The URL can be used to link to this page

Home My WebLink AboutX2007-1997 - PermitsCity of Newport Beach Building Department PO Box 1768 Newport Beach, California 92658-8915 COMB Permit No: X2007-1997 Permit Counter Telephone (949)644-3288 Inspection Requests/Telephone (949)644-3255 Combination Type - CIP/ GRAD/ PLUM/ / Job Address: 1 HOAG DR NB Inspector Area: 7 OF LOT Owner: Address: Phone:: Applicant: Address: Phone: HOAG MEMORIAL HOSPITAfZ±, 1 HOAG RR "/tf�' NEWPORT BEACH CA 926ir4.., 949-764488 D RBB ARCH 10980 WILSHIRE BLVD, „ '�^ LOS ANGELES CA 9134..E. 310-473-3555 Code Edit : 2001 Type of Construction: Occupancy Group: U2 Added /Newsq.ft. Bldg: Added /New sq. ft. Garage: No of Stories: 0 No of Units : 0 Bldg Height: Bldg Sprinklers: Flood Zone: Issued Date: 10/15/2007 Construction Valuation: Building Permit Fee: $ Plan Check Fee: $ Overtime Plan Ck: Investigatin Fee: Record Management : Energy Compliance: CA Seismic Safety : Disabled Access : Fee Increase: Fee: Additional Fee : Hazardous Mat : PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: e 17. OOl➢.n� ate • 75J- 4.0 $0.00 $196.00 $0.00 $0.00 $582.00 $0.00 $528.00 $0.00 Eledtrical %: • Mechanical %: Plumbing'%:' Project: Legal Desc.: "San. Excise 1_ aa. MUSD Fee: Description: PRECISE GRADING/SITE IMPROVEMENTS@ IMAGING DEPT 2456-2006 ' 2456-2006 (STORM DRAIN) IRVINE SUB BLK 2 LOTS 169 & 170 POR OF LOTS & BLK 1 172 POR KEMP BROS CONSTR INC . Addresb. !n135 GEARY AVE CF SPRINGS CA 906 Phe ' "on State Lic: Av-ic Erne Bus • Lic Carrier: i pigNn: 66/01/2008 562-aa 8/31 0B1311/ 2 8—.... K^"612109 Ise Zone: .. norm! Fee' 1,769.00 Grading. c/ 75:0(I WQ Insp,-Fee : $0.00 $0.00 $509.38, TOTAL FE EE;. $22,664.48 • W77a,-L • 1 70' Plan Fair Shar 9 ., SJH Tram: Architect: Address: Phone: Engineer: aSS: Phone: Designeff Address: • r hdne: brwaorks, Departm b, .. Park d&diea • n : $0.0b.., "" °Ian Check . 2.50 BALBONA JOSEPH 10980 WILSHIRE BLVD LOS ANGELES CA 90024 310.473-3555 State Lic:C006451 NODAL RAMZI 6080 CENTER DRIVE ' 4 CA 90045 - 'sn6 State Lic:S-003552 -451 Conditions: TOTAL PAYMENT : $727.00 TUTAL"D.. PERMITS EXPIRE 180 DAYS A Fire Department • Fire Inspection i Fire Plan Rev 4erpolition Fe - Ing De' 1dm- ;ral Se ;e Rewnd De -sit; ' A21;9r1Z $2,852.50 $1,173.66 $0.00 $0.00 $o.00 $0.00 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: ER ISSUANCE OR LAST VALID INSPECTION. OWNER -BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LICENSE LAW FOR THE FOLLOWING REASON (SEC. 7031.5, BUSINESS AND PROFESSIONS CODE: ANY CITY OR COUNTY WHICH REQUIRES A PERMIT TO.CONSTRUCT, ALTER, IMPROVE, DEMOLISH, OR REPAIR ANY STRUCTURE, PRIOR TO ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LICENSE LAW (CHAPTER 9 (COMMENCING WITH SEC. 7000) OF DIV. 3 OF THE BUSINESS AND PROFESSIONS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMPTION. ANY VIOLATION OF SEC. 7031.5 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CIVIL PENALTY OF El NOR MORE THAN FIVE HUNDRED DOLLARS ($500): I, AS OWNER OF THE PROPERTY. OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK. AND THE STRUC- TURE IS NOT INTEIYOED OR OFFERED FOR SALE (SEC. 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE. IF, HOWEVER, THE BUILDING OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OF COMPLETION, THE OWNER -BUILDER WILL HAVE THE BURDEN OF PROVING ❑ THAT'HE OR SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE.): I, AS:OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CO STRUCT THE PROJECT (SEC. 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AVV`OWNER .......E PROPERTY WHO BUILDS OR IMPROVES THEREON AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(S),WCENSE l.: `-URS �`rc;,� TO THE CONTRACTORS n LICENSE LAW.), I AM EXEMPT UNDER SEC B. & P.C. FOR THIS REASON;, DATE OWNER LICENSED CONTRACTORS DECLARATION • I HEREBY AFFIRM UNDER PENALTY OF PERJURYTHAT I AM LICENSED UNDER`PROVISI NS OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS IN FULL PIKE A LICENS�E.CLAS_S . LICENSE NO. '. f/ DATE XLt^.✓'�'A i~ ^ C+' 0 CONTRACTOR � � WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OFPERJURY ONE OF THE FOLLOWING,, ECLA AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF-INSURE„H'OR WO THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WH)I )1 THIS AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE, ASREQU OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, MY WORKERS$OMPE CARRIER Ai POLICY NUMBER ❑ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS F 1 CERTIFY THAT IN THE PERFORMANCE'DF THE WORK FOR W NER SO AS TO BECOME SUBJECT TO THE. WORKERS' COMPE .TO THE WORKERS' COMPENSATION PROVISIONS OF SEC. 3 DATE/ \/fL-i" O WARNING: FAILURE TO SECURE WORKERS.' COMPENSATION COVERAGE PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLARS ($100,00 AS PROVIDED FOR IN SEC. 3705 OF THE LABOR CODE; INTEREST, AND ATTORNEY'S CONSTRUCTION LENDING AGENCY • I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR WHICH THIS PERMIT IS ISSUED (SEC. 3097, GIV.C). LENDER'S NAME SO BO;. APPLICANT: ^• LENDER'S ADDRESS I CERTIFY THAT I HAVE READ THIS APPLICATION ANDSTATETHAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITH CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS CITY TO ENTER UPON THE ABOVE -MENTIONED PROPERTY FOR INSPECTION PURPOSES PERMITTEE NAME (PRINT) . �'Vi1 ON'- PTE FFE! ERS' CU.. ^@p,. -tlu SEC 3700 RMIT IS ISSvt.. BY C 3700-QF TNE`LAb... SJu. ''-` 4. TIOLANCE CARRIER AND r. avt, 4* NDRED DOLLARS ($1000 OR L RPoI SUED. -I SHA(J»1PLO I P S F.+ ';SAND AGREE?IYAT4I SHOO S AL FORTHWITH CJ OS AND SHALL S IN ANY MAN- M BJECT 737. CT AN EMPLOYER TO CRIMINAL. TO THE COS a COMPENSATION, DAMAGES P •RMANCE OFT SIGNATURE OF PERMITTEE -e /0 YS' of) DATE: PERMIT EXPIRED BY: PERMIT CANCELLED 4•.0-1 PERMIT EXTENSION. PERMIT FINAL CERTIFICATE OF OCCUPANCY ENANT NAME 12; t€4L FICE USE ONLY City of Newport Beach Building Department COMB Permit No: X2007-1997 PO Box 1768 Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288 Combination Type - CI Pi GRAD/ PLUM/ / Inspection Requests/Telephone (949)644-3255 Job Address: 1 HOAG DR NB U pew c Inspector Area: 7 OF LOT Owner: HOAG MEMORIAL HOSPITAL Address: 1 HOAG DR NEWPORT BEACH CA92663 Phone: 949-764-4488 Applicant: RBB ARCH Address: 10980 WILSHIRE BLVD LOS ANGELES CA 91343 Phone: 310-473-3555 Code Edit : 2001 Type of Construction: Occupancy Group: U2 Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: No of Units : Bldg Height Bldg Sprinklers: Flood Zone: Issued Date: 10/15/2007 0 0 0 N h,PvS Project : Legal Desc.: Description: PRECISE GRADING/SITE IMPROVEMENTS@ IMAGING DEPT 2456-2006 2456-2006 (STORM DRAIN) IRVINE SUB BLK 2 LOTS 169 & 170 POR OF LOTS & BLK 1 172 POR Contractor: Address: Phone: Con State Lic: Lic Expire: Bus Lic: Lic Exp Date: KEMP BROS CONSTR INC 10135 GEARY AVE SANTA FE SPRINGS CA 90670 562-236-5000 149816 08/31/2010 BT03012109 12/31/2007 Worker's Compensation Insurance Carrier: REDWOOD INS Policy No: W7737902 Expire: 06/01/2008 Building Setbacks Rear: Front: Left: Right: Use Zone: Parking Spaces: 0 Architect: Address: Phone: Engineer: Address: Phone: Designer: Address: BALBONA JOSEPH 10980 WILSHIRE BLVD LOS ANGELES CA 90024 310-473-3555 State Lic:0006451 HODAL RAMZI 6080 CENTER DRIVE LA CA 90045 310-665-1536 Phone: Special Conditions: State Lic:S-003552 DcA9Iica4t Copy Fire Hazard Zone : N ppT SCIL.ctfl*SI Construction Valuation: $700,000.00 Building Permit Fee: $4,075.00 Plan Check Fee: $2,984.00 Overtime Plan Ck: $0.00 Investigatin Fee: $0.00 Record Management: $196.00 Energy Compliance: $0.00 CA Seismic Safety : $0.00 Disabled Access : $582.00 Fee Increase: Fee: $0.00 Additional Fee : $528.00 Hazardous Mat : $0.00 Building Green Fee : $0.00 TOTAL FEE : $22,664.48 San Dist: Excise Tax: NMUSD Fee: FEES $0.00 Planning Department - $0.00 Plan check Fee : $337.50 $0.00 Fair Share : $0.00 SJH Trans : $0.00 Grading Permit Fee: $1,769.00 Grading PC Fee: $7,315.00 WO Insp. Fee: $80.00 Electrical %: Mechanical %: Plumbing %: $0.00 $0.00 $509.38 Public Works Department - Park Dedication : $0.00 P/W Plan Check : $262.50 Fire Department Fire Inspection: $2,852.50 Fire Plan Rev $1,173.60 Demolition Fee Building Dept Adm $0.00 General Service $0.00 Refund Deposit $0.00 Plan Check Fee : $22,664.48 Fee Due at Permit Issuance : $0.00 $0.00 $0.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit toconstruct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ I'as owner of the property, or my employees with wages as their sole compensation, will do (J all of or ( ) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors State License Law). • ❑ I am exempt from licensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year pnor to completion of the improvements covered by this permit, I cannot legally sell a structure that I have built as an owner - builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class . • License No. Date . Contractor Signature WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($10D,D00), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OFTHELABDTI CODE; INTEREST, AND ATTORNEY'S'FEES. I hereby affirm under penalty of penury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. • Policy No. ❑ I have and. will maintain workers' compensation Insurance, as requiredby, Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # ❑ I certify that, in the performance of the work for which this permit is issued, I shall not employ an person in any manner so as to become subject to, the workers' compensation laws of California, and agree that, if I shouldbecomesubject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant Date DECLARATION REGARDING CONSTRUCTION LENDING AGENCY I hereby affirmunder penalty of perjury that there is a construction lending agency for the performance of the work for is sued this permit is (Section 3097, Civil Code). Lender's Name Lender's Address By my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or county to enter the above -identified property for inspection purposes. Signature of Property Owner or Authorized Agent Date Print Property Owner's or Authorized Agent's Name: ACTION DATE: BY: PERMIT EXPIRED PERMIT CANCELLED PERMIT EXTENDED pherdir PERMIT FINAL CERTIFICATE OF OCCUPANCY ISSUED I't -zcs-12. DECLARATION OF COMPL ANCE WITH CODE OF FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403. ❑ I SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: FOR OFFICE USE ONLY 01/01/2009