL GRADING APPROVAL 0: '3 or' 't rn n9 1 1 1Q En ' in PI 7 nIn •I'. . u.V RIGHT OTHER DEPARTMENT CHECK PP OVAL • UE Tridit J. r__Ait(: PAID 3 AUG 0 51997 s !U�CITY OF NFYJPOFtT EiCACH 7•i7 .G3` is/2- 97 6:6 47 OSA 4 arts GO? lfax/s 9-Gt' fro,ie! `0D_ J G.vv�a/a&/ 4f 'f.� i u 1 C C. Wrc 19IJ-e )C o;'Newpooa Beach Building Department P.O. Box 1768 Newport Beach, CA 92659-1768 Permit Courier Phone No. (714) 644- 288/3289 INSPECTsON RECO entS 107.0 earxer of tierr cw 0 APPROVALS GROUNDING ELECTRODE UNDERGROUND UNDERSLAB/FLOOR ROUGH CONDUIT WALLS ROUGH WIRING CEILINGS ROUGE: SERVICE TEMP. POWER . UTILITY CO. NOTIFIED FINAL INSPECTOR ELECTRICAL PERMIT JOB ADDRESS: BLDG: FLOOR: SUITE: OWNER: ERG 'EHORIAL HOSPITAL ADDRESS: 1 HUG DR IIEVPORT REACH CA 92638 CONTRACTOR: ?RIM ELECTRIC INC ADDRESS: 16662 HILLIF,AO AVENUE IRYISE CA 92114 STATE 101336 CLASS: C10 LIPR CEO.: �I,_ , r PROCESSED BY: �' EY/�T/ t Electrical Persit Fees = TOTAL 10. OF LIORTIBG ?MUR.ES LICENSED CONTRACTORS DECLARATION INFAMY AFFIRM UNDER PENALTY OF PERNIRY THAT IAA UCENSED UNDER PROVISIONS PFCESSION rC�0 ( MID COMMENCING LICENSE SECTION ULL FORCE ANDFFFECI.N 3 OF INC BUSINESS AND DCEMSECUGB C10 uc ND • 1 291836 DATE it`-7—.CONTRACTOR WORKERS' COMPENSATION DECLAR ION 1 HERESY AITVIM UNDER PENALTY Cc PERJURY ONE OF TI1E FOLLOWING DECLARATIONS: 1 HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF.INSURE FOR 'WORKERS' CLNAPENSATION, AS PROVIDED FOR BY SECTION 3700 OF THE LABOR COMMA THE PERFORMANCE OF THE WORK FOR WHICH THIS FERMI/ IS ISSUED. I HAVE -- AND 00E ICOMPENSATION SECTION 3700 ITILABBORCODE.FOORTHE PEERF OMAINSURANCEF THE WORK R LARIA1AWUA»H E AD PUNT/NHMBOI ARE: CARRIER—_2444c9i-- P)UCY NUMBER - -- Hlr SSE' TTIOONN NNEEF LESS1T BE COMPLETED IF THE PERMIT IS TOR ONE HUNDRED ONOII CERTIFY THAT 114 THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS I5SUFD, I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO IRE WORKERS' COMPENSAI LAWS OF CALIFORNIA, AND AGREE THAT IF I SHOULD BECOME. SUBJECT TO THE COMPEN TION PROVISIONS OF SECTION 37000F THE LABOC CODE. I COM WITH SE PMVISANS. DATES 7.__i_7___ APPUCAIT_ _ — WARNING: FAILURE 70 SECURE WORKERS' COMPENSAT COVERAGE I NLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO UNE HUNDRED THOUSAND FOR IN S C1s10N 37.1 OF LABOR TO THE ST Of OAT OPNO EYl FEES.TES AS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THAT INC WFCA'OAATION GIVEN IS CORPECT. AND THAT I AM THE OWNER, OR DULY ,A TIC/RI/ED AGENT Of THE OWNER. I AGREE TO COMPLY VATH CRY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTNO HORIZED EIN MPOF THE LOYED LIOR CCM OF THE STATE OFF CAFORNI RELATING TWORKMENSCOMPENSATION INSURANCE. SUBTOTAL of electrical fees Is PLAN CHECK FEE required? (1) PERMIT 1SSUIR5 FEE TOTAL ELECTRICAL PERMIT FEES INSP AREA: PHONE: 7111E45-8901 PHONE: 714-R6i-99C1 NEWPORT BUS. LIC.: OCCUPANCY: '10362? Each 10. PLAN CHECK VALIDATION CK. M.O. CASH INSPECTOR'S COPY 9.15 0.00 9.15 26.85 0.00 26.85 DESCRIPTION OF WORK: Fee 16 80 16.80 L20 Y 15.00 Permit No E9601913 In action R-•nests Phone No. 714 6.14-3255 lii HES (2993511) LIGHT STANDARDS (UPPER CAMS) ADDITIONAL IKSPECTION RECORDS rift —aro Pay:ants: Cred t enteeded: Total Credits: 3aiaoce Adjutants Balance dae PAID NPR 0 71997 CITY OF NEWPOR7 BEACH PERMIT VALIDATION CK M.O. LASH Cim of Newport Beach Building Department P.D. Box 1768 Newport Beach, CA 92658-8915 Permit Counter Phone No. (714) 644-3288/3289 BUILDING PERMIT B9702096 Ins • action R : • u0515 Phone No 714 644-3255 OWNER -BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM TIE CONTRACTORS LICENSE LAW FOR THE FOLLOWING REASON (SEC. 70315. ntrAnts5 AND ALTER.PROFESSIONS IMPROVCODE. DEMOLISH. OR REPAIRTAMY STRUCNTY WHICH REInPRCA TO ITS ISSUANCE. ALSRMIT TO O REQUIRES Tiff APPLCl JT FOR SUCH PEPJAR TO FRE A SIGNED STATEMENT TINT HE OR SHE LA LK:ENSED PURSUANT TO TIE PROVISIONS OF THE CONTRACTORS LICENSE LAW :CHAPTER R ICCOMEENCIIIG WIN SECTION 7F.O9 OF ONIS)N 3 OF THE BUSINESS AND PROFESSIONS C.OI.EI OR THAT HE OR SHE 15 EXEMPT THEREFROM AND TILE BASIS FOR THE ALLEGED FJIEMFA CN ANY VIctario I OF SECTION 70315 AY ANY APPUUJR FOR A PERMIT SUBJECTS THE APPtICMJT TO ACML PENNTV OF NOT MORE TIUN FNE HUNDRED DOLLARS IS50011 I. AS OWNER or 111E ANOMIE?. OR MY EMPLOYEES WITH WAGES AS THEIR SOLO CAL PENSATIO'J. WILL 00 THE WORK. AND TILE STRUCTURE IS NOT INTENDED On OFFERED FOR SAYE I SEC 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOFS NOT APPLY TO AN OWNER OF PROPERTY WIIO WILDS 0R IMPROVES TIERED... IND YAK) DOES Sou I WOOK HIM'.FI F DO HERSELF MI THROUGH HIS 00 HER own EMPIOYL E5. PROVIDED THAT SUCH IMPHOVEMENTS ARE NOT INIEIAFD OR OFFERED FOR SALE. IF. I47W. EVER THE CUR DING 0n IMPRCVEken IS SOLD Wm4IN ONE YEAR OF COMPLE1ION. THE OWNETI{UJILDLII WIT HAVE 111E BURDEN OF PROVING THAT HE OR 511E DID NOT WUE On IMPROVE FOR THE WRPOSE OF SALE i I AS OMJEROF THE PP0PEnTY.4M EXCLUSIVELY CONTRACTING WITH UCENSEDIXOK TUCT0n5 TO CONSm0ET THE PROJECT (SEC 7044. BUSINESS MID PROFESSIONS C 0E' Fitt CONTRACTORS LICENSE LAW DOES NOT APPLY To AN OWNER OF A PROPERTY NHO TIDACT01XS) INCENSED PURSUANT TO THE CONTRNO WHO ACTORS CONTRACTSLAW.). WRNA CON D I AM EXEMPT UNDER SEC. ___ . 0.AP.C. FOR THIS RE %SON DATE 4.9-TIE JOB ADDRESS: BLDG: OWNER: ADDRESS: CONTRACTOR: ADDRESS: LICENSED CONTRACTORS DECLARATION !HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROASLY4S OF CHAPTER 91COYIAENCNO WITH SECTION 70001 OF DIVISION 3 OF THE BUSINE 35 MO PROFESSIONS CUM.MCAT LICENSE ISIN FIN. FORCE AND EFFECT. LICENSE CLASS IJO NO G79 Ei I:LDR DATE CONTRACTOR WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS': !HAVE AND WILL MANTAN A 0ER1FISAIE C', CO45FJR TO SELF.NPW SURE F041 WO _ERS COMPENSATION. AS PROVIDED FOR BY SECTION 3700 OF THE LABOR CC OE. FOT THE PERFORMANCE OF THE WORK FOR NIRCI THIS PERMIT LSISSUED. 1 HAVE ND WALL MAOCAN WORKERS COMPENSATION INSURANCE. AS REOL WED BY --SECTION 3793 OF THE LABOR CODE. FUR THE PERFORMANCE OF THE WORK FOR VRICI THIS PERMIT 15155UE0. LW WORKERS COMPENSATION INSURANCE CARRIER AND PCUCI NUMBER ARE: • GAMER POLICY NLABEFL MKS 6EC T PC NOT DE COMPLETED IF THE PERMIT IS FOR ONE HUNDATD DOL GARS IS10D) OR LESS).- . = I CERTIFY THAT IN THE PERFORMANCE OFTHE WORK FOR WHICH THIS PERMIT 15 ISSUED.I.BALL NOT EJAPLOY ANY PERSON N MN MANNER 50 AS TO BECOME SIB JECT TO THE YAMMERS COMPENSATION LAWS LY CALIFORNIA IA AHD AGREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF SECTION 37030E IRE TABOR CODE.' SHALL FORTHWITH COMPLY WITH THOSE PROVI SCOW. DATE APPUCANI, WAINWG: FAILURE TO SECB0E WANLFI.0 COMPENSATION COVERAGE IS UNLAWFUL AND HUN- DREDSHALL SLEMECT AN EMPLOyER CRIMINAL PENALTIES ANO CIVIL THOUSAND OARS 1fll T00.000). IN TO COST OF I OUNES COMPENSATION DAM- AGES AS PROVIDED FOR N SECTION 310E OF 1HE TA00R MOE. I/REPEST. MD ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALI'Y OF PEIWRY THAT THERE IS A CONSTRUCTION LEND 1W AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH T05 PERMIT 15 ISSUED iENT1EFES NAM LENDERS AOOPE55 STATE TIC. NO.: ARCHITECT: ADDRESS: UC. NO.: ENGINEER: ADDRESS: LTC. NO: APPLICANT: ADDRESS: I CERTIFY THAT I HAVE READ TES APPLJCA104 AND STATE TAT INC ABOVE I FORMA. TXYJ LS CORRECT. !AGREE TO MANLY WITH AL C1YNA COHMY OHCNANCES AND SIA1E LAWS RELATING TO BUILDWO OOHS (AUCTION. AND HERESY AUNOFTIZE REPRESENTATIVES 6 THIS COLMY TO ENTER UPON TIE ADOVEa.E.HIDHEO PROPERTY FOR INSPECTION PAR. SIGNATURE OFPERWT1UE • �IjLI; I!K FLOOR: ROE MEMORIAL EC3PITt_ SIRE: EOAG REYOR!AL EOSP T!.I 1 SOLE MR SMOLT n_IEN, CA 92653 DREua/+LJ.: CLASSI 2CRGEARO AL (C-13795) 485C 3ARRM CA (201 NEWPORT BEACH, CI. 925C4 PHONE: E TONE: NEWPORT BUS LTC: PH0Nf PHONE INSP AREA 714" 16.5901 DESCRIPTION OF WORK COAST.: TYPE CF LXN" IPI CTM3N ADDED / :LL1Y 50 FT. Ll DG. PC .F Ulna. 11E07) al DG a-JENCKS IFCAL DESC'.PTKTFI NOS. LIC. L1.7 Yes So 714/552-205: roars440r 5detzte r 7) //6% S?titorw e f G ior-ro - . /u.urt. Ace-- aIC r°e'- /447PC incr. .TiN (I4e p.l i RENT rj!r1141� bi)(11-1) J.Lul :wG: Lll' /1 ADD LIOET BRACKETS T2 E@LP .POETS FOR ILLOM. BCC. NO OF GROUP: STORIES. ADDED / NEW rbb 50 FT. GM. MUSE l PARKIHD c. S SPACES FRONT REAR LEFT HIGHT BURERAKU 1• 4S5G 9ARP.M0). '93 IR INN :A 9250!. PHONE 714/552-2061 BUILDING Feint Fees E ENTER)) Fiaal Project Valuation Regular PLAN CRECE FEES FOILDIUG PERMIT FEE CLEAN-UP DEPOSIT i of MICROFILM Sheets A PERMITS CALIFORNIA SEISMIC SAFETY FES PLANNING:COUNTER REVIEW FEE $127(1) TOTAL !LOG BOILDING PERMIT FEES I LIEv. o .r ftA_.% . «2 -l-L.L iL- LcovE cf1. {o s; bra 016 PROCESSED BY: GRAD APPRO 12000 133.72 151.00 300.00 1.00 2.52 12.00 7 575.24 3275`/ ' EER DEPARTMENT APPROVA TO ISSU Pay eats: 0.00 Credit extended: 0.00 Total Credits: U.00 3alaaco 575.24 Adjcstaents 0.60 Balance due 575.24 PAID JUL 311997 CITY OF NEWPORT BEACH Ao •L A.; 10; a ALL. _ . !;.1"0k A 1 • • El2.15410;.\ t . . SCH64-1., 13;R:1;,NN FOOTING PrIF-CiROU I 4.— INSPEC 110;1S —777, fle .ii,;1; ic-ATH .,•)! • • - — • ...ep 1444 " Fh,o4 EPA etAter fi4kJ cAje— 14tit OS- fit 477,e-r a." "7e--5. liti2-4 i4CIABF • Li P (qa 4° a t Pe PE Or l;.; • V n \J )11D -4?-70 -C.O20101) City of Newport Beach Budding Department P.Q. Box 1768 Newport Beach, CA 926^85915 PermNCouater Phone No. (714) 644-3288t3289 1 HEREBY AFFIRM UNDER PENALTY OF PER.IURY.THAT IMAM EXEMPT FROM THE CONRNCTORS.I aalAF TAW FOR DE FOLLOWERS PERSON A.PENN TO CO NSTRICT. M F. PROFESSIONS COOE: ANYS3W OR COUNTY WHICH MUUMS E ALSO ALTER O1EES FIR I PHUT m AIM STRUCTURE. PSTAMEN,' TINTO ITS �TICCOI%&p.Ei LTCS(OOEI�Ap.q SLCENSED PURSUANT STTICO.7�p003) CT RE OR SHE IS THE �MESO T 3 OFTHE 0 TEE 9F tSSSS A O PROfES40F6 THEREFTICOA Ate THR RASES FOR THE ALLE-GED lwEMPTO t. AW'OCATON EF SECTOR1T03158SY:NY APPLICANT FOR A PEfl1 DCLIARS �SUBJEcCTE111g. Ll L AS. ANCTi OFF TIE PROWERY. OR MPENALTYOF NOT Y EW OYEESORE THAN �YGTH BAST MIS COAL PENTAGON. WV. DO THE ROMAIO THE STRICTURE IS ROT. LATE HIED OR OITEREP FOR SALE (SEC. TTM. BUSNESS MD PNOFESSUIS CORE THE CONTRACTORS I10E CC LAW. COES NOT APPLY TO AN OWNER OF PSOPETTY TWHOCIIDS OR NATIOYES THEREON NO WHD DOES SUCH WORK RASELF OTT HERSELF ORTHROUGH HIS OR HER oYR. EIFWYE S. PROVIDEDHEAT SPX LFICYEEMS ARE NOT WOOED OftORI]QD FOR SUE. F. TOW' • EVER. TIEIBOO BDOR YEROW ATENF IS solo mum ONE TENT OF COMPLETION. TIE IoTPVIREpRDUIDER WILL HAVE TIE BURDEN RDEN OF PROWO THAT HE OR SHE DO POT.RIAD OR "MIS a AASI OF TE PPCAERIY. MA ExW Y(bRA NICINWT O IRMEWED CO,- TMLT3RS TO (XPCTRC! THE PROJECT (SAL TW(. BUESESS AND PROFESSORS cone THE COUORACTONO UGETCE LAW TOES PAN APPLY TO AN OWNER OF A PROPERTY WICBUILDS OR ILITTICHES THEREON. T G S)LOEP,ED Ptfl.W. TO THE CONIPWIC CON.iOM LICDAE LAW). WRiIAIR• ❑ I AY EKEMP.T UNDER SEC. - BAP C. FOR THIS REASON 'AP '. > 'DATE - yI owe eh y.S ••ir BUILDING PERMIT -YYIlr-Y@----mot---`- aLL20:'• -•'FLOOR� � -.. 5'UfTE- OWNEfi: HOICHsnORIlL-fluSPITAL_—.. �_— COt}T ±E '. HoLR�I n01Ili l0SP1UL, -- ` A&onEsa ;.. HOLD Pk PHONE STATE' DRIP ,Tgal CA-9265--711/616-8901 LIC.NO_ a._PIUSrTC-1 '' ARCHITECT: OE8-ELECTRICIL.EBGIYEstS----------`—eus:-de._LI ADDRESS -c--13111-HOULT01-t230 lea._90 LLCM► HILLS C1=91653 P"DNE ---JL4J830,551 SPECOt Cant SOLD 01 FIMAL FOR LIGHTS Pomdt No.• B9603522 .. • n R. • uess Phone No. (714) 644.3255 COAST Otp._LIGa? StaDpD.S(LRYCPjnu1SCP)OPPBR CURDS ._.__ 1\PE SL GROUP�.IES: MOOED 1PEW J so. FL Yl /I 50. FT. RDO: so Fr GAR _.._-_. N0.OF REF. PARKING (RWSmansIDGFRONT zcYE..- PG SPACES.___ ..:. ---. �� - _ RIGHT scram= DESIGRER' - CHECK ENGWEEHI f.�4 LN)ENSEDCDL(IMCTOITS OElX11RATWN .`¢ _ _ - - _ _ -`- - ADDR6SS I HEREBY AFFIMttOER PENALTY OF PEREURY TNT 1 UA LCEt D UNDER POVAONS OF OAPTER0 (MCIEONONG WHIN SEL^IONToWI OF DIVISOR S OF TIE BLLONESS D . . . ,T , - PFIONE POFEESS1016(YOF.NOIYLICER6EtIeN FLL.fOTICE APIIREFFECF. I IEBEnQAFFTiw UNOEFI PFNAi.TY OF'ftiuu IYoNe0F THE FTO��UOWNO AfNF10NLe. _IHAVEAID NTA WILMAN A CE1DINCA OF coNs xFTlLSEIi4a§IFE FOR WORK-. ES CCAPPWSATON AS MOWED FOR BY SECTION 3700 OF THE LC^AR COOS FEET THE PERFORMAN= OFT REWORK FOR WHO( TFbFETRS SSt.E4 1 HAVE ARTWIL Lamm WORV.DS cost :.1nor4 INSURANCE AS REWIRED sr SECTION 3T00 OF TAE LABOR CODE FOR THE P1.BFO(MNNCE OF THE WORK FOR WKCH RCS PEEWIT IS IC'IA.I :14Y WOR(ERT GOIOENEATON CSBWICE CAINK,R ANOPCULY NUTADDIARE:. --.�.,.., POULYRwcY - • .', i. , `' (f1AS SECTION NT3D NOT BE COWLS&A' PEFWTtiiiia ONEammo Oa LAFS(L100)LRLESS).'-- - H CERTIFY THAT N THE PETWO ANC-c CF.THE WOW( FOR l(11 CH THIS PERUT S ISSUED. I SHALL TOT LUNDY ANY PERSON el ANY WRIER S( AS TO a' ORE 96 .ECF TOTE WTFAE1C. COMPENSATION LAWS OF CAIFORM NO ACME TEAT F I SHOULD BEWATI CUNECT TO THE WORKE:S COMPENSATION PROVISIONS OF SE CTION 37O0 OF THE LADDR CODE, I SHALL FCEMNATH COLEY YAM TIME PROW. Mi£ APPIJCl41T: WARI NG:: FAILURE TO SECURE WORKERS COMPENSATION COVERAGE IS UAAWM. AND SHALL SUBJECT AN EMPLOYER TO CYMNAL AONLTES AIO CWL FINES UP TO OPE RAH• BRED 'THOUSAND DOLLARS (FIOO.WO). N MORON 1C THE COST OF COAPDISA1O4. DAAP AFFS SECTIO AS PROVIDED ECM N N OTW L'F RE LIBOR CODE MEREST. ND ATIOREYS F tl4tsIHUCTION LENDING AGENCY I HEREBY AFFIRM ULCER DEALT OF PERARTY THAT THERE IS A CCASTR-CIION LEND- ING ADER.Y FOR THE PE F IANLE OF THE WAR( FOR WHICH IRS PERMIT S LSSUFD LENDERS NNE) to LEADERS ADDRESS ;wore: THAI 1:LAVE READ'RS APPLICATOR AND STATE TENT we ABOVE NFORN- TYNSCORRECT. IAR E TO AMPLY W TH AL CRY NO DENNTY C?ONRIOFS NO STATE LAWS kELATi41(1 TO 131FLEC CONSTRUCTION. MO HEREBY AUTHORITY EPREVES OF THIS COUNTY TO ENTER UPON HE ABOVN.ENlUED-PROFTJHY LIT 38tF4.1RATPUR- POSES /HDofiEss• • _----4850- DAHYAACA.1103 .'.. t EOILDI IG PEuit Pees t ERTER» Final Project Valuation Pegalar PLLN CHECK FEES EOILDIRE PERSIT PER CLSAg-DP DEPOSIT Subtotal EOILDIBC PERIIT PEES Is KICLOPIIAIBG PEE requited! (!) GALIPORRIL SEISRIC SAPPY PEE 1 Is DISABLED REVIEW FEB needed! (Y) PIKE DEPT:PLLO RETIED PEE ! (Y) PIKE DEPT:IRSPECTIOH PEE 1 (Y) PLARkIlc:2091R0 PLAR CHECK PEE 1(Y) TOTAL BLDG EUILDIRC PHUT PEES 111,/552-2061 PROCESSED BY: ZONING APPROV, GRADING APPROVAL 412.55 127.00 1,000.00 2,199.Si -�--�--25.00 26.25 100.00 I 14.51 Y 145.40 Y 50,09, Y - 2,6(0.80— OTHER DEPARTMENT APPROVE.•. TO ISSUE 125000 Papeete: 617.1S Credit Weeded: 0.00 Total Credits: 617.15 Ialaace 2,023.65 Adjutants 0.00 Hahne he 2,023.65 i ' 1�: Ip.. • APPROVALS . - [)ATE 13Y _ _ COMMENTS__.,; FOUNDATION .` -;. r; 3 f�'_97_GUa'i-� .coz .:/-fly: S_ce eewcid dl.I�l�EiFs- ROUCH GRADE _.. .. - 4' /.i) - An'dia,0412>yf,/b`Y/ �/ E44re oxeL. P2��_4 t SCTf3i,Ch.- ... - . - - . -4 7.1O.r%iT ' ai d.�4 tetz,B t ,G'Oett1.4e?� ea_,«-,. f!: rzeyer FOOTINGS .. `1 i«'/ 7 r /,s J2 eaLrit'a Q/AK 9C t :L'."�C C�IG /Ptte%dfr w.��/ 9 If SLAB C�:.^•i�A� DECK SLAB , , , -S_S12 I?,IlY_/E./Y ei- xersi . mot . i'v&c ai36r.! ..O4 Arta: AR 101 e We:44rl a // ('4 Cd' /_� 81� /f&a0:::� SC. '__ SUBFLOOR ofXCfe cig/ in % J=R/Vl_�-/v'at" c .�/�A" /fe bi" RAMIN ROOF C. BURDIFIC; HI 6,.2•92 .GiccGv 4 /Ci%���5_tid ZfT/cDF. .�L EXT. SHEAR :HOLD DO`NNS .. .._ ..__,... CE";: F-AL FRAMING NS;L.,HON ' : _.. f_¢'29_F0447 i/d. rn, ,,!,,t ,- SUSP:L:NDFD CEILING . 1 SIERIt:G_ /d , :kel '`�.7-C.�.tstE__�"G_eit O_r/_(_ %2_c0Afte '9 - I ERIOR LA)Fi I.• decal/ .,fv4 __e/_teit%.- J, c ... ENT-E :FLDR LATH - ... .. r EiCilATCH. !tiiO4':i: . . SONRY: FOO ICI I I . . FINAL If .6 •y.,'�" CEISTIF:CAR OF OCCUPANCY T ENANT NAME. TYPE OF BUSINESS USE: , fic S _10_0�.•5— _.—,[._ RELEASFD � FOR R _ UND ON -_.S_ _ e fri TO:-jO —F�— - - - a..l pc %I . . N / City of Newpnrl Beach Building Department P.O. Box 1768 -- Newport Beach. CA 92659-1768 Permit Counter Phone No. (714) 644-3288/3289 OWNER -BUILDER DECLARATION I HEREBY AFFIRM THAT 1AM EXEMPT FROM 1HE CONTRACTOR'S LICENSE LAW FOR THE TOLLOV.TNG REASON ISEC.1031.5. BUSSNESSANDFROFESSIONSCODE:ANYCmY ORO:TONEY STRUCTURE.HRO TO r51SSUANCCAALSO REQUIRES A PERMIT TO REQUIRES HEAPPLICANT FOR FORS1111ER. IMPROVE. DEMOLISH. RCC11LLP�ERMIT FILE A SIGNED STATEMENT THAT HE 15 LICENSED PURSUANT TO T11E PROV 10PNfS OF NE - CONTRACTORS LICENSE LAW IOIAPTER 9 (COMMENCING Wm1 SECTION 70001 OF DIVISION 30F THE BUSINESS AND PROFESSIONS CODE( OR THAT HE 15 EXEMPT THEREFROM AND THE BASIS FOR THE ALLECED EXEMPTION. ANY VIOLATION OF SECTION 70313 BY ANY APPLI- CANT FORA PERMIT SUBJECTS HE APPLICANT TO A CML PENALTY OF NOT MORE TUN FIVE IIUNDRED DOLLARS 15500.00L1: COMPENSATION. WILL DO HE WORK. AND IIY EMPLOYEES IS HE STRUCTURE ISNOT INTENDED ORTHEIREITI WAGES AS OFFERED FOR SALE ISEC. 7044. BUSINESS AND PROFESSIONS CODE: THE CONTRACTOR'S LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES HEREON. AND WHO DOES SUCH WORK HIMSELF OR THROUGH HIS OWN EMPLOYEES. PROV..EDTHAT SUCII IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE. IF. HOWEVER. HE BUILDING 0R IMPROVEMENT 15 SOW WITHIN ONE YEAR OF COMPLETION. THE C t4R- BUILDER W.LLHAVEIHE BURDEN OF PROVINGTIIAT IiEDIDNOT BUILD OR IMPROVE FORM PURPOSE OF SALE). CI I. A5 OWNER OF THE PROPERTY. AM EXCLUSNELY CONTRACTING WITH LICENSED CON- TRACTORS AND PROFESSIONS CODE: T11E CONTRACTORS LIC NSE1LAWaDOES NOT APPLY OIAN NEOWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON. AND WHO CONTRACTS FOR SUCII PROJECTS LATH A CONTHAC OBIS/ LICENSED PURSUANT TO THE CONTRACTOR'S UCENSE LAWJ. [II AM EXEMPT UNDER SEC, e. N P.C. FOR THIS REASON__ JOB ADDRESS: LICENSED CONTRACTORS DECLARATION 1 HEREBY AT: IRM THAT 1 AM LICENSEE UNDER PROVISIONS of CHAPTER 9ICOMMENONG WITH SECTION 700010F DIVISION 3 O T11E BUSINESS AND PROFESSIONS CODE. AND MY LICENSE IS IN FULL rcecE AND EFFECT. LICENSE CLASS c A-612._---TIC NO CON'RACTOR_{��� !'SH! _ DATE10_ trt O Y 6MPENSATION DECLARATION CERTIFI- CATEI HEREBY Al FIRM OFWORKERS'HACO PENSADONIN5T I HAVE A ULRAVCE.OR ACERTIFlFOCOPY THEREOF IS C33900. ADDRESS: LAB ALLEY FORDS I1S C) BC1055195�,� WY X CERTIFIED con IS HEREBY FURNISHED. CI CERTIFIED COPY IS FILED WITH THE BUILGNG DEPARTMENT. • GRADING:PERMIT- i IOIOOI. LT1�A A"\ height OWNER: 1011-WOHAL 6 PItAL ADDRESS: I SOAR DI 11616-8901 IaIPD %CH ce. s6 `�ve�otKE ''i CONTRACTOR.. Y 16STEI1 P►VI16 COITIABTORS 11C ADDRESS: 2143 S MITLE AYE STE 1 10110111 CA 91016 PHOt4E: STATE 639093 cuss:: A ell .T ARCHITECT: IOIBILIID AL (C013795) ADDRESS: 4850 1*121BC1$203 t IIVIRE 0A 92601 PHONE 711/552-206 LIG.NO.: DESI0IER ENGINEER: ADDRESS: POLICY N0._ DATE_ 1 f/17 AIRICAN` CERTIFICATE OF EXEMPTION FROM COMPENSATION INSURANCE MN/ (THIS SECTION NEED NOT RE COMPLETED 1F THE PERMIT 15 FOR CNE ORED DOLLARS 1$1001 OR LESS) 1 CERTIFY THAT IN TIIE PERFORMANCE JP THE WORK FOR WHICH THIS PERMIT IS ISSUED.' SHALL NOT EMPLOY ANY PERSON IN ANY RUNNER SC AS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA. DATE APPLICANT NOTICE TO APPLICANT: IF. AFTER MAKING THIS CERTIFICATE O EXEMPTION. YOU SHOULD BECOME SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF THE LABOR CODE. YOU MUSTFORDBATICOMPLYV'AINSUCH PROVISIONSORTIIS PERMIT SHALLBEDEEMED ...EVOKED. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM 'HUT WIRE IS A MICE OF TIC WORK FOWH ICHTHIS WICHTHIS PERMTHE PERFORM - MICE IS ISSUED ISEC. 3091. CN.CI.. UC. NO.: GEOTECHNICAL COHSIA TINT: ADDRESS: LENDER'S.NAME IENDERSADORESS 1 CRTUV 1MTI HAVE READTHISAPPLICAT1ON AND STATE THAT THE ABOVE INFORMATION IS CORRECT. 1 AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND S1A1E LAWS RELATING TO BUILDING AND HEREBY AUTHORIZEPRESENTA EWES OF HIS COUNTY TO ENTER UPON THEOASOVEK ENTIONED PRO RTYRFORINSPEC- TION PURPOSES. APPLICANT:. SIGNATURE OF APPLICANT VIBIEI PACIFIC IOC 711 IIIIEILP III 1250 PLACEITIA CA 92870 PHONE aNISIAIO AL 4850 IAIIIICA 1203 IIVIBE Cl 92601 PHONE t 6I1DI10/MLUIL66 Perart $ Valuation of lalroas:mats ----> 611DI16 - tt FILM CAECI PEE tt* (1) BIADIB6 - tt PERM? FEB "tit** (T) PLABBIA6:ZOlI16 PLAT CRICK PEE 1(T) CLE11-11P DEPOSIT > IICROPIIAAIB6 PEE TOTAL 6RIDIIG/DBAIIAGE FERMI! PEES DESCRIPTION OF WORKS Permit No: • a N•aay:;' 09.600389 Inspection Requests Phone No. (714) 644-3255 ioolfill H 51flll (1191c-%) PIIVATE I0ID/PLTI16112(0PPEl CIAPOS) Precise Grebes Petalt TYPE OF PERMIT: NEAREST CROSSSS. DESCP TION: 7111993-3900 714/S52-2061 PROCESSED BY: ZONIN TRAFFIC SUBDIVISION GRADING IAPPROVAL TO ISSUE REVIEW DEPARTMENTS Name 893131 513.75 P 1,021.50 I 1;000.0r' 2,616.26 Payaeats: redit 'gelded: Total Credits: 954.61 0.00 954.61 INSPEC ONS DATE BY , COMMENTS ` � I 1— X PREGRADEMEETING • 'P y�:'- '/7 ,: �c `.... GRADING INSPECTION‘ - -' . ,. . /'. J7- l % ai I _/�l/S/ 'Z .1" Pt a/W- feW ;' ROUGH GRADE APPROVAL PREPAYING MEETING CURB AND GUTTER r-- PAVEMENT SUBGRADE i .. ,. , , ll.. .,.r- - .. .._ AGGREGATE BASE _ FL.?T1/20ou I _ ------- — STORM DRAIN 1 l - .. -' � CATCH BASIN i y.. --,- _ .. ..:!.• ' I _ _ -- — - i EROSION roNraoL _ . OTHER r —1 _ PFCCISEGRADING INSPECTION a �____ . - . -- DOCUMENTS .. ... _. - _ -i -... ... - r1 :G7 %d 1. -� ' FINAL 4 - - - RECEIVED BY F1RM CERTIFICATE TYPE - JNAME OF ENGR: ¢� f, iO KA --- Lfifil6 H(is e`��T. '_rN�1eyRe_%'%fiG iP — - [ti% Y—__::-. ::._. 1— ;,•lr J - I s-4000__ FOR REFUNQ ON ro: rv_r A:I,,rtt^Stv1nr.•-ra:',,,,cp.er'7¢i6^'i.Y'tt:re:PYn3* City of Newport Beach Building Department P.O. Box 1768 Newport Beach, CA 92658-8915 Permit Counter Phone No. (714) 644-3288/3289 INSPECTION RECO1Were 02Of ELECTRICAL PERMIT. JOB INSP ADDRESS: 1 111111 AREA: APPROVALS DATE INSPECTOR BLDG: - FLOOR: Sl11TE: OWNER: _ __--- soft II1011AL IOSPRl. ADDRESS: 1ROB 9I ISIlOIT iRICI CI 9280 n+o+E c«mmoroa: ISICILICTIIC rnu ADDRESS: - 10 101 43029 LOS MCILMS Cl 9004f PHONE: _ 7144 i3-1370 A 013046 cuss: C10 SIT insists PROCESSED BY: OCCUPANCY: GROUNDING ELECTRODE UNDERGROUND UNDERSLAB .' FLOOR -. ROUGH CONDUIT WALLS ROUGH WIRING CEILINGS ROUGH SERVICE TEMP. POWER UTILITY CO. NOTIFIED FINAL LICENSED CONTRACTORS DECLARATION ; • I HEREBY NFOW UNDER Paulo OF PERJURY THAT I NA MEWED UNDER PEOVSKMS OF CHAPTER 9 (CCIAMENCING WON SECTION TOUR OF 01WSION D THE BUSINESS AM PROFESS/OM: COO€. AMU MT LICENSE SIN TTAL FLAKE AND EFPPFCT. . U:ENSE y��ryIU11_ LIGNO DAZE /y'" - w WORKERS' COMPENSATION DECLARATION • 1 HEREBY AFFIRM LACER PENALIY OF PENURYOW 04111E FOLLOWING OELlNN1gN5: 1 HAVE AND WILL NNNTMN A CERTIFICATE OF CONSENT TO SELi•INSUPE FOR WORKERS' COMPENSATION.AS PROVIDED FOR RV SECTION 3T00 OF THE LABOR CODE FOP TIE PERFORMANCE OF THE WOPK roo YAOCN 11S PERM LSSSLED. _f>2._ MINE A1131via MAMTAN WORKERS' COMPE1CA1IO11SCSI RMICF' AS IEOUI ED BY SECTION! 3703 OF TIE LABOR CODE FOR THE PERFORMANCE OF THE WORK FOR VMICN no PER/II IS ISSUED. AW 0.1 s' OMPE E TIN INSURU CARRIER AND POLICY NUMBER ARE: ecl CARRIER VS104020100 ISSUED. I SHALL NOl .MPL SUBJECT TO THEat' COMPENSAI IF tgD BECOME OME SUBJECT TO THE SEC1 o°EWE LABOR COOS. I MMRyyAfAT� PR / ENS. DATE %YARNING: RUMPS TO SECURE WALKERS' COMPENSATION COVERAGE IS UAAWFlIL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAl1ES ANCVL FO tS UP TOME HU.OIEO THOUSAND ORRW IS°AAS PRY/ICED FOR SECTION 310 OFTHE COST OF ORNEY'S F POLICY NUMBER amnia,. LION. NEED NOT BE COMPLETES' IF 1HE PERMIT IS FOR ONE HUNDRED OR LESS) 1 CERTIFY THAT N INC PERFORMANCE OF 111E WORK FOR W1tCH THIS TERMIT IS OY ANY PE " to ROLAAI:_NEfl SO AS T E OME AND AGRETHAT I HEREBY ApQgMEDGE nNT 1 HAVE READ TIES APR/CANON. LINT TIIE UFOIENTION GRIN 15 CORRECT. AND TINT IAMTIE OWNER OR DLLY AUDIOR 2FD AGENT OF TIE owMER I A(IEE TO COMPLY WIm CRY AND 51A1E LAWS REClA1N0 CONSTRUCTION AND PI BORE' CIEAUTHONIL BERAPLOYEDRIZED DM OF THE TABOR CODEa5A�C OELATOWCf*UENS COMPENSATION ir WE .-. NAME �Tfl OF PERMITTIEE ADORES AN) 3ntp(T4 cam, 41/7-71 t ilectricp !esp. power pcle reit Pees t SOITOTAL of electrical fees HIl1! ISSOIl6 PIE TOTAL ILICTOICAL P61UIT PIES (Rev. 497) CK. DESCRIPTION OF WORK Permit No. E9800701 Inspection Requests Phone No (714) r to ps5 11011111 10111(111011%) ILIC/t67P POVII POLE ._ _.__--___.ADOmONAL INSPECTION RECORDS 11.00 c2.\\ M.O. CASH tee 18.00 18.00 18.00 36.00 taped:: Credit ettesded: Total Credits: lalasce Adjutants lattice dae 0.00 0.00 0.00 36.00 0.00 36.00 PAID APR 17 1998 CITY OF NEWPORT BEACH PERMIT VALIDATION CK. M.O. CASH PLAN CHECK VALIDATION INSPECTOR'S COPY City of Newport Beach Building Department P.O. Box 1768 Newport Beach, CA 92658-8915 Permit Counter Phone No. (714) 644-3288/3289 OWNER -BUILDER DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LICENSE LAW FOR TIE FOaowluc REASON ISEC. 70315. BUSHES$ MO P IIOFESSIONS CODE: ANY OT: GR COUNTY WHYN REWIRES A PETWIT TO COTISTPIfl. ALTER. IMPROVE, DEMOI ISII.OR REPAIR MY STRUCTURE. PRIOR ID ITS ISSUANCE. AL50 REOUTYES THE AWRICMIT FOR 5U01 PERWT TO FLE A SIGNED STATEMENT 11NT TIE OR SHE 15IICENSE0 PURSUMn TOTE RCL1SICNS OF THE CGVIRACTORS LICENSE IAW ICHAPTER 9 1COLWIE-NCMG YATII SECTION 1000) OF DM5101i 3 DF TE B'JSHIESS AND NCFE55XxS COOEI OR TIWT HE OR 541E IS EXEMPT THEREFROM MID T11E RA515 FOR THE MLEGEO EXEMPTION ANY NATATION OF SECTION 70315 BY MIY ANSIGVJT FOR A PER.9T SUBJECTS RIEAROCANT TO ACNE PENALTY OF 101 MORE TWN FNEHmOREDDOLLARS 0SECI I 1_1 1. ASCOTEROF TE PROPERTY.00 MY ELUEOYEESYATHwAGEs ASTTEIR SOTS LOLL PENSATO14 WIS 00111E WORN MO 111E STRUCTURE 15 NOT MTENDED OR OFFEIIED fOR SALE (SEC. 1044. BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT MAY 10 M1 OW'1ER GF PROPERTY WHO BLADS OR PAPROVES T£REON. MO MMODOESSUOiWORKHMLKELFORHERKMFOORTROVGHNGORLIERCMILOOLOYEED P ROVIDED 111A1 SUCH A.VIOVEMENTS ARE 10T WTENDEDOR DFTERED FOR SATE. A.10W- EVER THE BUILDING OR IMPROVEMENT IS SOLD W1TH:N ONE YEAR OF COMPLETIOt1 THE OTTER BIRDER VALL HAVE THE OURDEN OF PROVING THAT 1E OP Siff Om JOT MAIDOR ANf10VE FORTE PUUOSE OF SALE ), Li 1. ASO.YNEROF TIE PROPERTY. AM EXCLUSWAY CONTOACTING WITH 110ENSED COIF T ACTOR510 COYSTOCT THE PROJECT (SEC 70Al. BUSINESS MID 0 OLTSSO1I5 COCE: TILE CO RRACILWS LICENSE LAW DOES ROT APPLY TO AN OWNER OF A PROPERTY WlO 11W05 OIJ 1:114130VE5 lITEREOIL MO YMO CONTRACTS FOR SUCH PROJECTS LV1TH A CCAi TRACTOR(SI LICENSED PURSUMIT TO THE CONTRACTORS 10E115E LAW ) lT 1 ALI EXEMPT UNDER SEC. BEPC. FOR THIS REASON DATE_... _-- - -OWNER UCENSED CONTRACTORS DECLARATION I HEREBY APTIR M UNDER PENALTY OF PERJURY THAT 1 AM LCEILSED UNDER PROASOIS OF CHAPTER 9 (COMMENCING WITH SECTION 7000 OF DWISION 3Of THE BUSINESS M0 PIOPE 55CNS CODE. AND LAYLICENSE IS IN FULL FORCE AND EFFECT OCUISE CLASS �_F Ir __ _LIC NO DATE _A�%�0��_ __ CONTRACTOR•i/it WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PENURY ONECF INE F01OVM0 DECLAPAluls: I NAVE AND WALMAWTAN A CERWICATE OF CONSENT 1O SELF.INSI:.E FO0 WOPW -- ERS CCSWENSAIONAS PIOWDEDFOR BYSECT1IJ3TODFTHE LAB!WCODE FOR �MtHE PERFOWJMICEOFTHE WONKFO0IAMCH*05 PE1V TISISLIEB. I LAVE O WILL I.WIITAIN W'OPo(ERS COLWENSATON INSURANCE. IS RFOURED BY —_1NU0 THISPERMIT NPE IS ISSUED. WOR(ERS COMPEIISATION IOR NSURANCECARR• MOPOLCY IMJBER ABE CARItER REPUBLIC INDEMNITY POLICY NURSER_ 01032906 U4i5 ECRONORLIESm0NOTDE Cp.1AESEDIFTHEPENATISFORONEI PORED00) __ SE !CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERLIIT IS - ISSUCEL I S1 W L NOT EW') OY MIY PERSON PI MIY MAIlIER SO AS TO BECOME 5UD JECTTOTIff YNILCERS C($311(I3ATION LAWS DF CALIFORNW MOAGREELNA W1 SHOULD BECOLIE SUNECT T THE WORKERS' COUPENSATION Pi1PVIBQN OF SECTION 33WOF TIFF LM1UL ORC 15L FORWAIIH DATE:^j------' • A'2- 4 App.. • 4t JOB ADDRESS: BLDG: OWNER: ADDRESS: WARNING FAILURE TC 'SECURE W'OMERS C01JPENSANON COVERAGE IS UNLAWFUL MO SHALL SUBJECT AN EMPLOYER TO CRLUUAL PENALTIES N0 CIVL FINES UP 10 ONE TAN' SHED THOUSAND DOLLARS ISI00.000). W ADDITION TO THE COST OF COMPENSATION DAM- AGES A5 PROVIDED FOR N SECTION 3706 OF THE LABOR CODE INTEREST. MO ATTORNEYS FEES CONTRACTOR: CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERAURY THAT THERE IS A CONSTRUCTION LEND- ING AGENCY FOR THE PERFOIRUNGE OF THE WORK FOR MUCH T1S PER IT IS ISSUED (SEC. 309T. CW.C) LENDERS NAME LENDERS ADDRESS ADDRESS: STATE LTC. NO: ARCHITECT: ADDRESS: LIC. No.: ENGINEER: ADDRESS: LIC. NO.: APPLICANT: ADDRESS: F3UILDING PERMIT FLOOR: SUITE. HOAG HOSPITAL 301 NEVPORT BLVD NEVP08T BEACH, CA 92658 p)IONE: UNIT CONSTRUCTION 6 MAINTENAAC 17000 MARQUARDT STREET CERRITOS CA 90101 PHONE: 215506 CLASS: A NEWPORT ROBES-BANNELMAR E1C(4821050tlt5 Lt. 17000 MARQUARDT AVE CERRITOS, CA 90703 DESIGNER PHONE: PHONE: TAILOR 4 ASSOC(RICHAEL MCLANE) 2220 UNIVERSITY DR 1200 NEWPORT PEACE CA 92660 PHONE: INSP AREA DESCRIPTION OF WORK: CONST.: TYPEOF CONSTRUCTION: ABED U NEW _.. -. SG. FT. BLDG: NO. OF USE UNITS: ZONE REGTBA FRONT SECKS 310/404-8433 oe il.D0N 970303 BUS. LIC. LIFT Yes No 562/101-6565 714/S74-1325 SPECIAL CONDITIONS: PROCESSED BY: Permit No B9801567 Inspection Requests Phone No. (714) 644-3255 LIIII POLE (158i-91) ADD RELOCATE EXPO LION? POLE ON LOVER CARPUS GCC. NO. OF GROUP: STORIES ADDED / NEW 50 FT. GAR. PARKING SPACES'. REAR LEFT RIGHT 0 O 0 z 0 z w >- 2a 00 m OTHER DEPARTMENT w Q a 0 N t O W s LO < _ O J Payeeats 0.00 $ Credit extended: 0.00 Total Credits: 0.00 0 1 Balance 155,83 0 Adjesteents 0.00 Balance doe 155.83 0 m PLAN CHECK BY SIGNATURE OF APPLICANT • GRADING APPROVAL APPROVAL TO ISSUE 1 CERTIFY 11UT 1 HAVE READ 11LS APRICATION MO STATE THAT NNE AB VE 1FORIAA- TxA1IS CORRECT.I AGREE TOCOAPLY WITH All Ott MO COUNTY ORDINANCES AND STATE TAWSREUMPKITOMALIATKICONSIMCDON.ANDREREBYAURCERZEREPRESENTADVES OF Tw5 CCUITY TO EMER U'ON THE ASOVE-UENTIOfEO PROPERTY F01 NSPECMIN PUN POSES• uts r CoaaritAtt ao7 /M. MA2a'JEO PERMRTEENMAE(PRW) • 5%'NANRE OF PER.OIEE 'b11TiJ1RU?eisl!1 3 ENTER>) Final Project Valuation Regular PLAN CHECK FEES BUILDING PERMIT FEE CLEAN-UP DEPOSIT 1 of MICROFILM Sheets 1 PERMITS CALIFORNIA SEISMIC SAFETY FEE > PLARN1NG:0001TER P.EVIEM FEE 1121(Y) TOTAL BLDG BitILDIAG PERMIT PEES .25 2 11,93 24.90 100.00 .50 .50 12.00 Y 155.83 800 0 0 O w Mkt Z ►9u DA PAID MAY 2 21998 CITY OF NEWPORT BEACH APPROVALS DATE BY L jMit r; PC CB BUSINESS USE: MINA COME FOR F.E•-U !C CM f_7.Oc7G_ - - Cv✓Ltd—c DEPOSIT RELEASED 51J 1 0 1 City of Newport Beach Bullring Department P.O. Box 1768 Newport Beach, CA 92358-8915 Permit Counter Phone No. (714) 644-328813289 INSPECTION RECORD�%t4Y/, / %A c— 2z- APPROVALS GROUNDING ELECTRODE UNDERGROUND UNDERSLAB/FLOOR ROUGH CONDUIT WALLS ROUGH WIRING CEILINGS ROUGH SERVICE TEMP. POWER UTILITY CO. NOTIFIED FINAL DATE INSPECTOR LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERALW IUAT INA L+CENSED UNDER PROMSIOIIS OF CHAPTER 91COLIYENCING WITH SECTION TW% OF DIVISION J OF THE BUSINESS AND PROFESSIONS CODE. NA FAY LICENSE IS IN FIRE FORCE AND EFFECT. UCENSE CLASS A DC NO. DATE a9� WORKERS'COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOISOVAIIG DECLARATIONS: I HAVE AND WILL MNNTAR+ A CERTIFICATE OF CONSENT TO SELF.INSURE FOR m :CA IRE COMPENSATION OF PROVIDED FOR BW1 I SECTION RPEPWTS IISSSUELABOR _ HAVE AND WILL MANTAIN WORMERS' COMPENSATION DSUTANCE. AS REQUIRED BY SECTION 3700 O. THE LABOR CODE. FOR THE PERFORMANCE OF THE WOI1K FOR THIGH THIS PERMIT IS LIED. MYWORKERS' COMPENSATOR CE BIER ANDPOOCYUUMBERAIE ELECTRICAL PERMIT JOB ADDRESS: BUDS: FLOOR: SUITE OWNER: ROAD HOSPITAL ADDRESS:..._. CONTRACTOR CONTRACTOR ADDRESS: CARRIER 81032906 POLICY NUMBER UFOS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 01001 OR LESS) I CERTIFY THAT IN THE PERFORMANCE OF THE WOW( FOR WHICH 11115 PERI N IS ISSUED. I SHALL NOT EMPLOY ANY PERSON IN ANY MARINER 50 AS TO B ME SUBJECT TO TIE WORKERS' COMPENSATION LAWS, OF CALIFORNIA ID THAT IF •Ut13 0NBECOME s CT TOCODE.. ITS _ TAPE 1 .Ls IONS of DATE S- If_L Z ic» �/. %++"�ITn� WARNING FAILURE 10 SECURE E1S' COMPENSATION COVERAGE S UNLAWFUL AND SHALL SUBJECT AN EMPLOYER 10 CRIMINAL PENALTIES AND CML EWES LW TOONE HUNDRED PROVIDED 'ORI 51 K�1]106 OFF Vi THE LABOTON R CCWOE. IINNTERST. ANDAIIOOIP11EYSFEES AS I HEREBY AC)O10.VTEDGE THAT I HAVE READ NUS APPLICATION. RAT THE INFORMATION R.EN IS CORRECT. N10 THAT I AM TILE OWNER OR ILLY AUTHORIZED AGENT OF THE OWNER. 1 AGREE 10 COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTOR AND IN DOING THE WOFIK AUTHORIZED NS CODE OF TSTATE OF CALIFORNIA RELATING TO WORKMEN'S COMPENSATION INSUMMCE. STATE 21 LTC NO: PROCESSED BY- PENMITTEE MIc a. -Act_ - M/1' NAME PRINT J///r/T / PTUTIE ERWTTEE �1 DATEA__or4,qt VY1PFCs PHONE UNIT CONSTRUCTION A KAINTERANC 17000 MARQUARDT STREET CERRITOS CA 90701 PHONE 310/804-8433 CLASS: A W O".TBUS 970303 r AAn._4 QCCUPANCY: * Electrical Penh Pees ! TOTAL H0. 0P LIGHTING PIITURES SUBTOTAL of electrical fees PERMIT ISSUING PEE TOTAL ELECTRICAL PERMIT PERS (Rev. 4/97) PLAN CHECK VALIDATION INSPECTOR'S COPY Each Ho. 1 DESCRIPTION OF WORK Fee .85 .Is 18.00 18.85 Permit No. E9800917 • Inspection Requests Phone No (714) 644-3255 E1,1CI11111 POLE (B101S61) ELECJLIGHT POLE LOVER CAMPOS ADDITIONAL INSPECTION RECORDS Paytents: Credit extended: Total Credits: Ialaece Adjastuents Ialaece due 3.00 0,00 0.00 18.85 0.00 18.85 PAID MAY 2 21998 M.O.3 gc` ' CITY OF NEWPORT BEACF CKCASH PERMIT VALIDATI 7N CK. M.O. CASH O O 0 z 00 0 0 w m CC 2 u . s 0 ZO 0 0 O W O 0 IB 1- E 41 LL 0 :R 0 0 w 0. Q Z H 3 0 ul CC cc W m 5 3 1 City of Newport Beach Building Department P.O. Box 1768 Newport Beach, CA 92658-8915 Permit Counter Phone No. (714) 644-3288/3289 / /,‘Ae/n- (Cf1ir ' c',e.PJ .�/�� .VIP yrc j ai ft'//enX INSPECTION RECORL#- o-bvor JOB APPROVALS GROUNDING ELECTRODE UNDERGROUND UNDERSLAR / FLOOR ROUGH CONDUIT WALLS ROUGH WIRING CEILINGS ROUGH SERVICE TEMP. POWER UTILITY CO. NOTIFIED FINAL DATE DDRESS: . °u$ BLDG: OWNER: ADDRESS: INSPECTOR LICENSED CONTRACTORS DECLARATION !HEREBY *EMMA UNDER PENALTY OF PERTURY THAT INA LICENSED UNDER PNOV51aN5 OF CHAPTER 91COMUENCING WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS COOS. AND MY LICENSE S IN FULL FORCE AID EFFECT. LICENSE CLASS [%jpp- A LIG. NO F�/CFLyL372 4 DATEp_a7[ 3Oti CONiRUCIOR f�`-+�-'G1. .�s .W. /VRKERS' COMPENSATION DECLARATI/ON !HEREBY AIFIIA UNDER PENALTY OF PERVRY Ohl OF THE FOLLC644G DEaNUTIIS' _ 1 HAVE AND IVILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION. AS PROVIDED FOR BY SECTION a700 OF THE LABOR CODE roil THE PERFORMANCE OF THE WOW FOR %WIILFI 7H5 PERMIT 1565UED. SECTION 37000 IND of MAINTAIN LABOR COOS. FOUR COMPENSATION O E OFT E %YORK AS REOUIRED OR WDICII THIS PERMIT IS ISSUED. MY WORKERS" COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE: GRJRER CARE ARE COMP PO0CYMAINER C000260103 HIS SE TIOONNEED NOT OE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED 1 CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I SHALL Nor EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA. AND AGREE BRAT F I SHOULD INCOME SUOJECT 7011IE WORMERS' L1COMPENSATION PROVISIONS OF DATES✓N • V¢LABOR CODE MPLICAe If {�L�F9/ W2L.�� Remot5 WARNINGFAILURE TO SECURE IY0RIER5' COMPENSATION COVERAGE IS UNLAWTUL. AND SHALL SUBJECT AL EMPLOYER TO CRIIAINAL PENALTIES AND CIVIL EWES UP TO ONE HUNDRED THOUSAND DOLLAR.ISIIN.0.YA. W ADOITICW TO THE COST OF COMPENSATION. L WAGES AS PROVIDED FOR IN SECTION 37060E DIE LIBOR COOS. INTEREST. AND ATTORNEY'S FEES. 1 HEREBY ACKNOWLEDGE THAT I HAVE READ TILLS APPLICATION. THAT THE INFON.UT104 GIVEN IS CORRECT. AID THAI 1 AM DIE OWNER OR DULY AUTHORIZEDAGENT OF THE OWNER 1 AGREE 1O COMPLY WTDl CITY AND STATE LAWS REGULATING CONSTRUCTION AID IN DOING THE WORK AUTHORIZED THEREBY. NO PERSONYAIL BE EMPLOYED IN VIOLATION OF THE LABOR COOS OF DIE STATE OF CAIFOWU RELATING TO WORKMEN'S COMPENSATION INSURANCE. PMITIEE NAME (P 0J1) SIGNATURE G PERVIP AIYY.F55 �n//T//AT J .PouoIc� .11Ir -/I CA.W ` DAi� S1 Roy. 4/97) ELECTRICAL PERMIT 1 ILIAC D8 FLOOR: SUITE: HOAO MEMORIAL HOSPITAL 1 HOAG DR NEWPORT BEACH CA 92660 PECK/JOKES CONSTRUCTION COEPOR 10866 WILSHIRE BLPD-11H FLOOR LOS ANGEELLBES CA.90024 .NET . 310/538-2037 STATE INSP AREA' . 503224 B A CONTRACTOR: ADDRESS: PHONE: BUS. LIC_ 9702(494 FROCESSEE BY: //J/ OCCUPANCY: DESCRIPTION OF WORK Permit No. E9800405 Inspection Requests Phone No. (714) 644-3255 IBDEICIODID PIP110(89800116) 9NDBRGR0UID ELEC AND COMMUNICATION LINES ADDITIONAL INSPECTION RECORDS * Blectricaf Permit Pees * Each No. ENTER Misc. other iteas 45.00 3 SUBTOTAL of electrical fees PERMIT ISSUING PEE TOTAL ELECTRICAL PERMIT PEES PLAN CHECK VALIDATION CK M.O. CASH INSPECTOR'S COPY Pee 135.00 3 RR IRSP 135.00 S.00 140.00 Payients: Credit extended: Total Credits: Balance Adjastnents Balance dee 0.00 0.00 0.00 140.00 0.00 140.00 PAID MAR 0 5 i998 CRY OF NEWPORT BEACH PERMIT VALIDATION CK. M.O. CASH WORK MUST BE STARTED WITHIN A PERIOD OF 160 DAYS FROM THE DATE OF VALIDATION OR THIS PERMIT BECOMES NULL AND VOID. SIGNATURE OF PETL.IITTE ADDRESS d City of Newport Beach _-- - - - - Building Department P.O. Box 1768 Newport Beach. CA 92658-0915 Permit Counter Phone No. (714) 644-3288/3289 INSPECTION RECOH9 / 2?S4 yfi, .1" ' o•con,C Da,. cm. Lined, i�o/sro< 0#4t re..3, APPROVALS SOIL PIPE GROUND SEWER WATER PIPE GROUND GAS PIPE GROUND PLUMBING ROUGH GAS PIPE ROUGH WATER HEATER GAS. PRES. TEST GAS CO. NOTIFIED PLUMBING FINAL JOB ADDRESS: DATE INSPECTOR LICENSED CONTRACTORS DEC TIOLILRA N OF CHAPTER HEREBY AFFIRM COMfNIING WITH SECTION 0700W OFPENALTY OF PERFURY TI MI OMSIQ 4 3 OFOTH�E UNDER AAND PROFESSIONS CODE. ND MY LICENSE S N FIILL FORCE AND EFFECT. IICENSE CIAS/5q (� A LC. NO. m _ DATE- ✓/ J% % CORACTOR _i25° )2J0&e5 WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PEMIRY ONE OF THE FOLLOSWD DECLARATIONS. HAVE AND TALL AWIRAN A CERTIFICATE OF CONSENT TO SETFNSL:E FOR WORT(. ENS COMPENSATION A5 PROVIDED FOR BY SECTION 37000F THE IAROR CCOE. FOR THE PERFORMMECE OF THE WORK FOR WHICH MIS PERWT L5155UED. _ I HAVE AND l'.4L AWETNN WORKERS COMPENSATION UESURAJ CE. AS REQUIRED BY WHICTIONCH THIS KRAUT700 OF HIS ISSUED MCODE. Y WORKERS' COIFOR WE E.IPEN iDN PSURN:CANCE OF THE EOCARRER AND POLICY NUMBER ARE: CARRIER CARE-A,TE-COMP POLIOI'NUMBER C060264103— (1N15 SECTION NEED NUT BE COMPLETED I= THE PERWT IS FOR ONE HUNDRED DOL. LABS ISIN) 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 RUNNER SO A5 TO BECOME SUB- JECT TO THE WORKERS COMPENSATION LAWS OF CAUFOFUOA ND AGREE THAT IF 1 SECTION 37000E THE LABOR CODE. I SHALL F NTH SHOULD BECOME SUBJECT TO THE WORKERS' COMPENSAT PROVISO HS •F WITH F-1/I. S k15 DATES 5/ 3/9 F_S -----APPLICANT: D ,-)-- WARTENG FAILUT.E TO SECURE WORKERS' COMPENSATION COVERAGE (5 UATAWFLIL AND SHALL SUBJECT AN EMPLOYER TO CR/URAL PENALTIES AND CIVIL EWES UP TO ONE KINDRED THOUSAND 00ILAR5 (51030001. IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS PROVIDED FOR PI SECTION 37060E 111E LABOR CODE, INTEREST. AND ATTORNEYS FEES. 111.REBY ACKNOWLEDGE THAT I HAVE READ 1} S APR !CATION. THAT THE INU'OPo.UT'rw GI EJI I3 CORRECT; AND THAT I AM THE 0.1TEER C1 DULY AUltAAva; MIENT OF THE OAT/Di I AGREE 10 COMPLY NTTH CRY AND STATE LAWS REGULATING AND THE 140IM AU}O LTED THEREBY. HD PEPSON WILL BE EMPLOYED TIONOFONw=U IO CCOE Of THE STATE OF IF M TO WORWIENS COL TTONO PERMRTEEHW.141PRNT). O ?`� GATE 3/%% BLLW: OWNER ADDRESS: CONTRACTOR: ADDRESS: PLUMBING PERMIT 1 DOAG 01 FLOOR: SUITE: NOAG MlMORIAL HOSPITAL - -- - 1 NOAG DR - NENPORT BEACR CA 92660 PECK/BORES CONSTRUCTION CORFOR 10866 WILSHIRE BLVD 118 FLOOR - STATE - HASmu CA 90024 PHONE: °` fD- - 503224 A - R e«+* 9024942031 PROCESSED BY: A B05 "C- - - 9/024494 OCCUPANCY: PHONE: INSP AREA: L Plumbing Petit Pees * Each ENTER Misc. other hens 45.00 SUBTOTAL of phobias fees PERMIT ISSUING FEE TOTAL PLUMBING PERMIT FEES No. 3 DESCRIPTION OF WORK: Pemlil No. P9800316 Inspection Requests Phone No. (714) 644-3255 V OEIGUOID PIPIBO(P1100211) 010E16100ND CULLER PIPING TO RLDG ONLY ADDITIONAL INSPECTION RECORDS Pee 135.00 3 OR INSP 135.00 5.00 140.00 a. PAO mkt 0 5 7998 Cir'OF vEWPQRTBEAC H 7 -9;73 Payments: Credit extended: Total Credits: Balance Adjustments Balance due 0.00 0.00 0.00 140.00 0.00 140.00 City of Newport Beach Building Department P.O. Box 1768 Newport Beach, CA 92658-8915 Permit Counter Phone No. (714) 644-3288/3289 INSPECTION RECORD/ O273 JOB DDRESS: 3/1%/ /uac /A�/A ` -rJ lv /4J AV, APPROVALS DATE INSPECTOR SOIL PIPE GROUND SEWER WATER PIPE GROUND GAS PIPE GROUND PLUMBING ROUGH GAS PIPE ROUGH WATER HEATER GAS. PRES. TEST GAS CO. NOTIFIED PLUMBING FINAL", 2,„ //��", UCENSSD CO ACTORS DECLARATION I HEREBY AFRRMI INNER PENALTY OF PERJURY THAT I AM LICENSE) INNER PFHDVISIOS OF CHAPTER 9 (COM/AEMCING WITH SECT KIN 7090J OF DIVISION 3 OF THE BUSINESS MID PROFESSIONS CODE. ANC MrvIJCENSE IS IN FULL FORCE AND EFFECT. LICENSE .AASS 1 A LIC NO 503224 DATE L 2-' gr-4T " V COMPACTOR • WORKERS' COMPENSATION DECLARATIN N HEREBY AFFIRM INNER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: ___I HAVE AND W'KL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FUR WORK. ERS COMPENSAIKIN. AS PROVIDED FOR BY SECTION 3703 OF THE LABOR CODE. FOR THE PERFORMANCE OF THE WORK FORMNICH THIS PEIWJT IS ISSUED. I HAVE AND WILL MAINTAIN WO/:ERS COMPENSATION BSURANCE. AS REQUIRED BY SECTION 3700 OF THE TABOR CODE. FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WORKERS COMPENSATION INSURANCE GAMER MN POLICY NUMBER ARE CARRIER CARE ARE COUP W,MBER 0000260103 POLICY (THIS SECTION NEED NOT BE COMPETED IF THE PERIM IS FOR ONE HONORED 004 ✓uRSIS100)O1 LESS). I CERTIFY THAT IN TIE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I SHALL NOT ELIPLOY ANY PERSON IN ANY MANNER 50 AS TC BECOME SUB- JECT 10 THE WORKERS COMPENSATION LAWS OF CADFONM& AND AGREE THAT IF I SHOULD 3700BECOME 13SUBJECTR TO THE H LL F WORKERS'Al N PROVISIONS OF SIE«CNON 3n7W OF THE TABOR CODE.191ALL FORTM\ EM1!�PROW. DATE: • ^• ��• nPwcANr. WARNING- FAILURE TO SECURE \•.VRKERSCOMPENMTKKI COVERAGE IS UNLAWFUL. AND SHALL SIS,ECT AN EMPLOYER TO CRUMNAL PEWV TES AND CNK FINES UP TOONE MP.NDILD THOUSAND DOE NAPS IS1120.D001. IN ADDITION TO TIHL COST OF CCOAPEN5Al10N. DAMAGES AS PROVIDED FOR IN SECTOR 3706 OF THE LABOR CODE, INTEREST. AND ATTORNEYS FEES. I HEREBY ACKNOTTEDGE THAT I HAVE READ THIS APFLYARON. THAT THE INFORMATION! GIVER S C WU ECT. AND TEAT I AM TIME OWNER OP DULY AImgRIZED AGENT OF THE OM ER I AGREE TO COMPLY WITH Cm AND STATE LAWS REGULATING CONSTRUCTION; ATM IN DOING 11€1147/N( AUTHORIZED THEREBY. NO PERSON W1L BE EMPLOYED IN VglATIOJ OFTHELABOR COME OF THE STATE OF CALIFORNIA RELA TO V701710. COI. EffNISATO,IyN LL'�^• PERMITTEE (NAME WAND SIGNATURE OF PERAII OM'E " •44 •�V PLUMBING PERMIT I 1011 ll BLDG: FLOOR: SUITE: OWNER: EOIG KEHOIIAL HOSPITAL ADDRESS: 1 HOAG BR IEIPOIT MUCH CA 92660 PHONE: CONTRACTOR: PECK/JOKES CONSTRUCTION CORPSE ADDRESS: 10866 VILSHIRE BLTD 7TH FLOOR LOS IIG5LES Cl 90024 PHONE 310/538-2037 503224 CI -ASS: B A NEWPORT 91024496 BUS UC: PROCESSED BY: OCCUPANCY: t ?lambing Permit Pees * Sack later piping 3.50 — SUBTOTAL of pleebieg fees Is PLII CHEC[ FEB replete (Y) PERGIT ISSUING PEE TOTAL PLUMING REMIT PEES INSP AREA DESCR!PION OF WORK: Permit No. P98G'213 Inspection Requests Phone No. (714) 644-3255 OI1l1610019 PIPII6(341-9B) UIDEIGI001B CHILLS! PIPING TO ILDG GILT ADDITIONAL INSPECTION RECORDS lo. Pee 1 3.50 3.50 .88 I 18.00 5c6 22.38 Payments: Credit extended: Total Credits: Balance Adjestment: Balance die 0.00 0.00 0.00 22.38 0.00 22.3E PAID FEB 2 31998 CITY OF NN_E_WPORT BEACH ) WORK MUST BE STARTED WITHIN A PERIOD OF 180 DAYS FROM THE DATE OF VALIDATION OR THIS PERMIT BECOMES NULL AND VOID. INSPECTOR'S COPY City of Newport Beach Budding Department P.O. Box 1768 Newport Beech, CA 92658-8915 Permit Counter Phone No. (714) 644-3288/3289 INSPECTION RECORI,,aQ/F' ADDRESS: ELECTRICAL PERMIT 1 (MOGI INSP AREA f /erg-----. BLDG: FLOOR: SUITE: s� owe c.n.;f�O .&#ip her ehgrA9igt HOe6ROSPITu 3y JCfun s ur.&e„�, ADDRESS: 1 BOAC DR 3 r �� / REPORT IEICB CA PHONE: 714/646-8901 o CAS O✓,rim CONTRACTOR:HIT COISTRCCTI01 1 RAIITEIAIC ? toy /� ✓ �/ ADDRESS; 17000 1ARQOAROT STREET APPROVALS DATE INSPECTOR CERRITOS CA 90701 PHONE: 310/404-8433 GROUNDING ELECTRODE / e7TNo_ .-.. 275506 �CLASS: A NEWPORT 016804 UNDERGROUND .'� PROCESSED BY: ' I✓ OCCUPANCY: UNDERSLAB/FLOOR • .• • _ t Electrical Permit Pees * Each ROUGH CONDUIT WALLS SERVICES- 0 to 600V over 200A 3730 ROUGH WIRING CEILINGS, - /-_.. Rotors / Transformers (EP / CIA) --- ROUGH SERVICE 'T .- y U 7f _ _ over 1 np to 10 7.50 TEMP. POWER."- i Saupanels 11.00 i;4.; LICENSED CONTRACTORS DECLARATION . I HEREBY AFFIRM UNDERPENALTY OF PFTLXII Y TNT I AM LICENSED UNDER ,PPOVISIIONS OF CHAPTER P I�COOpMMVIO MENCWITH SECTION T00II O()MOON S OF THE eUGINE&S AND c O MOFESSIOa(dW MY Lx JRE IS N FULL FORCE NC EPFECT'-• . ucENsfuws" 1 'joieC. :!275(06. TOTAL ELECTRICAL PERIIT PEES onre`jt 'r! -S $ camvcia`i t:'.'`.rc C.•tscscucrieu WORKERSI COMPENSATION DECLARATION ,: I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE CIF THE FCLI.OWNG DECLARATIONS: I HAVE. MO WILL'MNNTNN A CERTIFICATE OF'CONSENT TO SELF -INSURE FOR — WORKERS' COMPENSATIONAS PROVIDED FOR BY SECTION 3700 OF THE LABOR CODE FOR THE PERFORMANE OF THE WORK FOR WMOI T.IIS HERMIT IS ISSUED. I HAVE MO WILL MAIM'. MI WORKERS' COMPENSAIIOII JW W10E,A5 REQUIRED BY SECTION 3700 OF THE TABOR CODE. FFO.RtriTHE PERFORMANCE OF THE WORK FOR YMOANDPOUCSWMOVI,IIE: ICEVILUIY iILYOEILLII TION INSURANCE CARRIER µ0 1TWS PERMIT AIIE: SOBTOTAL of electrical fees Is PL11 CBECR PEE regeiredl (T) PERRI? ISS0II6 PEE ----------------------------------- CARRIER POLICY NUMOEN NI(1 S SECTIONN NNEEEE DD NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED woolI CERTIFY THAI IN THE PERFORMANCE OF THE WORK FOR WHI THIS PERMIT 15 ISSUED, 1 SHALL NOT EMPLOY ANY PERSON IN ANY MAN S AS To BECOME SUBJECT TO TICE WARMS'-• '•.. ION LAWS OF LA. AND AGREE THAT P I SHOULD BECOME SUBJECT TO • J' TI0N PROVISIONS OF SEGIIOII3I00 OFFTTHE LADE IIOR CO. I N! COM' ' PROVISIONS. DATE I-142.1,s N'RYW1T WARNING' FNLURE TO SECURE •'' COM" SOON • •E IS UNLAWFUL AND !WALL SUBJECT AN EM1yPLOYER TO CIO PE IESµDR O• L FINES UP TO ONE HUMMED USANDPLARSLDS IN COST COMPENSATION. PROWL FOR RIN SLCMIN 3 OF THE LABOR • INTEREST. MOATTORNEYS FFEUES. SES AS —01032916-- I HERESY ACKNOWLEDGE TNT I HAVE HEAD DAS APRIDAIICN. THAT TIE NFORIMTION GNEN IS CORRECT. AND TNT I MI THE OWNER. OR DULY AUTHORED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE. LAWS REGULATING CONSFTIUCTION AND N DOING THE OF171 VIOULTION OF THE LABOR CODEFTTHE STATE F CMWORMA RELATINGTHORIZED THERFJ3Y, NO T0 WORKMEN'S WILL BE EMPLOYEDCOMPENSATION INSSUOWNCE NTE(PRW ATI SIGNATURE OF PERLOTIEF. (Roy. 4497) uEr COC.v Fo 1l PLAN CHECK VALIDATION CK. M.O. CASH INSPECTOR'S COPY Payments: Credit extended: Total Credits: Balance Adjutants Balance dae 0.00 0.00 0.00 150.63 150.63- 0.00 DESCRIPTION OF WORK Pee 37.50 60.00 11.00 108.50 27.13 T 15.00 150.63 PemlitENo. 9100168 Inspuction Requests Phone No. (714) 644-3255 6111111111E (19100110) ELEC/SOLDER TREAT1l? siS(CAS Pr E)(I5O) ' ADDITIONAL INSPECTION RECORDS .____ ._.__ JAN 2 6 1998 CITY OF NEWPORT BEACH PERMIT VALIDATION • City of Newport Beach Building Department P.O. Box 1768 Newport Beach, CA 92658-8915 Permit Counter Phone No. (714) 644-3288/3289 / ilc. % /a• 98 • W/W27sr-cw door odor" Ato• lecorinse Fr/,Ai ?ds/.trn az. 1S'r7Ml::P7 an'av sir Gnat-ti - *0 4rC sve,e 3 V /t,, dthozablk cola inns- "Nra - INSPECTION RECORDF3rcn V ,7 ADDRESS: APPROVALS DATE INSPECTOR SOIL PIPE GROUND SEWER WATER PIPE GROUND GAS PIPE GROUND PLUMBING .ROUGH GAS PIPE ROUGH WATER HEATER GAS.PRES.TEST GAS CO. NOTIFIED PLUMBING. FINAL Y7 LICENSED CO CTORSTION OFIHEREBY CHAPTER 9 (COMRM MEENNCING WITH SECTION 700011 O Iv NALTY OF PERJURY SIGN OLICENSAF THETHUNDER PROVISIONS PROFESSIONS CODE. MOIST UCERSE IS IN FULL FORCE AND EFFE UCENSE CLASS a UC. NO. DATE e_ gN� 9 ti CCNTRACTO WORKERS' COMPENSATION D I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OFTHE FOAOWING DECLARATIONS: I HAVE AND WILL MAJNTNN A CERTIFICATE OF CONSENT TO SELFINSURE FOR WORK. EERS COMPENSATION. AS PROVIDED FOR BY SECTION 3700 OF THE LABOR CODE. FOR '.TYRE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I HAVE AND WILL MNNTAW WORKERS COMPENSATION INSURANCE. AS REQUIRED BY SECTION 0700 OF THE LABOR COOS. FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY WORKERS COMPENSATION INSURANCE CARRIER AND POLICY NUMBER Me CMRIER POLICY NUMBER RBPQILIC-IIDBNIITT 01032906 (THIS SEC CTCTCONNNEED NOT DE COMPLETE' IF THE PERMON IT 15 FOR E HUNDRED VAS I CERTIFY THAT IN THE PERFORMMCE OF THE WORK FOR WHICH THIS PER ISSUED. I SHALL NOT EMPLOY ANY PERSON Si ANY NA AS TO BE JECT TO THE WORKERS COMPENSATION LAWS OF ORNIA AND AG SHOULD BECOME SUBJECT TO THE WORKERS' C ENSATION SECTION 3700 OF THE LABOR COTE I SHALL COMPLY -4G�9 DAT E S WARNING: FAILURE TO SECURE WORKERS' COM SHALL SUBJECT AN EMPLOYER TO CRIMINAL THOUSAND DOLLARS 5100.000J. IN AOOTION TO PROVIDED FOR IN SEJTW OF THE LABOR IT IS SUB MT IF NS OF PROW. T TION RAGE IUNLAWFUL NM SAND • FINE SUPTOOIEMJNDRED COST . - .. PENSATKTN. DAMAGES M E. INTEREST. AND ATTORNEYS FEES. I HEREBY ACKNOWLEDGE THAT 1 HAVE READ TINS APPLICATION: THAT THE INFORMATION GIVEN IS CORRECT: AND THAT I AM THE OWNER OR CULY AUnxIRID:D AGENT Cr THE OWNER. I WORSE TO COMPLY WITH CRY AND STATE LAWS REGULATING CONSTRUCTOR AND IN DOING THE WADI( AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF CAUFORMA REIATINO TO CAMPENSA DATE .a Y7 PERMRTEE NAME (PRINT) SIGNATURE OFPERMRTEE ADDRESS BLDG: OWNER: ADDRESS: CONTRACTOR: ADDRESS: PLUMBING PERMIT I Rd Ill FLOOR: HOAG HOSPITAL 301.IBVPORT BLVD HBVPORT BEACH CI 92658 01It COISTROCTI01 A HIIBTBVAIC 17000 KI180A1DT STREET STATE CERIITOS CA 90701 LICJIC 275506 LASS: PROCESSED BY: INSP AREA: SUITE: PHONE: PHONE: NEt•POBBR:: 970303 OCCUPANCY: 310/404-8433 DESCRIPTION OF WORK: • Permit No. P9800477 Inspection Requests Phone No. (714) 644.3255 P1J01/10EPB1 tltllt(19100310) PLR SIII,GIS PIPII0,BCRPLV,P-TWWP,8511 ADDITIONAL INSPECTION RECORDS * Plubial Pe mit Pees * Floor silk Gas - per system op to 4 odlets Raniflov device - up to 2' dial. P-trap House sever SOITOTAL of pluakiaa fees Is PLAT CHECK FEB required! (T) PBRIIT ISSOIIG PBS TOTAL PLUIIIIG PERRI? PEES Back 7.00 3.50 8.00 7.00 18.00 lo. Pee 1 7.00 1 3.50 1 8.00 7.00 1 18.00 43.50 10.88 T 18.00 72.38 PAir APR 0 6 1998 crN of ISIPoar 13EG" Payaeats: Credit ezteaded: Total Credits: laluce Idjestaeats Saline due d } 0.00 11 0,00 0.00 72.38 0.00 72.38 6 LL LL 0 O y 0 6 � a 1 W1 Ha l m 3 3 INSPECTOR'S COPY OWNEREWILDER DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE CONTRACTORS LICENSE LAW FOR THE FOLLOWING REASON (SEC.. MS B`JSBIE55 ANO PROFESSIONS COOE: ANY CRY DR COUNTY NRp1 REQUIRES A PE tb CONSTRUCT. ALTEREMgq R I& WROVE. OIS/l OR REPAIR ANY Ti1lICRRI�• PRgS ISSUANCE. ALSO REWIRES 1/E APPLICANT FOR SUIGN PEna T TO FRE A SIGNED STATEMENT THAT IT IN SHE ISI�PUSUANTTOi/E PFOVGIOSOF THE CONTRACTORS LICETNSE LAW ,PIER B 1OR THAT HE OR SHE S EXEMPT THEFIEF MOM AND THE BASIS FOR THE ALLEGED `�." \'•' " E> f10tL ANY VIOLATION OF SECTION77F0]IS BY ANY NT FORA .i1WT ADDRESS: APPllU1NT TOA LIVLPENALTY OFIXi EMPLOYEESYARiW ASTfE7i COI CCQµ- •:�: • •..r.. _ aYfEii of THE PROPERTY. City of Newport Beach Building Department P.O. Box 1768 Newport Beach, CA 92658-8915 Permit Counter Phone No. (714) 6443288/3289 JOB ADDRESS: • BUILDING PERMIT 1. .101111 �(pCw4 BLOC: FLOOR' KY IFTW SECTION 70301 OF DIVISION 3 OF TIE BUSINESS MO'PIIOFE590N5 OWNER: < APPaniw T Sl9L. LIlS DORMS SA�SEC. 701t1 DO TIT WOW 014 eeusinzs AND RPM' ROFEESSSIONS WOE: TSTRUCRME ISHE CONTMINIFACTTORRS U D OR OFFERED LAW OOESNOT•APPLY TO M OWNER OF PROPERTY NW) H1a DOOR &PROVES THEREON. AND WHO I ES -SUCH WORT( HIMSELF OR•ERSII$ ORTHROUGH WSORHER OYM FLTOYEES. PROVIDED THAT SUCH YWRCVEMENIS ARE NOT INTENDED OR OFFERED FOR SATE W. HOW- EVER THE BUILDING OR IMPROVEMENT Is $OLD WRIIN ONE YEAR OFCOMP_ETION: THE ONNERa(mDER VAL HAVE THE BURDEN OF P90WpNG MATTE OR EHE DO NOT BUILD OR 1. AFOR THE PURPOSE OF SALE). .. c S comp OF THE PROPERTY AM EXCLUSWELYGO TR ACTING W1M LICENSED COM TRACTORS TO CONSTRUCT THE PROJECT SEC.•7DN4, BU9HESS AND PPOFES$gNS CODE: THE TCONTRACTORS LICENSE LAW DOES NOT APPLY.TO AN ET flip'. OF A PROPERTY WHO BUILDS OR IMPROVES THEREON. AND WHO CONTRACTS YORSl1Oi PROJECTS WITH A CONS TRACTOR'S) UCENSED PURSUANT TOME CONTRACTORS LICENSE LAW.). 0 I AM EXEMPrUNDER SELL. -n ,- ? B.AP.C. FOR THISREASON S ... .. .t L DATE OWNER Cra LId SE'D CONTRACTORS`nFCL#RATIPN_'!il; '•a. • I LQEa) I1M UNDER PENALTY OF -PERJURY THAT 1 AM LTCm%n 1 W OEn PRD.VISICN5 OF CHAPTER 9 COLAFENCINO VAIN SECTICN7000i CF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND MY L-'FNEC IS N FU! FORCE AND EFFECT. LX•EH<F CLASS L 275506 HQII IOSP1t1IL•• l01 000101 IWPO1Y ISICI CI 926Sa SUITE Y PHONE CONTRACTOR_ Alt COISTIDCtI01_E.11IiTBWc ADDnEss:' 11000 oath stint; - ' 'CBIIItOS CL 90701 PHONE: STA. -c 2155ii6;" -' CLASS "1 ;" . NEWPORT ._ BUS. LIC.: ARciirTEBY ' 101I5/111181111/1L01 - ADDRESS: • LIC. NO.•- ENGINEER: ADDRESS: LIC. NO.: DATE-. I ' 6• 99 , • C«:PI/PGA�ei�� 2 e.tzt:lRc a T: WORKERS' COMPENSATION DECLARATIONI ADDRESS: • IIERESY AFFBWL UNDER PENALTY OFAERAMYONEOFF THE FOLLON WG oFimaLTions: �... . I HAVE ANITwo. MAINTAIN AkCERIIFICATEOFPCONdFM TO SELFASURE FOR WORK- fG. ERS.COMPENSITON. AS PROVIDED FOR BY 3700 OF THE LABOR EWE. FOR C1l!EPERFORMANCE OFTHEWq(VC FDRWtILPttnes usre ED. N.. • 1 HAVE AND WILL AWNTAN WORKERS CQAWENSATION INSURANCE. AS REWIRED BY SECTION 3700 OFTIELABOR CODE FOR THE PERFORMANCE OF THE WORK FOR WHICH TONS PERMIT IS ISSUED. MY WORKERS COMPENSATION INSURANCE CAWVER AND POLICY NUMBER ARE: CARRIER rv; •, IBPOILIC-IID61IIT1 SIGNATURE OF - APPLICANT outs SECTION NEED NOT IE zlLTdtikJT IF 1i1E,PE UMT ISIORONE HUNDRED 0/1,LARS(ST00) OR IF55). 1 CERTIFY THAT N THE PERFORMANCE OF THE WORK FOR WHICH 1N15 PERMIT 15 ISSUED. I SHALL NOT EMPLOY ANY PERSON W ANY OWNER SO AS TO BE.. - A; JECT TO SHOULD p COME SUBJECTEC• O THE WORKERDCW LAWS S' COMA P'PEENNSATIION PRNI OF , SECTION 37OG OF THE LIBOR CODE I SHALL FOR COMPLY i . PROVI- SUM- waif :•b—ZG-1e. WPLICMD: _ -�•_ - . WARNING: FAKDRE TO SECURE WORKERS COAWEN6giION • - GE UNLAWFUL AND SHALL SUBJECT AN <_:TAPLOYER TO CR'MNAO PENAL S AND VIL FINE • UP TO ONE HUN- DRED ASTHOUSAND �DIFOR W SE'CBON3706 F THL IN E LABN OO THE COST R CODE. 'MEREST. AND COMPENSATION. FEES. -=•CONSit1llCRON LENDING AGENCY�;:�� INC ACES FOR THE PEAFFIRM RFORMANCE OF POFERIURY RK TFOR�WHICH THISSPPERNAUR IISISSUED (SEC. 3097.OV. C.). LENDERS RAMS LENDERS ADDRESS CUMFY INFORM - TON IS CORRECT.' Mawr TO COMPLY WITH ALL CRYYAND CCOREAD DT APPIXADON AND A TOFO AND STATE LAWS RELATING TO BUILDING CONSTRUCTION. AND HEREBY AUTHORIZE REPRESENTATIVES OF .IRS COUNTY TO ENTER UPON THE ABOVE -MENTIONED PROPERLY FOR INSPECTION PUR- POSES. u C•' 1 -a"-2g DATE 110_001llQDLDDt.L1L . 66DIItOS CI 90703 PHONE: DBSTOIBP .; PHONE: 71741.1 15sofr(IICILBL 4140 2220.01Ital5ITT DI nib': ]1�POlT HICK CY926 T. CI? I dil Petit Pees; • BIt82» Piial Project lalutiol leplar PLII CBBCI FBI; - 101III10 PIi1I7 P6B.•. Is a CL611-111, DEPOSIT regliied! (t)j' PHONE: INSP AREA: 714/646-8901 00z; 390/606-8433 016804 10S. LIC. LIS' -Yes to 310/404-656S 114/574-1325 DESCRIPTION OF WORK: Permit No. - „ZY>1 .,, �9700390 _: '`& Inspection Requests Phone No. t714) 644-3255 111111 !EMI! 111(151.11) CONS..: 0T1 SILPII T161T1Bit S1St81 (11S PLI11)(i150) TYPE OF -. - OCC. NO. OF CONSTRUCTION... • . ' • GROUP. STORIES. ADDED I NEW • • • ': ADDED / NEW :A.IXi: _FT. BLSO. FT. GAR: NO OF • . - �`'.. , USE PARKING 19 _ ` • \`; 2CWE: SPACES: RE�� . FRON- REAR LEFT RIGHT SETBACKS . LEGAL DESCRIPTION: E«Tn«I5 1}oca ©ni — see. t es)m act.Mrc... — 4wd&ccg,a 3 trait s PROCESSED BY: ZONIN APP .. • OTHER DEPARTMENT FIRE 7 APPROVN. GRADING APPROVAL PLAN CHECK BY APPROVA TO ISSUE V1• Sl61otil CIP IOILDIID Psl1It P6sS" Is 1ICIOFILzIl0 FEB regsired? (T) CILIPOIIIL SBISIIC SIPS FIB ) II211DOOS 11t. foto prcreisial? (t) -?IIB-DBPi:PLll iB/IBIi�PII-? '(Y) PIIB DBPt:IISPBC7I0I III ? (T) PLIIIIIQ:20111S PL61 CBECI PIE ?(1) TOTE CIP IOILDIIO Ps11It PBBS • 50000 269.43 416.50 400.00 1 1,083.13 10.00 1 10.50 15.00 T S3.89 1 82.90 1 1,284.78 Pawed) Credit Welded: Total Credits: Ialaace Adjutants Ialasce die ci 0 0 z z w 0 cc cr m 1- 0 N N=- O z 0 cc O 0 0.00 0.00 0.00 1,284.78 1,284.78- 0.00 JAN 2 6 1998 CITY OF NEWPORT BEACH a. cc z O 1C cn cr INSPECTOR'S COPY t fan' - - . APPROVALS DATE FOUNDATION: BY FOOTINGS - SLAB ON GRADE DECK SLAB COMMENTS IV"- ievitgaterAve- ii4M.c_401fit era 7 -a= AP age want 7P dowifie_fl4zuc kiyedism _ atailere,f, as, -Vire_ tildriardiret; Are_. _ igp 41/70- i_e_z stediA -<'Is gentatravz. ARAVI _ __tedreit_a_resle44.•CCorar e eenlike ,ed_r -A 41D+ ' FRAMING. SUSFLOCH I - ROOF S. B'JILDING ,-IT RVT SHEAR HOLD DOVMS ;Cr 40" assacrthogy pur_mincs- 9re__42Greir ee GENERAL FRAMING .. . 7", at Iebtartatfr . t "AC. Scaelf#C79Ate en.... r Jono" Agior a - — arilA;ic5/ sr-eimar ,5”. Aar a sea thaw, core n6.0 .70-te...ert, riCa :7; ) DRYWALL INSUL A I 10 : --. ..-rt'lr-.7-t :41. , ie../.3 te ate 77 Anra-- ,ea, firilic fir/areg a larizetize, gis, trgitY te,70 if 0- Acc-e- t.w. sze t Ast,teretrealearalovr A°, _ SUSPENDED CUL :NG • 1 -i est... aer: ail INTER:OR LAM .- ' „\-1 I,• ...‘4,..AT--, , --.- - .); AS1 Er-i NG . . EXTERIOR • Tr' ,1 _ _ _ -0--1?_,__C#IC 17:,;;AT tereki -Arkies_-_-axr -,-",pyriet.07.A -in ,427-u, e ..< r 7, Afar e nwor, QCRA IC: i . :. 4:7_,V0,&" yra adesitesraarermf_ *ewe 3ROVI:N . . ' MASONRY : • . , ' algeent A X tragePeet,C. evedee27AC-otto - 4 FOOTIN•i . ) .79.114-s:tip-1-'1014147 eelanyir ar,90z. . es_v_ix.affe____44ca-ve , serearee Arrost-efix_* PRE GROUT '' 7- -7-77:7 - - 11T FIREPLL.CE. 4fseeatitred,. - -7- • rein_00le.AL___..r/z3jyt _./AteafetitAl evoner MSC. :1•2.=PECTiCr•;S: . . • . r iNAL CERTIFICATE OF OCCUPANCY 7-21d, pi- &Lai 7:44:1:isoscae, yrs _ tfi,Vdtt c ,V77.fr • e1,--1:E-23-----,CP,WiEr: arola,Qc oc.a>/,9_4/ba,efirce.: 7,ilt2- 6u922_ V#0_ eeW6_4(1(a_ &A-4r frem-tert-- /Wear-ic 6:74-Taig,_/)Wattutto ovaereal ot to* _sees%) (-2/efir . I , TENANT NAME: e1.1-1tOi ;4 MAL FIQA38 ROZN:IV 3;7; li!: TYPE OF BUSINESS USE: S DEPOSIT RELEASED FOR REFUND ON TO: • - 4 \ • \ • \ City of Newport Beach Building Department . - - --- - P.O. Box 1768 Newport Beach, CA 92658-8915 Permit Counter Phone No. (714) 644-3288/3289 OWNER-UILDER DECLARATION 1 HEREBY AFFIRM UNDER PENALTY DF PERJURY THAT 1 AM EXEMPT FROM THE CONTRACTORS LICENSE LAW FOR THE FO.LOWING REASON (SEC. 7931S BUSINESS MO PROFESSIONS CODE: MN CITY ON COUNTY WINCH REOUIRES A PEWIT TO CONSTRUCT. ALTER NPROVE DEMOUSY OR REPAIR ANY STRUCTURE. PRIOR TO ITS ISSUANCE. ALSO REougEs TTE.WPUCANT FOR SUCH PEWIT TO FIE A SKUEO STATELCHT THAT 1E OR SHE IS UCENEED PURSUANT TO THE PROVISIONS OF THE COHRNCTORS LICENSE LAW (OIMTER 9 (CDC A AIG W1111 SECTION TWO) OF DIVISION 3 OF THE BUSINESS AND PROFESS/OHS OR THAT HE OR SHE IS EXEMPT THEREFRKMA AND 1HE BASS FOR THE ALLEGED ANY VIOLATION OF SECTION 703:3 BY ANY APPLICANT FOR A PERMIT SUBJECTS TO A CIVIL PENALTY OF NOT MORE THAN AVE HUNDRED 0OLLAIS (SAOIF: PENSALIIIOR WtJ. DO T THE WOIEC AND TTHHESSTRUMY �CTURE�IS MITI INAGES AS NTENDEDD OR�OPTERED FSOLE OR SALE (SEC. TOM. BUSINESS AND PROFESSIONS CODE THE CONTRACTORS LICENSE LAW DQS HOT APPLY TO AN OWNER( OF PROPERTY WHO BUILDS OR (PROVES THEREON. AND WHO DOES SLAG WORK HIMSELF OR HERSELF OR THROUGH H60R HER OWN EMPLOYEES PROVIDED THAT SUCH NPROVELEMS ARE NOT NTEFWEEC OR OFFERED FOR SALEIF.HOW- EVER THE BOLDING OR IMPROVEMENT 15 SOLD WITHIN ONE YEAR OF COMPLETION. THE OVIICPE O THE SR THE PURPOSE OFURIOEN OF P WG THAT HS E OR E DID NOT BIRD OR ❑ I ). liarAS OWNER OF THE PROPERTY. AM EXCLUSIVELY CONTRACTING WDH LICENSED CON- TRACTORS TO CONSTRUCT TIE PROJECT (SEC. TOM. BUSINESS AND PIOFE55ION5 CODE THE CONTACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF A PROPERTY WHH0 BIDS OR IMPROVES THEREON. AM WHO CONTRACTS FOR SUCH POJECTS YATHH A CON !MOTORIST LICENSED PURSUANT TO THE CONTRACTORS DOWSE LAW I. 0 I AM EXEMPT UNDER SEC. B.&P.C. FOR THIS REASON DATE OWNER LICENSED CONTRACTORS DECLARATION I HEREBY AFFEW UNDER PENALTY OF PERJURY THAT I AM LICENSED UDER PFICIVISIONS OF CHAPTER 9 (COMMENCING WITH MOTION TOIDI OF ORISON 3 OF THE BUSINESS AND PROFESSORS CODE. AND MY uaiNse IS N FULL FORCE AND EFFECT. LIFSNAPCLISS OCT* 275506 DATEe I - Z6 - `t $ m Mama efPtl/ZC' ,4 WORKERS' COMPENSATION DECLARATION IHEREBY AFFI4:UN:EFT PENALTY OF PERJURY ONE OF THE FOLLOWING DECORATIONS I HAVE AND WILL MNNTAN A CERTIFICATE OF CONSENT TO SELF-It/SUITE FOR WORK- ERS COMPENSATION. AS PROVIDED FOR BY SECTION 370:1 OF THE LABOR CODE FOR THE PERFO WMICE OF THE WORK FOR WHICH INS PEAMR LS ISSUED. r I HAVE AND WILL MAINTAIN WORKERS COMPENSATION INSURANCE. AS RECITED BY SECTION 3700 OF THE LABOR CODE FOR 'THE PERFORM MICE OF THE W0IVL FOR WHICH THIS PEWIT S ISSUED MY WARMERS COMPENSATION INSURANCE CARRIER A/WPOUCY NUMBER ARE CARPER_ t8PUILIC 31OB1BItt POLICY RARER 01031906 (THIS SECTION TEED NOT BE COMPLETED E THE PERMIT IS FOR ONE HUNDRED DOL- LARS DIM ORLESSI. CERTIFY THAT N THE PERFORMANCE OF THE WORM FOR YAoCH 11115 PE IS SrLED. I SHALL NOR EMPLOY ANY PERSON N ANY RANIEA SD AS TO BECOME JEC1 TO FA WORKERS' COMPENSATION CAWS OF CALFORNA. AND ACREV14$ IF I SHOULD BECOME SUBJECT TO THE WORKERS ENSATION P SECTION 3/X) OF THE LAD:RCODE, I SHALL Al COMPLY SCRS. DATE /- 2-a - et_p WARNING: FAILURE TO SECURE W01bE IS .. IRON QOVER&GE IS UNLAWFUL. AND L SUBJECT AN EMPLOYER TO CRIMINAL • ,MET E. �. CALL UP TO ONE HUN- DRED THOUSMW DOLLARS (i1 WAOOJ. IN AOd10N TO THE OF COAPOSAION. DAM- AGES AS PROVIDED FOR N SECTION 3706 OF THE LABOR OOOE. MEREST. AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY I IE EBY AFFIRM UNDER PENALTY OF PEMJIW THAT THERE S A CONSTRUCTION TEND P IG AGENCY FOR THE PERFORMANCE OF THE WORK FOR WI4CH THIS PEEWIT IS ISSUED LLEFA� OE D LENDERS ADDRESS I CERTIFY THAT I HAVE READ THIS APPRCATICN MD STATE THAT THE ABOVE RiDWIA. TUN TSCORECT. I AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDNANCE MD STATE LAWS RELATING TO BUILDING CONSTRUCTOR AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS GoIAJTY TO ENTER UPON IRE ABOVEMENIONED PROPERTY FOR INSPECTION RR • . C-h.ss FAINT) -#&Sr••cfi aa"✓ •//-7i6-96 DATE JOB ADDRESS: GRADING PERMIT 1 NIB OWNER: HOB IOSPIUIL ADDRESS: 301 1817011 IUD 181POtt Ina C192658 PHONE CONTRACTOR: 11111 COIS1tOCtI01 811L81►1C ADDRESS: 1700011111011Dt STRUT C111I1OS Cl 90101 PHONE 310/404-8133 215506 CLASS: l NEWPORT BUS. LIC_ STATE LTC. NO.: ARCHITECT: ADDRESS: INSP AREA LIC. NO.: ENGINEER: ADDRESS: UNC.... �NOI.: OONSULFINIC L CONSULTANT: ADDRESS: APPLICANT: ADDRESS: SIGNATURE OF APPLICANT las 016801 H0115/11118t111/11U1 NIEAIIL 11000 11wg01nDt 118 CBIJItOS Cl 90703 PHONE 310/404-656S DISIOIER PHONE: PHONE: t11L01 l ►SSOC(IICHIBL !CLUB) 2220 UII18tSIt1 DI 1200 181POtt IBICH CI 9$60 PHONE 714/574-132S t 111D116/DIIIILDB Perait Pees * $ Paladin of iaprottuats —> D11I1888 - PLII CiEC1186 (1) MDR - HINT P88 (1) PLIIII1D:Z0I1IG PLII CE8CI-6y hers TOt1L CpmDIIO/Dt1I11C8 PINUP FRES PLAN CHECK VAUDATION CK. DESCRIPTION OF WORK m--:r • G9800063-..._ Inspection Requests Phone No (714) 644-3255 II IusE (SEE 158'11 DDII1168/SOLP68 IR81t SIS(CIS mu) Praline Permit TYPE OF PERMIT: VACANT SITE NEAREST CROSS ST. LEGAL DESCRIPTION: YARDAGE FOR PROJECT SPECIAL CONDITIONS: 0 YES ❑NO CUT: PROCESSE BY: ZONING TRAFFIC SUBDIVISION GRADING APPROVAL TO ISSUE 180.00 1 2S.56 1 25.56 295.56 JAN 2 6 1998 CITY OF NEWPORT BEACH M.O. CASH REVIEW DEPARTMENTS Name PERMIT VALIDATION Pipette: Credit Melded: Total Credits: JfDat 2S0 tIII /Sg 0.00 0.00 0.00 ;Tyluee` `N•;,Z95 16, ldjutaeats 2➢5.56- laluee dee 0.00 CK. M.O. CASH 0 0 O z (0 w } D IS f O cc w U tl ri) x tL 0 F- O U :z D. O J $ Z O 0 1- 0 cn 0 O w 0. Z 0 ct w to m co ¢ 3 PREGFADE MEETING GRADING INSPECTION ROUGH GRADE APPROVAL PREPAVING MEETING CURB AND GUTTER PAVEMENT SUBGRADE AGGREGATE SASE FLATA'ORIt STORM DRAIN EROb`i!Ca1_C:NSr^.CL PRECISE GRADi")C; INSPECTION DOCUMENTS FINAL CERTIFICATE i vPE , _ $ FOR REFUND ON TO: DEPOSIT RELEASED COMMENTS • City of Newport Beach Bulidirig Department P.O. Box 1768 Newport Beach, CA 92658-8915 Permit Counter Phone No. (949) 644328813289 INSPECTION RECORD lath .`--sue APPROVALS DATE INSPECTOR GROUNDING ELECTRODE UNDERGROUND UNDERSLAB l FLOOR ROUGH CONDUIT WALLS ROUGH WIRING CEILINGS ROUGH SERVICE TEMP. POWER _ _ UTILITY CO. NOTIFIED FINAL 1/ -20.78^ - ' UCENSEDCONTRACTORSDECLARAT1ON 1 HEREBY ARM UNDER PENALTY OF PERJURY MITT IMI LICENSED UNDER PRONSDS OF CHAPTER 9TCp MMENC IG WITH SECTION TOOK OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS On MMEMYLCENSE G IN FUL FORCE AND MIXT. LICENSECLASS DATE !L- fit 6. CONTRACTOR WORKERS' COMPENSATION D • . ' . TION 1 HEREBY AFFNM UNDER PENALTY OF PERJURY ONE. THE FOLLOWING DELINEATIONS I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION. AS PROVIDED FOR BY SECTION 3700 OF THE LABOR COCE FOR itE P6FOWAANCE eF THE WORK FOR WHICH THIS PEW IS 15SAEO. _ I HAVE MD WU. MAINTAIN WORKERS' COMPENSATION INSURANCE AS REQUIREDBY SECTION 900 OF THE LABOR CODE FOR THE PERFORMANCE OF THE WORK FOR WHOLE THUS PLIWIT IS ISSUED. MY WORKERS' COMPE SATON IN4m ws CARRIER AND PO.TCY NUMBER ARE: CARRIER POLICY NUMBER IC EKENPT (rtTHIS SECTION NEED NOT BE COMPLETED IF THE PERMIT 15 FOR ONE HUNDRED D3LLARS WOOL OR LESS) I CERTIFY THAT N THE PERFORMANCE OF THE WORK FOR WHICH THIS PER/MT 15 ISSUED. I SHALL NOT EMPLOY ANY PERSON N ANY MANNER SD AS TO BECOME SUBJECT MITE WORKERS' COMPEHSATICN LAWS OF AND AGREE THAT IF I SHOULD BECOME SUBSCT TO THE PROVISIONS OF SECTION3700 THE LABOR CODE I SHALL DATE —// 4- /w APPLOANT WARNING: FA4LAE TO SECURE WORKERS' PEISATION COVERAGE 15 UMAVNL AND SHMl SIIBELTAN FMFLOYERiro IES AND CNA FINES UP TO ONE HUNDREDTFOUSA CDOLNMS 0100.0001. N TO THE COST OF COAIPEFSATDON. DAMAGES AR PROVIDED FOR N SECTION 3706 OF IRE LABOR CODE NIEPERT. AND ATIC(DCY'S FEES .ROB ADDRESS: ELECTRICAL PERMIT PermBll980No 2323 Inspection Requests Phone No. (949) 644-3255 1 NCH BLDG: FLOOR: OWNER: HOAR HOSPITAL ADDRESS: 1 HOA0 DR RERPORT DEACH CA 92663 CONTRACTOR: SELECTRICAL CO ADDRESS: 1005 ELECTRIC ATEIOE SEAL PEACH CA 90740 uT o.: 689887 o`A`SS: C10 PROCESSED BY:Z��. * Electrical Permit Pees * SEPARATE CIRCO:, Motors / Transformers (HP / EPA) over 10 np to 50 1 HEREBY ACKNOWLEDGE THAT I HAVE READ 11y5 APPLICATION. THAT BE INFORMATION GIVEN IS CORRECT. ANC MALT I NA THE OWNER OR Dux AUTHORIZED AGENT OF TIE OWNER. I AGREE TO COMPLY WITH CITY ANO SLATE LAWS REGUATI G CCISBNCOON AM N DOING THE WORK •1i-"G-"—_ THEREBY: NO PERLSON WU. BE DELAYED N VOLATON OF THE LABOR 030E OF THE STATE OF CALIFORNIA RELATING TO WOROA71S COMPENSATION N9NA10E PERMITTEE NAME (PRINT/ • OF PERI9E-_!(' 1.41 OFPEALALE �r DATE ADDRESS (Rey. t0r99) INSP AREA: SUITE PHONE PHONE NEWPORT _ BUS. LIO: OCCUPANCY: Each 3.50 18.00 714/899-1377 _ 973012 DESCRIPTION 1`11t1t1�NT T 1/1�11 ��11 a�I{1 OF WORK: UWIVIllc� _time%) ELEC/EP CHARGERS AIDTRAISPORNER ADDmONAL INSPECTION RECORDS SUBTOTAL of electrical fees PLAN CHECK PEE required! PERMIT ISSUANCE PEE ! (T) TOTAL ELECTRICAL PERMIT FEES PLAN CHECK VALIDATION CK. M.O. CASH Ro. 3 19 Pee 10.50 18.00 45 KVA 28.50 7.13 T 19.00 54.63 PERMIT VALIDATION ci 0 ?meets:0.00 0 0 Credit extended: 0.00 Total Credits: 0.00 Fa r3 Balance 0.00 m Adjutants 0. 8aleece die 54.63 cr 0 a 0 0 0 0 111 0 0 u. N Q a 0 0 0 H a 2 0 PAID NOV 191998 is CRY OF NEWPORT BEAC: 0 3 CK. M.O. CASH INSPECTORS COPY CIVIL ENGINEER'S CERTIFICATION FORM City of Newport Beach 3300 Newport Blvd. P.O. Box 1768 Newport Beach, CA 92658-8915 Attention: Grading Engineer, From:David A. Boyle En jneerinq 2076 South Grand Avenue Santa Ana, CA 92705 (714) 957-8144 Date: July 21. 1998 Building Department GPC No.:158-97 Tract/Subdivision/Lot No.: Rough_ Final X Project Names: Project Address: ONE HOAG DRIVE #50, NEWPORT BEACH, CA 92658 Owner/Developer: HOAG MEMORIAL HOSPITAL PRESBYTERIAN Type of Project: Tract Commercial Industrial Drainage Other SULFUR TREATMENT SYSTEM RELOCATION OF FLARE Yardage this Review: EXEMPT PER UBC, CH 70. SECT 7003(B)2. Cut CY Stockpile CY Fill �_— CY Export CY I hereby certify that I have reviewed the finish surface gradas for this project in accordance with my responsibilities under the City Grading Code. and it appears that all areas exhibit positive surfacee flow to public ways or City approved drainage device:3. The grading has been completed: _X in conformance with, _ with the following changes to, the approved grading plan. Description of Changes: Company: DAVID A. BOYLE ENGINEERING Name: DAVID A..._._BOYLE_ (Print) License No.: 18559 (RCE/LS) (sign) HOBBS-BANNERMAN ENGINEERING, INC. ENGINEERS -CONSTRUCTORS 17000 Marquardt Avenue • Cerritos, CA 90703 (562) 404-6565 • FAX (562) 404-9636 T December 1, 1998 City of Newport Beach 3300 Newport Blvd. P.O. Box 1768 Newport Beach, CA 92658-8915 Attention: SUBJECT: Gentlemen: Don Scully HOAG MEMORIAL HOSPITAL PRESBYTERIAN METHANE GAS RECOVERY SYSTEM Per our recent telephone conversation please find enclosed the original civil engineers certification form from David A. Boyle Engineering indicating that the project was installed in accordance with the plans. In addition I talked to Gina Garcia in the planning department by telephone today and she indicated that she left you a voice mail message that the landscaping had been previously signed -off. I hope this clears up the matter and you can issue the Final Sign -Off for the project. Very truly yours, Michael A. Maronta President MAM/dmb 98-624 Permft No. E9801653 ti:.' roman L:Dunter mare no: gsayl Owi:CM3b.W N - : : :::::. - .. .: -i: - -.:. - - 1 R uests Phase No. 949 644-3255 -- INSPECTION RECOROeVW ADOREss, 1 IO16I1 TIN 8 .' IfsC�i�I(1989BBi_)------- PIIIMIIIIMPIE14110B_LOIEI_PI11119)_._ ADDMONAL INSPECTION — RECORDS ,�� i� SURE: comht IOU 111102IIL ROSPITIL 11019III j . MIT Inn CA 9208 PHONE ' cOWBACTOR 11111STIIILIBIELOPIBIIL ADDREss: _BM t11DLsn I LLI.tU[ 10_010 APPROVALS DATE INSPECTOR _ C1925E1_ PH°NE GROUNDING ELECTRODE STATEUC, Ma: 411023 PROCESSEDBv: —19/111-E4tL CLASS: 1 NEWPORT UNDERGROUND ( 8" )42,„„ojC OCCUPANCY: UNOERSLAB/FlooR9 -yb. * Electrical Permit fees * Lack TOTAL I0. 0P LIMBIC PIIT01ES BITEL Iisc. otter iteas 3.75 lo. 2 2 19 Pee 1.80 7.50 EELTSIS -------------- ; Papeats: Credit eCredits: Total Credits: Ialasce Idjutaests lalasce du 2.33 0.00 2.33 28.30 0.00 28.30 A9JGH 2 L W �A " S`�- ``. " a CQLINGS" " ROUGHNP.. •. ROUGH SEED E - j '-ter — SOITOTIL of electrical fees PLII CIRCE FEB recline (7) PRET ISS0110E FEB 1 9.30 2.33 1 19.00 TEMP• R} / ; in—fury o ED n 4. 3 4 `` iptU: -COntwiCTORSDEC i4. OBPE TW VIAM tsErW OFONSIO3OE 5 i{ 1?-' 7 TION r z s DitaFUU79sivas NS BUS1N®SAND �,-�J4 b'" TOTAL BLBCt1ICIL PHUT PEES ... ---- 30.63 Mfg� �4 ra I FEFEBY. G.WI1H .-pf...:MiE-Br� WRH ....1.~Un Ph tens a a. Mrue8t5EswRAJV�°[ei$/ /DAZE '-1W'.'. -s=,„ ifing - Arniks..-... WORK 'CbMP SAD�DON DELI AhAnoN err r2RILIV THE FeWINGDECAHATIONS: .CAT - , 4 . isf.=. PRO:ME FORE OF BY SE TIO TO 00 OF THE L FOR ASPROND JEFOR WI SECTION ERIA OF THE LABOR OFTHEVYATRKFOR W10�71�PEBOTS ISSUED. COMPENSATION IISU ANCE. AS RECURS, BY IHE ULCER PBJK �•ML A AND WEP MON♦,A W CORK FOR COMPENSATION. COOEFOfiTE{�.. 1 NAVE AND Wit. WORKERS' SECTION 3700 OF THE LABOR COCK FORTE PERFORMANCE OF TIE WORK Full MICK THIS PERMIT NUMBERSA %LYY,WOTIst400LFENSATION PCURMICE CMCER AND POUCY RE CARRIER POUCY HUMBER iC sluff . 01415 SECTION NEED NOT BE COMPLETED IF THE OOUNSR1X OTLES.) X1 CE,TIFY THAT w THE PERFORMANCE OF THE WORK ISSUED. 1 SHALL MN EMPLOY ANY PERSON IN ANY SUBJECT TO THE WORKERS' O MPBSA1ON LAWS PERMIT S FOR ONE HUNDRED FOR WHICH THIS PERMIT IS MANNER 50 AS TO BECOME OF CAUFMNIA AND AGREE THAT COEFBSATON PROASIU S OF JN V`-�. ',Er - F 1 SHOULD BECOME SUBJECT TO TIE WORKERS SECTION 37000PTE IA9011COOE I C A0.Y / DATE_ LI APPLICANT 'y'vLLL WA KING: FMLURE TN SECURE WORKERS' 7413UvS•74Dow CO SHALL SUBJECTAN EE W VERyTO CRIMINAL iSa ON97080 ADMEN COMPENSATION TO PE RULE.. MD I 1O TIE COVERAGE S UNLAWFUL. AND COAFrA.AS CNL FINES UP TO ODAMAGES NE HUNDREDFCR @matDF HAVE READ TITS APPUCATIOFL THAT THE INFORMATION ....1 HEREBY ACKNOWLEDGE THAT L ONEl SCOR CORRECT. AND THAT I AM THE AGREE TO COMPLY WITH OW ND STATE "RE OWNER OR qiY AINHOR® LAWS REGULATING PERSON WIL. BE EMPLOYED TOWONDAFNS AGENT OF RE OWNER I COSTRIICTION AND w COM N VIOLATION OF ME LABOR CCAFESATDH INSURANCE - WUi(ANA'D® TEIEBY, NO CO OE OF ME STATEOF CAFOR M RELATING Rc MAr ! TOTTERtUJPETTE 'URE ' _ `Jwz'Tso73 a t' W DATE tit-��SI_Ib / OFPEFORTI' Iwal�c' k AOf1RE54 PLAN CHECK VALIDATION PERMIT VALIDATION City of Newport Beach PO Box 1768 Newport Beach, California 92658-8915 Job Address: 1 HOAG DR Floor. Inspector Area: 7 Owner. Address: Phone: Applicant: Address: Suite: Bldg: 1 HOAG MEMORIAL HOSPITAL PRESBY ONE HOAG DR 949/646-8901 CHARTER DAVID, AIA 296 REDONDO AVE LONG BEACH, CA cR2MRz%Frs. Code Edit : Type of Construction: Occupancy Group: Added /New sq.ft. Bldg : Added /New sq. ft. Garage: No of Stories.: No of Units : Construction Valuation: Building Permit Fee : Plan Check Fee: Supplemental: Investigation Fee: Clean Up Deposit Energy Compliance : Fair Share: PROCESSED BY: ZONING APPROVAL: FIRE APPROVAL: GRADING APPROVAL: PUBLIC WORKS: $40.000.00 $411.00 $295.92 $0.00 50.00 $400.00 $0.00 $0.00 Building Department CIP Permit No: B9905472 Permit Counter Telephone (949)644-3288/3289 Inspection RequestsTelephone (949)644-3255 Legal Descrc.: Contractor: Address: Phone: Con. State Lic. : Lic Expire: Bus. Lic.• Workers' Compensation Insurance -- Carrier. Policy No: Expire: Building Setbacks Rear. Front Left Right Use Zone: Parking Spaces: Microfilm: Excise Tax: Park DED.: SJH Trans: SAN. DIST.: CA Seismic Safety: Disabled Review: $5.20 $0.00 50.00 $0.00 $0.00 $0.40 $32.00 TOTAL FEE :$1.649.95 Hazardous Mat.: Add. Fire Dep HMO: Other C'Fee : Description of Work: MOBILE_ TRAILERS (4) S CANCER CENTER PC 5360-99 $19.00 $0.00 $0.00 Architect: Address: Phone: Engineer. Address: rnone: Designer. Address: Phone: Special Conditions: Fire Department: Plan Review Fee: Inspection Fee: Planning Department: Counter Review : Zoning Plan Check: TOTAL PAYMENT :$460.32 TOTAL DUE: $1.189.63 (OTHER DEPARTMNT: (PLAN CHECK BY: Inspector State Lic: State Lic: $164.40 $287.70 $26.33 ITY OF Nt-vn•UH 1 UMCN WORK MUST BE STARTED WITH A PERIOD OF 180 DAYS FROM THE DATE OF VALIDATION PR THIS PERMIT BECOMES NULL AND VOID. APPROVALS FOUNDATION: ROUGH GRADE LINE & GRADE CERT/SETBACKS ERECTION PADS FOOTINGS SLAB ON GRADE DECK SLAB FRAMING: SUBFLOOR ROOF & BUILDING H EXT. SHEAR.'HOLD DOWNS GENERAL FRAMING INSULATION DRYWALL SUSPENDED CFiLING PLASTERING: NTERIOR LATH EXTERIOR LATH SCRATCH (2 DAY) BROWN (7 DAY) MASONRY FOOTING PRE -GROUT FIREPLACE 4ISC. INSPECTIONS: PERMIT EXTENSION! 1ST EXP. LETTER 2ND EXP. LETTER PERMIT EXPIRED PERMIT CANCELED FINAL ERTIFICATE OF OCCUPANCY — TENANT NAME: TYPE OF BUSINESS USE: COMMENTS jays.A9- eNteeno4 cw,Gier ,&ea ' $010sewerne Awe? Qf iiYft.Z' to_?o- 9A ,Ya,wE, eeeris ,e-lio rc ail e&Z'#Z - //Z•99- a et/Baiser 14109e S. la,.•trei_�e�f�' �a fief' 9 8O,itranvs s4 fiH,rt-SS Noy ter_ PLOT PLAN FOR ADDITIONS: Sketch a plot plan. Show all structures on site. Identify addition. Street side at bottom of sketch. (Show North Arrow) OWNER-DUILDEG DECLARATION 1 HEUERY AE2IR5! UNDER PEI.ALCY CF PERJURY THAT I AM FXEA!rT ril[A.I THE cCY.1RACTORs ECC1:SE LAW 409 THE F0 1Ct.NG PEASOII (SEC. 7J115. PLJS.:JE$S !NU PACT ESSO.'S CODE: ANT CITY Q. away Mi1.Cl1 AEOJE E$ A PC%:AT TO 'SNS14,JCI ALTER. , 3'POVL DEMOLIS•1 IAA REPAID ANY STRUCTURE. PR.;JJL TO ITS iESJAMCE AL SO REOIRRES THE APPLICANT FOR SUCH FtRMR O • TILE A SIDN D STATEMENT DIRT LIE DR 51 LCElSED PCRSJANT TO DIE PROVISIONS C - THE 1C1T4CTOr511 Et E! V H il' C ItW I!' VOW SEC (J''?^F DI 3CF DIEDJ5LJ-SE •.NO rROrrR I'V5 C-Ei CP FdAT HE OR SN E IS EMTARTTHEREFROM AND TLC eAsis 101 T::' Al1EC€0 TAI -D< ANY DYt I At Cr SEC. 'DTI 5 BY ANY APPLICANT Fell A PEAD.LT %SACIS . 'F 1Pr,_aN1 T 0 RCIPAP''AI IY CF ROT ErDop 1,I4,,47.1C.0 0311 All E. I5500. O I AS CANER OF !NC FRO: 'SPIV OR. L'V -tIr 3YL S LULL! WA(.LS A5 111 PI SOLL COLRFI5AT WILL GI Ill ( 'NID IC DTRt' LIME ISNOT L.:FADE:10R OTTFRED FOP SALE F 41 h. ESS A00 PP3I ESSIDDS CODE 1' IS.'! tCT 1 4 L'CPRIL LAID C f S No! f: Y CT AN J. A R r PI C 71 V I J I'JLJ J A: I SES IIRREON. AND IW AI RODS Y iCe t MR'+ 14-I'1F OR PE DEEI OD TIRICEN,H MS OS REP OWN EVPEOTEES i '1 J-II SIEER IM D.:_I 1 ;. AD7 AO" P. ET,CED O" ."ILED rcn Se E :F. HOA.DFP i _ RJ:ED RI OP iIPROVL ICT S SD,EC'JJ it C4r A- r I. LT `_I i O :REJ 1- l AAvi 11•_ DIN` T"Y WET i( I'1 es V t " NE !-rt.l F5: I AS 0.31E F (I we P.OII ST. AV I-M USVI V CrI:D 5 .J( ER T1. I CLyr.RD RA::13P.51U CCt.Srn:CT T4 PPC.LCT 'SAD t:! PUS :ESS AND I'IPD!L;$.':::,l:cr PI, C:AIR'CTE'4:: LY_[NY: 1.4.4 `Jv; 1:::1 AFP-.Y i -'. U..'IER CF T•IE FRC:DE. *: WAD PI - CF l•!'.;O'.FFl:':'T' AND NI"_O'J'RA^!S'CI'`Jr h PROJECTS Mid A CONTFAC`C4:S7 LICENSED PJFSJ.ANr V)-:' ccmiRGTi -S :."E1.cELY''. • I ALIT AC:PT l.'11EP SEC_ .B3 P C. EC-- THIS MASON DATE_AcrittZ / LICENSED CONTRACTORS DECLARATION MFi1!_Y A[F:!:.•: i PECILIT OR PI F'J,PY AIA1U'.i411 rFl7v.`t l<A.$ () CHARTER 2:COv17:47143 RRR:7CTKV 7('1I CG vrn5,(JF 3 EY' FIE BC"Ir55 AND OHO:F;S;?S CODE. AND Al r L1::E PILL .S IN 1. ELL FOH:;C AMC` 7:: CCT LICENSE C: A'7 LC NO._ - GAT: Cn.TRAC10l WORKERS' COMPENSATION DECLARATION I FE 77124 AF1:EMNNT cR P('J1-_C` OF PEDD:RV VIE ON TdE TO.LO::NLI DEC1 ARA- 04; 1 HAVE AND .Y'-t V' 4(AIl A 0* - t.I : A''! CF CC:.i11.: TO CLL E:I.SC: 7. FCF 'FFJ:441s. CCM^'Y!.. 1'^'' A" r:....,._ .- -CF BY 1FC1:C4. J'S Cr ref V.CCl LA.)[, 0, i 11! F.F)C:'u•+LE✓ "NE v;:2l PODY..CH II:;S FFP44Ir-s:3ECE0 I RAVE A10 6L1. L1.41•T1L'4 AORSp0S' CCM:R.SA•T 09 PJSCRAN7.E AS IIC0;,!;-1 ?' ..EC. I D'l T. OF IT E IAR(L: COLT . :OR !FF. PEPE: *I1A4> 0: 114 T.!S PEAl,i 1'5 5SJEl; MY A::TI.E?i- C C1.!PEI.S."llGN Pi sF:JJ.Cr AND :.4:1 G 'ID:AREit ARE (PFS SEO':,YJIIFtu TOT MI CO:Ill. i EJ 6 ELIE 1'EFV:!'i :CP DAIL H'JS:im1D D:kV•PS 011EE9S: ICE=- T'.1' TAT 1.`1 TEE EL 4rOR VATIC c1 -'l[•AC55:c::Y:.ac'iTM:S 01 PIL S 59.7U.' LV l R01 "JUA 9Y /!.Y 1-1'-•.. c '•T' J"+'-.• <0 A' 10 Pt tO.' •:l11LC- TO TT.t Y•C?1E1S CC'JPL45A' 0.7 LANs GE CAL.FiiIRJ A. A9'J <6RFC RIM IF I SPCI)J! READOI':. SC3T 1 TO11:E N01(r_(35 CO':RE ASAIYY. TP7.4.1S0':50's0J1',D4/ 193Ei: 11.0 LAEC RI CODE. I^✓R3L FDA li ::(-i-I CC1.12V:1!:.:R*-04-:; rroD I3 s DATE AFT',l:t441- A1:47.0 Fl.il1d1 TO SECUFE KC^LEAS CCUPENSATICII CO'i IEP4G'_ 5 I...LAHTUL. CND S-1411 SELECT AN CA'=10YER TO I:RLV:44'.. PL•IAET!S AND Crv:. R'IES IS: TO 401C Id 10RCD TH,AhLNO toll N15 iSImOX;• Pi ADORXYI TO THE COS,- Cam" C'CIAPCNSAT10N. JA!'A :LS AS 1'IIOlWDIG 101: P: S'':1101: 37CE 04 TAD LA CDR COLA. IMF DES I AND 41 TORN( VS FFsS CONSTRUCTION LENDING AGENCY I HERRIN AFFAII NXR PENA:TV OF PER:C134 TAT THEE IS A CTNiSiPoKLMM LERDIND A CR.cY FOR TNT- PERFCRLANCE OF THE Ev0r44, FOR W:44:.11 T1113 PE!1 V,! i5 156UEO!SEC ':JDT OV LET.DI:RS N4AP LENCERS ADDRESS CO: FY 14IAT 1 R.VEL DEAD 111.5 A'YLY:UM.:.': AND SIA3L IF AT 71'E A•_W±E I1.ICOVAItiM 4 CORRECI. IAGR'E IU CCIJRY HTTH AL'.CS rM? CCLMTY ORDINANCE 5-1ND STATE LAWS 11ELAT.T.R TO RJLD`:G C(N.SIP::CTICS, AND ❑a150Y' IIP14Po: E REPRCSUIFATr.FS OR rats COJNIY TO ENTER{;R%ITHE AFOVE VENTq'IEO FRE1!TIRVFCMI^SFECTIO'1 T'JRP( LS. C a /_& nit 1( - . L.1 r iticktrig411‘,W,' F 8000,8 R .....•• „ . • IjI-HEREBY AFFIFUA UNDER PENALTY OF PERJURY THAT I At/ EXEMPT FFIOLI_THE PFICIFESSIONS COM NEY CITY OR COMFY WHICH A PERMIT CO/STRUM 'ARIMERMROUppLIEIS_OR REPAIR Nif STRUCTUFM, PRWR 113 RS ISELMICE. ALSO BLOM • R.00Ft - SUITE: - CONST.: 811112r4r121 .r..mMturISUCN FEMOTTOFILE A SMNEOSTATELOSAITTHAT lEORStE 119--1181Tilirm IBLIOENSED PURSUANT TOTTEPROVISIONS OF1HE 7"47-'7-17-1011.11 111;;;--'t .'" WDESVICRI°Rtni°14PIIE frr rt---10111E1101ILL HOSPITAL 7.% Nowt:— "fmAmcaEsucsirmori= l • • OR THATME OR 0 yam srmax DIVISKIN ORTHE THEREFROM AND THE BASIS mar ALLEGED I ANYVIOLA ADDRESS: AFTUCANT ,IR APERWT SUELECTS . ....: riti1PPLICANTTOACIVIL PENALTY OF NOTMOREMIMI AVE HMMRET3 00UARSM0A. - LASONNERC€THE AflASTHEIR , FlsoAllote, WILL comic MP:14MlunRA4391141EIWEIMUSSUCIYEESFE a TitITHIrCi EiTiE0 ce.OFFEPIED FOR • SALE 7044. BUSINESS AND.PROFESSIONS C013e..7HE CONTRICTC42 UCENSE UN -:' ! ' vac cm sum wonc , OCES YMAN=C€IIMPI3ITY VAMMUILDS OR I/PROVES M43 CR HERSELF _tunousitilS ORNER ONN ... PROVICEDTHAT SUCH WFRINEMENTS Alt NUT /MUCBEI CMOFFERED FOR SALE F. ,: t . THEMA/MOCM IMPFOVEMENT IS M/LD MOAN ONE YEAR OF COIMLETIONTHE . YALIMAVE TIE BURDEN CE4WAtEUrRIAT HE OR SE OM NOT BUILD OR itinsmclor.6HE =6"FelpErWAis =lawny cottracnuci %mu ucetscocou- 70 MiaTnuct THEFRCIECI: mic ausuuzss MC PROFESSIONS owe r_..._ 11t• Bums oR arRovEs flJ neRecrtIV DOES num APPLY TO AN OWNER OF A PROPERTva TRAGIC/NM MZENSED FURSWWFAIN "CCaNCOMFIACTOFSRACTS F°Rucet5r2 &Tr= Wall" Will3 CC/ISTRUCIIOM SONTRACTOR, , • .11111)11IllizIROTSC71011,4IC V SOOTHEIIVEIR • .1111GrCL-92665 pHoNe 714/97 'Ono. LBW. UC. STATE 202554 - aatc• Clb NEWPORT 970206197rr BUS. UC.: AkDRESS: BAP nts REASON . . "7 . '," - • • . *• Atti:H:AkeS" NV, /W ••• it4,TE :,s.44.7„,i4E•dym; kr_ - '1/4..1.4 • dr tr.. i-* .t.4 e- • 14.4..,-f Le' ' • b". „ . 77"1-41," / -ONEHIJMiREEIDOU 2100)013 .:€4.`"-`' • • • THIS PEEWIT LS - isc54),1 SHALL HOT SRO? ANY IN ANY MANNER SOAR TO BEE sue- Jew-soTHE WONDERS' COMPENSATION LAWS OF CAUFORNM. MO AGREE THAT F I SHCMLEI BECOIM svar-crro 1HE WORICERS' COMPENSATION PROVISIONS OF SECTON 3703 Cr1HE LN3OR CCOE. I SHALL FORIIMUNCCIAPLY THOSE PRON. r . Cale ' • 1 ' • • APPUCANT: _ WARING: Mintz TO SECURE WORERSCOMPENSATIMI COVERAGE IS UMAWFUL. AND SHALL SULUECTAN EMPLOYER TO CRIMEML PENALTES Ate CNC FINES UP TO GE HUH ACES AS FRONDED !CR IN OF/33 THOUSAADOCUARS&TioN W ADOID3N TO THE COST OF COUPENSKICIL DAM - OF THE LABOE.CCOE, Mittiv-si. AND Al ILIFIFItTS • - • "QC"' 1 • i• - ' Ate, ._,..„ADDRES..S........ ,,,: - : ... r',... \ -cc .1/4S---1—:.plioNE: .-'.-:_ 2-:;\. _ alGINEEFt LIC. NO.: \ : . - ....• RNE: ' 4 \ CC.4CIT"i& -hot Eli -tract r-Ir toa . .. sPEcIAL g., tfr-e-01-7/44,1_C>iel_el_ri-e—:_j I .. PROCESSED DY fin ......S- .:‘•-.) A•pilicAhrn:s•_Cr11 A --..‘,... ,... _.,;.;1. ,,,,4 ADDREss,-C• --;,,.. . 5e111I0011BILAYS -"...' Ic:-‘ 3? : FIRE /1 c • • ' 717 ; - ,-,---: •k-:- 011,110118791865--c\ •-: ' -thr' 114/914;8770 APPRCWAL SIGNATURE OF , APPROVAL- - - • APPUCANT c.o....5, • -‘. k Ill , APGRADPROINGVAL TO ISSUE I c:FSTIFY THAT IN THE LITIEREFFIAFFIliA LBEIER tieVAL-TY OF.PERJURY- THAT DERE IS A COSIFIUCTION IENC. ZONING APPROVAL. EITER3)% 'Projecf-Yalaatiot ' »E•., .. .238500 FIRE ?LAI CRC! PEE , 897.23 \ - FIRE 111141f/IISPECTIOR-PEt ...... )'' - 1,246.15 ------- ' .. TOTAL Fill/ SUILDII0 PERI? PEES . 2,143.38 ----- MO AGMICY FOR ;111E_PERFORMANCE Cf.'RE WORK FOR WHICH THEIMERMIT IS ISSUED _ . . .. , . . . .- ‘•-• ' SA-.... - - - -- 13Aln-i _ . :nom ISCCARECt IACIREEMCCSIPLYWITHAULOWANCICOUNIYOADRUCESMOSTME ''''''''''' .""":"``: c ''.."`".'‘''''''''"'' t '- ''''''' ' ' ' " ' '" '41 ''''"`'''' ' a '''M''''''' --.- - ' ' '' '`'"''''..--- '''' - ''•---'..*''.'"<' ' " "" ' , .... ..._ - . .. ... _. ..... ... _ - . -.. ... , , .. ••. • - . ,_ - • - ' ' - '• - 1 JAN 0 8 1999 -.. . . . OTHER DEPARTMENT. PLAN CHECK BY Payteats: Credit extended: Total Credits: a &eCIO el-W 817.21 0.00 897.23 lalaace .• 1,246.15 . Adjastaents . 0.00 Balance due 1,246.15 CITY 9F NEtivP0fIT.OEAc - • .24).0 "*. -'-'1.2.•FSVINOZer.54'/X;$151-4 :4S.q "?.....1; • ci 0 z 0, us 0. c3 0 S C.) cc w U) co CC X 0 cc I- 0 0 z uj P 0- Z U. 0 2 0 EC u. 8 u_ 0 . _ . .11117Sillite ;OW/ .AL irt tr.177 sr' / 4t,,77.1in: :11rA aOr ragmitr-/ oper . " • k$4;-:::,•:i'iit---.'/›..1:.W.7i-fit,6,?-11itir'-,'); ;:.•:,c-:,'11.- .. '. ''..- '.,••••• -,.. ' . ,..„ .. H. . _ 4ri---1:0*-,--.v4I ' ' i , -1:11r;;Zt-, "•_:.-.-r.•:-.. -. ' ::--:, :::•-•-.:: -,- '. . - _ ... — :.:..:- !.... ` . .h. i I* : ‘.' .:ir e if." C±C.C.e;..*INi '...Pir jai, ilt/:*:-.•:. e'l i-P;t-i'aisc-'1".. ,--::-....-Y-;•:. .1-,i1 .. - .7:-?4•4•11.f.:1 tp. ."3‘ ' 'Stj..1 • - . „ • e i 4:.".•-'1?:-4,71:ii•----:"..,; ::-:40.9'..• ...::::••.:-. :I.:. ' 2.4 , t:, • c-... 2.,.,,,,,,,,H,..-;•,,,;(--1/4-. 40 --.:*•'-‘ i,-,---k '744.0401:TF19-YAciPilbx**41-1Z9.-,..1k::-: . - DATE .''' - : '''Ect; . • -... -:.: -: - k A A IS 1 AA 4 t." $ "`Ab.A." a 3 g t4:771 4 - % var.' ' - -"I.`, -• •• %ti el: t-''..1-..t, s; ..) ft ,ii,!--: .L.-nz•11---- ' r.; f:•FIREPROTECTIONO 1ite::: iitli ' . :-NT:[4:=1 -,,-;!,ft. ' !ft: it! 9 - - 1 ' - . i! 7r .C7!=. . , .„ . e3.:•.;:-.f; ioN,747tn 1.,77.: . . 4?1 `-;•.,[.. UNDERGROUND, HYDRO TEST T. • 4!TrIrli r; 7.14 UNDERGROUND PIPING FLUSH'rr.3 rre49.-; STANDPIPE ROUGH PIPE CHEM SYSTEM FUNOTION CHEM SYSTEMAPOROVAIDI f 4 I 1:: FIRE ALARM SYSTEM I. BOUGH WIRING SYSTEM FUNCTION TESTC/:. CENTRAL STATION MONITOR -- TANK REMOVAL--.V! - — TANK INSTALLATION t-TEST: PIPING PRESSURE TEST., 4,• FINAL- CERTIFICATEOV&CUPANCY • c , A, h .. _ .>. a 4�r. .r. � .rr mteYs ees. ?ixicatanb GlyQdstole bwsse `4.�orlsbuclbn andhdoing the work au£hodrndt ulY aulilo lmd agentalho ownerlagree to f�_ �,,,�,,,,� •.!, e 7• flerebY no persorsyvS17 be artrpbyedtivlalaRorlWtlw laborcode (Ilse st 1 � ). .y ,•i"� �. is r7 :Cce'` tt 4'{vi r `t ... l 2 - ' �• Permittee mama (Frio } t., rr %/$ �.4001. {»Address ^. eta*.,,. r 1�• . .4 'Yrr i' y a}Ri ''S- 'rt ':. Contractor: - Address: Phone: Description of Work: J;LECTRICAL FOP RELOCATED GAS METER 6034-99 UNIT CONSTRUCTION & MAINTENANC 17000 MARQUARDTSTREET CERRITOS CA 90701 319/40441433 Con. State Liz : 275506 Lic Expire: 10/31/2000 Bus. Lic.: Lie. Exp Date: New Construction Resldentia( MulUfamliy seance • 0 to 600V up to 200A • 0 ,0 to 600V over 200A 0 :Over 600A/1,000A`: Receotade/switch/outiets ReceplOutiets::_ . 0 $0.00 $0.00 Fixtures . 0 $0.00 $O 00 , :.. ° : Sep Circuit 1 $3.50 $0.00 , Branch Circuit 0 $0.00 $0.00 . each Add Circuit 0 50.00 $0.00 '' TOTAL $23.38 PAYMENT: $0.00 FEE Motors/Transformers (HPIKVA1 0 to 1 HP/KW/KVA 1 to 10 HP/KW/KVA 10 to 50 HP/KW/KVA 50 to 100 HP/KW/KVA over 100 HP/KWIKVA Other • Time Clocks INSPECTOR NOTES: cbacip- 0 0 0 0 $0.00 50.00 50.00 $0.00 50.00 0 50.00 LICENSED CONTRACTORS DECLARATION' IIMerebyantrrrunderpenalty of pe fib• tMt I am Ieensed under povhfwu of Chapter (commencing with Section 7000) of Division 3 of the Business and Rofesbns code. my tense b in frArorce and effect. I7aean Nat tens -f Clmc CalYaebr:'Mf CONSTRUCTION i MAINIMANC - - WORKERS' COMPENSATION DECIARAUON•1 hereby affirm under penalty of perjury one of the followingdedaalionc _I have and wit matifak a certificate a! consent to self -Inure for waters', compensali++, as provided fa by Section 3700 of the tubcode. lathe performance of the work for which tits permit biased - a _l have and wt niairrtuln workers•"compensation kuuranee as requted bySeCOon 3703 of the labor code. is the perfomance of the work for wNeh this pang is bsuod MYsvcdcers'.eampeiealbn tuirarice eorliarard polay numbers lc .:: Carr$sr ZOMdNINSCO Paleynunrbar- WiNiffi1QA Brpie.:0V0l/2000 •.. This section need not be completed rf the permit is for one hundred dollars (5100) or Less• !hating!! perfamaae of the work fa Wblrh tits prmll b bsred. l shall not e CeAforla,.ard epee theft,' sliosd betonb aubja to the wakera' mPbY�YpersaninIhe mariner ash; be�torrie subject to the wakens compensation laws •t , • I x + aarpanation provisions W Seelm 3700 W use labor code. I shall forthwith torfplSwi those Provisions. • Temp Power Pole Temp Underground Sub Panel Investigation Fee Plan Check Issuance BALANCE: $23.38 O $0.00 O $0.00 O 50.00 0 $0.00 • O $0.00 50.00 $0.88 519.00 Aoorovals Grounding Electrode Underground Underslab/Floor Rough Conduit Walls Rough Wiring Ceilings Rough Service i s�nat ,:.� ` �.. H' I ,/ Temp Power •Applrnnt 0 s I ti < fpertsalion aoverogekuMawlulondsta.ssAsjetanamployer loakntolpon•othesand WSftses upto onehunsked NOV 81999 +Y �. Cass 11�r + v ' :IS AOD)�h�a J itolheoost ofoompensaoflo.td mopes as ptovlded(orIn Secfbn 370E of ft'a borcode Merest OndaU f- ., utility CO. Notified::: 0 eby ,c vIedge nm 1 hove,oad rl,>: apptglar. mgr ft inrananq, pa n b Cagier$ and than q;r itte owner. ad c _ n ._ .: CITY OF IVEWPORT BEI�ji�l. ' - s o "erect .-.. WORK MUST RESTARTED WRHIN A PERIOD OF 180 PAYS FROM THE DATE OF VAUDAAON OR THIS PERMIT BECOMES NUL AFJO VOID �? tom. .r rtrkt ve: PO Box 1768 Wewport Beach California R6.4,4 3915- HVAC kems ?Furnaces up, to.00k Btu/hr 0 -$0.00 over 100k Btu/hr 0 $0'00 Nall/Floor Heaters.,0 • �$0 00.. Heat Pumas & Package Units ? ` up to_100k atu/hr 0 $0,00 _.:up to. 500k Btu/hr- 0 $0.00 up to,1H' Btu/hr 0 $0. 00 up to.-1.751t Btu/hr 0 $0.00.. over '1.75N-Btu/hr 0 $0.00 .'LICENSED CONTRACTORS DECLARATION _l herebyellkm under penad y of palury_that t am Oeansad under provisions of Chapter 9 (commenting wits Section 7000) or Division 3 or the bus!ness and professions coda. and my liaise b M hill force and effect. l �+ lk«w.Nob' 2UVI aeu Dotett $• C\ corkecter: unrrcaNSTRtrcnopaMARHENANc wonses' COMrlaanoN DECWATIO1t 1 hereby Stni underponody of pMdury one tithe following I have and will maksbMa pMgiate Mcoro+nt toiet imua for deol ,,S.s , compensation, provided for by8.sYioe, 3700 of labor code, rorur performance of die work tor wNM1lrb perrrrakkawd. - .. I hive andwW maMhM Workers',wmpanatlon Insurance, to requkod by Section 3700 or Ibe labor code, forthe performance of the work for whkh this permit is Issued. workers coinpane+Bon lnierance centerand poky number Is. -•x.�ZslBicN pls co??}pikyrsy .; :)Y ��q S_ Legal Desc.: Contractor.- Address: Phone: Con. State Ldc. : Lic Expire: Bus: Lic.: Llc Exp Date: Boilers & Compressors up: to-3HP 0 over 3E1P to 1513P 0 over 15HP to 30HP 0 over 30HP to 50HP 0 over 50HP 0 Misc Items Fire Dampers 0 Gas Lino 1 Natal Fireplace 0 ICBO App.#- TOTAL: $32.88 ermtt No d1990049T Permit CounterTelephone (949)644-3288/3289 . InspectIon RequestsTelephone (9:9)6443255 Description of Work: )NECHIGAS LINE/CONDENSATE TRAP SEE 6034 99 UNIT CONSTRUCTION & MAINTENANC 1T000 MARQUARDT STREET CERRITOS CA90701 310/4048433 275506 10/31/2000 FEES Ventilation $0.00 Bathroom Pan 0 - $0.00 $0.00 Exhaust Fan 0 $0.00 $0.00 Attic Pan 0 $0.00 $0.00 Down -Draft Fan 0 $0.00 $0.00 Residential Hood 0 $0.00.. Commercial Hood 0 $0.00 $0.00 Repair/Alter/Add 0 $0.00 $3.70 Air Handling Units $0.00 up to 10k cfm 0 $0.00 over 10k eft 0 $0.00 PAYMENT : $0.00 BALANCE: $32.88 section need not: be cogiplete'ti tf the permk Is for one hundred dollars. ($100,or less) y ditty' apr�e,� ,F - eery m+mwso asbDecaiss to the workers' compensation laws taMa l7 �r b+MmMlanb)eCim DtewerkM'CpmptleNebnpmVbbna t. de 1/��d�y(ja_+L%b+bMe� }fin fpywkhtlaseproNebm. :hr t � �li L� '• Yo?: � �%'�'(I�,6 �T�i1 '(A W+minO FaasvLto seenvw;'.+4 prpNsH�bn eaV19 +Is uNa"-11". tlgilt subjeUan`upPby+rm ukMrul p+rsCW aMiMrDMaup.m ole tasdnd �~H�r a Onusand do0an (ttogeos). M addkbn mine oustot e�K${a��,�¢,�� �� t�t,� �eon4,+e*+OWLdamaass as provWW mrmStetbr3796 offM bboreode, kMetpt, and+ttonsi/s fop: �/" p 1��. �rrbYecknrwl+dee tlstlNve mad WeappflaOorq Matti MamntlonpMnbodneet; artl thatlam lls owner or '��`y �' �0•�Op H7�79 4a�orrsla��i! b�laws^rspsWiiq eonbue8onaed duy auOgrbW snt VAV Box Other COED TRAP Investigation iae Plan Check Issuance lie s w1.�,� !??A�i7:l <n Deaornurce of the waikrorwhlch the pefltb bsmds l sMe aol emptoyany per cal it if" rbhs-- -- kauesetnd +a, owrsr.l�eres 'stk i. J U"by swperaonwtab!! 1P"d; vfob0on oft”-b.a"ode;Y..0bd N loco`` .� �/• , ' Y '--, •,• , CIIYOF NEWPORTBEACH �I � � i `" ' i pis > t PAYS FROM THE DATE OF VAUOA710N OR THIS // . Yt • to $t rJ- �ti Y� I" YS 1r.T:. v1 "*' r -,„ pERMtT BECOMES NUtI AND VOID z t= vim• �,�r ti3'• s a'%• '� �..q. r TS."Y ;i, �x�cYs �•� t ;eti"'`t:. �i �! �`R ..t'�••�:= yfi'+� ; u t r ram. o i > •� �`T���•�� � 2 ^F .. i!l3rv4. `si d. tr v.r.. .._l.t �F Approvals Underslab/Ftoor HVACIHood - Rough Fireplace -Rough Gas Test Fireplace - Final HVACJHood - Final 0 $0.00 1 $7.40 o $o.00 $0.00 $2.78 $19.00 Inspector/Date • . • • a'lYw City of Newport Beach PO Box 1768 Newport Beath, California 92658-8915 Job Address: 1 HOAG DR Inspector Area: 8 Owner. Address: Building Department ELECTRICAL Permit No: E9905260 Permit Counter Telephone (949)644-3288/3289 Inspection RequestsTe!ephone (949)644-3255 Bldg: 1 Floor. Suite: Code Edit: 97 Legcl Desc.: HOAG MEMORJLL HOSPITAL PRESBY Contractor. ONE HOAG DR Address: Phone: 949/646-8901 CTh • Processed Phone: Con. State Lic. Lic Expire: Bus. Lic.: Lic. exp Date: Description of Work: MOBILE TRAILERS (41 Q CANCER CENTER ELEC(899054271 BRIGGS ELECTRIC INC 16662 MILLIKAN AVENUE IRVINE CA92714 714-863-9901 : 297836 New Construction Resident's( Multi -Family 1-2 Family Service 0 to 600V up to 200A 0 to 600V over 200A Over 600A/1,000A 0 $0.00 0 $0.00 0 0 0 $0.00 50.00 $0.00 Receptacle/Switch/Out lets Recep/Outlets 0 $0.00 Fixtures 0 $0.00 Sep Circuit 0 $0.00 Skins Branch Circuit 0 $0.00 each Add Circuit 0 $0.00 TOTAL: $35.50 PAYMENT: $5.43 80003113 FEE Motors/Transformers (HP/KVA( 0 to 1 HP/KW/KVA 1 to 10 HP/KW/KVA 10 to 50 HP/KW/KVA 50 to 100 HP/KW/KVA over 100 HP/KW/KVA Other Time Clocks INSPECTOR NOTES: inspector 0 0 0 0 0 $0.00 S0.00 $0.00 $0.00 S0.00 0 $0.00 LICENSED CONTRACTORS DECLARATION _I hereby e eby alrrm tensed m under penally of perjury that I am teed under provisions of Chapter 9 (comendng with Section 7000i of Division 3 of the Business and Professions code. ond my [cense is in (unlace and effect. License No: 297836 Claw Contractor. BRIGGS ELECTRIC INC WORKERS COMPENSATION DECLARATION I hereby citron under penalty of perjury one of the following declaaliont I hove and w l maintain a certificate of consent to self4nsure for worker' compensation. as provided for by Section 3700 of the labor code, for the performance of the work for which this permit is issued. I hove and will maintains wakens' compensation kaurance, as reamed by Section 37E0 or the lobo code. for the performance of the work la which this permit is issued. My workers' compensation insurance carter and poly numbers is: Corder. RELIANCE NATIONAL Pelcy number: U}Ye014LOt4I Erpte :07b1/j00Q This section need not be completed if the permit is for one hundred dollars ($100) of Tess. I certify that In the performance of the work fa which this permit is Issued. I shop not employ any person in a of California. and agree That if 1 should become subject to the workers' ooroensalon provisions of Section 3700 of tb Date. 0 ^ Waning: Fakirs to secureworkea' v aaty`ensotbn coverage b unlawful, and shall subject an employer to criminal I - S 1 Apptoont Signature: X finer so as to code. l shall 1 Temp Power Pole Temp Underground Sub Panel Investigation Fee Phan Check Issuance BALANCE: $30.07 0 $0.00 0 $0.00 1 $13.20 0 $0.00 0 $0.00 50.00 $3.30 $19.00 subject to the workers' compensation laws candywith those provisions. oEadT'ies and dvR to one hundred ($100.1X1CL In ao 11!on to the cost of conpensatkxudamages as provided fa in Section 3706 of the labor code. interest. and attorneys fees. I hereby actaowledge that I have read this °ppication; that the infamatlon given is correct: and that 1 am the owner. a duty authorized agent of the owfser. l agree to comply with city and state lows regulating construction: cod in doing the wak authorized thereby. no person wit be employed In violation of the labor code of the state of Celfania relating to workmen's comp - , . non insaancer Permittee Name (Print) 4 Signature of permittee: Approvals Inspector/Date Grounding Electrode Underground Underslab/Floor Rough Conduit Walls Rough Wiring Ceilings Rough Service Temp Power PAttiIPCo. Notified OCT Fia`1999 Address : Q41� GITY OF NEWPORT BEA.CH Date: /O /--!p to-G.-et? 40 /drfs•/9 tw WORK MUST BE STARTED WITHIN A PERIOD OF 180 DAYS FROM THE DATE OF VALIDATION OR THIS pERMR BECOMES NULL AND VOID.. u STRESS EXPRESS FIFA D REPORT TO: Peck Jones - Hoag Hospital DATE: 10/6/99 40201/2 Pacific Coast Hwy. ATTN: Bruce Andersen Newport Beach, CA 92663 RE: Tendon Repair - Parking Structure INITIAL INQUIRY: Tendon mysteriously broke from vibration of slab while working on drain. Tendon is 1/2" mono strand. REPORT: Tendon was found to be broken where hole was drilled for wedge anchor at another drain. Drain was removed and concrete was chipped up to allow access for repair of strand. Tendon was repaired using couplers, new strand and loc-couplers as shown in sketch. Anchor at intermediate joint was exposed j _.: y : es were removed to allow stressing of entire tendon near center. Tendon was stressed to 30.0 Flnngnrinn;14" All work was performed under my direct supervision and is as stated on this report Paul Faynor P.E. 5- roeEs5 .4 ` /4,' c o uPc.E, NEW STRA Loc.-COvPLEA EXPOSE ANCMO,e le "EM o vE ws ES AT !Aft Con/S j, , -• T-otAl t)RAIN� :DRAIN POST TENSIONING SPECIALISTS 23172 ALCALDE, UNIT A, LAGUNA HILLS, CA 92653 TEL 949-837-5590 FAX 949.837-5591 LIC. NO.647378 TENa0n AS PART of EXPGoRATo,ey'; vs/ oAte I ;t $2.000.00 $55.00 $39.60 S0.00 $100.00 50.00 $0.00 Building Department Permit Counter Telephone (949)6443288/3289 Legal Descr: Contractor. Address: Phone: Con State Lic: Uc Expire: Bus tic: Uc Exp Date: Description of Work: )LLUM DIj1ECTIONALSIGN "HOAG CONFERENCECTR" 0115-2000 • ._t LETTERING CO 17822 GEORGETOWN LANE HUNTINGTON BEACH CA92647 714/8485596 591853 04/30/2000 Workers' Compensation Insurance - - Carder. FARMER INS EXCHANGE Policy Nc: A09233074 Eire: 08/01/2000 Architect :'address: Phone: Engineer. Address: Phone: Designer. Address: Phone: Special Conditions: State Lic: State Lic: Building Setbacks Rear. ! Ref. Hoag Hosp. P.C. Front / Left: 1 Right: 1 Use Zone: PC Parking Spaces: FEES Microfilm: Excise Tax- Res.: Excise Tax- Com.: Supplemental P/C: San District: SJH Trans.: TOTAL FED : S209.05 City of Newport Beach PO Box 1768 Newport Beach, California 92658-8915 Job Addre3ls: iJ Inspector Area:8 Owner. Address: Phone: Applicant: Address: Phone: OAG DR Floor. Suite: Bldg: 1 HOAG HOSPITAL ONE HOAG DR NEWPORTBEACH,CA STOUT DENNIS 871 N MAPLEWOOD ST ORANGE, CA 92867 714/744-2845 Code Edit : Type of Construction: Occupancy Group: Added /New sq.fL Bldg: Added /New sq. ft. Garage: No of Stories: 0 No of Units : 97 Consinrction Valuation: Building Permit. Fee : Plan Check Fee: Investigation Fee: Clean Up Deposit Energy Compliance : Disabled Access: PROCESSED BY: PLANNING APPROVAL; FIRE APPROVAL; GRADING APPROVAL : PUBLIC WORKS: $0.78 $0.00 $0.00 $0.00 $0.00 50.00 Additional Fire HMQ: Fair Share: Hazardous Mat Disclosure: Park DED: CA Seismic Safety. Other Fee: S0'0 Planning Dep - - $0.00 Plan Check: $13.17 $0.00 Counter Rev.: $0.00 $0.00 OverTime Plan Check Fee: $0.00 $0.50 Fire Dep - - $0.00 Plan Review: $0.00 Inspection: S0.O0 TOTAL PAYMENT : $39.60 TOTAL DUE : 5169.45, OTHER DEPARTMENT; PLAN CHECK BY; APPROVAL TO ISSUE: -k1 A 14-1 1;7;44-- PAID FEB 10'2000 CITY OF NEWPORT BEACH WORK MUST BE STARTED WWI A PERIOD OF 180 DAYS FROM THE DATE OF VALIDATION' OR THIS PERMIT BECOMES NULL. A"'D VOID, APPROVALS DATE BY FOUNDATION: ROUGH GRADE LINE 8 GRADE CERT/SETBACKS ERECTION PADS FOOTINGS SLAB ON GRADE DECK SLAB FRAMING: SUBFLOOR ROOF & BUILDING HT EXT. SHEAR/HOLD DOWNS GENERAL FRAMING INSULATION DRYWALL SUSPENDED CEILING PLASTERING: INTERIOR LATH EXTERIOR LATH SCRATCH (2 DAY) BROWN (7 DAY) MASONRY FOOTING PRE -GROUT FIREPLACE MISC. INSPECTIONS' PERMIT EXTENSION 1ST EXP. LETTER 2ND EXP. LETTER PERMIT EXPIRED PERMIT CANCELED FINAL CERTIFICATE OF OCCUP: 'ICY TENANT NAME: TYPE OF BUSINESS USE: COMMENTS PLOT PLAN FOR ADDITIONS: Sketch a plot plan. Show all structures on site. denti y addition. Street side at bottom of sketch. (Show North Arrow) ..OWNER-BUEOER DECLARATION pry` I EtTIEBY AFFWY UNDER PENALTY (1F PERJURY THAT t AII.EABIPT FNMA THE CONTRACTDIG LICENSE LAW FOR 1NE FOLLOW/0 REASON (SEC. UD1S. SLIMNESS APW PROIIJsEs CODE MT OW OR COUNTY WHICH PEG: FS A PERMIT 10 CONSTRUCT. ALTER. IMPROVE. DEMURE OR REPRO ANY STRUCTURE PRIOR TORS ISSU NCR. A150 REQUIRES THE APPLICANT FOR SLOT PURE TO FIE A SOWED STATEMENT WAY HE INTSJW S LICENSED PURSUANT 70711E PROVISIONS OF THE CONTRACTORS LCFNEE LAW le'APTER 9 COAPENQFC KITH SEC WM OF MV.S OF 111E EIT SNElS AND PROFESSIONS CODC) OR MAT HE OR SHE IS EXEMPT THEREFROM AND 1HE BASIS FOR THE AUSGEO EAEDPTIG4 ANY VIOLATOR OF SEC. 70315 BY ANY APPI 'MAR FOR ANENWT SUB4C75 ME APPLICANT TO A CM PENALTY OF NOT MOIETWF FIVE HOWIE-13 MUM '1500k ❑ L AS OWNER OF 1/E PROPERTY. OP. ITV EMPLOYEES WITH NOSES AS THEIR SCLE Cp1FFNSAICH. WEL 00111E WORK MD TIE STRUCTURE IS NOT 'NICKED C RFFFERED FOR SALE (SEC TON. BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY INTO BUILDS OR WOROVES THEREON. NW WHO DOES SUCH ARM NNSELF OR HERSELF OR ThR0.tDH HIS OR 14R CNA11 EMPLOYEES. PROMDETI THAT SUCH MPROVOIORS ARE NOT RIEADFD CFI OFFERED FOR SALE. F. ICWEVER. TE BULDYIO OR IMPROVEMENT IS SOLO YATHN ENE YEAR OF COMPLETION. THE OM4SM LDER Wil HAVE THE BURGOF PRORYC THATH'E OR SHE MO NOT BOLD CA IMPROVE FORT14EPURPOSE OFSAEEN L AS OWNER OF THE PROPERLY. A•! EACWSMLY Cann*cTBa N'TII LCEHSED CONUUCIORS 10 CONSTRICT SHE PROJECT )SEC ,DK BUSINESS AND PROFESSIONS CODE 10E CONTRACTORS LCENSE LAW GOES NCI APPLY TO AN OWNER OF THE PROPERTY WHO WADS OR BIPRORES THEREON: AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONIRACTOR!SI LICENSED PURSUANT 70 THE CONIRACIORS LICENSE TAW.I. _ ❑ ISM EJtEUnUNDER SECS BA P.C. FOR THIS REASON UCENSED CONTRACTORS DECLARATION 1 HEREBY AFFEW MAIER PENALTY OF PERNRY THAT 1 AM LICENSED (MCA PROVISIONS OP CHAPTER 9 ICOLMEMYIG WYTN SECTION 70013 OF DN5CII 3 OF 11C BUSIRMS AND IN OFESEIONS VIDE MOW UCEISE S N RAL FORCE AND EFTECT. UCENSE CLAW DATE / a— to -CO TDR p`l\p �(_`.Q�i WORKERS' COMPENSATION DE 1 HEREON ARAM ENDER PENAL F/ OF PERJURYOW OF THE FOLLOPPFG OEMRANOS: I HARE AND Wit. MANTAt1 A CER1FCATE OP CONSENT 70 SELF4 CURE FOR WORKERS COMPENSATION. AS PRCMOED FOR BY SECTION 5700 CF TIE LABOR CODE. FOR HIE PERFORMAMa OF TIE WORK POOL WHK.71 MIS PEWIT S ISSUED. I HAVE NO WILL WWTAN WORKERS' COMPENSATION NSURM CE AS REQUIRED BY SECTOR 7751 OF THE LABOR CODE. FOR THE PEHFDIDMHCE Ef TIE WORK FOR WHICH 71V5 PEFM1Y, S ISSUED. MY WORKERS COMPENSATION NSURPAICE CARRIER AND PEROT RAWER ARE CARRIER FOL. Y ROWER (DR5 SP:TOTV NEED NOT BE COMPLETED F THE PERMIT S FOA ONE 101011ED Rums OI WT OR LESSI. IVERTIFY 'MAT N THE PERFORMANCE OF THE WON FOR WHOM 1MSREMIT S L5S.'ED.I SHALL NOT EMPLOY ANY PROWL N ANT IWWER SD AS TO BECOME SUBJECT 10 THE WORKERS COMPENSATION LAWS OF CALIFORNIA. AND AGREE MAT F I SNOT, IECOAE SUBJECT TO NNE WOR.KERS'ca*APENSAION tON5OF S . ELABOR 1 SHALL FONIWOH COMPLY % !T H 7KG3 DATE�Y WARMING FALURE TO SECURE WCARERS' ERNIE 15 IJP4AWNL. SHALL REJECT AN EMPLOYER TO CIUAANAt PENALTIES AND OWL RNES UP 10 CAW MICRO] THOUSAND DOLLMO 4100000). N ADDROF TO THE COST OF GOMPE BATON. DAMAGES AS P1I0NDED FOR N WORM NOP OF 'NE TABOR WOE. MEREST AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY. *EARN AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTER LENDING LAMY FOR THE PERFCFRAA'CE OF TIE WORK FOR WIBCII THIS FERRITE IS SSUED ISEC.3097. 0V6L LENDERS ACORE55_ 1 CERT*1/2 THAT I HATE READ 1HS APPLCATION NO STATE 111A1• THE ABOVE INFORMATION S CORRECT. I AGREE TO COSTA WITH ALL C MY A:IOCCUITYO RDNAICEE AND OTAIE LAWS RELATING TO BULONG COYSTRACIIOIL AND HEREBY AUTHORIZE REPRESENTATIVES OF INS COLT IY TO ENTER UPON THE ABOVE MENT1011E0 PPOPEIVI IMP r1LS City of Newport Beach PO Box 1768. Newport Beach. California 92658-8915 Building Department Permit Counter Telephone (949)6443288/3289 ELECTRICAL Permit Ncc, 1 Inspection RequestsTelephone (949)644 3255 a D75 i-ar" Job Address:1 HOAG DR Bldg: 1 Floor: Suite: Inspector Area: 8 Owner. Address: Phone: Code Edit 96 Legal Desc.: HOAG HOSPITAL ONE HOAG DR NEWPORT BEACH, CA Processed By. /W Contractor: Address: Phone: Con. State Uc. Uc Expire: Bus. Lin.: Uc. Exp Date: Description of Work: ILLUM DIRECTIONAL SIGN "HOAG CONFERENCE CTR" ELECTRIC f82000-01441 LETTERING CONCEPTS 17822 GEORGETOWN LANE HL'NTINGTON BEACH CA92647 714/848-5596 : 591853 04/30/2000 New Construction Jtesidentia( Multi-Famiy 1.2 Family Service 0 to 600V up to 200A 0 to 600V over 200A Over 600A11,000A 0 0 0 0 0 Receptacle/Switch/Outlets Reeep/Outlets 0 $0.00 $0.00 Fixtures 0 30.00 $0.00 Sep Circuit 0 $0.00 $0.00 $0.00 $0.00 Sions Branch Circuit each Add Circuit 1 t:19.00 0 $0.00 TOTAL: $42.75 PAYMENT: $4.75 FEE INSPECTOR NOTESz Motors/Transformers (HPIKVAI 0 to 1 HP/KW/KVA 0 30.00 1 to 10 HPIKWIKVA 0 30.00 10 to 50 HP/KW/KVA 0 30.00 50 to 100 HP/KW/KVA 0 $0.00 over 100 HP/KW/KVA 0 30.00 Mtn Time Clocks 0 $0.00 Temp Power Pole Temp Underground Sub Panel Investigation Fee Plan Check Issuance BALANCE: $38.00 O 30.00 O $0.00 O 30.00 O $0.00 0 $0.00 $0.00 $4.75 $19.00 r San CONTRACTORS DECLARATION hereby aiMn under penalty of p 4ay that 1 an tensed under provisions of Chapter 9 (commencing wlth Section 7020) of Division 3 of the Bauhaus and Professions coda. 3/4a my license is In furnace and effect. erne No: 5t11153 Claw Contactor: LETTERING CONCEPTS DAIn WORKERS COMPENSATION DECLARATION 1 hereby oRFm under penalty of penury one of the foAowtng dedaatbnc E� ors _I hove and ova rru ntdn a certificate a consent to selliswe for walrus' compensation. as provided fa by Section 3700 of the labor code. for the cave and al which ilk permit Septti tip . v . _t have and ova maintain workers' compensation hwanae, as negated by Section 3700 of the tabor made. for the performance or t h 6su�dl`y My workers' compensation Insurance canter and policy numbers t Canter: NARIPORD INS Sp Poky number. 72t'C2II1 Exploit : 9itMfl994 This section need not be completed if the permit is for one hundred dollars (5100) or less. 1 catty that In the performance of the work fowhlrh this puma I hued. t shall not employ any person in any manner b es of California, and agree that 111 should More subject to the waken' compensation Provisions of Section 37 labor rpdprisshal gal./ra- \Ci — Applicant Signature: w sal i Fdure to seau awarkers' compensation coverage 5 unlawful. cnd stag subject an .a to the workers• compensation laws �h:h65e.araMTCIS and civil fifes up to one hundred ($103.000). h addtbn to the cost of compensatbn.danages as provided for In Section 3706 of the labor code. Interest. and attomey's fees. I hereby ock nowiedge thot I have reed th s appicatlon: that the hfa malbn given Is correct and that I am the owner. aduly authorized agent of the owner. l ogee to comply with dty and state laws regulating cc sbuatbm: and iv doing the work authorized thereby. no person will be employed h violation of the labor code of the state of CaWoala yet -ling to workmen's Mon Mon hsurance. Permittee Name (Print) /‘ be V\ • t -U Address: Bi i ta' AnAlittatict 11- alb Signature of permittee: Date: a -(0-OD ADDroaals Grounding Electrode Underground Underslab/Floor Rough Conduit Walls Rough Wiring Ceilings Rough Service Temp Power Utility Co. Notfled Final JnsDector/Datq WORK MUST BE STARTED WITHIN A PERIOD OF 180 PAYS FROM THE DATE OF VAUDATION OR THIS pERMR BECOMES J4ULL AND VOID, ..'" t ' irk Kn:A itiia � t . BUILDING ELECTRONIC CONTROLS I 457 W ALLEN AVE STE 109. SAN DIMAS' S; CA91743 '909/305-1600 •- Edit Code: Type of Construction w;Occupanc i Group: i (;Added /New sq_ft:Bldg Added/NewGarage: No of Stories ' No of Units ::' ?: CoostipCtiori Valuation: 63.00 = r . Rre Plan Check Fee Fire Perm!tl Inspection !ee. ` Mcrofiim r investigation Fee Other Fee ennri Coun.` Telephone (949)644-3288/3289 Inspection RequestsTelephone (949)644-325f Descriptlon of Wort. TVFIRE ALARM: MEZZANINE.. - 10668:20001 Contractor 'i- BUILDING ELEC Address.: "" 457 W ALLEN AVE STE 109:'_' . •SAN DIMAS : CA91743 Phone 909/305-1600 Con. State Lic Lie Expire: 11/30/2000 Bus. Lic.: BT97025666 ' Lic Fxp Date: 10/31/2000 Workers' Compensation Insurance - - Carrier. SUPERIOR NATL INS Policy No: ` W0N18997-C Expire: 06/26/2000 $98.00 $98.00 62.34 $0.00 90.00" TOTAL FEE :'$198 34 729905 Engineer. Address: Designer. Address:` - Phone: Special Conditions: TOTAL PAYMENT : $98.00. TOTAL DUE, $100.34 iMiNtia r*f.`Ia- FIRE•PROTECTION"FN! UNDERGROUND ROUGH'.PIPE THRUSTBLOCKS EXCAVATION.i' UNDERGROUND PIPING'FLUSH5 UNDEFIraOUND HYDRO`TEST UNDERGROUNDIBACKFLOW.APR V: STANDPIPE HYDROSESTL ' `.- STANDPIPE FLOW TEST STANDPIPE ROUGH PIPE r <. CHEM SYSTEM FUNCTION TEST CHEM SYSTEM APPROVAL SYSTEM FUNCTION TEST CENTRAL STATION MONITOR TANK INSTALLATION/TEST TANK PIPING PRESSURE TEST MEDICAL 'GAS 'PIPING TEST r . CROSS CONNECTION. TEST /9JL-'.feSlf El . ' L.t hl r ti N ri'• • :YYY 1• t OWNER•BUILDER DECLARATION .. I .Y •.:. HEREBY AFFITIM omen. PENMTYOf: PERJURY THAT-1 AM EXEMPT.FR04R jHE CONTRACTORS+ . UCENSE LAW. FOR THE FOILOWIFiG R.TASON iVL-C 70315. WUSMESS AND PROFESSICIR t 00E_ANY! CRY OR mom %T O1 RFCUIRES. A PERMT TO CORSO-Mt ALTER: IMPROVE: DEl10l6N Mt` 'REPAIR ANY STRUCTURE. PRg11 TOGS ISSUUA.E ALSO PEOJRESTHE APPLICANT FOR SUP/ PERM' I 70 PIE A SIGUED STATEMENJTTH AI HE 00 SHE LS TYENAFR PURWMITTOTNE PROVISOG OFTHE' *read RACKETS LICENSE IAWICHMTER 9(COIJECING WIN SEC. TRIO OF DIV. 30F THE BUSINESS - AND FRC$1SSQ'IS CODES OR THAT HE ON SHE TS EAEMPT.THEREFROM AND IWE BASIS FOR THE ALLEOID EXEMPTION -ANY VCLATNON OF SEC. 703i BYANYAPPLICANTFORAPERMITSILBJECTS- THEAPLtJ1ANTTOACWLPEiNALTYOFNCTMORETHANFWEIKWOPEDDOLLARS(T500Y ❑ L AS OWNER OF THE PROPERTY: OR MY EAD'LOYEES WITH WAGES'AS THEFT sax CGJPEN,ATION, Will 00 THE WORK. AND THE STRUCTURE S NOT INTENDED OR OFFERED FOR SALE ISEC. 70LL. BUSINESS AND PROFESSIONS CODE- DC COHTIULTORS LICENSE -I. AW DOES NOT APPLY. TO AN OWNER OF PROPERTY WTNO BUILDS OR MPIlOVES THEREON. AND WHO 00E5 SUCH WORK (**SELF 01 HERSaF. OR TIROUCM NS OR NFA OWN • EMPLOYEES.. PROVIDED' :THAT: SUCH IMPROVEMBRE-ARE NOT INTENDED OR: OFFERED FOR SALE. IF: HOWEVER. THE GUIDING OR WPROVEICNT IS SOLD RATTAN ONE YEAR OF OCMPLET OtI. TIT£. OWNER.BUA.DER wax HAVE THE SUDOIOE PRO} MAT HE OR SHE 010 NOT EUILDOR RWROVEFOR THE PURPOSE OF SALE/. -I. AS OWNER OF THE PROFERTY. AM - EXCIUSNELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT ISEC. nu. BUSINESS AND PROFESSIONS CODE: THE COYTPA.•TORS LICJ'-' 1E LAW DOES NOT APPLY TO AN OWNER OF THE PROPERTY WHO GUILDS OR IMPROVES THERE. :...ND WHO CONTRACTS FOR SUCH PROJECTS WITH A GOYTRACTO4i5)LICENSED PURSWNT TO THE ..JINTRACTOta' LICENSE LAW.) LICENSED CONTRACTORS DECLARATION I HEREBY AFFRU UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER 9 TOO ITEWcniG WITH SECTOR MIX OF IIMISX 113 OF 111E BUSINESS AND PROFESSIONS CODE AND Mt LICENSE IS N FULL FOIE AND EFFECT. WORKERS' COMPENSATION DECLARATION 1 HEREBY AFFWMUNDER PENALTY CFPEFWRy ONE OF THE FOLIO -NAG DECLARATIONS 1 HAVE AHD WILL MAMAN A CERTIFICATE CA' CONSENT TO SELFVISLJRE FOR WORAERS• C0tWENSATIOtt. A5 PROWOED FOR BY SECTION 3700 OF THE LABOR COOS FOR THE PERFORMANCE OF DC WORK. FOR WHICH TINS PERWT IS 6SU0O. 1 HAVE AND WILL MANTA** WORKS S- COAETS*TON PJSURAt1(E. AS REOUIRED BY SECTICY73700 OF THE LABOR CODE. FOR THE PERFORMANCE OF THE WORX FCR WHICH TINS PERMIT LS GLUED. MY WORKERS' COMPENSATION INSURANCE CAREER AND POLICY NUMBER ARE: CAREER POLICY TIMBER (TIPS SECTION NEED NOT BE COMPLETED F THE PERMIT C FOR ONE MJND(IED COLARS . . 15L0a ORLESSi. I CERIWY'MAT N THE PERFORMANCE OF THE WORK FOR WIII(3N THIS PEWIT IS ISSUED.1 SHALL. NOT EAFLOY ANY PEPSCN E ANY MANNER SO AS TO BECOME SUBJECT TO THE WCItI•ERi COMPENSATION LAWS OF CALIFORNIA. AND AGREE THAT IF I SHOULD BECOME SUBIECTTOTHEWORKERS'COMPENSATION PROVISIONS OF SECTION 3 THE LABOR -/ (QjppEyI SHALL cORTHWITH COMPLY WI E FROVNIOKS. SIT DATE- l` ©C� APPLICANT. WARNING. FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UIRATYFTK. ARO SHALL SIRIECT AN EMPLOYER TO CRIMINAL P€HALTIE3 AND CNK F:4ES UP TO ONE HUNDRED THOUSAND =LARS 151010071. N ADMIOV TO THE COST OF COMPENSATOR. DAMAGES AS PROVIDED FOR N SECTION 3TOS OF TPC LABOR TXKOF. INTEREST. AND ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY 1 HEREBYAFFIRM WIDER PENALTY OF PERJUIYTHATTHEPE IS A CONSTRUCTOR LENDS(' AGENCY • FOR THE PERFORMANCE OF THE WORK FCP WHICH THIS PERMIT IS ISSUED 4SFI' 'WIT. CIV.0 I ;LE NDERSILWE - .. .. I CERTIFY THAT I HAVE READ TH19, APPLICATION AHD STATE THAT THE ABOVE INFOWMTKN S CORRECT.' I AGREET° COMPLY W TIH ALL OI Y AHO COUNTY DDDQ VICES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION. AND HEREBY AUTHORIZE REPRESENTATWES OF THIS COUNTY TD TITER ION THEABOVFMEMgINEO 'NY FOR INSPECTION PURPOSES 1� EY'p �L �J G� Alt -e NAME(PRP/ Bog1768 Newport Beach California 926b8-8915 . Pennit Counter Telephone (949)6443)8813289 Inspection RequestsTelephone (94.9)644 3255 1,- r - 38s;<k;1"HOAG.DR. HOAG MEMORIAL HOSPITAL 1 HOAG DR ; NEWPORT BEACH CA 92660 rs GARVIN FIREsPROTECTION 501_W SOUTHERN AVE.,. ORANGE CA 92665 Phone: i ;. .;714874-8770 Code Edit 97 Type of Construction Occupancy Group: B . • Added /New sq.ft. Bldg Added /New sq. ft.'Garage No of Stories. f. No of Units : Construction Valuation: `; 42.400,QQ Fire Plan Check'Fee Fire Permit Insertion Fee: Mlc:oflri . • 'InJestigation Fee: 2 Other Fee. - - oor': : 3"Sui $98 00 $98.00 $0.52 $0.00 $0.00 Description of Work:` FIRE S_ SPRINKLERS f0289-20001 "BLDG'44i" ADD 71RELOCATE 17/MEZZANIN LVL ' inspector ntractor_GARVIN FIRE, PR ; dress;' : ; 5011N SOIH t: ERN AVENUE Phone:714/974-8770_. Con. State tic.: 702554 Lic Expire: 02/2812001 Bus. Lie.: BT00022557 LIc. Exp Date: 06/3012000' Workers' Compensation Insurance Carrier. AMERICAN CAS CO Policy No 1067940443 Expire: . - 06/20/2000 Architect - Address: Phone:' Engineer. Address: Phone: Designer. Address: Phone: TOTAL DUE : $98.52 PROVALTO ISSUE:' Job WORK MUST BE STARTED WITHIN A PERIOD OF 180 DAYS FROM THE DATE OF VALIDATION' OR THIS PERMIT BECOMES NULL VOID ru 4 APPROVALSY : 'E:'-"'.tzik:FIREIPROTECTION; r ':"$ sc� UNDERGROUND -ROUGH PIPE At THRUST BLOCKS EXCAVATION UNDERGROUND:PIPING FLUSH UNDERGROU N D' HYDRO=T ES L UNDERGROUND/BACKFLOWAPR SPRINKLER FLOW TEST SPRINKLER ROUGH PIPE g-17-00 STANDPIPE HYDRO TEST STANDPIPE FLOW TEST STANDPIPE ROUGH PIPE CHEM SYSTEM FUNCTION TEST CHEM SYSTEM APPROVAL FIRE ALARM SYSTEM ROUGH WIRING .^_.VdTEM FUNCTION TEST CENTRAL STATION MONITOR FIRE MISC. TANK REMOVAL TANK INSTALLATIONTTEST TANK PIPING PRESSURE TEST MEDICAL•GAS PIPING TEST CROSS CONNECTION TEST MISC. INSPECTIONS: Rxk=:4- !tit it•._.T, OWNER•BUILDER DECLARATION. .• 1 HEREBY AFFIDA WIDER PENALTY OP,PERNLY T1MT:1 AM EKEIAPT FROM THE CANTHACTMC OCBSE LAW VCR THE FOLLOtwIG REASON ISEC 703IS BUSINESSAND PROFESSIONS CO *. ANY CITY OR COUNTY W1C1 REQUIRES A PERMIT TO CONSTRUCT. ALTER. IMPROVE. .BEMOLISF40R ;ERRANT STRUCR:RE.PWON TO ITS ISSUANCE. ALSO RE JIRES THE APPLICANT FOR SUCH PERMIT, `TORE A SIGHED STATEMBIT TWAT HE OR SHE IS LICENSED PURSUANT TO THE PROWSgIS OF THE CONTRACTORS LK:OISELAW COMPEER (COAIETNNGWITH SEC TODiD OF Div. 1 OF THE BUSINESS AND PROFESSIONS OCHER OR THAT HE DR SHE IS EXEMPT' THFAFLROM AND THE BASS FOR THE ALLEGED EJEWTAYL ANY VOTARY/ OF SEC TOT 5 BY ANY APHICANT FOR A PERMIT -SUBJECTS THE APPLICANT IDA OR PENALTY OF NOT MORE THAN ME RHYMED DOLLARS GSM' : ❑ L AS OWNER CIF THE PROPERTY: OR MY EMPLOYEES WITH WAGES AS TER SOLE COMPENSATION. WILL 00 THE WORK MO THE STRUCTURE IS NOT NTENDED OR OFFERED FOR SALE LSEC 7044, BUSINESS 0-VD PROFESSIONS CODE THE CONTRACTORS LEVEE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS CR IMPROVER THEREON. A.ID WHO 00E5 SUCH WORK HOLSE(F OR HERSLIF 011 INR0JO1 1AR OR TER OWN EMPLOYEES PROJBEO THAT SUCH I PROvEMB1TS ARE NOT NTENDED OR OFFERED FOR SALE: IF.- HOWEVER THE BULDIAT OR WPROVA.ENT IS 50L0 WITHIN one NEAP. OF WMPLETCN. THE OWNERBUIOER VRLL TIME THE. BURDENOF PAWING THAT HE OR AIL 040 NOT BUILD OR IMPROVE FOR THE PURPOSE OP SALE/ ❑ 1. AS OWNER OF THE PROPERTY, AM' EkCU:51VELY CONTRACTING WITH IICEHSED CONTRACTORS TO CONSTRUCT THE PROJECT (SE(:. TOT. BUSINESS AND PROFESSIONS COIL: THE. CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN CANER LE THE PROPERTY WHO WILDS OR NT4.GiES THEREON. AND WHO CONTRACTS FOR SUCI PROJECTS WITH A CGNTRACTON(S LICENSED PURSUANT 10 THE CONHACTOS LICENSE LAW.1 - - ❑ I AM EXEMPT ENDER SEC - B A P G. FOR TIES REASON DATE 'OWNER LICENSED CONTRACYORS DECLARATION 1 HEREBY AFFRM UNDER PENALTY OF PEHJURY THAT 1 AMU LICENSED UNDER PROVISOS OF CHAPTER 9 (C ALENCI G WITH SECTION TOAD or ON6KT 3 OF THE WSRESS MID PROFESSIONS CODE AND NAY LCENSE I5 N FULL FORCE AND EFFECT. LICENSEE CLASS.---- Lc. NO BATE\/ 3--24 -oy CONTRACT )JS—P7' - WORKERS' COMPENSATOR DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OFPERAIRY ONE OF THE FOLLOWING DECLARATIONS 1 HAVE M.O WILL MANTAN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR CORKERS' COMPENSATION. ASPROVIDEDFOR BY SECTION PCC OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I HAVE AND WILL IMMATT WORKERS' COMPENSATION INSURANCE. AS EMCEED BY SECTION 37C0 OF THE LABOR CODE. FOR THE PERFONAAT E OF THE WORN FOR WHICH THIS PERWT IS ISOJED. MY WORKERS" CWPENSATICN INSURANCE CARRIER AND POLICY NUMBER ARE: PDX? FARMER (TTHISIOISECORLTIONESS,. NOT T BE COLIR TIER IFTHE PERMI' IS FOR ONE HUNDRED DOLLARS I CERTIFY THAI N THE PERFORMANCE CF THE WORK FOR WHICH 1HIS PERMIT 15 ISSUED. 1 SHALL NOT EMPLOY ANY PERSON N ANY MANNER 50 AS TO BECOME SUBJECT TO THE WOOFERS' COMPENSATION TAWS OP CALIFORNIA AND AOREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF SECTKN 3T00 OF 1HE LABOR CODE. I SHALLNMTHWITH COMPLY MTH WFTHOSE I FNONIS(. /* • DATESC3-24.-OD APPIIGWT �F,J�J/�YiL�Q(ti. WARNING: FA11E TO SECURE WORKERS' COMPENSATION COVERAGE IS.UNLAYMIS. AND STALL SUBJECT AN EN'LOYEA TO CIIOA?AI PENALTIES ANC CIVIL FINES UP TO ONE HUNDRED. THOUSAND DOLLARS MIAOW. N ADDITION TO THE COST OF COMPENSATIONN. DAMAGES AS PROVIDED FORTH SECT013703 OF THE IA9OR LODE INTEREST . AND ATOFN, JEYB FEES' • - CONSTRUCTION LENDING AGENCY IHEREBYAFFIRM UNDER PENALTY OF PERJURY THAT IHERE S A COTSTEtlx1)ON LENDING AGENCY FOR THE PERFORMANCE DP THE WORK FORWWOI DOS POPATIS ISSUED ISEG3397.CN.4T. ' • LENDERSNAME - - 1 CERTIFY THAT I HAVT: READ 1HS APPLICATION AND STATE THAT THE ABOVE INFORWTION S CORRECT. I*GREET°CONVEY YAIH ALL O1YAND COUNTY ORM/TOO S MD STATE LAWS RELATING TO 1pl1DNG CONSTRUCTION. AHD HERESY AUTHORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE RgPERTY FOR INSPECTION PWSG9ES Eirii%:4'" .ALEYmAN ON MOP 2IF PFNIARTITF - - -_.. .HAIF City of Newport Beach PO Box 1768 Newport Beach, Califomia 92658-8915 Building Department Permit Counter Telephone (949)644-3288/3289 PLUMBING Permit No: P2000-0951 Inspection RequestsTelephone (949)644-3255 Job Address:1 HOAG DR Bldg: 1 Inspector Area: 8 Owner. Address: Phone: Floor. Code Edit: 97 HOAG MEMORIAL HOSPITAL 1 HOAG DR NEWPORT BEACH, CA Processed By: Suite: Legal Desc.: Contractor: Address: Phone: Con. State Lic. Lic Expire: 04/30/2001 Bus. Lic.: Lic. Exp Date: Bathroom Fixtures Toilet 0 Bidet 0 Urinal 0 Bath Tub 0 Shower Stall 0 Wash Basin 0 Hydro -Mass Tub 0 Floor Sink 0 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Floor Drain Kitchen Fixtures Kitchen Sink: Garbage Dlsp Bar Sink Vegetable Sink Ice Maker Dishwasher Lndry/Trap O $0.00 O $0.00 O $0.00 O $0.00 O $0.00 O $0.00 O $0.00 O $0.00 FEE$ Regulator Lawn Sprinkler .; 0 $0.00 Misc Water Piping Water Softener j. Water Heater Gas up to 4 outlets Gas over 4 outlebk Backflow up to 2'! TOTAL: $283.00 PAYMENT: I1 0 $0.00 O $0.00 0 $0.00 O $0.00 0 $0.1I Description of Work: PLUMBING/4" FLARE GAS PIPELINE REPLACES EXP PMT P9905019 COAST PIPELINE CM P O BOX 5711 • ORANGE CA928635711 714/998-0550 222184 INSPECTOR NOTES: %/2 (A �YAxon_ vMf/LGt7lstD 7, `74 4,caL //�9Aen "et_ 74/27 cos r %/174.O. /edffl 0 $0.00 Backflow over 2 $0.00 0 $0.00 Hose Bibb 0 $0.00 Drinking Fountain Roof Drain Grease Trap Grease Interceptor P-Trap BALANCE: 1 1/2 FEE 83.00 0 $0.00 0 $0.00 O $0.00 O $0.00 O $0.00 1 $264.00 0 Sewer Sewer 0 $0.00 Sewer Alter/Repair 0 $0.00 Sewer Abandon 0 $0.00 Investigation Plan Check Issuance $0.00 $0.00 $19.00 LICENSED CONTRACTORS DECLARATION _I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (co mencing .'ih sect and my license Is In full force and effect. lleeme No: ZY1184 clan: Date: C WORKERS COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declara I hove and will maintain a certificate of consent to self -insure for workers' compensation. as provided for for whisk this permit is Issued. I have and wit maintain workers' compensation insurance. as required by Section 3700 of the labor code, My workers' compensation Insurance canter and policy number is: Career. STATE FUND Peaty number. 913-0000494 Explr. : 04/01/2001 (This section need not be completed if the permit is for one hundred dollars ($100) or I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any ma of California. and agree that if I should become subject to the workers' compensation provisions of Section 3700 of Dale: - Applicant Signature: ons: Sect r the pe SS. 70001 of Division 3 0 eves slness d Pro ions co ` so as to ices• e sub ape. o `. • ers' compensation laws labor cod e,lsh.l v `�- complywith those provisions. . of ilia rsci; o r code. for in9 pertartnan e wofk forwhich Warning: Failure to secure workers' compensation coverage Is unlawful. and shall subject an employer to criminal penalties and thousand dollars ($I W,000). in addition to the cost of compensatbn,damages as provided for In Section 3706 of the labor code. nes up to one hundred Merest. a I hereby acknowledge that I have read this application: that the Information given is correct; and that I am the owner, or duly as. hared agent of the owner. I agree to comply with city and state laws regulating construction: and In doing the work authorized thereby, no person will be employed in violation of the labor code of the state of California relating to workmen's compensation Insurance. Permittee Name (Print) Address : Signature of permittee: Date: Approve Soil Pipe Sewer Water PI Gas Pi Plu round) (ground) (ground) ing (rough) as Pipe (rough) Water Heater Gas PSI Test Gas Co Notified Final WORK MUST BE STARTED WIWIN A PERIOD OF 180 DAYS FROM THE DATE OF VAUDATION OR THIS PERMIT BECOMES NULL AND VOID. Inspector/Date City of Newport Beach PO Box 1768 Newport Beach, California 92658.8915 Job Address: I HOAG DR NB Legal Desolptlon: Bldg: 1 Floor. Suite: Owner. HOAG MEMORIAL HOSPITAL Address: 1 HOAG DR NEWPORT BEACH CA Phone: Processed Building Department Permit Counter Telephone (949)644-3288/3289 inspection RequestsTelephone (949)644-3255 Inspector Area: 8 Contractor. Address: Phone: Con. State uc. Lic Expire: Bus. Lk.: Lie Exp Date: • Description ofWork: COAST PIPELINE CO P O BOX 5711\ ORANGE CA 928635711 2221998-0550� 222184 003418 Bathroom Fixtures Toilet 0 $0.00 Bidet 0 $0.00 Urinal 0 $0.00 Bath Tub 0 $0.00 Shower Stall 0 $O.30 Wash Basin 0 $0.00 Hydro -Mass Tub 0 $0.00 Floor Sink 0 $0.00 Floor Drain Kitchen Fixtures Kitchen Sink: Garbage Disp Bar Sink Vegetable Sink Ice Maker Dishwasher° LndrylTrap 0 $0.00 0 $0.00 O $0.00 0 $0.00 O $0.00 0 $9.00 FEES Regulator Lawn Sprinkler Misc Water Piping Water Softener Water Heater Gas up to 4 $O.00a.f suer 4 outlets ZS 4 M TOTAL: I hereby affirm under penally of perjury that 1 am lcensed and s previbns of Chap and my license k h lull farce and effect. licenseNa .222114 ono Date: WORKERS COMPENSATION DECLARATION: 1 hereby °film under penalty of picky one of I have and wit maintain a cergicate of consent to self -insure la waters' campensat fawhick this permit k Issued. X1 have and WA maintain v.crkere compensation Insurance. as requked by Section 3703 My workers' compensation Insurance carer and policy number k Canter FROMM' Poawnenner: WCI044a67St7 Expire :Q6@1ama Baio, up 9.00 P/iMAE�I labor code. fa (This section need not be completed if the permit is for one h ' red dollars ($100) or less. 1 away that h the performance of :he wok fawNch this permit Is lsued. l • .t empty any pawn in any roamer so as to become subject to theworkers• compensation laws of C°9a nio and agree tr t 9�qp�j�e�mte subject to the waken' -• pensalan proviso ns of Section 3700 of t boy sh crlh th wig h�vSons. jDal•• /�uL � �7t7 Applicant eo tnononEENcI AppRaanlskirtakx•) c>O � PLUMBING Permit No: P9905019 PLUM/GAS PIPING (502C-9V zi f CO ° o'F G45. LJnt IN ECTOR NOTES: obi 4,e /sr skids, if art CPO Wan `ir?i,`fR 2 ` Sa- C..c f. 0 0 30.00 $0.00 $0.00 00 00 Backflow over 2 Hose Bibb Drinkin t ' • u Roof 0 0 ntain 0 in 0 se Trap 0 rease Interceptor 0 0 p er 0 n.00 BALANC : 6 0 3 • the and Prolessions code. { SPA ID �y bar code. rc to t r 9 row wait he EAC leantg: Failure to secure waked compensation co - • and than subject an employer to ahnhol penalties and dd Ones up to one hundred thousand donors (S100.000). h addition to the cost of • • - nsation.darrages as provided for h Section 3706 of the labor code. Interest. and attorneys fees. I hereby acknowledge Mat I cpplaation: that the Information given is correct: and that l am the owner. a duly autncdzed agent of the comer comply with city and state laws regularly construction: and h doing the work °uthocked thereby. no person will be employed In violation of the labor cgae California.'s la relating to wormeperaa �kwsarnce. Permittee Norms (Pnnt)%/E/c�B-Ee i' L. CAI1rayAddress : Signature of permittee: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 1 $0.00 Sewer Sewer Sewer Alter/Repair Sewer Abandon Investigation Plan Check Issuance Approvals Soli Pipe (ground) Sower Water Pipe (sround) Gas Pipe (ground) Plumbing (rough) Gas Pipe (rough) Water Heater Gas PSI Tes 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $132.00 $19.00 Inspector/Date N 'E •DOFI:O $ FROM THE DATE OF VAMATION OR THIS PERMIT BECOMES NULL AND VOID, City of Newport Beach Building Department it P.O. Box'176B Newport Beath. CA 92658-8915 Permit Counter 'hone No. (714) 644-3238/3289 OWNER:!11LDER DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LICENSE LAW FOR THE FOLLOWING REASON (SEC 70315. BUSINESS AND PROFESSIONS CODEANY CITY OR COUNTY WHICH REWIRES A PERMIT 10 CONSTRUCT. ALTER. IMPROVE. DEMOLISH. CFI REPAIR ANY STRUCTURE. PRIOR TO RS ISSUANCE. ALSO REWIRES THE APPLICANT FOR SUCH PERMIT TO FILE A 51ONED STATEMENT THAT HE OR SHE IS LCENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS UCENSE LAW (CHAPTER 9 (COMMENCING virtu SECTION 70001 OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODEI OR THAT HE OR SIC IS EXEMPT 'THEREFROM AND 1HE BASIS FOR THE ALLEGED EXEMPTION ANY VIOLATION OF SECTION 70315 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE¢ APR (CANT TOA CNI PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS 15500 0 I. AS OWNER CA THE PROPERTY. OR MY EMPLOYEES WITH WAGES A5 THEIR SOLE COLA PENSATION. VAL1. DO THE WORK. AND THE STRUCTURE 15 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 MHO DOES SUCH PARK HIMSELF 0R HERSELF OP THRQJGH N15 O1 HER OWN EMPLOYEES. PROVIDED THAT SUCH IMPROVEMENTS APE NOT INIENDEU OR OFFERED FOR SALE IF. HOW- EVER. THE BUILDING OR IMPROVEMENT 15 SOLD WITHIN ONE YEAR OF COMPLETION. THE OWNER -BUR DER WILL HAVE THE BURDEN OF PROVING THAT HE ON SHE DID. NOT BUILD OR IMPLOVE FOR THE PURPOSE OF SALE I. LJ I. AS OWNER OF THE PPOPERTY. AM EXCLUSIVELY CONTRACTING WITH LICENSED COL TRACTORS TO CONSTRUCT ME PROJECT (SEC. 7044. BUSINESS AND PROFESSIONS CODE THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON AND WHO CONTRACTS FOR SUCH PROJECTS WITH A COL TRACTOR(S) UCENSED PURSUANT TO THE CONTRACTORS UCENSE LAW). ❑ I AM EXEMPT UNDER SEC. B AP.C. FOR THIS REASON DATE GYMER LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PFONSIOIS OF CHAPTER 9 (COMMENCING WITH SECTION 70001 OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS COOS. AND MY LICENSE IS IN RM. FORCE AND EFFECT. LICENSE n• C16 UC. NO. j(,(01[_ GATE y q�___ CONTACT W WORKERS'I:OMPENSATIONDE LARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FCKIOWM OECURATIOIS I HAVE AND WILL MAORAIN A CERTIFICATE OF CCNSEUT TO SELF -INSURE FOR WORK. EHCPERFORMANCEETHE WORK FOR MICR THFOCI BY IS PE•R�MITIIS ISSUED. 000E FOR _ JL I HAVE ASO VALL MAINTAIN WORKERS COMPENSATION INSURANCE. AS REWIRED BY `SECTION 3700OF THE DOOR CODE. FOR THE PERFORMANCE OF THE WORK FOR ?RICH THIS PENAIT 15 ISSUED. MY WORKERS' COMPENSATION INSURANCE CARRIER A N0 POLICY NUMBER ARE: CARRIER 00LUEflA 1E 1A5 HOUCY NMJBEFL----(Wet-7i;-]f— --- (THIS SECTION NEED BE COMPLETED IF THE PERMIT IS FC' ONE HUNDRED DOL. I CERTIFY THAT IN THE PERF.)FIMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I SHALL NOT EMPLOY MR PERSON IN ANY MANNER 50 AS TO BECOME SUB. JcCT TO THE MARKERS' COMPENSATION LAWS OF CALIFORNIA. AND AGREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS COMPENSATION P IONS OF SECTON3700 OF THE LABOR CODE. I SHALL FORTHWICMPu IT SE PROVE VMBNIN) FMLURE TO'SECURE WORKERS' COMPENSATOR COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUM BRED THOUSAND DOLLARS'3100A001. IN A00mON TO THE COST OF COMPENSA TON. DAM. AGES AS PROVIDED FOR IN SECTION 3706OF THE LABOR CODE. INTEREST. AND ATTORNEYS TEES CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT r. ERE IS A CONSTRUCTION LEND. ING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED LEPNOERSNAME I LENDERS ADDRESS I CERTIFY TAT I HAVE NEAR MIS AWUCATION AND STATE THAT THE ABOVE INFORM - MN IS CORRECT. I AGREE TO COMPLY LWM ALL CITY AND COUNTY OR! .N I NCFS AND STATE TAWS RELATING TO BUILDING CONSTRUCTION. AND HEREBY M.- HOP'. E REP ESENTAT IVES OF THIS COUNTY TO ENTER 'WON INC A • • EMENTONED PROPERTY FOR IN PECTION RJR FUSES JOB ADDRESS: BLDG: OWNER. AZ DRESS: CONTRACTOR: ADDRESS: FIRE PERMIT 1 rjiij jig FLOOR: SUITE: anlr M(Y))PILII Po!! "CD anin nP NFVPPDT !Flril, rl FT, DDfTrrtW 9 LDrnifl.TCTC 730 F DFPPI 1:)Ar MN!PFIA r!. N?PAS PHONE: PHONE: LITATE C.NO viol; CLASS: r!� NEWPORT BUS LIC ARCHITECT: ADDRESS: UC. NO.: ENGINEER: ADDRESS: LIC. NO.: PPLICANT: ADDRESS: PHONE: PHONE: F!!! PP! FPFr9IJCT117woT) 711 r PF!PA, !,N MAFIA. N 929 FIR! 90'PPF95104 Drrrit P000•e PATPP)) Drn!ert VRlr1tin^ rTD! DWI emir rrr FIEF FFPgITIINSDFrflnN FFF TOT(! Mr! Pf111P1Nr '.yut! rrrr INSP AREA. 71i/615-6510 ofnn91QPf1 71C Tin TT.+ VAT PHONE: 711(61i-6 W DESCRIPTION OF WORK: CONST.: TYPE OF CONSTRUCTION LEGAL DESCRIPTION SPECIAL CONDITIONS. PROCESSED BY: FIRE APPROVAL GRADING APPROVAL Permit No. F9700111 Inspection Requests Phone No. (714) 644-3255 'f lnlnl,rr l 1�NT r 1 ri ig(5501 !IT !TT? FTPr MEWS! TAD YI19F) OCC NO OF GROUP. STORIES OTHER DEPARTMENT PLAN CHECK BY APPROVA TO ISSUE P3y!Antc: Predit ettended: I Trta! ("milts: Ptlanre 71!i9ct!Ap t! ?alanre due 93.00 D.DD 93.00 93.00 0.00 91.00 APR •0 91997 CITY OF NEWPORT BEACH APPROVALS 1 DATE 1 BY COMMENTS FIRE PROTECTION THRUST BLOCKS EXCAVATION UNDERGROUND HYDRO TEST UNDERGROUND PIPING FLUSH UNDERGROUND ROUGH PIPE SPRINKLER HYDRO TEST SPRINKLER FLOW TEST SPRINKLER ROUGH PIPE TEST STANDPIPE HYDRO STANDPIPE FLOW TEST STANDPIPE ROUGH PIPE CHEM FUNCTION TEST SYSTEM CHEM APPROVAL SYSTEM FIRE ALARM SYSTEM 'TOUGH WIRING TEST SYSTEM FUNCTION CENTRAL STATION MONITOR FIRE MISC. TANK REMOVAL / TEST TANK INSTALLATION TEST PIPING PRESSURE MISC. INSPECTIONS: FINAL \ PPt t' li'l eI C AC i.I' CERTIFICATE OF OCCUPANCY • " TENANT NAME: YF!C TYPE OF BUSINESS USE: S FOR REFUND ON TO: DEPOSIT RELEASED ::i N. Pa . C'�tryy�yo(NeWPPettBad• el s BuildingDepaRment .1.7..--- P.O Box 1768 Newport Beach:CA 92658.8915 .. peonCounter Phone .ND. .(714) 644328813289 GRADING PERMIT • OW11EA BUILDER DECIMATION. ':.• • I HEREBY AFFIRM UNDER PENAALLTTYY OF PERRJUIIY THAT 1 AIA EXEMPT FROM THE I ALILT��'O1� ARMtAREASON O. TTNT� PBOlF ` REOIYESTE APPLICANT FORMER ._. .- .... ' e IICETSEO FUSSIER!' TORE PEIVOOKS CF TE COMMOVEilCENSE LAWIOUPIEfi. : ICING TMT OR 1WI S BY AM � THE T� MD FERI ALLEGED SUBJECTS 'Err�o EIL PAW.tMYF DrEESWmmwlfm AS W 001E • PENSATCHL WILL CO THE WORT AND THE STHICIIUE IS NOT INTENDED d1 OFFERED FOR SALE MC. 7044. BUSOX:SS AND PROFESSIONS 030E TM CONTRACTORS LICENSE RAW DOES NOT APPLY TO AN OWNER OF PROPERTY RHO BUILDS OP RXMIOJES T5JEOA AND WIE DOES SUOI WAN HIMSELF OR HERSELF OR THi014H fE Ce HER OWN EJPLOYEES, PROVOED THAT SUCH SPIOVEFEEN S ARE IXT MD. ORORT:FEDFOR SALEF,HOW- EVER TIE BUILDING OR W'E CVDENT IS SOLD WHIM ONE YEAR OF COMPLETION. THE • OWNERBULLER Wit RAVE THE BURL° OF FMOVIxi THAT HE Ci SHE DO NOT BUILD O11 PEWEE FL OTIE PU WSE O'sNE �iRS TO OWNEROFCONSTRUCT AM B COOT THE CONTRACTORS LX%]SE LAW DOES NOT APPLY TO AN CMEER OF A PROPERTY TWO BUILDS OR WMOVES T/EIEON. MO TMO CONTRACTS FOR STAG PROJECTSWITH ACO - TRACTOSTL ICED PURSUANT TO THE CO TRACTO S LICE SE LAW). INSP REP TO e8 1 AM EXEMPT UNDER SEC. B.LP.C. FOR 'DVS REASON DATE - ' OWNER ... LICEHSEDCONTRACTORS DECLARATION - I HEREBY AP .I LIKEN PENALTYOF PERMW THAT i M1 LEFICED II/JODT R10Veg*IS OF 0IAPIER 9 (COMMENCING WITH SECTION 7ppp) Of OMSON S OF THE BUSINESS AM/ PROFtSLR6 CODE. NO MY UMEL ES NRALFORCEMOEFFT T. / DATE t 119 f-8 mailic7d1 WORKERS'CONPENSATION DECLARA : I IEFEBYAFFVW wan PERLLTYOF IU YdEOFTNEFdLONWOOEOAMTOHi F HAVE NO YYIL MAYITAN A CERTIFICATE OF CONSENT TO FOR EOM ERS COLFENSATION. AS PIOVCED FOR BY SECTION 3700 OF THE LABOR CODE FOR t 'TIEPTlFORXWICE OF THE WORD FORWTOI THIS PERIM IS59ED. �( . PAYE ANDMILMAXTAN WOiiOM FOR THE P RF N%IRN ASEMAKFBR \. SEC:ON 5700 re THE tAOOR COOS, FOR THE PERTOPoJMIAN suTHE WLM FOR wHLDRTIE FEA.XT S ISS,IED MY WOWEFLS COAPB/SATION XSLXAKTE CNRI✓ER AND POKY MAKER ARE . _. " tARI-Al16•COIP- PaleTti'"BER-_60002b0103 W6OHM¢sec- iIa NOTff WHED MEIFTHEPDIXTSIE FOR oa t- , I CERTIFY THAT N THE PERFORMANCE OF TIE WORK FOR VNHCH MS PERMIT IS ISSUED. I SHALL NOT SPIRY ANY FFJSO4 N ANY WANNER SO AS TO BECOE SUB- JECT TO THE W OBE15 CO A ETSLTON LAMS OF C ANC AGREE THAT F I SHOULD BECOME SUBJECT TO THE WORKERS' OF SECTION Glut OF RE CODE,I SHALLSr - 1 Y DATe APPIriu WARNMG: FASDRE TO SEGUE WORKERS' CCLPEHSATON COVERAGE IS tNUWFUL NU MEL SU E ECT AN ELPLDYER TO a PENALTIES MC'GVL FINES LP TO ONE HUN- DRED THOUSAND COMM ;IMAM N ADORTON TO THE COST OF COTE SATUI. LTW AGES AS FRC EED FOR N LEGION NW OF THE LABGi CCOE, INTEREST. NO ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY I IERLBY AFRV I OR PENALTY OF PERJURY THAT THERE IS A CONSTRUCTOR LBO NC AGENCY FOR THC PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS 4SSINEO 1IFFllC�Q1i8B NAME 3 LENDERSADOIESS .' :1 CSnMY THAT I WIVE READ ERNS APP CATON AND STATE THAT RE ABOVE NFOf A i- ' TCNa CORRECT.I AGFEE TO COSM.Y WIMALLOIYMID COUNTY d 4WNCES NC STATE 'LAWS MAgTCOMTIUCTION. MO A EMSM° BTEFI UPCNVEME RPROPERTY FCRW PH. -Y, DAes ebter. - J • Pe4-core— DATE ADDRESS nil 6l OWNER IOIOtii IIUL Ifs}IN4\ 111k ADDRESS 301 good ILO l8VP4Rt 18ACE Cl 91658-6190 PHONE: li4/646-8901' CONTRACTOR PECK/Im11S CO1stioCT1o1-COIPOI ADDRESS: 10866 IILSIIIE ILYD 7TE PLOOM LOS AICILES C190014 PHONE: 310/S38-1037 STATE503224 CLASS:8 1 I* 91026494 ARCHITECT: ADDRESS: VC. NO.: ENGINEER: ADDRESS: UC. NO.: GEOTEOWICAL CONSULTANT: ADDRESS: APPLICANT:. ADDRESS: SIGNATURE OF * APPLICANT / PHONE PHONE: PHONE PEC!/JOIES COISTI 10866 WILSHIRE ILVO LOS A86ELES CA 90024-4303 PHONE * CRADIIC/DIAIBACE Permit Pees * $ Valuation of iaproeeeeats --) IRAIIACE7- mina YEE 63AIIAME - PERRI' PEE (t) PLARRIIC:000RTER REVIEW PEE $121(P) CLAM -OP DEPOSIT- DRONE . (T) TOTAL CIADIRB/DRAIRACE PERRI' PIES 310/470-1885 0 )' • Plant o 14 6W3256 vc rO OF WORK: pBAIIACE/?ESP: DSTOQLao1B, . . Oraiaage_Peuft .. .. .: TYPE OF PERMIT: YAGER Ent NEAREST CROSS sT.LEGAL DESCnIPTIOt YARDAGE FOR PROJECT SPECIALCONOMPLX 0 YES FILL: C PROCESSED BY: ZONING TRAFFIC SUBDIVISION GRADING REVIEW DEPARTMENTS Name Dale 7Al 2 ii-erg 1,1LPf"D APPROVAL TO ISSUE — 90.00 9 i = " 180.00 1 12.0C 7 100.00 7 ��-382.00 ci c Gt. co 1tfLLAA 0 O 0 I. o W ri La- > w LL Z _/r Payaents: Credit erteaded: Total Cr.dits: 0.00 0.00 0.00 Sainte 382.00 Adjutants 0.00: Salome die 132.00. pair`_..._. Fg6,1 I 1998 ,:: F O LL 2 0 Q (REv 7/9l%) i Lk4,'s;.I�3Yb,Y�,i PLAN CHECK VALIDATION • CK.,.- T ILO. ;= ?Elam IYVALIDATION 4 Y4k• • '••• : -'x••1"• '29 ri.0--€9-5:=93;',....At.'ff'• •••••:4-&-f...z7" -1- • ' - • • ?at,*•• -",•;•••••••••:.• .. ..._ . . ff t7.1.T1 . -a- ;=•,[5'4',/.";-,,Ty----):::-...-. :-ii.42.--.-.:'?!.,•-: ,. ".-----".; ..,_.. . „ :-.2. .., DATE.- .... . ...-,=?-5•::•• .1.:-.'•.' ki.- •:." Br: •::;- ':.• "•!'=":"7.‘.:-.:4111,,,titrapcv.r. e. ,v 4.-,5*-4..•• :7'i zi : r-7,'.•4•-•t'".4iiitic."-‘a-• • = .1..:., I ti =.:,;•?•.•-•::-. ::•••%.,..s. - • - : -t•49-,...-:...k- t .i'•:,...:::::•;,,--.,curn!....1.k.ry:s ,:._ -. T :-.., ..- - -. , - ,,:- • ... - ... • : .-,c;-•.:.;#;4-, -a-, :- i;-..:]-'4.-:•.11.;:fitt-r:3-a,-, : , ...- MEGRADEVIEarekla--7.4`t-rira,...----/-1,' --: ,. ,.„ - . ,'•;.‘ , -: :,, VAR!' ::!-..:9T7;,. at:; k.2._,... : - - ' -s ..t. - ' -V ,t .:.::, 7,....a.-.;:.-.-...4.,--.-k GRALliNdliNSPECTION: (' : ; -11):- .:gMl:!1;;; . ''':-.. :.. '. .- i, . . • a?" '7 . ' ' - ' ' 41,0 .1 " :1.. . ; --; , 'ell; ' k -±'.---:.::-.'' k .`k":''' ..'-t: 71' .:1:--'. *-t.:... -:::21j1,,,tlfkil':1.... ':-:.I.,, „ MkF.....42e02,-2i- ROUGH GRADEAPPROVALi, ; .' „,. - .,••• 7:-::,•,..;2;•.:.:, .;•>_,i,2-, ,- 7.:.7 --.-..k.1 PREPAVING MEETING ' . n ' • 4:,;:,.,:, p„ffm,77;7,*.-, --.1iir- 1-;'.'-,: UPR AND GUTTER .1-'1='; ...tit: 7;0.4; .; h.:c PAVEMENT SUBGRADE AGGREGATE BASE - , . , • FLATWORK .. . STORM DRAIN ;, .. . - " • ..- . CATCH BASIN 4Thaftr e . c r•-• .1 ).' ' -a , ----JP..4.1-0 :7:741'..J • \II.tt. . i- ..'. 3A .,;:rj\-7.X.3n1- : , • f• tr - ^ : ' %. ' gRosic10-0-0.vraot. ' . S. i0.. = . , . __I ••,' -‘•• --as.., _ . . : - -- • • .. ' . • - ' • : .. _ .. . : - . —VI— OTHER - - - . _ , • '' - ;: 1 :Ir.: ` n; .. . , 1. : . - .. I ' 1.. - - - . • - - - , • . . •-•,./... __, -7:2-'--.. • - . - . -.-.- •- .. ___LA.I- :_\---.Ti\.-4-.- - 1 ,„1- ;‘,,,,, PRECISE GRADING- ifaltEbTiON ;:zi- , , -,, •, ,-,,, ..7- -, L---- .i .. DOCUMENTS iT - .,e:a:-:',:j: = :.. ..,.., , ", ., r: -A:' I, '_ •• HSAL :.H7! -2.74, a--... zw,ssinc.ptuwaj/eti p,rts . : CERTIFICATETYPE :i•r: t-,-; 1fij ' NAME OF ENGR. FIRM - • '1'i , . . . ... - -...-.1.:::,.. . . : . -::•••••• ..-.....,:z.• -- -ttni _ ---tii.-- . - - .. • . ' " - t .. Av. .tti --.'s t • :7. • ..:-.7.: irkf ',•• k7;kk 7: ', ; r. , __, .....,... , . -, -, --, .., . , .. . 9 - . I ;ell At) J»Lba DEPOSIT RELEASED _ : _1 9(fseAie9-9.49.0.-9.V.:91.N;07-',9:29 .-ia I./ ":-V-2 z?-2.tiv:ff;-\=itaii‘i ;•• . . . t , • - 54. . C 4. Ci ll Of t,: at Beach' 'nuudm9 Dt788 aps •_ `c ,PO Bot -Newport Beach; CA 92658-8915 ';Permit Counter. hone No. (949) 644-3288/3299 INSPECTION RECOR✓ Xfl02' 0 JOB ADDRESS: IM P 8 APPROVALS DATE INSPECTOR GROUNDING ELECTRODE UNDERGROUND -' ' _s, UNDERSLAB / FLOORri i..rkez:Fi '.le ROUGH CONDU ,WAIIr •,7 i L,. 4C;. ROUGH WIR N EIUNGS ----- 'r ', ROUGH SERVICE �,: ij +:: •�- . TEMP. pQ.�w- Ry s 7 .�7 y �i KL'W 1FflLI C o,NOT1Ftm —•/ t La z , F1NA, itilI., ,A ” i i``4; i---uceeisEDCON RACTO DECLARATION f-' . i I6Eer Anal iiiiidrieikreilpeviiikiwYtim ucel^� Oman A1W19Ws OF CHAPTER 91C04MS MEWING WITH SECTION HMI OF DIMON 3 OF THE BUSINESS AND PNOfHsgeGal7- riY`IL4NSE6NflAl FORWMOWITAT ;1 r. y0 LI:: uo CIAs.31 '-\ ritc t2:.cUC,NR c WE l%24115i .. DD�TTNA 1. 'AC a CC ` c , WORC.ERS'' COMPENsATIOM T10N a -r IHEREBY9IIAUIC ENA RFLTYOFPaUU1Y OFTHETLL OOIM31.N ICaATIONS 1 HAVE MO WILL LWNTAIN A CERTIFICATE OF IYTMSFNT TO SELF -INSURE FOR - WORKERS' COMPENSA , AS PROVIDED FOR BY SECTOR 3700 OF THE LABOR r CODE FOR THE HENNA MOFTHE W_OALFOR WHCH M4 HERMS ISSUED. - OWE AM WKL. MWTM4 worn's. WWBC..ATON P SLANCE. AS REQUIRED BY SECTOR 3700 OF THE LABOR FORTE PERFORMANCE OF TE WORK FOR M ICHI THIS PEI9YT 5ISSUED-1 'yCOMPENSATION ISUFLAJICE CARRIER AEA POLICY NUMBER ARE CAS POLICY NUMBER IItI0ILL 0E01 PILE vC108165600 L7N13 SEC OR SNOT BE COMPLETED IF THE PERMIT 6 FOR ONE HUNDRED MOO I CERTIFY TINT N THE PERFORMANCE OF THE WORK FOR WHICH TM PERMIT S T EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SELECT TONO 7O DE I SHALL NDM®6' COMICATION LAWS OF OF CALFORN AND AGREE 11VT1MT F 1 SHOULD BECOME SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF 3RTI 0 OF E LABOR CWE1 SHALL CO&WLI�WTIN THOSE PPO aIC 1n / APPLICANT y WATIMM FAILURE TO SEOJ E WORERS' COMPENSATION COVERAGE S UNLAWFUL. NA SHALL SUBJECT AN EMPLOYER TO CINW AL PENALTIES MA CNL HIES UP TO OBE HOOFED THOUSAND OOUAR ip. mWHE . N ARON TO TCOST OF WMON• PETSATDAMAGES AS PROVIDED FOR INSECTON 3705 OF THE TABORCOOS. MEREST. MOATTOR EYS FEES. FLOOR: SUITE: . f101t MESCIIIL IOSPRIL DESCRIPTION OF WORK ILICRICtL_(1910Itsij_ ELEC/SBIR1'OYBB POLE ADDITIONAL INSPECTION RECORDS ADDREss' 1 jWjI _IBflt01UBACl CI PHONE CONTRACTOR: IBLIBLBC'IIC COUP ADDRESS: P 0 101 45019 _.— LOS_116ELES_CA_ 91045_ PNDNE 114-6311310 STATE 085046 M/c`✓A� C10. 0957595_ PROCESSED BY: V/ r OCCUPANCY: t Electrical Permit Pees t Iact Ro. Pee Reap. payer pole 19.00 1 19.00 I HOMY ACIOHOM EDGE THAT I HAVE READ THIS APPLICATION. THAT THE IIWCRAATON GOTN S CORRECT. AND THAT I MI THE OMEFL OR PLY AUTHORIZER) AGENT OF THE OWNER I AGREE 70 COMELY WITH CITY NA STATE UL M REGULATOR; COWSTRI)C11oN NA N D0N3 TIE WOW• OF DE STATE�1OOFFC F RELATING RSON10 WgIIO COMGE EMPLOYED PENSATOR INSURANCE a. PERMITTEE NAME MCI CF PENNTEE G - aTE�dJ`. 7 Ammo] efc sir Ali, ea`3-d 4 iltYls.o lima)• =� s,4.t-,¢.c SOITOTAL of electrical fees PBIUIT ISSOIICS PIE ? • 19.00 19 19.00 TOTAL BLECTIICAL PBI1It PSIS 38.00 Payouts: 0.00 Credit Welded: 0.00 Total Credits: 0.00 Ialaace 31.00 ldjaatteats 0.A0 lalaace dae 38.00 PAID FEB 011999 CITY ot= rew1'Utit BEACH PLAN CHECK VALIDATION CK M.O. 1 CASI1 - !' PERMIT VIWOATION - CK M.O. CASH INSP.ECTOR.SCOPY • ,0 1310 MOLDS AR, 1115 117I1E C/ 93614 SESIIIEL LIEIILE I/UODI M 1310 i8TIOLDS ITB, 1115 I1TI1E CI 91614 SURE• I Bilk EIDG: FLOOR: OWNEP: M0/OIOSPINIL AoDR S. _ 1 von -se IEVP01r Ina CI; 92638 RHONE CONTb1CTOR V,llS0I TITEStMERT ISTSL018EIt 18182 SElI410 1UtVE TILL/ PIil CI 92667 PHONE: 711/914-3431 lPr,ar„ NEWPORT BUS. LC - PHONE: PHONE.' PHONE SIGNATURE OF APPUCANT IRAdtex.r4L La{ ern Fees 3 EIMEI» heal Project Taleatioa lelalar PLi1 MCI PEES 214.42 10IL1I1C .PEIMIT PIE 291.80 is a CLE/1-CP IEPG 1t regairedl (►) 100.00 T 1 of MICIOPII! Sheets / PBUITS .26 6 1.56 CILIPOUII SEISMIC SIPETT PEE > 5.25 Is DISBUD IETI/9 PIE seeded! (I) 32.00 T PI1E IEPT:PLII IEiI69 FEB 1 (I) 119.12 t FIB IktT:IISPECTI01 FES 1 (►) 208.46 T PLIIII15:wuiac PLII CIECE-by Deers 26.33 .50 13.16 INSP AREA: 7 Ids. LTC. LiSfj Tea la 919r'158-5052 349/752-S052 Perin Ne. B9102822 IrLsperion Requests Phone No. 014) 644-3255 DESCRIPTION - } j1 OF WORK: 1 $�LMBi (1110198) CONST: ILt DOS HELM 110101?SPITIL (LVU PU:) TYPE OF .ANS1BUC1EPE ADDED / NEW _ -. NO. OF LINTS: RECO BtEIG GETO AC(S SPECIAL CONDITIONS: GRADING APPROVAL OCC. NO. OF GROUP' STOCSS-_ *COED / KEW SO. FT. GAR USE PABDNCI ZONE: SPACES: FRONT REAR LEFT RIGHT TOTHL CIP IOILOIIO PEUI? HIS 1,291.11 • Glv of NeewppoorrttrBeach • • Building O. Box 1768 .Dent Newpoi Beach, CA 92658-C915 Penntt Counter Phone No. (714) 644-32W/3289 1 HEREBY AFFIRM UNDER PENALTY OF 'JURY THAT I AM EXEMPT FROM THE CONIP_?CTORS UCENSE LAW FOR THE FO.OV 1IEAS0 4 (SEC. 7W/3. BUSNESS NO PROMISORS CODE_ ANY MY OR COUNTY YM..,'IEOXRES A PERACT TO CONSTRICT, ALTER. SWROYE.DIp SH OR REPAIR ANY BTRUCIWE, MOR TO ITS ISSUANCE. ALSO RRE/MARESTIE WM TFOR SUCH PEIBXTTO FILE A SEINED STATPETITTIMT IE OR SHE IS LIOBEED FUR:EWTTD 7HE PROVISIONS OF THE CONTAACILI S UCE SE LAW ILCOIAPPTE�R El PATH SECTION 701:0) aF DIVISION 3 EV Ti BUMESS AND PROFESSIONS OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED ANY VIOAION 69EC ION 7DI13 BY AiAPPUCTAIT MR A MOAT SLBECIS TO A OVA. PENALTY OF NOT ICR-E T1 W 7 RIVE 1XUDVE D DOLLARS L�pp1k Lt30RTER OP TIE PROPERTY. OR MYESUtOYEEs WITH WAGER ASTHOR aX K CtXI. POSATXY& WILL DO THE WOK AND THE STRUCTURE IS NOT NTEADED OR OFFERED FOR SALE (SSC. 7044. BUSMESS AND PROFESSIONS CODE THE CONTRACTORS LICENSE LAW DOES NOT APPLY 70 AN OVAER CF PROPERTY INTO WADS OR IMPROVES DEEM MO WHO DOES SUCH WORK I sa- CR HERSELF OR THEO./GM ITS OR HER OEM EMPLOYEES, PROVIDED THAT SCCH IMPROVEMENTS ARE HOT NBEATIED OR OFFERED FOR SALE. IF. I. EVER. THE BWDIND OR MNOLEOENT IS SOLD WRHN ONE YEAR OF COMPLETION: THE OWWNIDABUIDEA WEL HAVE THE BURDEN OF PROVING THAT HE CR STE DO NOT BUID OR 11FOR THETURPOSE OF /SALE.. ❑ L /LS OWNER OF TIE PROPMTY. AM EXC-LSNE3.Y')ONTRAC RKT WRY 1 CE SED CON- TRACTORS 70 CON`TRUCT TIE MEUCCT (SEC. TON. TISIESS AND PLACMISIORS COLS: THE OMIRACTORG UCENS11 LAO DOES NOT APPLY TO AN OWYFR OF A PRO.'FRTY WHO BUILDS OR IMPROVES THEREON. AND WhO CONTRACTS FOR SUCH PROJELIS WITH A C3N- TRACTOR(S)UCEN.m PURSUAST TO THE CONTRACTORS LICENSE LAW.). 13 I AM EXEMPT UNDER SEC. - B &P.C. FOR THIS REASON GATE - - OWNER ADDRESS: BUILDING PERMIT ADDRESS: STATE rAASS' I LTC. NO: ARCHITECT: LIEUE 1111101) I ADDRESS: LJC. NO.: ENGINEER- • UCQISED CONTRACTORS DECLARATION • HIEREEY AFFIRM UNDER'Tway OF PERISH THAT I AM UCDSUNDER ED ER PROADDRESS: OF CHAPTER B I0ON Ole WITH SECTION TOWHE ) OF MOON 3 OF TBUSINESS AND PROFESSIONSCCUAEGOM. X.:: HAYUCFJSEISN FULL MACE AND EFFECT. • LDCENSE CUSS • . LDC NO 436023 DATE /J-r 3- F t - • - CONIRACf0R F--`+ <WA/ WORKERS' COMPENSATION DECLA..RAT1ON I HIEFFBY AFFNAI IRAER PENALTY OF PERJURY ONE OF THE DEOLARILMNS- _I HAVE AND WILL MAINTAIN A CERTEIGTE OF COMBO 10 Ir.TF*eJE FOR YYOR:- ERS COMPENSATOR AS MOWED FOI BY SECTION 37CA OF THE LA9013 COCE FOR THE PER` INN ONCE OF TIE WORK FOR WITCH THIS PERMIT IS ISSUED. _I RAVE AND WILL W ra N woRERs COMPENSATION NAJWCE AS REOURED 9Y SECTION 3700 OF THE LABOR CODE. FOR THE PZRFORAANCE OF THE WCAK FOR WHICH THIS PER/AT IS ISSUED. MY WORSTS COMPENSATION INSURANCE GAMER • cAnitan Pace NUMBER__eC-6AeBn - - n1X5 SECTION NEED Noy BE COMPLETED IF THE PEFWUT IS FER ONE HUNDRED O(L- ' LARSISILIC) mums). .Jc I CERTIFY THAT /V THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I GALL NOT EMPLOY MY PERSON N ANY MANNER SO AS TO BECOME Suer JECT TO RE WORCERS COMPENSATOR LAWS CC CAUFORHNL AND AGREE T1A* R' R SHOUTD BECOME SUBJECT TO 711E WORKERS' COMPENSATION PROVISIONS OF SECTOR 371:0 OF THE UKM LABOR CODE I SHALL FD ATTH CDIA0.7 WRY I%CSE PROOW sota Dire //-n*th:T APP *,Mn. /-A-CgWLd .AAIT r- WABMNG: FAILURE 70 SECU'E WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUE ECT AN EMPLOYER TO CR*fl PENALTIES AID CVL FINES LP 70 ONE WIN- DED 7HOUAOC DCWRS ((SSI W.W%. N ADDITION TO 71C COT OF O)r.PENC•A7DN CAA' AFEE AGESS AS PROVIDED FOR PISECTION 310/1 OR OF THE LABCCOE. INTERESE. AND ATTORNEYS LIC. NO.: APPLICANT: ADDRESS: CONSTRUCTION LENDING AGENCY 1 HEREIN' AFFIRM UNDER PENALTY OF PEJULJTY THAT THERE IS A CONSTRUCTION LEND ND AGENCY FOR THE PERK/PRIM E OF THE YORIC FM WHICH THIS PERMT IS ISSUED (SECSEI D3047.CN.C). .X5 NAME LENDER+)ADDAMS 1 CERTIFY THAT 1 NAVE 17EAD TLS APPLICATION MD STATE THAT TIC A004E XIFORLA. TROT ISOMRQCT. 1 AGREE TO COOLY WITH ILL CT' AND COUNTY OLONANCES MD STATE LAWS RELA74FJ TO BUMDN3 CONSTRUCTION MD HEREBY AUTHORIZE FEP ESETOATVES OF T IE COUNTY TO EWER UPON THE ABOYEAEN10ED PROPERTY FOR INSPECTION PUR. POSES. RtCA4041:0 tAaJhctSosJ PERATTEE RAZE (PRINT) saR YA.'.d_ GA)aHa. 5I01IATAE OF PER.ETTEE lt-t3-953 O.TE 25000 Payouts: (f 300.19 Credit Welded: 0.00 total Credits: 300.19 Salute tit SI /djsstaeats 0.00 talent he 991.58 HAZARDOUS MATT:TEALS 1 YES NO, PVC? . h--^::sd 0 .CAL:. :!I , I' crn'oF I art A11. •/ 2 • w 8 INSPEC•TOR'S COPY APPROVALS ; . I DATE E31' COMMENTS em FOUNDATION. -LI-, c '$1 c is ROUGH GRADE o- r i ?— li — — — -- SETBACKS ..,:: Ato, •.., °.;_ Lr. ,.::-.. -!. :... 11 , FOOTINGS I i -- --_ — 47. — _ SLAB ON GRADE j 1 -i-:�-"_ .. =s DECK SLAG I . • FRAMING: -- --r — . .... SUBFLOOR ROOF & BUILDING HT - , EXT. SHEAR i HOLD DOWNS 1 J ` ' ' — ':' - -- ...- - -- ------ - --- ----__ .. _ .- - - - . GENERAL FRAMING - . INSULATION - — — DRYWALL SUSPENDED CEILING -{.; ' . ( j - — — PLASTERING: --` . ., h, I L', INTERIOR LATH (4_---_r7k2:1,3, EXTERIOR LATH'' +,' 1 I 1 I .. SCRATCH 4'.'=,• - . BROWN ni i i - - MASONRY:' _• FOOTING... \. — — — —' 'PRE -GROUT' I :. FIREP' CE 91S .INSPECTIONS: .. ------------- ---- — — — -- - _ I 1 ... F NAL 3.f. yP d'r CERTIFICATE OF OCCUPANCY ---- TENANT NAUE.: } 1 O:'i TYPED% 1 EFTS USE: DEPOSIT RELEASED 1 I • .f r _ t 0 d I ti. r.n 1 0 Mr. Gary Simmons Taylor &Associates, Architects 2220 University Drive, Stare 200 Newt ort Beacig, California 92660 t.U1 .YIlY! DISLUN ♦I 1t.. 1430.419 Subject: .Hoag Memorial Hospital Emergency Generators MCB Project No. 95104 Dear Mr. Simmons: • 010 J. c.la'+ r . cJc/ u.) McKAY CONANT BROOK INC 18 November 1998 The foilowingiettcr summarises the results of the sound level measurements made at Hoag Memorial Hospital during the operation of the four new emergency generators. The measurements were made to evaluate compliance with the limits of local noise regulation. The results of them suremenes indicate that the sound levels of the generators, with the recommended noise control measures installed, comply with the requirements of the noise regulation. MEASUREMENTS Ort 16 November 1998, Michael P. SancaMaria of MCB, performed sound level measurements at two property line locations adjacent to the generator building between the hours of 6:00 am and 8:00 am A description of each location is provided below. l ocatiort 1- Location 2 Three feet from the curb on the north side of Hospital Road. This location is approximately 100 to 125 fleet directly north of the generator building. At the east property line of the condominiums located to the west of the generator building. This location is approximately 100 feet west of the generator building. Sound level measuremtnts were also made inside the Switchgear room to document the generator noise levels inside this space. Sound levels were measured throughout the mom during the operation of the generators. The indoor and outdoor measurements were mrde during the operation of all four generators. Each generator was operating at the ma dmumload that could be achieved for the test, approximarely 850 KW. All measurements were made using the firm's Type 1 Larson Davis Model 800B sound level meter. The microphone was positioned approadmately 5 feet above the ground. The meter was calibrated before and after the meav zrernents using an acoustic calibrator, 565513ndere Canyon Road Suite 325 Westlake Village CA 91362 818 9919300 FAX 818 9912324 Ir • 110;7 rcrri LIJ*I(Y1 64Lln Inc. 010 771 4JG3/4 r.oj/Id4 The Community Development Plan (CDP) for this project states that noise levels due to the emergency generators shall not exceed 55dB(A) at all property lines. Because this requirement is inconsistent with the local Noise Ordinance (Le. the 'Noise" section of the Municipal Code, We contacted the City of Newport Beach planning department for clarification. They informed us that since the CDP was written before the Noise Ordinance, the CDP 55dB(A) requirement should be adopted as the design criterion for this project, irrespective of the time of clay the generators are operating. MEASUREMENT RESULTS 1.0 Property Line Locations The A -weighted sound level measured at Location I during the operation of the generators, and without the influence of local vehicle traffic noire on Hospital Road, was 52-53 decibels. Nore that the A -weighted sound levels measured at this location represents the sound levels from the generators and ocher mechanical equipment located on the hospital property. The results indicate that the measured soundlevels were below the 55 dB(A) limit set forth by the CDP. Sound levels measured at Location Z, during the operation of the generators and during lulls in traffic noise on Hospital Road, was 54 decibels. Again, these results reflect the sound levels from the generators plus other mechanical equipment locate on the hospital property. The result shows that the noise treasured at Location 2 also complies with the CDP noise regulation. 2.0 Swltchgear Room The A -weighted sound levels treasured inside the Swithgear Room ranged from 76-77 dB(A) in the middle of the room to 78-80 dB(A) three feet from the doors of the room. The sound levels at the doors were slightly higher than in the middle of the room because the gaskering had not been installed an the doors, allowing sound to leak into the room. Even without the door gaskets, levels inside this room were low enough for intelligible speech communication (using slightly raised voices) at a distance of 5 to 10 feet. I trust this information is sufficient for your present needs. If you have any questions, please call, Yours sincerely, Ivt�Cd1NC��QOK mrc Q1 Michael P. SantaMaria Consultant MPS:bh D1Ininjob dhjobs195104 Hoag Hospital Gcneraroakloettmentsi\Compllance Testing,doc TOTAL P.03 r q Sr a • 1 06-10-99 13:44 PFEILER 8 ASSOCIATES ID=909 860 3967 1:1VAL. CNL1:VCr.LC•s ten.1S11r1un/AV,V rvnm City of Newport Beach 3300 Newport Blvd PO Box 1768 Newport Beach, CA 92658-8915 r P02/02 From: PFEILER 6 ASSOCIATES ENGINEERS INC 612 N DIAMOND BAR BLVD DIAMOND BAR CA 91765 Date: 06/10/99 Attention: Grading Engineer, Building Department GPC No.: G9700199 Tract/Subdivision/Lot No.: • Rough Final X Project Names: HOAG MEMORIAL - EMERGENCY GENERATOR BUILDING Project Address: 1 HOAG DRIVE, NEWPORT BEACH CA 92658 Owner/Developer: HOAG MEMORIAL HOSPITAL PRESBYTERIAN Type of Project: • • Tract • Drainage • • Commerc• ial • Other HOSPITAL • Industrial Yardage for Project: • • Cut • Fill 1973 303 • Borrow .• Export 1670 • I hereby approve the grading for this project in accordance with my responsibilities under the City Grading Code. I have inspected the project and hereby certify that all exhibit positive surface flow to public ways or City approved drainage devices. The grading has been completed: X in conformance with, with the following changes to, the approved gradingT Description o f Changes: Company: Name: License No.: PFEILER E. ASSOCIATES ENGINEERS INC DON MASUKAWA RCE 21789 (print) (RCE/LS) 42/ ign • l r 1 71 ri ri J j j s ft • LASV Crandall LAWGIBB Group Member S FINAL REPORT GEOTECHNICAL INSPECTION SERVICES EMERGENCY GENERATOR BUILDING AT HOAG MEMORIAL PRESBYTERIAN HOSPITAL HOSPITAL ROAD AND WEST SERVICE ROAD NEWPORT BEACH, CALIFORNIA Prepared for: HOAG MEMORIAL HOSPITAL PRESBYTERIAN Newport Beach, California June 15, 1999 Project 70144-7-0473 4 • LAW Crandall LAWGIBB Group Member I June 15, 1'999 Mr. Leif Thompson, A.I.A. Hoag Memorial Hospital Presbyterian 2220 University Drip e, Suite 200 Newport Beach, California 92660 Subject: Final Report of GAotechnical Inspection Services Emergency Generator Building at Hoag Memorial Hospital Presbyterian Hoag Hospital Road and West Service Road Newport Beach, California Law/Crandall Project 70144-7-0473 Dear Mr. Thompson: SUMMARY We have completed geotechnical inspection services at the site of the subject project. This final report provides: • Verification of our observation and approval of the installation of shoring at the subject site. • A formal record of our observation and testing of the compacted fill placed to grade the site. • Confirmation of our observation and approval of foundation excavations. - i The observation work was performed between September 17, 1997 and January 28, 1999. The location of the site is shown in relation to adjacent streets on the attached Plat Plan. We performed a geotechnical investigation of the site and submitted our recommendations in a report dated May 21, 1996 (70131-6-0171.0001). J J This final report is limited to the earthwork performed through January 28. 1999, the date of our last observation and/or testing of the soil -related work for the project. Based on our observations, we are satisfied that the shoring system was installed in general accordance with the shoring plans and project requirements. The fill, at the locations and elevations tested by us, was compacted to at least the specified degree of compaction. Also, foundation excavations observed by us extended into satisfactory soils. A Division of Law Engineering and Environmental Services, Inc. 200 Citadel Drive Los Angeles, CA 90040-1554 323.889-5300 • Fax 323-721-6700 Hoag Memorial Presbyterian Hospital - Geoteclmical Inspection Services June 1S, 1999 Law/Crandall Project 70/44-7-0473 Our professional services have been performed using that degree of care and skill ordinarily exercised, under similar circumstances, by reputable geotechnical engineers practicing in this or similar localities. No other warranty, expressed or implied, is made as to the professional opinions included in this report. The scope of our services did not include surveying or the responsibility for job safety. The soil -related work was performed to the limits and at the locations indicated by stakes and hubs set by others. OBSERVATION OF SHORING Prior to mass excavation to the lower building level, temporary shoring was installed at the nor .. portion of the site. The shoring consisted of cantilevered soldier piles with limber lagging. The soldier piles were installed at the design locations indicated on shoring drawings prepared by 'Wagner Construction. Our field technician observed the drilling of the soldier pile excavations to verify that the soils were consistent with those encountered during our previous investigation of the site. He also measured the soldier pile shafts to confirm that they were excavated to at least design dimensions. The data for the soldier installation are retained in our files should further reference be required. OBSERVATION AND TESTING OF COMPACTED FILL The earthwork for the project consisted of placing compacted fill to grade the site and provide support for the building floor slab, as well as subgrade support for adjacent concrete slabs. The grading work included placing compacted soils as backfill against walls below grade, around underground storage tanks, and in trenches for selected utility line installations. FILL MATERIALS The soils used for the required filling consisted of on -site clayey sand and imported sandy silt. Cement -sand slurry was used as backfill in some utility trenches. COMPACTION SPECIFICATIONS The specifications required that the fill be compacted to at least 90% of the maximum dry density obtainable by the ASTM Designation DI557-91 (equivalent to UBC 70-1) method of compaction. lj i -J J J Hoag Memorial Presbyterian Hospital - Geotechnica! Inspection Services June /5, 1999 Law/Crandall Project 70144-7-0473 Compaction tests were performed on representative samples of the soils to establish the maximum dry densities. The tests were performed in general accordance with the specified ASTM Designation D1557-91 (equivalent to UBC 70-1) method of compaction, which uses a 1/30-cubic-foot mold in which each of five layers of soil is compacted by 25 blows of a 10-pound hammer falling 18 inches. The results of the compaction tests were used in establishing the degree of compaction achieved during the placement of the fill. PLACEMENT AND COMPACTION OF FILL After the installation of shoring, the site was stripped and cleared. Existing fill and disturbed natural soils were then excavated to the planned level for building construction. Next, the exposed natural soils were scarified to a depth of 6 inches, brought to near -optimum moisture content, and rolled with heavy compaction equipment. The required fill materials were then placed in loose lifts approximately 8 inches in thickness, brought to near - optimum moisture content, and compacted using a vibratory plate attached to a backhoe, and a hand -guided impact compactor. Areas to receive backfill were first cleared of construction debris and loose soils; the required backfill soils were then placed in loose lifts approximately 8 inches in thickness, brought to near -optimum moisture content, and compacted. The backfill was compacted using a vibratory plate attached to a backhoe, a vibratory sheepsfoot compactor. and a hand•guided impact compactor. FIELD DENSITY TESTING Sand -cone field density ta.ts were performed to establish the degree of compaction achieved during the placement of the fill. The ;asts were performed in general accordance with the ASTM Designation DI556 (equivalent to UBC 70-2) for sand -cone field density testing. Where a test indicated less than the required degree of compaction, the soils were reworked and retested until the specified degree of compaction resulted. The results of the field density tests are presented in the attached table, Test Results; the approximate locations of the tests are shown on the Plot Plan. OBSERVATION OF FOUNDATION EXCAVATIONS The following foundation design recommendations were presented in our geotechnical investigation report: Spread footings carried at least 1 foot into the firm natural soils and at least 3 feet below the lowest adjacent final grade or floor level may be designed to impose a net dead -plus -live -load pressure of 6,000 pounds per square foot. A one-third increase in the bearing value may be used for wind or seismic loads.... 3 9 Hoag Memorial Presbvterian Hospital - Geoteclrnical Inspection Services June 15, 1999 Lax/Crandall Project 70144-7-0473 Spread footings for minor stntctures supported in properly compacted fill or the natural sc11s, such as low retaining walls or free-standing walls, may be designed to impose a net dead -plus -live -load pressure of 1,500 pounds per square foot at a depth of l'/•feet below the adjacent grade. Excavations were made for spread footings to support the emergency generator building. Our field technician observed and probed the footing excavations to confirm that the soils were undisturbed natural materials recommended for foundation support. After observations indicated satisfactory conditions, written notice of our approval was left at the job site for the information of responsible parties. In providing professional geotechnical observations and testing services associated with the development of the project, we have employed accepted engineering and testing procedures. We also made a reasonable effort to evaluate that the soil -related work was we observed was carried out in general compliance with job specifications, our recommendations, and the City of Newport Beach Municipal Code, and is suitable for the intended use. Although our observation did not reveal obvious deficiencies. we do not guarantee the contractor's wore., nor do the services performed by our firm relieve the contractor of responsibility in the event of subsequently discovered defects in the contractor's work. Respectfully submitted. LAW/CRANDALL A Division of Law Engineering and Environmental Services. Inc. / eny H ley Project Manager Martin B. Hudson. Ph.D. Principal Engineer G: linspect197-proj170-173170473rpt.doclGHlgh Attachments (2) (2 copies submitted) cc: (2) City of Newport Beach (1) McCarthy Brothers if• 4 Field Density Test Results Moisture Dry Maximum Test Elevation Content Density Dry Density Percent Number (ft.) (% of Dry Wt.) (Ibs/cu. ft.) (Ibs/cu. ft.) Compaction 1 58 9.5 117 125 94 2 54 12.5 116 125 93 3 56 11.7 118 125 94 4 59 11.7 117 125 94 5 61 12.4 115 125 92 6 63 11.3 114 121 94 7 65' 11.2 116 125 93 8 60 10.2 118 125 94 9 59 11.4 115 121 95 1 10 67'/ 12.0 115 121 95 1 11 60'/: 11.8 114 121 94 12 58 13.7 117 125 94 13 60 12.7 113 125 90 14 63 12.7 116 125 93 '15 64 11.8 116 125 93 16 64' 11.6 116 125 93 17 60 15.1 113 125 90 18 57 13.4 113 125 90 19 59' 14.0 113 125 90 20 59' 13.5 112 125 90 21 60 8.8 112 121 93 22 62 10.0 112 121 93 23 64 9.6 111 121 92 24 62 11.5 116 125 93 25 64 10.5 117 125 94 26 62 11.4 112 125 90 27 65 12.1 121 125 97 28 64 12.8 114 125 91 29 60 10.6 119 125 95 30 57 12.7 112 125 90 31 59' 13.6 112 125 90 32 62 13.8 113 125 90 33 64' 13.3 115 125 92 34 62 12.9 117 125 94 35 65 12.5 114 125 91 36 62 13.6 115 125 92 37 64 12.0 116 125 93 38 64 11.4 115 125 92 39 57 11.1 116 125 93 40 60 11.1 120 125 96 70473tbl.xlsgh 6/15/99 Page 1 4 Field Density Test Results Moisture Dry Maximum Test Elevation Content Density Dry Density Percent Number (ft.) (% of Dry Wt.) (Ibs/cu. ft.) (Ibs/cu. ft.) Compaction 41 61 11.1 120 125 96 42 60 6.4 118 125 94 43 60 8.1 112 125 90 44 61 7.5 121 125 97 45 62 8.7 126 125 101 46 62 8.7 123 125 98 47 63 9.8 123 125 98 48 63 8.1 118 125 94 49 63 10.5 124 125 99 50 67 9.8 118 125 94 51 64 9.8 115 125 92 52 68 9.8 118 125 94 53 68 8.1 120 125 96 54 68 9.8 120 125 96 55 63 9.9 120 125 96 56 64 8.7 118 125 94 57 64 6.9 116 125 93 58 65 7.5 122 125 98 59 66 9.8 119 125 95 60 67 10.2 121 125 97 61 66 9.4 120 125 96 62 64 8.2 120 125 96 63 75 8.7 120 125 96 64 76 9.8 116 125 93 65 76 9.3 120 125 96 66 77 9.3 123 125 08 67 75 9.9 116 125 93 68 76 7.5 114 125 91 69 76 7.5 114 125 91 70 66 8.7 124 125 99 71 76 12.9 116 125 93 72 76 11.7 113 125 90 73 76 11.7 114 125 91 74 79 9.3 117 125 94 __I 75 70 12.9 118 125 94 76 70 9.3 116 125 93 _.1 77 68 9.9 106 125 85 78 65 9.9 118 125 94 79 68 11.1 116 125 93 J80 65 12.9 116 125 93 76373lhl.xls/gh 6/15/99 Pnge2 Field Density Test Results Moisture Dry Maximum w Test Elevation Content Density Dry Density Percent Number (ft.) (% of Dry Wt.) (lbs/cu. ft.) (Ibs/cu. ft.) Compaction 81 65 11.7 118 125 94 82 66 11.1 124 125 99 83 66 9.9 122 125 98 84 76 9.9 119 125 95 85 77 9.9 119 125 95 786 78 9.9 122 125 98 l 87 77% 12.4 121 125 97 88 78 12.4 122 125 98 89 78% 8.7 118 125 94 90 79 14.3 122 125 98 91 79 12.4 118 125 94 92 80 16.1 117 125 94 93 80 13.9 114 125 91 94 80 13.5 116 125 93 Notes: Elevations refer to job datum. * Indicates area reworked and retested see Test 79. 70473tbl.xis/gh 6/15/99 r s j J J CITY OF NEWPORT BEACH P.O. BOX 1768, NEWPORT BEACH, CA 92658-8915 MISCELLANEOUS GRADING CERTneiCATE L/C Project No.70144-7-0473 Project Address Hospital Road and West Service Road, Newport Beach, California Grading Permit No.: G9700199 Owner: Hoag Memorial Hospital Presbyterian • Type of Project: Single Family Multi -family x Non-residential • The following grading work was performed after the preparation of the Rough Grading Report and was not included as part of the Rough Grading Report: Trench backfill. Retaining wall baclff Subgrade compaction Foundation for for hardscape retaining walls Other (describe) • Did you perform the required inspections and testing for each of the checked items? x Yes No • Specify the compaction test locations and results and the tested foundation bearing pressure (if applicable). See final report dated June 15, 1999 for details. • I certify that the grading work was done in compliance with the Soils Report for this project and the work complies with City grading regulations. Geotechnical Engineer's Name License No. 54220 12/31/99) LAW/CRANDALL Martin B. Hudson, Ph.D. /Principal Engineer , q ?ESS 0 k AddreSs200 Citadel Drive, Los Angeles, California 90040-1554 `�cQ``�0 . H, Signature Date J 3300 Newport Boulevard, Newport Beach 54220 Exp.12-31-99 CNN I' CO , / • I /./ / n, LII 7.1 REFERENCE; SCEMATIC GRADING PLAN (DATED 12/22/95) BY DAVID A. BOYLE ENGINEERING. I I \` �•`r 4yryr ....` t APPROXIMATE LIIMTS OF EARTHWORK • 76 7• l 14 .. / -i`V74y / .`.. � ; 92 / . ••• • • i►� •l 66, 65• • • i. %' ire '• 55 / o •.. 1/i1 4d8in I ibtt54, 14r.7:21(3/41ig":' 33/44.(1.3:1:\ 9 I 1 I y,�a1600:30//00/0`I#.::.7n4•I/7 i;r" 2-— 111nu PLOT PLAN SCALE 1' . 20' 11fi IIII111111111 4 1/ a• QWER PLANT LAW/CRANDALI • r i CITY of NEWPORT BEACH - BUILDING DEPARTMENT DATE: 9 Z' ` JC0 ADDRESS: PRE -GRADE MEETING AGREEMENT 1 (-IoeCO— 0g 1. The grading plan check number for this site Is % �j '6 9 fnd will be referred to In all reports, certifications and correspondence. 2. ;TGP ORDERS. Whenever any work Is being done contrary to the provisions of the City Codes, the Building Official or his authorized representative may order the work stopped by notice In writing served on any persona engaged In the doing or causing such work to be done and any such persons shall forthwith stop such work until authorized by the Building official to proceed with the work. 3. The steeped set of approved plans shall ba on the Job site at all times. b. )OTIFICATiCO OF NONCOMPLIANCE. If, in the course of fulfilling their responsibilities, the civil engineer, the soils engineer, the engineering geologist or the testing agent finds that the work is not being dons in conformance with the approved grading plans, the discrepancies shall be reported immediately In writing to the person In charge of the grading work and to the City Grading Engineer. Recommendations for corrective measures, if necessary, shall be submitted to the City Grading Engineer for approval. S. When import or export of materiels is required, haul routes to and from the site shall be approved by the City Traffic Engineer and hauling procedures shall be in accordance with Chapter 1S of the Newport Beach Municipal Code (NBMC). 6. Between October 15 and May 15, erosion control measures shall be In piece at the end of each working day whenever the five-day probability of rain exceeds 30 percent. During the remainder of the year they shall be in place at the end of the working day whenever the daily rainfall probability exceeds 50 percent. 7. Desilttng basins, when required, shall be installed and maintained for the duration of the project. B. Alt fills shall be compacted throughout to a minimum of 90 percent compaction as determined by ASTM test method 1557 and approved by the soils engineer. Compaction tests shell be performed approximately every two feet to vertical height and of sufficient quantity to attest to the overall compaction effort applied to the fill areas. 9. All trench (including Interior and,exterior•utility trenches) and retaining wall backfill shall be compacted throughout to a minimum of 90'percent relative compaction and approved by the soils engineer. 10. Whenever work on which'rtgtrlrtd Inspection/testing is covered by additional work without first being inspected/tested, the Building Official, shall require by written notice that the work be exposed for examination. The work of exposing • .and recovering Shall 'not•ehtetl.or'be subject to expense to the City of Newport Beach and will be the solo expense of the Permitter per Section 7014 of the NBMC. • 11. Landscaping of all slopes and pads shall be 1n accordance with Chapter 1S of the NBMC. 12. Approved drainage provisions shall be used to protect adjoining properties during the grading operation. 13. The permittee or his agent shall notify the Building Department when the grading operation is ready for each of the fallowing inspections: a. INITIAL INSPECTION. When the permitter is ready to begin work, but not less than two days before any grading or brushing is started. b. OVEREXCAVATION/BOTTOM INSPECTION. After the bedrock, natural or competent ground is exposed and prepared to receive fill, but before fill is placed the project geotechnical engineer shall approve all areas to receive fill. e. EXCAVATION INSPECTION. After the excavation is started, but before the vertical depth of the excavation exceeds ten feet. d. JILL INSPECTION. After the fill placement is started, but before the vertial height of, the flit exceeds ten feet. e. DRAINAGE DEVICE INSPECTION. After forming of terrace drains, downdraine or after ptpeaxnt,of pipe in subdratns, • but before any concrete or filter materiel is placed. f. Special: . •• g. Rooms GRADING. When all rough grading has been completed. This Inspection may be called for at the completion of rough grading, without the necessity of the Building Department having previously reviewed and approved the reports. h. PrepavTni Meeting. A site meeting shall be required prior to commencement of any paving work with the following people present: Owner, Paving Contractor, Design Civil Engineer, Geotechnical Engineer, Building Official or their representatives. i. FINAL. When all work, including installation of ell drainage structures and other protective devices, has been completed and the as -graded plan, profeostonal approvals end the requirr reports have been submitted. • 14. The Building Department will give a ROUGH GRADE RELEASE when the following his been approved: a. Design Civil Engineer's rough grade approval. b. Geotechnical Engineer's compaction report and approval. c. Geologist's report. d. Grading Engineer's or Building Inspector's field Inspection. 15. Alt footing exeovettens, slab on grade areas and subdretne shall be inspected end approved by the Geotechnical Engineer or Engineering Geologist. Written approval shalt be submitted to the Building inspector. 16. The Building Department will give a FINAL GRADE RELEASE whin the following items have been approved: a. Design Civil Engfneer's final grade approval. (Completion of the Civil Engineer's Certification Form.) b. Geotechnicel Engineer's final capactlon report and approval including inspection of all foundations, slab on grade , utility line and/or retaining wall backlit( testing, as well as asphalt pavement testing/Inspection where required by the City Grdtrg Engineer. c. Grding Engineer's or Building Inspector's field inspection. d. Landscape architect's certification letter. 17. Paint, plaster, mortar, concrete or other materials or residue shall not be allowed to enter streets, curbs, gutters or storm drains, all of which enter Newport Bay. Violators wilt be prosecuted (NRNC 17.32.020) 18. Failure to request inspections and/or have removable erosion control devices on -site at the appropriate times shell result in forfeiture of the construction cleanup deposit. 19. The undersigned acknowledge a copy of the above and agree to comply with the Grading Code of the City of Newport Beach, the recommendations of the project soils report and any special requirements of the permit. OWNER: By: Address: Telephone: GEOTECHNiCAL ENGINEER: By: Address: Telephone: GRADING CONTR.: By: Address: Telephone: NEWPORT BEACH REPRESENTATIVE: GRADING ENGINEER: (714) 644-3280 INSPECTION: (714) 644.3255 fppregrclmt5-91 DESIGN CIVIL ENGR.:1,0,4a/)a ie Mare /NL— By: Address: Telephone: GEOLOGIST.: By: Address: Tetephone: City of Newport Boach Building Department P.O. Box 1768 Newport Beach, CA 92658-8915 Permit Counter Phone No. (714) 644-3288/3289 GRADING PERMIT OWNER -BUILDER DECLARATION T HEREBY AFFIRM WIDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE CCF.TRAOTORS LICENSE LAW FOR THE COLOILMG REASON (SEC 7031 5. BUSINESS AND PROFESSIONS CODE. ANY CITY Oil COUN'Y WHICH REQUIRES A PERMIT 10 CONSTRUCT. AL TEO W'PROVE DEMOLISH Oil P.EPAR ANY STRUCTURE. PRIOR TO ITS ISSUANCE. ALSO REQUIRES THE APPLICANT FOR SUCH r€P) r O FILE A SIGNED STATEMENT TUT Et OH SHE IS E1CD15ED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS UCENSELAW ``a1MILA. 9 ICOLWEPCING MIIH SECTION 7000I OF DIVISION 3 OF THE ROSINESS NA PRDFF'F^.£•IOINS CO E, OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS/OH THE ALLEGED, . EXEMP DON ANY VIICAATION OF SECTION 70315 BY ANY APPLICANT FOR A PF-IOAIT $URECTS'' 141E APRICAN710 A CIVIL PE1I4LTY OF I101 I.ON1E TRIM FIVE HUNfWRED DDLLARS ISS0011 '' I AS OITLEH Or THE P/O PERRY. 0R MY EWWLOYEFS W1TH WAGES AS THEIR SOLE COAT PENSATHON. WILL DO TIE WORK. A53 THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE ISEC 7614 BUSINESS .V13 PROFESSIONS 030E THE CONTRACTORS LICENSELA,V DOES NOT APPLY To AI O11NE0 a l)PSPVY VINO RODS OR AYPIYJJER 3)PAE0)C' MCA WHO DOES SUCH WORK HIMSELF On HERSELF OR THROUGH W5 OR HER CNN EMPLOYEES' PROVIDED THAT SUCH BnMIOVELIEn.TS ARE NOT INTENDED OR OFFERED FOI SAE. IF. HOW- EVER THE BUILDING OR IMPROVEMENT 15 SOLD VATHIN ONE YEAR OFF COMPLEJON. THE 01.:7.ER GUILDER NIlL HAVE DIE OUROEN OE PROVING THAT ICE OR SHE DC HOT BALD OR Ixl. NOVE FO+T.E PURPOSE OF SUE I H AS ON VIER OF THE PROPERrt. AM ExCLUSrvELY CCWTUCING WITH UCENNEO CON. IIACIOOS 10 CONSTRUCT THE PM IEC1 ,SEC 7041 BUSINESS AND PROFESSIONS C006 . THE CONTRACTORS LICENSE LAW DOES NOT AMPLY TO AN O.•MER•OF A PROPERTY YMO MODS LDS OI IMPROVES THEREON MD WHO CONTRACTS FOR SIJOH PROJECTS LATH A CONE TRACI0.T151 LICENSED PURSUANT rJ THE COMPACTORS IKEUSE UW( - . 1 NIA EXEMPT UNOER.SECE _ • . B AP.0 FOR THIS REASON: DATE UCENSED CONTRACTORS DECLARATION 1 HEREBY MEMOIR UAINNU(Ep PENAGMNOF PERAIRY THAT L AM tIE1LSE11 UNDER PROVISIONS OF CHAPTER R ICOLV.IENCI)1G WITH SECTION 70Q01 OF DR1S10N 3 OF THE BUSINESS AND ,110FE5510NsCODE.NO LIT LICENWGIN FULL FORCE A•NDETFECT - LK:ENSE CUSS _ LC NO DATE - /f/O_ _ _ 00NTRACTOIjio.- WOR COMPENSATION DEC t ON I HEREBY AFT1RM UNDER PENALTY OF PERIOOY ONE OF THE FOLLOWING DECLARATIONS I HAVE NO WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELEVISURE FOR WORK- / 1R1 COAPENSATON. AS PRUV OED FOR BY_SECTION 3.'000F THE LABOR 0.305. FOR J THE PERFORMANCE OF TIE WORK FOR Will al 111S PERMIT ISISS1ED _ _I HAVE AND WILL ?AAAN %YO KERS' COMPENSATION INS1JRMICE. AS REQUIRED BY SECTION 370D OF TIE LABOR CODE. FOR THE PERFORMANCE OF THE WORK FOR }NIGH 1W5 PERMITS ISSUED MY NV%L(ER5 COMPENSATION INSURANCE CARRIER NO POLICY NUMBER ARE GAMER _.. OTIIT PrvP INKS 5EC110N HEED N01 DE COMPLETED IF THE PERMIT S FOR ONE 1AMO,EO DOA- LARSISII.I1ORLESSI. __ I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PEEWIT I5 ISSUED. I SHALL NOT EMPLOY ANY PERSON 51 NC( MANNER SO AS TO OECCAIE SUD JECT TO THE WORKERS COLPENSATION USES OF CAIFORAA AND AGREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS COAIPF��AAAA AT ON PROVISION - YF SECTION37N F THE LABOR CODE. 1511AL1 FORTHWITH PL TH • 5 1 T SIONS ♦ / DATE 1__ - {-+/ _ I . _ I I II WARNING' FA URE TO SEaWRE %YORKERS' COM RAGE IS UNLAWFUL AND HO SHALL SUBJECT AN EMPLOYER 10 CRNAL Pa4ALllt •CI• VIL EWES UP TO ONE 1A1N. DIED THOUSAND IYY I AR5151N0301 MADDITIONALTION TO T1¢ COST OF COMPENSATION. DAL-, AGES AS PROVIDED FOR VI SECTION 37060E THE JABOT (YYW INTEREST. AND ATTORNEYS' FEES. - JOB ADDRESS: OWNER: ADORES&.:. PHONE: NE\Y^ORT BUS LIC: ARCHITECT: .: . T17(AD ( MCnr ADORES: - _ a _`11,9n R T rOCTTP TIa, PP! ?tin EOM ,Krlp&?AL.HOSPITU IES11. 1-pnlh•np IMYPO? IrL3.C192S54 PHONE: CONTRACTOR:`'MC'Clm,. Imps COI oy ADDRESST MET. mat.PPon° .: YEYPORT eteck 9266Q LIC. NO.: ENGINEER: ADDRESS' LIC. NO.: reCHrt1ICAL CONSULTANT ADDRESS: APPLICANT. ADDRESS SIGNATURE OF APPLICANT CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERAIRY THAT THERE 5 A CONSTIL/COCI LEND IRO AGENCY FOR THE PERFORMANCE OF THE NORK FOR WHICH THIS PERMIT IS ISSUED (SEC 3097. CIA. C I LENDERS NAME LDNOERS AO.^et55 1 CERTIFY THAT I HAVE READ THIS APFUCATION AND STATE THAT THE ABOVE LNTMAA. TON 5 CORRECT. } AGREE TO [ONLY WITH ALL CITY MD COUNTY ORDINANCES MA STATE LAWS RELATING TO BIDING CONSTRUCTOR. AM HEREBY AURIORIZE REPRESENTATIVES OF THIS COMTY TO ENTER IRON THE AOOVEIFNIONE0 PROPERTY FOR INSPECION PUR- POSES ��aY z v i 05 PERMITTEE • VEVPOE!. Grua CA 926E9.- PHONE: TV( rarO ' 40;40041;11lft I Tr Inn rltrnVT TO En! tirrrre r} Onn4n vinare OLr1O1r (TRY own) 711 ermine, ter, CTr ,5n D ryr1t rt 0767n ,71 Air FAIL 1 . 1' t COIf1ap(1101T1117 oe..;t Pees t 1 p+ln+t;nn of ;arroyo.entl ----) c010TSn - Prly CSFCr rrr !tl CO$JTIC - prey!! Par (vl mgran Ora rarrr raa(AY a_n,r!!1 (al fraay_a? n!Onatr_ CO(ntyr (Y) 1 of VTPOAPTTV at;eele t Or0UTTC, TAILT COInTainv.itylrr 9rarrr ar'C PHONE;. PHONE: PHONE: INSP AREA- 711/616-49E1 7111454-414.1 9701!979 -_714/516_t325 71F,007-1can DESCRIPtIOM OF WORK: TYPE OF PERMIT: IN ) . Permit No.' ' 'In G91001991-.l:,J�_. Inspection Requests Phone No (714) 644.3255 4�l: K HEIR ;10511 (builn)-il) ppprlpp rg4pTort pno yrrpp ? e?M OLrr} Precise Grading ceteit VACANT SITE NEAREST CROSS 5T. LEGAL DESCRIPTION: YARDAGE FOR PROJECT SPECIAL CONDITIONS: ❑YES ❑NO FILL: 11)1 IOU ON Mu CUT: 1971 PROCESSED BY: ZONING TRAFFIC SUBDIVISION GRADING / REVIEW DEPARTMENTS be__ Name slDate b 'Zal'(— a w LoA.,L.-nett-mot r try' G t9-8-gi13 2 O 6 0 .5 OIL O tu 1- 0 '5 LL N IL APPROVAL TO ISSUE ,S SA ?5 1n `ila 75 'v' 1,.992.59 v 25.5E t A16- fIP'_v. = ?An — 1 014 71 ?73702J 0]!ynnte: !Prc.;! e!Fen1t4! Tnt+! eredlls• Pohoc. �A�nsreenle'�`- 1 O+I vnn Ann PAID . AUG 2 01997 CITY CF NEWPORT B 2,1125. 56,_'-: n:np' ?,1?S.t6 0 a W li sn ACH 3 REV. 7/96) PLAN CHECK VALIDATION CK M.O. LCASH PERMIT VALIDATION CK M.O. CASH INSPECTOR'S COPY Y }1' Pit y 76a•239d ��. INSPECTIONS DATE r BY COMMENTS .D�j �7 j-)irw+ 7. MFET'NG ' Q . x( I'':(; 'in ;'fiE h HCA . /dsr,7 I.lGtr, ssi a*La - ----------------------------- //• Z(• 99 /use _. 4t4! t e' ,6e: fl CW ,t At09.etwa- - i1/44,14 seat •,2-9t /Ye marl de/4# ror s , iy6- SAr- • jcfrfonye as, fi.Yy#. Sado soy- ,03 e rY'fX es? ,te ssiiva • City of Newport Beach PO Box 1768 Newport Beach, California 92658-8915 Job Address: I ITOAG DR NB Legal Description: Bldg: 0 Floor: Owner: Address: Phone: Building Department MECHANICAL Permit No: H9905019 Permit Counter Telephone (949)644-3288/3289 Inspection RequestsTelephone (949)644-3255 Suite: HOAG HOSPITAL 301 NEWPORT BLVD NEWPORT BEACH CA � t Processed By: '(7 Inspector Area:8 Code Edit: Contractor: Address: Phone: Con. State Lic.: Lic Expire: Bus. Lic.: Lic. Exp Date: 0 Description of Work: MECHANICAL(D008901S1 5o Z L, S 7 MECHIFILTERS,CONDENSATE TRAPS INSPECTOR NOTES UNIT CONSTRUCTION & MAINTENANC 17000 MARQUARDT STREET CERRITOS CA 90701 310/464-8433 275506 10/31/1998 970303 HVAC Items Furnaces up to 100k Btu/hr 0 $0.00 over 100k Btu/hr 0 $0.00 Wall/Floor Heaters 0 $0.00 Heat Pumps & Package Units up to 100k Btu/hr up to EdOk Btu/hr up to 1M Btu/hr up to 1.75M Btu/hr over 1.75M Btu/hr 0 0 0 0 0 $0.00 $0.00 $0.00 $0.00 $0.00 FEES Inspector Ventilation Bathroom Fan 0 $0.00 VAV Box Exhaust Fan 0 $0.00 Attic Fan 0 $0.00 Other Dorm -Draft Fan 0 $0.00 PIPING O Residential Hood 0 $0.00 COND TRAPS Commercial Hood 0 $0.00 O $0.00 Repair/Alter/Add 0 $0.00 Investigation fee D $0.00 Air Handling Units Plan Check O $0.00 up to 10k cfm 0 $0.00 Issuance over 10k cfm 0 $0.00 TOTAL: $63.13 PAYMENT : $63.13 BALANCE: $0.00 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of pedury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the business and professions code, and my Ilconse Is In full force and affect. �p license No: 275506 Clan: Date • 'z • qL / Conbaclor: UNIT CONSTRUCTION & MNNTENANC WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of -.hq following declarations: _I have and will maintain a certificate of consent to set 4nsure 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. 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the labor code, for the performance of the work for which this permit Ls Issued. My worker's compensation insurance artier and polity number is : Confer: REPUBLIC INDEMNITY Policy number 1032906 Expke: 0910111999 (This section need not be completed if the permit Is for one hundred dollars ($100 or less). 1 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 sub( Boilers & Compressors up to 3HP over 3HP to 15HP over 15HP to 30HP over 30HP to SOHP over 50HP Misc Items Fire Dampers Gas Line Metal Fireplace ICBO App.11- 0 0 0 0 $0.00 $0.00 $0.00 $0.00 $0.00 m are coo c pensation laws of Calffomlaand agee Wtii should become subjecto tib wokers' compensation provisons of Secon 3700ofhelaborcodeIshafoDale3o e provisionsppant UNIT CONSTRUCTION& MNNTENANC Applicant 5ignafur �...�y Warning: Fallure to secure workers' compensation cavonge is unlawful, and shall subject an employer to cdminal penaWes and cMl up to one hundred thousand dollars (S100,000), In addltion to thecost of compensatk;damages as provided for In section 3706 of the labor code, Interest, and attomey's fees. 1 hereby acknowledge that l lave read thh applkatlon: that the infomaucn given Is correct: and that 1 am the owner, or dulyaut odzed agent of the cwner. l agree to comply with city and state laws regulating constnrctlon and In doing thn work authorlaed thereby, no person will be employed In violation of the labor code of the state of Callfomla relating to work nen's eompensatikn Insurance. Permittee Name (Print) L. ; casz." C $D.n° 4 $22.00 3 $28.50 $0.00 $12.63 $0.00 Signature of permittee: Approvals Underslab/Floor HVAC/Hood - Rough Fireplace -Rough Gas Test Fireplace - Final HVAC/Hood - Final Inspector/Date AUGat. a 10 „ N 1�99 ter, dnYOFNEwroHt tst:ACH Address : ill Goo M p.st j b#as r A are t cog l7of WORK MUST BE STARTED WNITHIN A PERIODR OF 180 DA• YS FROM THE DATE OF VALIDATION OR THIS Date: 7-s o- yy PERMITBECOMES NULL AND VOID. ar > y s T z Bli Laing aepaitment iese Box 1768. . . iNewpoI Beach CA 9265843915 - Permit Counter Phone No. (714) 644-3288/3289 FIRE PERMIT rr: Penmlt No. 'CONTRACTORS' 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE PROFESSIONS Busmen CODE: ANYUCW FOR THE IY OR COUNTY WHIFAI OWING REOU1 ALLPERINI TO CONSTRUCT. ALTER. IPRCVE. DEMOLISH. OR REPAIR ANY STRICTURE, PRIOR TO ITS ISSUANCE. ALSO REOARESTHE APPLICANT FOR SL CN PERMIT TO FIE A SIGNED STATDeIT THAT IE OR SHE' IS UCENS D PURSUANT TO THE P ICVISCNS OF THE CONTRACTORS tXETSE uw OTNOA ICING WITH SECTION 700D) OF MOON 3 OF THE BUSINESS AND RTTAT HOAR SECS TF 3R�1 � THE HUMMED OCCURS T LLE U LAS OARIERRPLICANT TO OFFTIE P�ROPERIYFNOT &ORE OR AR' EMPLOYEES�WTH ASTER SOLE PENSATIGL WIL OO THE WC4V( ANU TIE SIR CIU m S NOT WEAVED OR OFFERED FOR SALE (SEC. 7044. BUSINESS AND PROFESSIONS CODE THE CONTRACTORS LXENSE LAW DOES NOT APN.Y TO AN OWNER OF MRJPEOY WIC RIDS OR IMPROVES TFEREOR AND WIC C06 SUCH WORK IMASEiF OR HERSELF OR TNOWH HIS OR HER OWN EMPLOYEES., PROVIDED714AT SUCH IMPROVEMENTS ARE POT MENDED OR OFFERED FLA SALE F. HOW- EVER THE BUILDING OR IMPROVEMENT IS SOLD WRNS ONE YEAR OF COLWLETON. THE OWNEFIBUIDEf WILL HAVE DE BURDEN OF PFCVNG THMTHE ON ERE DO NOT BUILD OR FOR THE PUW'OSEOF�c. LASOYFMEN OF THE PROPEFFTY NA occwSVELY ITRWTNUwatrua SmCON• TRACTORS TO cotamuCr THE PROJECT MC. 704. BUSINESS AND PROFESSORS we THE CONTACTORS UCESE LAW DOES NOT APPLY TO AN OWNER OF A PFCCER1Y WNO BIRDS OR IMPROVES THEREON. AND WIC CONTRACT` FOR SUCH PROJECTS WITH A CON; TRACTORS) LXENSED PUiSUN1TTOTHE CONTRACTORS LICELiE LAW.). 0 • I AM EXEMPT UNDER SEC. . B.IP.C. FOR THIS REASON DATE .AT'' R f0y.vY C ADDRESS: BLDG: OWNER: INSP 1___lo it - AREA: urrE: .. U 0 H9(DIIIL HOSPITII P1BHDI— ADD ADDRESS: � .;'.t HOAR OI �� • _IERPDIf_I6ACH,_CA_92658___ 114/6151600. c°"TpAa`°R •—_BHILDIHO_ELHCTIOIIeORIOLS..I------- _----.-_ - ADDRESS_ _451_tt ltr,EHlit1108_•— DESC2'PTION OF` iNiK. ?IIR. ---- ----__fill :ILlll-iIs_(.1938G-91} C INST: - IR__FIRE -max .SISTBH/SOPFOitSISTER 8LD0—__. 0 OCC. NO. OF COA.11lUCTIDN: GROUP - SJ-OJVEt F9800090 Phone No. 14 644-3255 Sl! DIN15 4]1.4z—_ PHME: 909/305-160I. STA7E129905 Dom^. C-1C10 N<YAP.ORRT 91024562 tiC' M ARCHITECT: " ADDRESS:.. LIC. NO. DOS. LIC. LI Lea to PHONE LEGAL DESCRPRON: SPENAL COMMONS: . r uce zo -+CONi CTOa�LM ime ` ;,•+ •ENGINEER: /.A • J TI_t d a. ADDRESS: IHEREBY /1FFYIMI LIID.'R1'ENAtTY OP PEFLMRY THAT 1AU UL:ISmL1NXIm PROV610NL5 --.- - _ -... COMMENCING WITH SECTION 70 OF DIVISION.] OF JIF, BUSINESS AND }�� IAND IX/ uESN FDFCE'MDEFFECL �+�'- --- PHONE "-"- PROCESSEDBY: (�fr+elliPln` I • L1C. NO W M1 C C011PENSATION DEclaWl)" OLDER 4--• • RIM!arEOFTE Y7GdRNBOEtWA TE I' a L,A T� 1e.�q *IRA ANDMILLMANTANACERIFICHE0FctJSDNTTOSELFnSUREFORw'171Rc- �[ERSDOAFENSATxIRABFH» EDF DR BY SECTION 3703OFTIE FOR SIGMA O • • r• 'la 4F7NE4.WUx.,..„R rrtg17RS, m r- ., z}a:. APPU.„.!-1 _ w• • . ;HAVE MO WIlIMNTAINWO1P WORKERS PI O IRSURACE. AS MOORED BY SECTION woo I MTHE LABOR CODE. FOR THE -PERFORMANCE OF THE WORK FTM WH CH THIS PERMIT IS ISSUEDE : MY'ORAti COMPENSATION *STROKE COMER M�.•,at NOECUCYNUIARE-PS"•+.e-.,....‘ / E�) fi"T Platt. '-.4 �SBPE10ENATL,IIS'o ` ,elpi a1R- f�VDM�.�If/f-1- ; .e..:.� TITS SECTION to NOT BE C0AHEIED IF THE�.} IS FOR ONE HUNDRED DO EMS (SIECI) --NE,. :4A1eT.A !t CERTIFY THAT N THE PEIKOPWIFDE DPITYS WORK FOR WHICH THIS PERMIT IS 1 SAW_ NOT EMPLOY ANY PERSCM N ANY MANNER SO AS TO BECOME SUB - SHOULD RE W*.*ESUB ECAPDSAT W LAWS OF GIUPENSA NO AGREE THAT FI SHOULD 3700 ME SUBJECT TO THE WORKERS' COMPENSATOR PROVISIONS OF SECTION 3700 OF THE LABOR COOS. I S �L\\FAN_7HI COMPLY WITH PBOW- DATE:SiCtill — l�"�. APr Irutr.'t`11.�1aty�` \M 1 �� WARNING: FAIWRE TO SECURE WOOERS' CO -SENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EPLOYER TO CRIMINAL PENALTIES AND CNL RUES UP TO ME HUN- DRED THOUSND DOLLARS (3100. 04 N ADDITION 70 THE COST OF COMPENSATCH, DAM. AGES AS PROVIDED FOR IN '-= ON ]7118 OF THE LABOR COOE, INTEREST. AND ATTCREYS FIRE APPROVAL GRACING APPROVAL PL ANCHECK APPROVAL TO ISSUE 0\ RC, t PITS ALAIH/LIPE SAFETY Permit * SITED» Project Volution » FIRE PLAN UCH PEE FIRE PERMIT/IISPECTICN PBB 1 of Microfilm Sheets A Permits CONSTRUCT10N LDIDWG AGENCY I HEEBY AFFYW UNDER PENALTY OF PERJURY -IT -Kt THERE IS A CONSTRUCTION LEND- INC) AGENCMIAN Y FOR TE PERFOCE OF THE WORK FOR VOUCH VAS PERMIT IS ISSUED raNNAE g. LENDERS ADDRESS • I CFNIWY THAT I HAVE READ THIS APR CATION AND STATE THAT THE ABOVE IiORMA. 1xw INCORRECT. I AGREETO COMPLY WRH ALL CRY M D COUNTY ORDINANCES MO STATE UfWS RELATING TO BUILDING CCfSTUCICR AND HEREBY AUTHORIZE REPRESENTATIVE; ORS -ELLS COUNTY TO DREN UPON THE ABOVEME NIOED PI OPEAIY FOR INSPECTION RX: SIMTUPEOFPERI TEE Qb tIII:(• �,.� p DATE TOTAL PIPE/ DOILDIIO PERMIT PEES DART pp14Diasf_�d,EO;Roe'r IOJ LS ADDRESS •449 L$Eff an SAD DIMAS = CA •9111 PHONE _j009/305-1600 ZONING APPROVA_ OTHER DEPARTMENT .25 14 T5000 421.92 586.00 3.50 _---t,011.42 agar Payouts. Credit Welded: Total Credits: Ia1aace Adjust.eats Ialaace doe 421.92 0.00 421.92 589.50 0.00 589.50 PAID AUG 10 19 CITY OF NEWIPORT IEEE 0 3 0 0 00 w 0a CC 2 0 X0 F W o N �z 0 0 0 LL 2 0 rc a €z_ Iq: rtnniir:+it,a ;' APPROVALS DATE BY COMMENTS FIRE PROTECTION ••II .... 1'711I --'• THRUST BLOCKS EXCAVATION • • - • ' •-- -= - - UNDERGROUND HYDRO TEST:. - =!._- :.: `i --/3 -- ,- /6 - % `(`f UNDERGROUND PIPING FLUSH UNDERGROUND ROUGH PIPE SPRINKLER HYDRO TEST SPRINKLER FLOW TEST - SPRINKLER ROUGH PIPE STANDPIPE HYDRO TEST i %C " a/ � � STANDPIPE FLOW TEST i,atC - - Aop_ _ . _ _ _ -. T-4 -¢rf . STANDPIPE ROUGH PIPE CHEM SYSTEM FUNCTION TEST, f a0 C.2-44.4 CHEM SYSTEM APPROVAL S?-C •a FIRE ALARM SYSTEM '. i0 - a 9? ROUGH WIRING - ; 99-a%f_ SYSTEM FUNCTION TEST • ' ,a-.20-IP ` G fi!!Kvrie4 Mt ri,A244C LIEV&LS , • ... - {, CENTRAL STATION MONITOR': Lo x-11 ,, F/ - -4- ' Seek-. Al/ Stao�'S,-,. • :.. `"` "_-• :, i...--: ," - t - * . S1JeaBoc` Fuss, stoioLr t gfrru ea to FwucEau ,, --, RePA+i— ' me s FIRE MISC. t " I � r Ws$// ! r MAS ! vi-gr-Ta—ajof P4 TANK REMOVAL -- - --• 1 - , - TANK INSTALLATION%TEST PIPING PRESSURE TEST : - MISC. INSPECTIONS: FINAL UtA1 - • /o Z,' j1 CERTIFICATE OF OCCUPANCY I . uunr ,r aBIN UV. I V TENANT NAME: - . 3A39 TRO9W3Ii iO YTl3 TYPE OF BUSINESS USE: •1 S DEPOSIT RELEASED FOR REFUND ON TO' :) / • • Bu , P Depa�trne t�evwpoitO. Box 176E Beach, CA 9658.8915 Permtt Counter phone No. (714) 644-3286/3289 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS UCENSE LAW FOR THE FOLLOWING REASON (SE 703I3, BUSINESS MO coot COOANY CITY OR COUNTY WHICHREOURES A�PERIYT TO CONSTRUCT, N.TE.L WPMVE OEMOUSIt OR REPAIR ANY STRUCTURE. PRIOR TO ITS ISSUANCE. ALSO PEOUI ESOE APPUCANT FOR SUCH PERIM TO FILE A SSIED STATELIER THAT HE OR SHE LS UCE)JSED PURSUANTTO NE PHONEMIC OF THE CONTRACTORS THEME LAW (�QQ4lAApp�TEpp1 0 WITH SECTOR 7000) OF MGM 3 OF THE BUSINESS AND PROFEs510NIS OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED ANY VEXATION OF SECTION 70315 BY ANY APPUCANT FOR A PERMIT SUBECT5 TO A CIVL MULTI OF NOT MORE T W N FIVE HUNDRED MUMS S •. OR MY OWLOYEESIMMWAGES AS men PENSATION. WAL COME WOW. NO T S WIT T VI EWED IEWED OFFERED FOR SALE 7141. BUSINESS AND PROFESSIONS CODE THE OOmnACTORS UC05E LAW DOES NOT APTLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES TIEREOL AHD WHO DOES SUCH WOK HIMSELF OR HERSELF CR THROUGH MIS OR HER OWN EMPLOYEES. PROVDED THAT SUCH OPROVEMENTS ARE NOT MEMO OR OFFERED FOR SALE F, IqW EVER. THE BUILDING OR IMPROVEMENT IS SOLD WII1NN ONE YEAR OF C0I01I.01ON. THE OWNER —BUILDER WIL HAVE THE BURDEN OF PROMO THAT HE OR SHE DO NOT BIRD OR FOR THE WVOSEOF^.MF) L AS OWNER CFTHE PigPERtY, IW E DILISNB.Y COMPACTING WITH LICENSED CON- TRACTORS TO CONSTRUCT THE PROJECT (SEC. 7044. BUSINESS RAND PROFESSIONS Coot THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF A PROPERTY I 1 SUKDS OR WPIWVES TIEIEOH, MO WTO CONTRACTS FOR SUCH PROJECTS WITH AU:.7N- ITNDTORI(S) LLB PURSUANT TOME CONTIACT00.S WEISE LAW). ❑ 1 AM EXEMPT UNDER SEC. - B.SP.C. FOR THIS REASON :; r r'1 ,04.m 1 �ucFI, . d4.a RACTORSt `CLAM e _ ' - IlIEREdYOiF. UNDER PE LTTY.OF PE/WRY THAT I MI LICENSED USER PROVISIONS OF OULFRat','^AL/ABNCINB WITH SECTION TTpompp)1 OF O.'VIMI/3 OFJ1F,,BLISNESS AND 5CUDEAM• L$WPULLFOflG£ wow ( /�CIP� C16C rY 1$ `a .ia }� [y �Ty" f DATE eikilS c�& :i P' `AU•�compAgoR ` j'R w I L t•a mower rt.'V. Yam. it TY t- 4 — otEgFTIE • TON" tINA ANDS M NTAN A CERI CJIE OF O�a�BttTD SELFI REFORWOW(- L EMS' COMPENSATIaL. AS WCMIDED FOR BY SECTION 3700 OF THE LA9001 Cl7DE, FOR " IO�C`U PBFONVAANCEOETFE FORWHg�.YIS PBMAKISJ55UED,,if • S IOIVEE no vac worm WORKERS' COMPENSATION OLSJIRANCE. AS REQUIRED BY SECTION 3700 OFTHE LABOR CODE, FOR THE PCIFORMARCE OF THE WORT( FOR Via GAMIER, n \\ ra+ar.,1 s... Asir I S, ` ^6A[TTU11.ns-CO N. I anst PD(JCYNUI. ! •,eW5899.. r-' r:hJ �n� �cC[- (mRIOSs SECTION 1lE}ID:N�O�TL B®5 COMPLETED W itt PETOJTIS TR)R EHZIXEDDOL- LAFS(SIOOIDR -_____ n riMAI*1- ✓ 1 CERTIFY THAT IN ,HE PFAFDfl4ANCE OF.71E WORK FOR WHICH THIS PERMIT IS ISSUED. 1SHALL NOT EMPLOY ANY PERSON N ANY ,. BECOME SUB- JECT 7071E WORKERS' CC4APBSATICN LAWS OF •r• . AM a THAT IF . SHOULD BECOME SUBJECT TO THE WORKERS P'-, SENNS OF 3700 Of f TLABOR CODE. I SHALL PFOVF iDATE dts. APRIGMC, • WARNING: FAILURE TO MCURE WalsEFS COMPENSATION COVERAGE IS WILL AM SHALL SUBJECT AN EMPLOYER TO CRO.NNAL PENALTIES AM OIVL FEES UP . ONE HUN- DRED UCUSMO D=LV6 lRS100AOI. N AUDITOR TO THE COST OF COIPENSAIION. DAM- AGES AS PROVIDED FOR N SBCTCN 3700 OF THE LABOR CODE. INTEREST, MO ATTORNEYS CONSTRUCUCNiEND1N :AGENCY -- • I HEREBY AFFO W UNDER PENALTY OF PERINV THAT THERE S A CONGTFIUCIION LBO. N0 AGENCY FORTE PERFORMANCE OF THE WORT( FOR WHICH UM PERMIT S ISSUED t I CEN FY THAT I HAVE PFAD T78 APFtCM10N MW STATE THAT THE ABOVE INFORM - TON ISCORRECT. I AGREE MOM/PLY WITH ALL CRY AND COUNT OFOP1MCES AND STATE LAWS RBA c TO BUILDING .. . . AND IEFEBT' AUfC7EE REPRESENTATIVES OFTMS.. . TO ENTER UPON ' PROPBRY FOR INSPECTION PU4 FIRE PERMIT 1 - lots II AREA ¢IRE- OWNEW " 1014 MOSPITIL CONTRACTOR: PHONE FACILITIES P10TBCTI01 SISTERS ADDRESS' 2211 BAST VIISTOI 1010 SUITE P- _ 11118IA C1 92806 PHONE: !TM 592289 CLASS: CIO! C16C-7 NEWPOOHT DESCRIPTION OF WORK: Permit No. F9800083 Inspection Requests Phone No - (714) 644-3255 IveellSsIII_siI�I6� (193$1.91) CONTT _oTa___PIL-200 SOPPIISSI01 STS,PREICTI01-1 /C01---- TYPE OF OCC NQ CONSTRUCTION:- GHOV t_ _STORIES ARCHITECT: BUS, LIC, LIST ADDRESS: Yes la PHONE SPECIAL PHONE UC. NO.: APPUCANT: ADDRESS: SIGNATURE APPUCANT HERD AIM (CEEIS REIMER) 2211 B 1111Sf08 10 9 I PHONE 714/635-4260 t FIRE-SUPPIBSSI0I Permit Pees t 61TE1» Project Palsatie:. PI16 PLO CBBCE PEE PIER PERMIT/IISPBCTIOI PEE T0T1L FI1B/ 10ILOIIC PERMIT FEES PROCESSED BY: FIRE' APPROVAL GRADING APPROVAL 523.01 726.40 1,249.41 w CL ,j OTHER t 0 _ DEPARTMENT ¢ 0 a (A PLAN CHECK (r BY APPROV _ O 0 TO ISSU F esn sYNHLLn.— o co Z 103599 Paned': 523.01 Credit Weeded: Total Credits: 0.00 523.01 726.40 0.00 126.40 0 O 2 W a z_ • 3 PAID MAY I2 7 1999 CITY OF NEWPORT BEACH Y !Mime Adjutants Ialaaee die •. C. U V I V.0 '. y r ..,.:. ... APPROVALS :: -: . k ..... •.,_-:. DATE BY... .., . .. COMMENTS FIRE PROTECTION , :, ; ---r - THRUST BLOCKS EXCAVATION -a '-' °' " '•' • - UNDERGROUND HYDRO TEST • '' UNDERGROUND PIPING FLUSH _ .... - • .. UNDERGROUND ROUGH PIPE 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 • FIRE ALARM SYSTEM - ROUGH WIRING • - "' ' - - SYSTEMFUNCTIONTEST•- t6_/'t`� . .... - ;(', . ,'. . c ` CENTRAL STATION MONITOR A n-or �c - .. _ _ - - - ..- -, p-,-' 4 t a� l..S FIRE MISC. - + .� , - TANK REMOVAL - TANK INSTALLATION /TEST PIPING PRESSURE TEST - ` • . INSPECTIONS: ., -r i ---- ._-_...,...-..-fir 1 1 ..��.; j,`;�n. 1 • FINAL (JIA9 !U /e-e-C CERTIFICATE OF OCCUPANCY - I' t + ' h - TENANTNAME:S " '• 0A3a THO914/3KK 90 YT tom' TYPE OF BUSINESS USE: $ DEPOSIT RELEASED FOR REFUND ON TO* - 4 .vtn1,:91 -` i• wilLA •I w Bu Dep9rtineat sP.Q: Box 1768 _, Newport Beath. CA 82658-8915 . _ , "' •Permit Counter Phone No. (714) 644-3288/3289 .:..OWNERBULDEH DECLARATION - , _ .. .. 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE CONTRACTORS UCENSE LAW FOR THE FOU.OWNET RULSCIL BUSINESS AND PROFE1S C ANY OTT OR COUNTY WHICH A PERMIT T SSO COIGTRUCT. ALTEa. IMP/ME. DEMOLISH. OR PEPAIR ANY SI1WGTURE, PROW TO ITS ISSUANCE. ALSO REOUARESTHEAPPUGUITFOR Si]4PEIMTTOFIE A SO EC ST*1Se4TTHAT PE OR SE IS UCENSEDPURSIMNTmTHE PROVISIONS OF THE C HIRACIORS LICENSE LAW 9 ICd. CID WITH SECTg 17000) OF DIVISION 3 OF THE BUST ESS AND LAW UE7O�OE) ORTHATHE OR SHE IS ,/PT THEREFROM AND THE BASIS FOR THE Al LEOED EXEI I1 XAAAN�Y VCAN EATON OF SEC110N 7001S BY Y APPLICANT FOR A PERITTO A MAL PENALTY OF NOT ACRE THAN FIVE HUNDRED OCCURSRS51R�I.IE,CTS Ll L/L40VAER OF TIE PROPERTY. OA MY EMROYFES WITH WAGES ASMEIR SOLE PENSACOLL ` SALE (EEC.7014. BUSINESS ME PROFESSIONS CODE THE AND TIE STRUCTURE IS NOT NCONTRACTORS LICENSE TENDED OR OFFERED FOR Y OOE.S NOT APEX TO AN O MER OF PROPERTY WHO BUMS OR 3FICVES TIEIECN, ARID WHO DOES SUCH WCAK MASSY OR HERSELF OR THROUGH HIS OR HER OWN EAPLOYEES, PROVIDED THAT SUCH YRCVELQOSARE NOT INTENDED OR OFFERED FOR SALE E. HOW- EVER TIE BUXOM OR WIK)VD.ENT M.. SOLD WITHIN ONE YEAR OF CO:APLER01{ THE ONNNERR.BUIDER WILL HAVE THE FBURDEN OF PECTIC THAT fE CR SHE DID NOT BARD OR WZBOVACTS S m CONSTRUCT ED P �A T (EEICU, YBI C : THE COf71RACTORS UCENSE LAW DOES NOT APPLY TO AN OWNER OF A PROPERTY WIC BUILDS OR RPTOVES THEREON. MD WHO CONTRACTS FOR SUCH PROEM WRH A CON TRACIOMS) L CENSED PURSUANT' TOTE CONTRACTORS UCENSE LAW D 1 AM EXEMPT UNDER SEC. B.SP.C. FOR THIS REASON r_ils Air .t`"\c‘A tom, `-ct ...._t. 6....' _ . rat. . DECLARATION.UCENSED CONTRACTORS ' d' t=r�. 1 AFVWUNDES PENN.IY OF PERJURY THAT I A14110EHSED 1s13I34 PROVISIONS OFF oDEAEFN- CING MyUM 113INr�7000T OFONI91 ECT. HE WfC1Tit AND I OOD)E / 1014C11070FJ"RCE gFE '374-2• i DATE TI i. L :j9 4 '1/.`fj 7,j°• TVCA, ..:CO•MPENSATONDES +7 { I LEFEE6/. LIVER KRAUT Oe PEILJAN ONE OF neraIDWID DECIAMTCNS I SS{iii Ct `Y - 1 y- \... nY. '' \ 1 I I 1 J VE AHD WVL WNTANA MOOED FORTE OFCa liSei mSELF-NSNEPoRWIXtK- EAiCOMPELISA EoAS Ewax FOR BY �TIION 37000E ITC LABOR CODE. FOR TIEPERPOHWANGE OFTHEYA7FKFORWN043IYSPBIMTI5tSSUED: t;'- PRAVE At1 WLL MN?AN YWOWiS C04PBGATCN WSUF NCE. ASFEpUIRED BY SECTION 8700 OF "E LABOR CCDE. FOR THE PERFOWIMICE OF IRE WORK FOR VAIOIIHS PERMCGIrEr-MY COAEB1SATCH IGURANCE CANbER AH b.Aa. MNBBLARE:•C.�_V-i S I S: '! ..id. '\ ~� , `t evs. - tom. ..•t�Y . ---,Wield Culp \ , :' ; w Ne DAIS SECTION LESS] ERCOMPLElED1Fl EF 101 RE HUNTED DOL. LMSR10010R y�/ _1 CERTIFYSUED.1 RNA' NTHE PLOY ANY RNA WORMFOR 1WAC11THIS PEANUTG .ECT 1 I SHALL RKNOT EHAPLOY ANY PEFLSON N ANY TAMER SONS m SECURE TJB SHOULD TOTE BECOME SUBJECT ECT TO THE N LAWS .. . AGREEIFNT0 L SHOULD BECOME SUBJECT m THE IRIS • . • SKINS OF SECTION 3700 C6!111EENKE CODE I SHALL WL`�.-I. TICSE PNOVF DATE: Mail v .. �y • •_ - WARNING: FAILURE TO SEOIE WORKERS' CdRENSATON COVERAGE G WFUL AND SHALL SUBECT AN EL/PUTTER TO CRUCIAL PENALTIES AND CIVIL FINES UP m ONE HUN- DRED THOUSAND OOUARS LS100.000L N ACOION TO THE CW'T OF COMPENSATOR DAM- AGES AS PROVIDED FOR IN SECTOR 3703OF THE LABOR CODE MEREST. AFD Al Runt, S CONSTRUCTION LENDING AGENCY ' MEREST AFFIRM UNDER MALTY OF PERJUfii THAT THERE IS A Cpcni1CIgN LEND- ING AGENCY FOR TIE PERFORMANCE OF THE MURK FOR WHICH l}RS PERMIT G ISSUED iaDEnS'FN�1E SECTS ADDRESS _.. 1 CERIWV HINT-1 HAVE READ 11C APFUCJLTION AND STATE 7NAr ITC ABOVE Df0l L&• wE LAWS TO BIOS COISTT JCTON AND HEREBY AUTHORZE °R'NWCIiTEl 'C'l`�TARVVESS CC TISWSW10 BIDER UPON TIEABOVE-MENTIONED PROPERTYFOR IGPECICN PUFF STATE LTC. NO: ARCHITECT: ADDRESS- LIC. NO.: ENGINEER: U11 SP R FIE FLOOR: - SUITE 1011 I1101IAL HOSPITAL 11011II IBVPOIt 11401 CA PHONE CONTRACTOR: FACILITIES t10TECTIOI STSTEIS ADDRESS: 2211 BASF PTISTOI 101) SUITE P 1111611 Cl 92806 PHONE: 714/6354260 oE1FO"iscwPr at 592289 CLASS: 0101 0168-7 W I 98030162 10S. LIC. LI!T Tes to DESCRIPTION - Of -WORK: F9800464 Inspection Requests Phone No (714) 644-3255 SOP!! S[Si?l61e'Ie1(39361-91) - coNsr RBI 11200 SOPPIESS301 STS/PIBuCtI01 OBP/CUR T NsTnuc iott oGRoup NO.OF Si01-TES: FACILITIES PIOTECTIOI STS ADDRESS: 2211 1 VIISt01 ID IHBI1 SIGNATURE OF APPLICANT * PINE SUP!IESSI01 Permit Fees EwTEm» Project Taleatioe PINE HAI CHICK FEE FI1B PEIIIT/IISPECTIOI FEB 9 of licrofilt Sheets I Permits TOTAL PIII/ IOIf)IIS PBIII? PEES PHONE 714/635-4260 PROCESSED BY: ZONING APPROVAL FIRE APPROVAL GRADING APPROVAL 145.73 202.40 1.56 349.69 15977 OTHER DEPARTMENT PLAN CHECK gt cheeK Payouts: Credit eeteeded: Total Credits: lattice Adjutants lattice dee 0.00 0.00 0.00 349.69 0.00 349.69 • ,: L . 3 ; • .APPROVALS - _ i _.-. DATE BY ..,. ., COMMENTS . . - - FIRE PROTECTIONi6i7++<s .r, :; :. •,I •, THRUST BLOCKSEXCAVATION ;_-_-„_ .'. -•' - :... UNDERGROUND HYDRO TEST''" •'-- `" '" ' - UNDERGROUND PIPING FLUSH UNDERGROUND ROUGH PIPE _ SPRINKLER HYDRO TEST SPRINKLER FLOW TEST SPRINKLER ROUGH PIPE -- STANDPIPE HYDRO TEST STANDPIPE FLOW TEST - - STANDPIPE ROUGH PIPE CHEM SYSTEM FUNCTION TEST /Q_�j, -7 CHEM SYSTEM APPROVAL y>t 3t7 1 FIRE ALARM SYSTEM. , ROUGH WIRING SYSTEM FUNCTION TEST' CENTRAL STATION MONITOR ' f ,q -- • \ FIRE MISC.\ ' ri TANK REMOVAL _-. ' . _ a ..L 4: TANK INSTALLATION / TEST_ PIPING PRESSURE TEST' MISC. INSPECTIONS: I- ''l. , FINAL /0tAr>Y'P-4?4/41 CERTIFICATE OF OCCUPANCY TENANT NAME: met .i $ DEPOSIT RELEASED FOR REFUND ON A TO: j TYPE OPa ikatN Fj�•i�elnlFi'• \`� \ \j \ ' f_ f^ �. JOB ADDRESS: BLDG: FIRE PERM11- i .. FLOOR: - - SUITE INSP AREA: OWNER:—_IDI�IO$2IiIL ADDRESS. ,Q1_D1{11IODLBLIO ®PO11_I81CD CL9265E PHONE 114/616-8901 _OIILCOISTIOLTI01.1_IIIIREwc ADDRESS: 17000_111QUIPIL SflnEr_ L:IILA S190701_ 215506 CLASS: CONTRACTOR: F9800024- Inspection Requests Plane No. (714) 6443255 DESCRIPTION _PIRG_ GFWORK: �.IIt_PIPIII_sis( _III-I1)PE OF ___ COAST: Off tut IILPIPI/�SYSTEI_(01$ TMCONSTRIICTIOfk GROUP: -. .. S1Qita STATE UC. N0: PHONE 310/401-E433 016804 ARCHITECT. BUS. LIC. LI ADDRESS: — -' ---- --- let _In_ PHONE ITC. NO.: ENGINEER ADDRESS: PHONE t)C. NO.: SIGNATURE OF APPLICANT / "ssh > . _ L3 IDS I A.Per) Box1 .._:a .a..o., ... _ .. • -. Pert Beach CA 9g658-8915 . - Cougter Phone No. (714) 644-328813269 i;•_ s? .,.- ., ..... OWIER•BILDER DECLARATION•. ._ 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT FPOU THE OOFittss TORS UCENBE LAW FOR TIE FOUDVING iFASO,1 WEC. 70 1.5, BUSINESS •YR .. EZS C (IO11r ANY CITY OR COUNTY WHICH RECWtS A PERMIT TO AL.TEI. IMPROVE OS.CLLSTRUCTUREL OR REPAANY STRUCTURE RUM TO Re ICI IAI ALSO P"IAIES RE Ara CANT FOR SUCH PERITTN FIE A SIGHED STATEMENT THAT RECO SHE L31:.x,AFAPIJL.IANTTOTIE PROVISIOtGwilt OONIRAOTORsLW LAW 0S0077104. AiIII SECTION aF IXVISION3OF THE BUSINESS AfO� I THAT RE OR SHE W E1Q1WT THEREFROM AND THE BASS FOR THE ALLEGED 1 R•.IVIOIJOXN OF SECIIWTBIISBY ANYAPRICJNT FOR A POUT SUBJECTS TO:. CNLPENALTYOFtCTMORETHANFIVE iuwoDOLLARSI�npLt� I ASOW,e OF TIE PROPERTY. OR MY EMPLOYEESWITH WAGES AS TIEWSOLECOI4 PENSATON VIIL CO THE WOW MO71E STRUCTURE S NOT RIDDED OR OFFERED FOR SALE (SEC. 7044. BUSINESS AND PROFESSIONS CODE THE CONTRACTORS LICENSE LAW WHO NOT APPLY TO AN SUCH WW03( HIMSELF OR HE ELF OR M1lUGH EMPLOYEWHO BUILDS OR IMPTOVES THEREON. ES. PROVIDED TINT SUO i IMPRO ELEMS NE HOT INTENDED OR OFFEf EO FOR SALE F HOW- EVER. THE BUILDING OR NPTCVBI@1T S sap wrier at YEAR OF COMWIETOII. THE OWNERBUALDER WU. HAVE THE BURDEN OF PROVING TINT HE OR SHE DO NOT BIRD OR I.PB W E FOR THE PURPOSE OF SALEL ❑❑ L AS OMER 6 TE PROPERTY AMXQU" EYELP CONT.AACtNG wax UCENSEDCON- TRACTORS TO OONSRUCT TIE PROiCT WEG, TOM, BSIES Ale PROFESSORS WDe TIE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF A PROPERTY MO BUILDS OR RMPROYES THEREON ANC WHO CONTRACT FOR SUCH PROJECTS WITH AWN. ;7RACTOYSI iSENs PURSUANT TO THE CONTRACTORS UCESE UN.). • - - . EXEMPT UNDER SEC ..--.--,—.-- BAP.C. FOR THIS REASON DATE c O. bWtNBin 1 Y I HERE SERF UDER e DATE CIF .OECt.ARt1TTON, TAT IT AMLWIaO UNDER PROVISIONS L P OF BUI$IJESS AND 'j ... (�.Tlt �DECUwDN1U, 114 ta Y�F` +CiaM.W��T'µ3}IL °c O_NE`4GFT"E s. 1 , I) T sf IA mo COMP 4211ANTAllA Y BYE NTH TO SELFAIURE WORE 4T� P‘,, ��,,4 `` o �gYV:OPoIFpiM1(71 1$/ "' 1 r},7 ' 1NAVE MO mu- i. AYA SECTION 3700 OPTHE LABOR "PERFORMANCE RMANCE O AS BY CODE. VD 7H CEGIRREH CONCHMSMAGERA WSU® WDI)EMii6.,. THE WORK FOR AIOFOLX NAl1_ ARE: ¢y+ cARFaik a .. �\ !Pv� Tw 2N POUCY �se 4 J 76PnnLIL9I111,1In.; • TIES nSECl�i1O1COtEID CORP[EhIIPTE ONE HNDREDO_L- IlCCEERRTIFY THAT IN THE OF_11E FOR WHICH TRIG PERMIT IS ISSUED. I SHALL NOT EIROY ANY N ANY MMAMER SO AS TO _.. JCCTTO THE YORKRS COMPENSATION LAWS OFCAUORAA AMC ..._ 7TFF1 SHOULD BECOME SUBJECT TO THE WORKERS COMPENSATION P:.. SECTION 7.00 OF TE LABOR COLE.I SHALL -. COMPLY PnovFF BATAPPUC NT E- L—ua-�8 wnvaia FAILURE TO SECURE WORKERS .. - a 9TON .. UNLAWFUL. Ate SHALL SUBECT AN EMPLOYER TO CR I NAL LP TO ONE HLW- DRED THOUSAND DOLLARS lSi00oppppAA,, N ADCWPON TO TIE .. OF -• T AGES AS PROVIDED FOR IN SECTION $CS CO SECREST. LABOR CODE. EST, Ate ATTORNEYS CONSTRUCTION LENDING AGENCY H HEREBY AFFIRM LNOER PENALTY OF PERI.NY THAT THERE W A CONSTRUCTION LDS I G AGENCY FOR THE PERFORMANCE OF THE WORK MR WHICH THIS PEWIT S ISSUED ISEQJaB%CM ('car:7�a NICE WADERS ADDRESSI CERTIFY TNT TON IS CORRECT. I IA TOTOOC Y IONE READ ins tSTY STATE RMA CESND STATE LAWS REARMS TO MUMPS CONSTRUCTION AND WREST AUTHORIZE REPRESENTATIVES OF TIC COUNTY TO ENTER CHORINE ABOVEMENTIONED PROPERTY FOR ISPECIOM IS Co>R.sl"'TLu CTt." LI IMRE (PRINT) DATE _1/IL01_6_I$8000RC666L_ICL61B)___ ----2220.OIIISISIiIDl_1200._--- IRVPOIf IB1fJ C4A1660 PHONE cellgs PIIB Trait Fees ! IRE» Project 16iutio' PIIEPLII PEE PIPE PB11IR/IIBPBC1I01 FIB 714/374-1325 LEGAL DESCRPTIOtt SPECIAL CON DMONS: PROCESSED BY: ZONING APPROVAL OTHER DEPARTMENT GRADING APPROVAL PLAN CHECK BY ROTIL PIII/DOILIIID PB11IR PIES -:•-•--1• APPROVAL V Yip TO ISSUE 80000 hyenas: 0.00 439.92 Credit Melded: 0.00 611.00 Total Credits: 0.00 1,050.92 Pilate 1,030.92 Idjutests 1,050.92- lease. he 0.00 JAN 2 61998 CITY OF NEWPORT BEACH ce ce 0 n-V VtJ\ ...-. It r APPROVALS ..". DATE -. BY ';-- i .5: i:..d ..it COMMENTS .: i � • FIRE PROTECTIONIr.”- rya-•.b.a v n ,t'- THRUST BLOCKS EXCAVATION i9'-3 • • 1 4 4'.:C..a UNDERGROUND -HYDRO TEST,' _f,aa •;7 . LL UNDERGROUND PIPING FLUSH ' ' t - - " • • UNDERGROUND ROUGH PIPE - -- - SPRINKLER HYDRO TEST ": '- - •- - - .1: - •` SPRINKLER FLOW TEST ' = SPRINKLER ROUGH PIPE • - STANDPIPE HYDRO TEST ' STANDPIPE FLOW TEST STANDPIPE ROUGH PIPE CHEM SYSTEM FUNCTION TEST CHEM SYSTEM APPROVAL FIRE ALARM SYSTEM i=I ROUGH WIRING - -- • `• SYSTEM FUNCTION TEST - OENTRAISTATIONMONITOR -' -• -• •• -- - '"'' - - s • : FIRE MISC,{ s TANK REMOVAL '' - TANK INSTALLATION / TEST - - l PIPING PRESSURE TEST - • ®: . ::.0 _.. .. .._. ..._ .. _.. MISC. INSPECTIONS: 1 ... ... _. .... .- FINAL CERTIFICATE OF OCCUPANCY TENANT NAME: ElJF BUSINESS USE: >7JA:i f F HOi W3Mt fir.? Wit`' t • . • . Jct."- :IrTITO , • , 1.11-11E pERmin • • ! l'iftiaor , • MIME 1404.1111EW rnone NO. (714) 1344-.7261:1734311 , i Inspection Requests Phone No. (714) 844-3255 ADDRESS: 1 AREA: 1011 VI- 111i ' F" .)'"°fl::,- • 1111111-111 111(11111-11) . . -'- ---. -. ,i, • I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I MA 'EXEMPT FROM THE eamvCIERS MEUSE LAW FORME FOUDWItil REASON 7031.5,BUSIVESS MD PROFESSIONS OWE MN CITY OR COUNTY WHICH A PERMIT TO CONSTRUCT. AUER. BAPROVE. OBACUSAL _CR FEMUR ANY STRUCTURE. PRIOR TO ITS ISSUANCE. ALSO BLDG: FLOOR: SURE: CONST.: ASV NETRINE PROTECTION SISTER . REOURESTHEAPPUCANT AM RCN MEW TO RLEA SKIED STATEMENTRIAT FEOR SHE TYPE OF OCC. ND OF SUMMED PURSUMIT MITE PROVISIONS CFTC COMPACTORS UCENSE IAN CONSTRUCTXXt GROUP: Iilkift,b. II WIM SECTION 711013) IMF CAMPER 3 OF TTE BUSIPESS MC. ..s.r OR THAT FE CR DE IS EXEWT THERE}11011 AND THE BASIS FOR Tic ALLEGED ADDRESS: ANY VIOLATION OF Warm mis BY ANY PPPUCANT FOR A PERINI SURE= THFJPPUCANT TO A CIVL PEMILTY OF NW MORE1HM4 AVE HUCRED DOLLARS 0100013 •PHONE: U 1PB*1,34.0MIERogrne PROVERT1'. OR MY IMPLOYEE:3 WITH WAGESASieR :nzcate CONTRACTOR: Pil-PACIPIC PLUMB CO - SALE (EEC. 7014, BUSINESSVCia, PROCESSIONS CCOE: TIE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OMER OF PROPERTY VoN0 EINDS ai IMPROVES DERMA Ate WHO DOES &CH WOW ISISELF CFI HERSELF OR TROUGH HIS OR TER ONN EMPLOYEES. PROVIDES/THAT SUM IMPROVEMENTS AFE NOT EMENDED OR OFFEFED FOR SALES NOVO- EVER. THE BIALDING OR ilapROyEmENT is sow WMII4 ONE YEAR OF CONNED* ME ONNERSUILLEFI WILL HAVE THE ISMER OF PROWL; THAT FE OR SHE DO MOT BUILD OR ADDRESS: 42 CORPORATE till STE 130 IE A 92714 PHONE: 213-875-iiiiLE3AL RC DESCRIIMOtt APIIOFOFIE VVEIIEPURGEOSALE} ErATE ue. Nix: 093910 °Ass: C4C20C423611.1=c7 98031997 U LAS OMROTE____ AM ECLUSMEY COMFUCTMG MTH UCENSED CON- TRACTORS TO CONSTRUCT ME P93.ECT MiLM. M44. MOMS AND PECCESSPOIS CCM THE CONTRACTORS UCENSE LAW COES NOT APPLY TO AN OMER OF A PROPERTY MO RADS OR IMMOVES THEREON. AND NC CONTRACTS FOR SUM PROJECTS INIM A COPI- moirman 10S. LIC. LI TRACTOR(S) UCENSED PURSUANT TOTFECOMRACTORS LCENSE LAW.). • 0 I JUA EXEMPT UNDER SEC BAP.C. TOR THIS REASON ADDRESS: Tes lo PHONE: SPECIAL CONDITIONS: . DATE Air e's UC. NO.: ENGINEER: 1,.:.r udirtenima.a4natc‘liti A--.-..ss91 it r‘7-LNerP= TietY1TIAMbce:34=042 • cI ADDRESS: PHONE PROCESSED BY: OF CHPTR 0 WH SCTN OEDVONSC AND IO U..EMIM 58....IU. *Fume . . 1 • ''' . IllitNa.-^, \ , UC. NO.:• ZONING APPROVAL OTHER DEPARTMENT '.. DATE AV 9.11.•W V:' 1 ' \ *., APPLICANT: CIOSCIENCE LIALTTICIL IIC re. poet Tail 1 'Pr Lew PENALTY OF napipwrommignis Era .2-----1 _._1 LI_ 4E ADDRESS: 4454 IIDOSTRIE ST FIRE APPROVAL PLAN CHECK BY — SIII VALLEY, el 93063 PHONE 805/5264532 77. 1-0°Ckat CI. SIGNATURE OF . APPLICANT ..." GRADING APPROVAL APPFtOVAL 0) TO ISSUE ..... MD MALAN A CERFIFOSE TO r 1:13".Filt- PROVIDED FOR BY ',Us- :."jre CCM/As FID" ME PERFORMANCEOFME n:eiticammmo, ArRS`COAFENEATOCAS ittie1/4Mgvirituistl - ctiggairetWsUceretree: BY i nig supplissioi ?trait Fees t SITED> Project Taltatiot » 35000 PULE PS CBI PEE 254.16 PRE PERNIT/IISPECTION PER 353.00 Payouts: 0.00 Credit ettetded: 0.00 Total Credits: 0.00 SECTION 3700 OPINE LASOR CCOE FORTHEPERFORAINCE THEVA:411C MR cARRER: !tibia -inn punt 6 issugoitrovoiner nsuRvics ;:ri;canagy'emter „neck0,-• `ti.---.1.„ 40ifs •-..es , ,... CaTfOrnilk I!S Apr POWs' 1 f - 144, • Gm saint EE COMPLETED F -me OE HUMMED DO: LARS (3100)0R I CEFMFY THAT M THE 'ME- FOR VMICH TIM PERMIT IS TOTAL FIRE/ IOILNIIC PRIM PRES 607.16 • lalatce 607.16 ldjastoetts 0.00 lattice dm 607.16 ; ISSUED.' SHALL NOT MALLOY ANY PERSOMN ANY IMMEFI SO AS TO BECOME SUB- ' JECT TO ME WORKEENSAT/ON LAWS OF CALIJMMC AGREE THAT F I SFIOULD BECOME SUWECT TO THE WORKERS' LABOR CCCE.I SHAU. Y WITH THOS5 PICO- 'MATE 6126 /ES eiippuran, •-'7-- ; PAin - , . MAY 2 9 1998 . • ._ . .. _ . ' - ' " • 6 . • MY OF NEWPORT bEACH , . - . .n.2.7- ..... . . . • . - . WMINO: FALURE 1Ofr�JFIEWOROMET COMPENSAIEW COVERAGE tS UNLAWFUL. MO SHALL SUBJECT Mi BAPLOYIER TO CRIMINAL LTES AND CML FINES UP TO ONE HUN. DREG MOUSAND DOUAELSttt�.I. IN ADDRIEN TO THE COST OF COMPENSATION. OMI- AGES AS PROVIDED FOR M SECTOI S7 CC THE LABOR COW.. MEREST. ATV ATTORNEYS FEES. CONSTRUCTION LENDING AGENCY • I HEREBY AFRFII UNDER PENALTY OF FEMUR/ THAT THERE IS A CONSTRUCTION LETO No ACIEICY FOR THE PERFORIANCE OF ME WORK FOR WHICH THIS PERMIT tS ISSUED gitsca7.ay.c.). _ . t 1 CERTIFY THAT I HAVE READ MIS APPLICATION AND STATE THAT THE ABOVE WORM- MONIS CORRECT.1 AGREEM COAILYWITHAU-OlY NO COUNTY CADMAN= NCI STATE LAWS RELATNO TO BUILDING CONSTRUCTOR. AND HEFEETY AUTHORIZE REPRESENTATIVES WINS POSES TO ENTER unmayllEAEOVElENIMED PROPERTY MR INSPECTION PUR- . kirlili4#1/4/ ,iatfryL . • ye• . _ . . SIGNATURE . • 6 11. .33,,.A.w APeROVALSi .,:v.t ay:t 'DATE ~: BY COMMENTS , n FIRE PROTECTIONjiI1 17I5. _ _11 :':1 - ; r II: THRUST BLOCKS EXCAVATION' -;' 2 •'-' _ _:I'.. ,.... UNDERGROUND HYDROtE§T' •'`19 . c,:;t -' UNDERGROUND PIPING FLUSH =' UNDERGROUND ROUGH PIPE 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 FIRE ALARM SYSTEM • ROUGH WIRING SYSTEM FUNCTION TEST -` -' _' '�\ \.� CENTRAL STATION MONITOR ... -_ : - - , .,_•,1 I c% (• . ...... . :.. . FIRE MISC. TANK REMOVAL - - ' TANK INSTALLATION 1 TEST- . - ._._ .,.... PIPING .PRESSURE TEST-" MISC. WSP,ECTIONS: - ,. tie 1 • FINAL %st: 79 et ear CERTIFICATE OF OCCUPANCY TENANT NAME: TYPE OF BUSINESS USE: $ DEPOSIT RELEASED FOR REFUND ON TO. - LAIN. il_13A1-1 r•Qe4—j • • • • e ' City of Newport Beach ildig opartmt• - . 768 Newport Beach, CA 926 a-8915 Permit Counter Phone No. (714) 644-3288/3289. GRADING PERMIT oWNEn.at*DER DECLARATION JOB I HEREBY AFFIRM UNDER PENAL �k.\PEN,tlyWC 1rA AWE ESlPTTFROY THE-ti' klIgRESS: „Al: .C.• '�: tlll 1^j ' �'' DDNTRAcTaIsuCENSE LAW WRTNE OYIIq AE^60R HWtt BU4aDS AND+-Z+S•. •• .G-4• . ...5.J •LLOIa��l �: 1:.'1'�� • PRCFFSS1aNS race ANY CITY OR COUNTY WHICH BECUIDES A PERMIT TO CONSTRUCT, - - ALTER P.WSOVE. DESflS& OR REPAIR ANY SIRUCMIE PRIOR TO ITS ISSUANCE ALSO WOLVES THE APP CANT FOR SUCH PERMIT TO F V E A SIGNED STATEMENT TINT IE OR SHE s LICENSED PURSUANT TORE PROVISIONS CF TIE COMPACTORS OCOEE LAW ER n I EMOWECIVON Yd IW]�DDS M .d 9 �OEIRER _ $OOIG DIE.L EOSPTIAL PUSDT� `` roACNL TY a NOTO= THAN FIVEHUNDED •-'••'•�4" '� Inn DR~JA` '�\�. ' wi OOT E STRUCK ll"`"ar As Ta+ `' :': "`Y; " S%;IEIPOItTUlCR� CI 92663 r, `PlioriE • oceshorGAPPLY OWNER BUSINESS ANO I�TDFEPFUM I BUMS on AND •\ NIONS - THE CONTRACTORS LICENSE coNTRAcrora: DIaTOCO*$ROIiS$tINE:.160RSTtQC CND DD®SUOI WON(IYSpF OR I6 EPC NS OR VIER OYRI EINOYEES EVE UEDTNT SnNJPRDYOVE S ARE NOT INTENDED OA OFFERED FOR SALE F.HOW- EVER. THE BUILDING 011 IMPROVEMENT IS SOLD WARN ONE YEAR OF COMPLETION. THE . 41" NE PfOM% I Y TFE CR SHE COD NDT BOW OR t%1NmM:ING WITH LICESED con- ,...___ Jo_ PgT1EPEARLTlIPROIECTrL\RA\ fyNN. BUSNESS MB IY OF gllup CODE THE OONIRACTURS I qF LAW DOES NOT APPLY TO AN ome% FA WHO 1. DSO 10ERWF3T/EREO AIM Inc CONTRACTS FORSU01 PC,ECJTS%MT1 A Ca. TRACIDR C TEWNIRACTD{S LJCCN LAW). y.(�T I AM EAEIAP, DER SEC. B.BPA. FOR THIS REASON ..A,. � :: ,. ,,: c.� :PHONE:. DALE OMER LICENSED CONTRACTORS DECARATION OF CH� tcGs I 140 WADI SEMEN MOO)atc OFO ISIDN McUSPE Pi0FESSWE CODE AIN MY LICENSE S N FUU. FOAcE AND EFFECT. PisVer4t-HAt- 1C N0H yD Coom WCf kERW upENSATION DECUR'ATION • , I HEREBY ARSYA LINER PFTI.TLTYOF PERAMYOHEOFTHE FD W,WG DEQAMTDNS: 1 HAVE AND WILL YANTAN A CERTIFICATE OF CONSENT TO SELF-WU E FOR WORK- ERS COLPENSAMWASPROVIDED FOR BY SECTION 91000F IRELABORI5OGEz,FOR THE PEFOfVAAICE0F THE WORK FOR YAI%7SPEII ,;• ligft. MUSE iOMMI±O T'�"Ne 1Y ni .'t'OFOR"e'E'L Da lERC=DFaitS-MIZNEss::t\. 2420-iniettiLT:Ls`.\ �`' ;:•, ADDRESS: 14801 SLOTS! ATE PONTARA CA 92334 STATE'zs( 217170 CLASS: 1 A 07,2 ARCHITECT: ADDRESS: LIC. NO.: ENGINEER: AhOAESS:?<•-' PHONE NEWPORT BUS. LAC.: PHONE: � «'„w DleesSr SIGIlEERIIC ADDRESS ' . -15790 BA�CRO-VIEjfl . '� � RIVERSIDE, CI 92506 INSP AREA 1 714/645-8600 909/350-4646 17022711 PHONE: 909/180-2813 meal Tile PERMIT s s5UE0. MY womanly COMFESATION esURNNCE CA VEER AFC POLICY NUMBER ARE CARRIER CAIRANRRIC110112 �'o`FpH!B $T'�NUIiEiL < iS cgo"L$ET7100D(' '- Z�I`FMBTfHOM011L } f. ; "k 7, \E'TIIE PHMr Y I.fer;°p{`:, _I CERTIFY THAT N THE PERFORUNNGE OF THE WOW FOR MCI IRIS PEAMT IS ISSUED 1 SHALL NAZI D.PIOY ANY PERSON N ANY MYIER SO AS TO BECOME SUM- -%. T)ItE NOW031G of NOA6REE.TNiEF.• '' AD BEOtIME'i{IBEGTOOA�t g�TION PROVISIONS DF-. , SEC11007103pF]1E upon cope.' 6N(4CFD t `C011PLY,N(IiN 71gSE / DATE Q , <93 lY . WAPRG: FMLI E]p,SSCNIE YgPEis' capeSATION COVERAGE 15IXLAWRL. AND -:seAwUS{6EC ANI MWER.Tt7OQYAVML' In $CALF s P.mora.n- ��OBED .R!,yG S y.O NAOM w..9”.ociristi CCCI.EI##GAInoN.DMA- ... N _ "���J���'�-ETC•: l"_"Ve...`L.�TJ1 ��}} CtINSTRUCT70N LEHDeki AokTk.'1', - - . .•::: HEi♦�HVAF4EY\AOEAE4LTec OF'FFNHYTNT'MYs•OALatin.lcTg111END` !! rOsI OYF'OR THE PD3a1BlvcE OF 0*WORE FOB WNQI T96 PERAtlT IB ISSl1ED amT LEIOERSNXEESS 1 CERTIFY THAT 1 HAVE READ 1MS APPIIGTON MD STATE THAT TIE ABOVE SEN NA. TON S CORRECT. I AGREE TO CO PLY WTH ALL an AND CORM CRONANCES AID STATE LAWS MATING TO BUILDING COAST UCTEN, NO IEREBY AUTIIDR� REPREMNTATlVES OF THL9 COUNTY TO BITER IPOI THE ABOVEICTOMED PROPERTY Fal VSPECTUN RAI- P06ES DZSAIlsocti &.FTEENLE(PpNO--e- `k:LI)I5 9-" •97 s10NA1UEOFPBFVREE DATE (REV.7/96) ' ,� i- 0RD0 IEACR, -CL•90211 SIGNATURE OF '-PHONE: 110/798-0513 APc1FIR - '� ?li.1*e p;ei>rro • s : = ORIDi16/DIIIIAOB:Pttiit Pei * -;,, , ; •`•`_ +•;C ,.::,'t'; Vilsatie'S If iteiaieircats.-�- > ; 's 1611DI10'�a211NIRPEI:, via (T1+.�:,, H�=•201I1s-11L>>I'C11CC-P81(6R.dours) (1):A.ti.< 2�<i6 'CL111411r1EPOSIt=kcR10I10: ,T) • '1:= 'ef`'7lICR0PILII Shot! Lp61Ni?$T rt, -:t DIRERf11-Fletosatik040de x..^?:�' (6escriptioa of fee) TOTAL CRIDIIS/DRIIIIOE PIPET PEES PLAN CHECK VALIDATION DESCRIPTION OF WORK Permit No. A- ,,. G9700417 Inspection Requests Phone No. (714) 644-3255 1UCI1116/16PhkCB(IM$41)( UPLOG -97) EICAVITI I REPLACE 7000 CT TYPE OF PERMIT: Precise Oradins Permit VACANT SITE NEAREST CROSS ST. LEGAL DESCRIPTION: YARDAGE FOR PROJECT SPECIAL CONDITIONS: ❑ YES ❑ NO FILL: 7000 CUT: 7000 PROCESSED BY: ZONING TRAFFIC SUBDIVISION GRADING REVIEW DEPARTMENTS ,Name Date APPROVAL TO ISSUE R. '"_�. / 850.00 '•i 1,700 00 T, 1 is56. 2,500.00 T 5 1.25 150 150.00 2900-5004 0.T. P/C (-71\ M.O. CASH 5,226.81 PERMIT VALIDATION Payouts: 1,000.00 Credit ettended: 0.00 Total Credits: 1,000.00 Ialatte 4,226.81 Adjsstoeats 0.00 !alone doe 4,226.81 --------------------- PAID SEP 161997 CRY OF NEWPORT BEACH O O 0 2 z CO p U CO ✓ D. 7¢ 0 Lit 0 I CO • La- 0 0 2 I... o W a. a rn 0. Z '1 '�o 2 CC CC r 0 2 0 0 w 2 0 I . . • • f • [ *'� G" IP 'INSPECTIONS PREGf1ADE MEETING GRADittiNSf'iILU, i G ffi-g e 942tfflyr DATE BY COMMENTS • ROUGH GRADE APPROVAL PREPAVING MEETING CUR3 AND GUTTER PAVEMENT SUE F?f-.DE AGGREGATED SE I_ATWORI< STORM DRAIN CAFQJ sASiN EROSION CONTROL HEC;FE GRlos EC.T: lNN ^OCJ:.•EIJFS NAL . • • • ERTIr tCATE T' F • 79492 ati t yeeoevese roe( tar olfrfrol: #aa* 440 /ll3J,li1' rfFACIA; ~de ',sire. _ .Pr, tiv ai Atria Wet ow Min silt i c Zt.JJi - ' s'7$04ts A¢9• S7¢. a ZflV dui x ¢/f7� l'W& 4*S r- is 3?3- soo 2•/O'• $7 1axCa& ,* fi/Y.n to'Sdetrater poaraC tar, "59€ Dolt ,&n tin irnerr /eas • /e-a? dodo "re: 4 0/%9 4/,8pvc'; P6• 111 , Idr arto.il Ara; Oftriterr se /f' ograeo, =Pa//PE °4er. --itfirr , 2,41:2 aC fue err »e0eJ,u gc GI* .aa'« ya - it%4: Cb% 43 JCS! �' C9/, fit) /S���oeetai aire.el/a. i' t€UCems' s' #Q risrxr aroZY aknetL' v t€at ' r .�/ri>a..as ? .rx� Afran�s O/ .f£YtrAlea/4a /trgr /lrar eaecrq'z,-/fT,,,J & ((»t1.a ), /Yl#!/y 4/9.'O.q (4,10' eofehloW til$-r4 z-w) reap (l ai), Sikes) Mr a aia etc nfter0freiret $P4 Ei44 f atefiC06 Lrra io.9,l"4. RhP4 A44e n sr Hari i care far net 490-e 65s teca /a,Atr - a ' &lnV/FM*- /,• jt r /PfYorf 9» ra BA°.GiWe /s e, r /1eeri d s'AI/.d s fat .teU/v/6 avaorg61/,t' Via, er Aadi'/r a4ro /rrry a men "veer ctip $ ;25C0u � FOR A UN, ON_ IpL To::_ i.OtD �fet 4 DE,I:.PSIT RELEASED` ansT c. LA\\T Crandall LAWGIBB Group Member FINAL REPORT GEOTECHNICAL TESTING SERVICES BACKFILL ADJACENT TO RETAINING WALL HOAG/NEWPORT ARCHES #311 NEWPORT BOULEVARD AND COAST HIGHWAY BRIDGE NEWPORT BEACH, CALIFORNIA Prepared for: BRUTOCO ENGINEERING & CONSTRUCTION, INC. Fontana, California November 18,1999 Project 70144-7-0550 r _ LAWCrandall LAWGIBB Group Member A November 18, 1999 Mr. Victor Arrigo Brutoco Engineering & Construction, Inc. P.O. Box 429 Fontana, California 92334 Subject: Final Report of Geotechnical Testing Services, Backfill Adjacent to Retaining Wall Hoag/Newport Arches #311 Newport Boulevard & Coast Highway Bridge Newport Beach, California Law/Crandall Project 70144-7-0550 Dear Mr. Arrigo: Our geotechnical testing services for the backfill area adjacent to a retaining wall for the subject project have been completed. This final report provides a formal record of our testing of the compacted backfill placed at the site. The location of the site is shown in relation to Newport Boulevard on the attached sketch provided by our field technician at the site; no plans were provided to us at the time of our services. The testing work was performed periodically as requested between March 25, 1998 and July 23, 1998. We performed a geotechnical investigation for the Arches Interchange and submitted the results in a report dated May 14, 1997(our Job No. 70131-5-0362). Our report provided recommendations for retaining wall design and grading, including backfill. The new retaining wall, along Newport Boulevard, was constructed a distance from the existing slope descending from Hoag Memorial Hospital property. We understand that the backfill behind the retaining wall and the Hoag Memorial Hospital property line was placed per Caltrans standards; there A Division of Law Engineering and Environmental Services, Inc. 200 Citadel Drive Los Angeles, CA 90040-1554 323-889-5300 • Fax 323-721-6700 p a Brutoco Engineering & Construction, Inc. - Geotechnical Inspection Services November 18, 1999 Law/Crandall Project 70144-7-0550 was no continuous observation of backfill placed in that area. Our contract for the work performed which is the subject of this report is for the backfill that was placed within the property limits of Hoag Memorial Hospital. This final report is limited to the earthwork performed through July 23, 1999, the date of our last testing of the soil -related work for the project. The backfill, at the locations and elevations tested by us on Hoag Memorial Hospital property, was compacted to at least the specified degree of compaction. Our professional services have been performed using that degree of care and skill ordinarily exercised, under similar circumstances, by reputable geotechnical engineers practicing in this or similar localities. No other warranty, expressed or implied. i made as to the professional opinions included in this report. The scope of our services did not -delude surveying or the responsibility for job safety. The earthwork was performed to the limits and at the locations indicated by stakes and hubs set by others. TESTING OF THE COMPACTED BACKFILL Our services consisted of testing of the compacted backfill, as requested, on top of the slopes and on the face of the slopes behind the existing retaining wall recently constructed along Newport Boulevard. SOIL TYPES The soils used for the required backfilling consisted of on -site silty sand/sandy silt. COMPACTION SPECIFICATIONS The backfill was to be compacted to at least 90% of the maximum dry density obtainable by the ASTM Designation D 1557-91 (equivalent to UBC-70- i) method of compaction. Brutoco Engineering & Construction, Inc. - Ceotechnical Inspection Services November 18, 1999 Law/Crandall Project 70144-7-0550 Compaction tests were performed on representative samples of the soils to establish the maximum dry density. The tests ware performed in general accordance with the specified ASTM Designation D1557-91 method of compaction, which uses a 1/30-cubic-foot mold in which each of five layers of' soil is compacted by 25 blows of a 10-pound hammer falling 18 inches. The results of the compaction tests were used in establishing the degree of compaction achieved at the locations the backfill was tested. FIELD DENSITY TESTING As requested, our field technician visited the site and performed sand -cone field density tests to establish the degree of compaction achieved after the backfill was placed and compacted. The tests were performed in general accordance with the ASTM Designation D1556 (equivalent to UBC-70-2) for sand -cone fieid density testing. Tests 1 through 5 were performed on the face of the slope (Caltarns property); the test results indicated 85 to 99 percent compaction. Tests 6 through 10 were performed on top of the slope (Hoag Memorial Hospital Property) and the results were satisfactory. However, we do not have information on the soil conditions of the backfill that was placed behind the retaining wall, and that was tested by others. We understand from you that the backfill placed within Caltrans property was acceptable based on the Caltrans testing criteria and the tests performed by others. It is our opinion that the soil conditions should be evaluated should any structures be planned in this area. Test Data are presented in the attached table, Field Density Test Results. The attached sketch shows the approximate locations of the tests. In providing professional geotechnical testing services associated with the development of the project, we have employed accepted engineering and testing procedures. Although our testing did not reveal obvious deficiencies, except as noted, we do not guarantee the contractor's work, nor do the Brtuoco Engineering & Construction, Inc. - Geotechnical Inspection Services November 18, 1999 Law/Crandall Project 70144-7-0550 services performed by our firm relieve the contractor of responsibility in the event of subsequently discovered defects in the contractor's work. LAW/CRANDALL a Division er Law Engineering and Environmental Services. Inc. erry iley Resc rcrcee Manager 5"/ Martin B. Hudson, Ph. D. Principal Engineer G: ' Insp 'ct 197-proj l70550170S50rpt. doc Attachments (2) (3 copies submitted) cc: (2) Hoag Memorial Hospital Attn: Mr. Leon Roach Field Density Test Results Moisture Dry Maximum Test Elevation Content Density Dry Density Percent Retest Number (ft.) (% of Dry Wt.) (Ibs/cu. ft.) (Ibs/cu. ft.) Compaction Number 1 * 10.1 104 119 87 2 * 13.0 105 119 88 3 * 13.3 105 119 88 4 62 11.1 101 119 85 5 63 12.4 118 119 99 6 66 4.2 112 119 94 7 66 5.3 112 119 94 8 66 5.3 110 119 92 9 66 4.2 110 119 92 10 66 4.2 111 119 93 NOTES: Elevations refer to job datum. * Indicates tests were performed on the face of the slope. 7O55Otbi.bShz II/18/99 haft VW M\VY•V/b-Y iaV -3044998 16:02 V�W�VY set sou • 11- 3-99: 4:42PM;HOAC. FACIL. DESIGN HOW HOSPITAL Date: To: From: Reference: Subject: FACILITIES DESIGN & CONSTRUCTION Ono Hoag Drive • BOX 6100 • NEWPORT REACH CA 92658-6100 FAX MEMORANDUM November 3,1999 Distribution Leon Roach Project Manager Facilities Design and Construction Hoag Project 1251.96 Landscape Phase 5 - Newport Blvd. Project Meeting Inquiry Phone: 949-574-4462 Fax: 949-574-4466 Date: Time: Location: Remarks: Distribution: LR: c: Thursday, November 18, 1999 10:00 a.m. Hoag Hospital Facilities Design & Construction Newport Superior Medical Plaza 1501 Superior Avenue, Suite 309 Newport Beach, CA 92663 Meeting to discuss issues related to Project Close-out. Reference Permit No. 69700417. Please notify Lynn as soon as possible regarding your availability. Fax: 949-574-4466 or Phone: 949-574-4460 or E-mail: Ilastrap@hoaghospital.org Victor Arrigo Brutoco Engineering and Construction Jerry Haffley Law Engineering and Environmental Services, Inc. Marty Hudson Law Engineering and Environmental Services, Inc. Donald Lewis Brutoco Engineering and Construction Don Skelly City of Newport Beach Leif Thompson Hoag FD&C Woodcrest Engineering 91 Chron File File; 12S1.98-01.35-MTO-INQUIRY-111899 CONFIDENTIALITY/DISCLOSURE WARNING: This transmittal contains rRNILEGED AND CONFIDENTIAL inlonnation intended kw use by the recipient named above. Use. copying, or distributing by any other person is strictly prohibited. II you have received this transmittal in emir, please notify us immediately by telephone and relum ihb misdirected transmittal to us by U.S. mail (or as directed by the sender). Thank you. PAGE 1 of I { City of Newport Beach - Budding Department ---- - - AC�9). P.O:Box1768 I r Newport Beach, CA 92658-8915 Permit Counter .Phone No..(714).644-3288/3289 -. :. I MTrON ynALb‘t As SAW. ]]{ 1 HEREBY AFFRIA UNDER PENALTY OF PERJURY THATT$1FIFA AEAM EXEMPT FROM THE CONTRACTORS UCOGE LAW FOR RE FOLLOVAN3 REASCN IM TO CONSTRUCT. SG. 7031.5,__BUSNESS AHD BR1L 0 � ALTER. IMPROVE. oeucu5SSIONS CODE4 MY CITYPREP SCANTY�Ti1CRIRE PRIOR 10 REDUCES TIE_ PUMP-JAWACCNRFORSIAJ PEWIT TO FIX A SIGNED STATEMENT TNTHE 0119E 1.ISvUCENSED ASSHREEPTIOD OF TIE CONTRACTF THE ORSLICENSE ESS MD BAIC UW [. E101APlL T10N T VWra BYBY AIf APA_fVI FORA ;, • W A CIVIL PENALTY MORE TWJ RVE HUMPED COLLA�Si 550RX- THE PENSATI LWU DO 1BT11E3T WWAGESDS011OFFEfED UCENSE {FAORR DOE• S APPLY BUSINESS. 7044 OWNER OF PIOPERIY vac autos ORT M&' INTO DOS SU41 WORK HMSO" OR HERSELF 011 THOUTII HIS OR Rita.®TNi91p1S VUC4TS NE POCI4IFSMEDOR ORERED FOfl SME F.'WI- EVER TIE BlfdN0 OR VE1REStEHT S SOV) WIIIW OIE rEM, OP.Op.NM BOIL. • • nor AS THE Wit WAVE OTFES:BMDEL LOF PAOVEUk7INT-4 •• •DID NOT BUILD :. LI L A.S OWNER PROPER[Y. AA SCQJ. IVELY CONIMCTP$ NTH LICE SED C014- . TRACTORS TO CONSTRICT THE PROJECT ISSEC 7044. ases AND P'F10iESS10Ns MOE: THE CONTRACTORS LICENSE LAW GOES NOT APPLY TO AN OWNER OF A PROPERTY EDO BUMS OR IMPROVES THEREON. MO WHO CONTRACTS FOR SUCH PRDECIS WRH A E TRACTORLSI LICENSED PURSUANT 1071E CONTRACTORS LICENSE UIWJ. 0 1 AM EXEMPT UNDER SEC. B.&P.C. FOR THIS REASON DATES : OWNER UCEFSEDCONTRACi=RSDECLARATION -.... I IEMET M1fl4 VOEH PENALTY OF PERJURY THAT 1 MI LICENSED HMEii PROVISIONS . OF CHAPTER 9 (COMHNC G WITH SECTION7pM OF DIVISION 3 OF THE BUSINESS NM ' PROFESSIONS C M AND MY UCESESN FALwNc AND ERECT. ucensECLAss • -LTC. ND. • - nVIU/PLD1-- OATE� QOm ltron • woegal COUPENSATION DECLARATION I BEDEW fly IA IRAEI VFlLILTY OF PEPLUM. ONE* OF 11E FOLLOWLNG DELTARLICO6 I HAVE AH! W{L WVRAIN A 53111FICATE OF CA NTTO SELF-rf6WE FOR MAibC- . -- ES' CCA@ENSA77gqRRAS PRDVNEDF(q LW SECT013tlO OF TIE LABOR O'IOE. FOR TIEF/]POf4Mi EO 1)EWORCFtRY.I fl F4WXT6691® .: HAVENO WILL MWUN WONERS CORiamATCFi Mu11RANCE ASREaJI DNY SECTION NW CC THE LABOR COOS FOR THE PERFORM/GE OF TIE WOW FOR WINCH RAS PERWT 5 ISS ED: MY 140R/334F COMPESA11091 INSURANCE CARRIER RNLI P` .EYNUMBET ATE 'r . �: ,• CARRIER (p1)H15g EECIION NEED ICTBE C K'LEIW F THE PEUT IS FOR ONE NAMED DX- LATCSKO)O6LESS). r• ' I CERTIFY THAT N THE PEAFORWI CE OF 1IE WORK FOR WHCH THS PE WBT IS SUB- JECTTTIEE AIL WJC COMPENSATION LAWS OAF CALFORMA. AAM3 AGREE THAT F 11 SHOULD BECOME SUBJECT TO THE WORKERS COMPENSATION PROVISIONS OF SECTION 3SOOF 1HE LABOR CODE I SHALL FCRRHVAIH WILY WITH TIMM PROVE SY1fA 017E APPIOANP. WAIVe10: FAMXE TO SECURE WORKERS' COWEISMON COVERAGE IS UNLAWFUL. AND SHALL &SECT AN ERDYEI TO CIOOAL PENALIET MO CIVL MES LP TO 01E HUN- DRED nOUSNO 00UNS 491=LN MORON TO THE COST OF COIPBNSOION. SAN AGES AS PROVIDED FOR N SECTION NOS OF 1NE LABOR CODE INTEREST. NO ATTOREYS COl6TRUCTwNLERDON ` - ''••�-���Vs. >oFistr# 1 *oec AFFIRM IXOEIPENALTYOOF THE n NO AGENCY FOR THE PEPfORYANHCE OF THE WORK FOR AHEM THIS FVMr Is ISSUED WINSE 1. NAME •EEERSADD E5S GRADING -PERMIT AIN DDRESS: 45. tJ "Jig , -D.-, t) s>r•. '1 - t P �r -•- a' 1. ` fl0A01110H1LlOSPIT1L PIES ADDRESS: IN • ':'18VPoot IK1tI-Cl 92658 6, OptHDNE STATE . - It/ILDI CLASS: NEWPORT LJC. ND: - BUS. UC.: ARCHITECT: I CURET THAT I HAVE PEAR THEN APPLICATION FPO STATE THAT TIE MIME NC IN - TEN IS CORRECT.; AGREE 10 CCMPLY WmI NL CRY AND COUNTY ORCAN CES Mon STALE LAWS 18AING TO BUXOM CCHSTTRIICIIOIL ANO 1ER1337 AUTHCAM REPRESENTATIVES OF Tay F3UNTY TO ENTER UPON TE ABOVEMEMON®PROPERIY FOR INSPECTION FTIF meet • 3ONMTIEOFPFIMTTEE_ (REV.-7/96) DATE ADDRESS: UC. NO.: ENGINEER: ADDRESS: UC. NO. GEOTECHNICRL CONSULTANT: ADDRESS: APPLICANT: ADDRESS: SIGNATURE OF APPLICANT 1/4 110I1DI DOTLE IMPALA! 2076 S OWAID AYE SARI III, CA 92705 C-018559 - L1V/CIAIDILL 200 CITADEL DRIVE LOS IIOELES CI 900t0-1554 TOILE DAVID 1 2016 S CLOD, 5TE S►IT1 III CI 92705 * CUIDI10/DWWIII08 Permit Peer * 1 Valeatioe of improvecents ----> RIDING - PLl1 CIRCE P88 (f) 11.6111 - P8t11T PEE CO 2OIIIG PUP CHECK P88(6y Soars) (1) CL811-0P DEPOSIT- 0111I10 (T) 1 of IICIOPILI Sleets i P811ITS! TOTAL 011DI10/Dt1IIl68 PE11I7 PEES PLAN CHECK VALIDATION Ss a-+ �GhiOf�-+cn.c:.1:3X--:: i '..•..xC. < ":r - -lr •k, A�4.'rL"#.'."..s-t_-'.'`+«uA+.-�2�is$•€.YW�.FaYv.t4,zt�.a.na�- -L �hk PHONE PHONE PHONE PHONE: 714/957-8144 323/889-5300 711/957-8141 DESCRIPTION . OF WORK: Permit No. -:G990.0076- nspechon Requests Phone No. (714) 644-3255 11UI11(:11 PI1116)(1fl -91) - 011DI10 Pot T81P FAILLE TAT Precise Bradley Feint TYPE OF PERMIT: VACANT sae NEAREST CROSS ST. LEGAL DESCWPTON: YARDAGE FOR PROJECT SPECML CONDITIONS: PROCESSED BY: ZONING TRAFFIC SUBDIVISION GRADING ❑YES ❑NO Flu: 1500 CUT: COISTIL WAIVER 1599102 5/11/99 lOYH LT! 01 PILE P01 L801 ROlCR TO SIBI 0/1 1500 TherAi') 42,21 99 APPROVAL TO ISSUE f)G_ 6-2,4•99 741.00 T 26.33 3 78.99 .26 2 .52 2,291 01 �v MO. CASH PAID JUN 2 41999; cth Eft teict PERMIT VALIDATION .. MIT BECOMES NULL AND VOID. 0 Payments: 370.50 u- Credit Weeded: Total Credits: 0.00 0 310.30 O =kk1b Idjartmeats 0.00 it lalaate O V • Q 2 I ce INSPECTOR'S COPY A • • a .43 • . , ,.. DATE BY ... COMMENTS - : , • • . • , .. I PREGRADE MEET1NG;: ; :;.,:,.; ",:.,...... - . ... i Is ti tsar Ara. seen Pow, .4.,ns 'me_ te,",,, ..,,c #4,44.04.4r cotac 4: a.. GRADING INSPECTION:lad 1;;ILIS: lt, nt.:,..: ii.4 eavithei____. tutildiri )MS: Eili:c54.: Iii 'fi. ._ , II. i• 2 1‘712 _et - /Aotil edeles 011-ifer e/.0/ cereatoefrete,-- ROLPSH GRADE APPROVAL leric_eie.r_e 1-.49,- den tP, rang_ PREPAVING MEETING _Segi _412rese2,ter_ e CURB AND GL'TTER -7:tett __ _ _____ t•f7.00 Oa- r0:1-1Q/749%,Lf2t6r a PAVEMENT SUBGRADE 1-- AGGREGATE BASE n”. iOli'in H7:2:4 !'"•11". I FLATWORK STORM DRAIN -a_ I- , .• • CATCH BASIN, , -3T-- -1---74 -EROEFirsi ---- - ;--- — -' • • • f" 2r• " ' _ . _ . . . . . ... 7,.-„ . • • . • • - " •..I: . . s; ..! ' :, .. Tr- -.0 , ,. j i . -OTHER , ,...t. • •• •-• - -1 .. . .4.. -PRECISE GRADING INSPECTIO-N ' DOCUMENTS • . _..,_ ,. .. FINAL ; :!.;9!I:JZ.51: :,.;*2 .Z.Jj'aief)4-- GEM -IMAM TYPE "It:i7 I:1,i.; NAIE or.Enick'Finfyi r gari"--__fr-va \A. ,y . • . - . RECEVED BY 074 2 _ .. -L , ; I.', .-•• e: 4:!' '.- , 0 2 a/7.cb .. i civic sop eh* - : : „.., -!3!"",r:-.., lc/Age? ' a •':3! 'FS 442670/9 --- - - i . - - - ' , (IQ s FOR REFUND TaiLe . • , • . • CIVIL ENGINEER'S CERTIFICATION FORM FINISH GRADE GRADING PERMIT #G9900076 From: pavid A. An Enginserin 2076 South Grand Avenue City of Newport Beach 3300 Newport Blvd. P.O. Box 1768 Newport Beach, CA 92658-8915 Attention: Grading Engineer, Building Department GPC No.: 7938E-97 Project Names: Project Address: Owner/Developer: Type of Project: • Tract _ • Commercial _ • Industrial _ Yardage for Project: • Cut Fill Santa Ana. CA 92705 (7141 957-8144 Date: January 27. 2000 Tract/Subdivision/Lot No • Rough_ Final TEMPORARY EMPLOYEE PARKING LOT (FORMER BORROW SITE) One Hoaa Drive HOAG HOSPITAL 2..270 CY • Drainage • Other Hospital. Parking Lot . Caey eavr I hereby certify that I have reviewed the finish surface grades for thisthigs project in accordance with my responsibilities under the City Grading Code, and it appears that all areas exhibit positive surface flow to public ways or City approved drainage devices. The grading has been completed: conformance with _ wi.th the following changes to, the approved grading plan. Description of Changes: Slight adjustor nts to bus atop slab Company: Name: 460 CY • Stockpile - CY • Export L.810 CY DAVID A. POYLE ENGINEERING DAVID A. HOVLE (print) (sign) License No.: 18559 (BC/LS) 9 City of Newport Beach', '..Snarling Department Newport Beach, CA 92658-6915 Pertnit-Counter-Phope No.1(714) 644-3288f3289__ • DAM'y'" ! b �fl comnpamR or ..10 WORIORS' ccuPEn9ATtotF occau RCMINEaEO'1 F eet Caen PENALTYoF PERNRY COF PE jalousie I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I A4 • XEMPT FROM THE CONTRACTORS UCENSF. LAW FOR ME FOLLOWING REASON (+SEC. 7031S BISIESS AND PROFESSIONS COOS ANY CITY OR GUMMY vacs A REPENT TO CCSSTRUCT. iI. N.TER. SWFOVE. UEYULEK OR REPAW MW STRUCIIHE TTMOR TORS ISSUANCE ALSO 5 IEOUI E4TIE APPUGIIR FOR SUCH PEFYTTO RILE A SIGNED STATELENTWAT FE 011SHE • IS LICENSED RUIS{ANTTO1IE FRDIT9@S OF THE CONTRACTORS LICENSE UW T . 9 YHTH SECTION Nag OF DIVISION 3 OF THE 9S•ESS AID OR THAT HE OR SHE IS EXEMPT THEREFROU AND THE BASIS FOR THE ALLEGED APTIfCN MY VEXATION OF SECTION Ram BY ANY!m.�••^ a^A P@I.`--TS�ELE,C1B LJ 1. 7/E*5 ONEA OF TIE PROPER1Y. EREIMAN YAM WDYEEMWAG SAC. TEIR BOIECOK PENSANOIL VAL DO TIE WORM ENDUE STRUCTURE S NOT MENDED CR OFFERED FOR SALE SEC. N. BUSN!G PROFESSIONS BUSINESS DFESSIONS COOTIE CONTRACTORS UC NSE LAW POT DOES NAPPLY TO AN OWNER OF PROPERTY WHO BMX OR WAVES ITEIEOR MD W O GOES SIGN WORK MYSELF OR IE.159F °R OEMER RECO TEN OM! EFNDYES. . PROVIDED THAT SUCTI UVROVS&NTS ME NOT imam oR cfrEFED FOR SME E. HON- EVER. THE BUILDING OR IMPROVEMENT IS SOLD WRHW aE YEAR OF COAPLET101L THE ONWIgERRE9Um DWEL HAVE MESALMOEN OF PROVED BMW •E OR E DO NOT BUOR LJ L ASFORMEH Of PC PRO' RRY.NAEXCLUSIVELY CONIRACRNOWITH UC96mCON- TRACTORS TO CONSTRUCT TIE PROJECT 70N. Ruse ESS A70 PROFESSIONS 1:04E: SPUDS OR PAPROVES THERECONTRACTORS Lana ON. ND�O Ca/NoT TRAMS *019 IIP AN WailOF ACO IRACTCMSj ULU15m ROSUANT TO THE CONTACTORS UCE16E LAW). - - ADDRESS: 0 I A4 EXEMPT UNDER SEC. BSP.C. FOR THIS REASON DATE - I HEREBY MNYUDTA PENALTY0FPER*nY THAT I NAIXEMEOIXDUNPFOVSIONS OF CHAPTER 9 WITH SECTION 7BM OF dVLS1ON S OF THE BUSINESS AND PROFESSIONS CODE MD MYMOSE S H FULL na AND EFFECT. r- iiAA� • f '/ ..41" diBANl Arafferb°MiginV TES ... :-.TIE PERfORIMI CEOFTIEWCWFORWRGI TMS R7YiSISSED. - • `-I HAVE M7. WILL IJAHTAH Y.ORIEf15' epWBSATON veiLANCE AS fEOUIED BY tWIICI SECTION J700 OF RI LABOR GOTH OF FOfl E PFAFOIO.NLENSUVOF TIE WWCEGIK FOR TIl4 PEJMT IS S&E0 4Y vD.laB_ LIILPBSAI01 CA1V991 r�r:� iv>ie sire "iyiir Pa7cY'iAaAeEn_�BD1i0143=. ; "GRADING -PERMIT : y IYSPZI s 1 �6 ryC AREA: OWNER: HOAG MEMORIAL HOSPITAL —____! FAIaAO EU9a_...-.-- ADDRESS; Jul a9atvaT 9UTI IEIPOIT 1EACE CA 92658 PHONE conTRAcroR. PECK/d01ES CONSTRUCTION CORPOI 10866 9ILSIIRE ILO 7T1 YLOOI LOS AIGELES CA 90024 PHONE STATE" 503114 - CLASS: 1 A NEWPORT ARCHITECT: ADDRESS: ADDRESS: UC. NO. ENGINEER. ADDRESS: UC. NO.: GEOIEURIICAL CONSULTANT: N DRESS: APPLCMIT: ADDRESS: SIGNATURE OF I PHONE 101LE DATID kW 2076 S BRAID AT8 SA11A AMA, Cl 92105 PHONE C-018559 LAN CRAIDALL ITC 200 CITADEL DR - LOS AIGELES CA 90040 PHONE 11DEL AICHITECTS IIC 1990 S D01DT DR 4TE FLOOR LDS ANGELES CI 90025 PHONE: mRTI�IS5 SECfIPIPHDNDTBE CanETEO IF TIE Per ISfaecal-untooa. I1VS R1WPailESSL 4.. i CERTIFY THAT II TE PERFORMANCE OF THE WORK FOR WHCII MS PERIMT S •.. y y Jill EA1r•rwo TFJ.RO ge ff PFI60N ST 4M9ERSOABTOSLaETTE" I1131 B/DRB11A6Brerelli Fee •:'avT .SOTTO TIE Lvaamb'cOYISISAT1oNuwaoPOALiar9UA AwSF�1 a YELIN SECTLABOR MCC. OF THE LABOCE. I SHALL • ' '. ale)(0 •q$ �,�1 !1 Palutioc of hunting;• — > SHOULD BECCIE SUBJECT TO THE PARSERS' APMEANT I► _! li Id �NM�p A{�DE TO S 7�X� Ii SNLL SBECfAA Q/SOTEif F/D • 7 � �� '' !1 P. BRED THOISMD DOLLARS (WWI AMMON TO TIE ..- •. ' • . AGES AS PROVOS, FOR NSaa457al OF OE LABOR...•'•AI- • F� r - -�. - : - CONSTRUCTION LFHDBAi GENCY Y' - <' • HA FOR TIE• Know Anal S OFPENALTY OF �YWOFTMTTHERE FO R w St nes PETMT IS miaow I CERTFY TIAT . NAVE READ Pa APPLICATION AND STATE MATTE ABOVE I!OIW: TON S CORRECT. IMIEE TO COCKY ram AL Im NO COUNTY CRONANCFS AMI•'ATE :. LAWS RFiATNO TO manta W AND _HEREIN AUROWE REPRESENT* BR OF TUS COUNTY TO ENTER PROPERTY I SPE CT°.•'r.! c,r .Aar. • at BmA (REV. 7/9 Lead_ 16 4 DATE' GIADIUG - PLAT CHECK PIE (1) BIIDIIG - PRINT PER (T) ZONING PL11 CRICK PEE(6y Hours) (1) CLEAE-UP DEPOSIT- GIRDING (1) TOTAL GRIIIIG/BRIIIIGE REMIT PLES 116/645-8600 310/S38-2037 97024494 ' DESCRIPTION OF WORK 11I/957-814i 213/889-5300 110/826-2100 Permit No. G9700487 Inspection Requests Phone No 14 644-3255 P116I16 611116 (19116.41) PRECISE CRAOIIG POI !RA COOL BLOB TYPE OF PERMIT: reuse •LA Nos unit VACANT SITE NEAREST CROSS ST. LEGAL DESCRIPTION: YARDAGE FOR PROJECT SPECIAL CONDITIONS: 0 YES FILL: 19969 cur: 10937 PROCESSED BY: ZONI TRAFFIC SUBDIVISION GRADINS EVIEW DEPARTMENTS Nar. e Date *fi 0E1 'or APPROVAL TO ISSUE 0.V oNAN41 o. . 511 etoyFL ._i;26S.00.l ' 2,530.P0 Y 25.56 a•1.5 7, 1)21.80NWZ>; - 7,422.80 G z z z w 0. D I=- 0: 0 z 0 0 0 0 LL Payouts: 1,250.00 Credit erteaded: 0.00 Total Credits: 1,250.00 . ¢¢S Idjostlekts 0.00 Malice du 6,172.80 PAM APR 1 6 1998 COY etippya.qucti PLAN CHECK VALIDATION M. PERMIT VALIDATION-:31) a\ . TAU: INSPECTOR'S COPY • • • Al J • PREGRADE'MEETING , .. ROUGH GRADE APPROVAL PREPAVING MEETING curia AND GUTTER PAVEMENT SUCGRADE AGGREQMf BASE f LAllVORK !norm DRAIN - CATCH BASIN l f f ' i a i_EROSZ1NCONIT OL '\ j' ` r ' \ r — PRECISE GR.ADDNG 114SPECTION DOCUMENTS � IT RELEASED AV `COMMENTS d'��}i1tiY,'�L1 City of Newport Beach PO Box 1768 Newport Beach, California 92658-8915 Job Address:1 HOAG DR Eldg:1 Floor: Inspector Area: 8 Code Edit: 97 Owner. HOAG MEMORIAL HOSPITAL Address: 1 HOAG DR NEWPORT BEACH CA Phone: 949/646-8901 Contractor. Address: Phone: Con. State Lic. Uc Expire: Bus. Uo.: Uc. Exp Date: Building Department Permit Counter Telephone (949)644-3288/3289 Descdptton of Work: SEWER CAP/DEMO CONFERENCE CTR S PKG LOT:`: D9906267 A-1 DEMOLITION INC 11432 SOUTH ST PMB 265 CERRITOS CA 90703 562 7465555 : 783614 05131/2001 FEES Bathroom Fixtures Floor Drain 0 $0.00 Regulator 0 $0.00 Toilet 0 $0.00 Kitchell Fixtures Lawn Sprinkler 0 $0.00 Bidet 0 $0.00 Kitchen Sink: 0 $0.00 Mlsc Urinal 0 50.00 Garbage Disp 0 50.00 Water Piping 0 $0.00 Bath Tub 0 50.00 Bar Sink 0 $0.00 Water Softener 0 30.00 Shower Stall 0 $0.00 Vegetable Sink 0 50.00 Water Heater 0 $0.00 Wash Bashi 0 $0.00 Ice Maker 0 30.00 Gas up to 4 outlets 0 $0.00 Hydro -Mires Tub 0 $0.00 Dishwasher 0 $0.00 Gas over 4 outlets 0 $0.00 Floor Sink 0 $0.00 Lndry/rrap 0 $0.00 Backflow up to 2" 0 $0.00 TOTAL: $37.00 PAYMENT: 30.00 Backflow over 2" 0 Hose Bibb 0 Drinking Fountain 0 Roof Drain 0 Grease Trap 0 Grease Interceptor 0 P-Trap 0 Other BALANCE: $37.00 by affms under penalty of perjury that lam Icsnsed under provhbns of Chapter 9 (cormrenckg with Section MI of Divb.on 3 d the Business and Proiessbm code. my icense b in full farce and effect. No: 763614 .Case Dale" s, - -CP) Confroctor:A-1 DEMOIIIION INC WORKERS' COMPENSATION DECURM1ON: I hereby affirm under penalty of perjury one of the following dedaratbnn _I have and veil maintain a cola:ate al consent to sett -insure for waken' compensatipt as provided for by Section 3703 of the lobo- code. for the performance of the work for wtrielc this permit b Issued. I have and wa 'nankin workers' compensation kwurance. as teethed by Section 370) of the labor code. for the performance of the wed; IorwhJch this permt b issued. My uarkers' compensation asuroncs coffer rand potty number In Code: STATECOM►INSn1N0 lacy number liTn 3 Expke:454ZD04Q (This section need not be completed if the permit is for one hundred dollars ($100) or less. 1 certify that In the performance of the wok farwhich this permit is issued. l shall not employ any person h any manner so as to become subject to the waken' co npenation alas of C agree that ifI should become subject to the workers' compensation provWau c? 703 of the bar code. l forthwith campy with lh sse provisions o4 t 20°0 Ape/Man Signalers)? � rr Wowing: Fdwo to securewakere compensation cavarage b unlawful. and shot subject an employer to afld peno9es and dvl isles up to one Laded thousand dodos (6101.000), 1 clubs to the cost of. ampensation canages as provided fain Section 3706 of the labor code. Interest. and attorneys fees. I tarebya knowledge that I have rend this application: that the Infatuation given Is correct: and that i am the owner. a dry certhalred agent of the owns;. l agree to comply %Rh city and stale laws regulating construction; and In doing the wart aulhwtled thereby, no person wit be employed in vaatan of the labor cods Cavoma relating to workmen's tuuanoe• Permittee Name (Print) F Z44tte M Signature oFperrnitfee: f SA 10.00 50.00 $0.00 10.00 $0.00 Son So.00 0 $0.00 Sewer Sewer 0 $0.00 _.`. Sewer Alter/Repair 0 $0.00 Sewer Abandon 1 $18.00 Investigation 30.00 Plan Check 30.00 $0.09 Issuance S19.00 Anorovais Soil Pipe (ground) Sewer Water Pipe (ground) Gas Pipe (ground) Plumbing (rough) Gas Pipe (rough) Water Heater Gas PSI Test Gas Co Notified Final Inspector/Date of the state of PAtD a -Ill a9 WORK MUST BE STARTED WITHIN A PERIOD OF 180 i EB 10 2000 DAYS FROM THE DATE OF VAUDATION OR 1H1S _PERMRBECOMES NULL AND VOID.