The URL can be used to link to this page

Home My WebLink AboutB2005-1423 - PermitsCity of Newport Beach Building Department PO Box 1768 Newport Beach, California 92658-8915' Permit Counter Telephone (949)644-3286 BLDG Permit No: B2005-1423 Inspection RequestsTelephone (949)644-3255 Job Address: 1 HOAG DR Floor: Inspector Area: 7 OF LOT owner: Address: Phone: Applicant: Address: Phone: HOAG MEMORIAL HOSPITAL 361 HOSPITAL RD, STE 229 NEWPORT BEACH CA 92663 949/764.4467 ROBERSON ROY 21 TECHNOLOGY DR IRVINE CA 92618 949/727-7307 Code Edit : Type of Construction: Occupancy Group: Added /New sq.ft. Bldg: Added /New sq. ft. Garage No of Stories: No of Units : Bldg Height : Bldg Sprinklers: Flood Zone: Issued:04/13/2006 2001 V-N U2 N N 0 N Suite: Bldg: 1 ,Description of Work: 30'-35' SOIL NAIL RET WALL/SITE IMPROVEMENTS 1107-2005 Legal Description: IRVINE SUB BLK 2 LOTS 169 & 170 POR OF LOTS & BLK 1 172 POR Contractor: Address: Phone: Con State Lic: Lic Expire: Bus Lic: Lic Exp Date: T R C SOLUTIONS INC 21 TECHNOLOGY DRIVE IRVINE CA 92618 -.949/727-9336 - 409606 07/31/2007 BT00904143 05/31/2006 Worker's Compensation Insurance Carrier: HARTFORD INSURANCE Policy No: 02WNMF5430 . - Expire: 07/01/2006 Building Setbacks Rear: / Front: / Left: / Right:- / Use Zone: PC Parking Spaces: Architect Address: Phone:, Engineer: Address:, Phone:' Designer: Address: Phone ROBERSON ROY 21 TECHNOLOGY DR IRVINE CA 92618 949/727-9336 State Lic:C044160 BARAR PIROOZ 424 GREENFIELD AVE SAN ANSELMO CA 94960 4'f5/259-0191 State Lic:S-002502 • Special Conditions:. /tiS,A For off, Construction Valuation:$4,400,000.00 Building Permit Fee : $14,592.00 Plan Check Fee: $10,506.24 Investigation Fee: Clean Up Deposit Disabled Acess • Demo Adm Fee: Fee Increased 60.00 $0.00 $0.00 MOOD. 658620 • • •• • • PROCESSED BY: • ••• .••• PLANNING APPROVAL:. GRADING APPROVAL : • • ••• • • • • • •• ••• TOTAL FEE : $41,294.7 .•• :• • •_ • • • • • •• • •• •`p• ••- �,w• • • • • •• • • • •• • • • ••• ••• • • • • • •• Microfilm: $626.00 Excise Tax- Res: $0.00 Excise Tax- Com: $0.00 Supplemental P/C: $0.00 Fair Share: $0.00 General Sery DMO $0.00 Refund DMO Dep $Q.00 FEES Haz Mat Disclosure: $0.00 CA Seismic Safety: $0.00 Other: ADDITIONAL PLAN CHECK $294.00 Public Works Plan Ck: $53.00 TOTAL PAYMENT : $14,708.74 TOTAL DUE : $26,586.00 OTHER DEPARTMENT: PLAN CHECK BY: APPROVAL TO ISSUE: PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST19ALID INSPECTION. Planning Dep - - Plan Check: $220.00 Counter Rev.: $0.00 OT Plan Check : $0.00 Fire Dep - - Plan Review: $4,202.50 Inspection: $10,214.40 o2.-111371 APPROVALS. FOUNDATION: WATER QUALITY BMP'S ROUGH GRADE LINE & GRADE CERT/SETBACKS ERECTION PADS FOOTINGS DATE BY SLAB ON ( GRADE FRAMING: DECK SLAB SUBFLOOR ROOF & BUILDING HT EXT. SHEAR/HOLD DOWNS GENERAL FRAMING FIREPLACE THROAT M ENTS 7 Ph oA Pi- Ahr/' uvst /•--, S-3•OC-VEIL-MAL n+nsl.s OK- +vn STEse. GN40,4E ArPtiot i HoR.f N42LS oveot+vc To RISE (. YE2 ec SHOT- 6 .ERE - s-i /i 6 •` stierLrssr& PA .-ft 3 4 gm.. .�M�4i/di.��A-.SW • I9�/ +iY * 4iYJ✓/ o+�KZ� --- 9 t�•o�-c'W, (lj rc-IPtti MU- A/AiL ftaW14tt, thaws -taw G SP6 241.'11✓sP• (kEio,R,TS -{ N 8 023+) taint- It•S-ot - Ptt - SHetseScrt colt, Wl1ltt' %M LL,C INTERIOR & EXTERIOR INSULATION DRYWALL SUSPENDED CEILING SHOWER LATH EXTERIOR LATH SCRATCH (PLASTER) (2 DAY) MASONRY PRE -GROUT 1.11-4VeroVt t • EllaT- t 6 —oe:wTj+�' i ce' SHX3, i& o)&. to AP11 Ref I{'� go qo�•' 1•f&c241. 2MvsP. �ND e�k3d) 1-It-ol-rfiereatre rR,awl leo' SOt7A•.� gdier t-at -e i. rtlerc&s-rk fecal 1740 -:o 3TS16744 3-S-07 ` flM ucTytt L. r-rvfl Fats, LA a I31T to cot.nPEfl ' a OWNER -BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE CORTMCT LICENSE LAW FOR THE FOLLOWING REASON (SEC. 1W15. BUSINESS AND PROFESSIONS CODE. Alaf CITY CR 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 0R 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 NOT MORE THAN FIVE HUNDRED DOLLARS ($500): ❑ I, AS OWNER OF THE PROPERTY, CP MY EMPLOYEES WITH WAGES AS THEIR CNF COMPENSATION, WILL 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 WHO DOES SUCH WORK HIMSELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH MP OVE E S 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 O: SHE DID NOT BUILD OR IMPROVE FOR THE PURPOSE OF SALE.). ❑ I, AS OWNER OF THE PROPERTY. AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7044. BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF THE PROPERTY WHO BUILDS OR I ROVES THEREON. AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(5)UCENSEO RSUANT TO THE CONTRACTORS LICENSE LAW.). OWNERS NAME: DATE: LICENSED CONTRACTORS DECLARATION 1 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 UC. NO. , Nl�3lQ6 WORKERS ikf�.i._4 ' COMPENSATION D-Aoyez" r.N CO I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS: I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE 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. MISC. INSPECTIONS: PERMIT EXTENSION 1ST EXP. LETTER 2ND EXP. LETTER BUILDING FINAL CERTIFICATE OF OCCUPANCY 12-3-og sezzaboa TENANT NAME: TYPE OF BUSINESS USE: NAME: OWNER / BUILDER AGENT INFORMATION ADDRESS: DRIVERS LIC. NO. ._ •• I 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 IS ISSUED, MY WORKERS COMPENSATION INSURANCE CARRIER RIO POLICY NUMBER ARE: CARRIER POLICY NUMBER (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS (5100) OR LESS). 1 CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I SHALL NOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE WORKERS COMPENSATION LAWS OF CALIFORNIA. AND AGREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS' COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR CODE I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. WARNING: FAILURE TO SECUK WOVERS COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TOCRI0.1.4AI•PENAAFIEE CIVIL FINES UP TO ONE HUNDRED THOUSAND IVY I MIS ($100.000). IN AOATj1ONSO HE COST F CI�`�•I�'PENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR 811. IIRIREl, AND ATi(.IRNEY'S FEES. CON&I RUCTION1,ftDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT MERE 15 A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH TINES PERMIT IS ISSUED (5EC.3051, CPIC.1.• • • • ♦•• LENDER'S ILAMG 1. • • • LENDER'S •• • . = . �• KOO•ESO • • • • • • • •• . - I CEIO••TIFY THAT 1 HAVE READ.TAIS APLICATIONW10 STATF•.MAT TAE ABOVE INFORMATION 15 CORRECT. 1 AGREE TO COMPLY NTH AR•CITY NNNO COUNT. Gi?JaNMINCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS CITY ID ENTER UPON THEABOVE-MENTIONED PROPERTY FOR INSPECTION PURPOSES. / tsa • 'Oro d t c SIGNATII 4 /131D6 DATE Shared\Permits Dep181dgPermit(Back)8/04 City of Newport Beach Building Department PO Box 1768 Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288 BLDG Permit No: B2006-1984 Inspection RequestsTelephone (949)644-3255 Job Address: 1 HOAG DR Floor: Inspector Area: 7 OF LOT Owner: Address: Phone: Applicant: Address: Phone: HOAG MEMORIAL HOSPITAL 361 HOSPITAL RD, STE 229 NEWPORT BEACH CA 92663 949/764-4467 ROBERSON ROY 21 TECHNOLOGY DR IRVINE CA 92618 949/727-7307 Code Edit : Type of Construction: Occupancy Group: Added /New sq.ft. Bldg: Added /New sq. ft. Garage: No of Stories: No of Units : Bldg Height: Bldg Sprinklers: Flood Zone: Issued: 2001 U2 0 0 0 0 0 N 07/20/2006 Suite: Bldg: 1 Legal Description: Contractor: Address: Phone: Con State Lic: Lic Expire: Bus Lic: Lic Exp Date: Worker's Compens Carrier: Policy No: Expire: Building Setbacks Description of Work: REV TO PERMIT/ADD CANTELEVER WALL 3' TO SOIL NAIL WALL l t o l . 9..00.E IRVINE SUB BLK 2 LOTS 169 & 170 POR OF LOTS & BLK 1 172 POR T R C SOLUTIONS INC Architect: ROBERSON ROY 21 TECHNOLOGY DRIVE Address: 21 TECHNOLOGY DR IRVINE CA 92618 IRVINE CA 92618 949/727-9336 GRANT Phone: 949/727-9336 409606 Engineer: 07/31/2007 Address: BT00004143 05/31/2006 Phone: ation Insurance Designer: HARTFORD INSURANCE Address: 02WNM F5430 07/01/2006 Phone: Rear: / Special Conditions: Front: / Left: / Right: / Use Zone: Parking Spaces: 0 State Lic:C044160 BARAR PIROOZ 124 GREENFIELD AVE SAN ANSELMO CA 94960 415/259-0191 State Lic:S-002502 Construction Valuation: $400,000.00 Building Permit Fee : $2,591.00 Plan Check Fee: Investigation Fee: Plan Check Ext Fee: Disabled Access • Demo Adm Fee: Fee Increased • •• • PROCESSED BV: •• •„ .• •• PLANNING APPROVAL: GRADING APPROVAL : $0.00 $0.00 $0.00 $0.00, 10.00• $¢00 •• •• ••• • • ••• • • ••• ••• • •s' Microfilm: Excise Tax- Res: Excise Tax- Com: Supplemental P/C: Fair Share: General Sery DMO Refund DMO Dep TOTAL FEE : $3,583 FEES $25.00 Haz Mat Disclosure: $0.00 $0.00 CA Seismic Safety: $0.00 $0.00 Other: $0.00 BAGAHI $930.00 $0.00 Public Works - - $0.00 Plan Check : $0.00 $0.00 Traffic Plan Check : $0.00 TOTAL PAYMENT: $0.00 TOTAL DUE : $3,583.50 P/W APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Planning Dep - - Plan Check: $37.50 Counter Rev.: $0.00 OT Plan Check : $0.00 Fire Dep - - Plan Review: 60.00 Inspection: $0.00 APPROVALS DATE BY COMMENTS OWNER -BUILDER DECLARATION . I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT FROM THE CONTRACTORS LICENSE LAW FOR THE FOLLOWING REASON (5E0. 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 (COMMENCNG WITH SEC. 7000) OF DN. 3 OF THE BUSINESS AND PROFESSIONS CODE)/ 0R THAT HE OR SHE 15 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 NOT MORE THAN FIVE HUNDRED DOLLARS ($500): ❑ LAS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION. WILL 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 MI 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, (F, HOWEVER, THE BUILDING OR IMPROVEMENT IS SOLO 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.). 0 I. AS OWNER OF THE PROPERTY. AM EXCLUSIVELY CONTRACTING WITH UCENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC. 7044. BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW 00ES NOT APPLY TO AN OWNER OF THE PROPERTY WHO BUILDS OR IMPROVES THEREON. AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(S) LICENSED PURSUANT TO THE CONTRACTORS LICENSE LAW.). OWNERS NAME'. DATE: FOUNDATION: WATER QUALITY BMP'S ROUGH GRADE LINE & GRADE CERT/SETBACKS ERECTION PADS FOOTINGS I - Ig-Q7 cotftlic SLAB ON f GRADE FRAMING: DECK SLAB SUBFLOOR ROOF & BUILDING HT EXT. SHEAR/HOLD DOWNS GENERAL FRAMING FIREPLACE THROAT LICENSED CONTRACTORS 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 LIC NO INTERIOR & EXTERIOR INSULATION DRYWALL 9^ DATE '7J O/O CONTRACT 4� W_li SUSPENDED CEILING L WORKERS' COMPENSATI DECLARATION - 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY qJ F THE FOLLOWING DECLARATIONS: I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' SHOWER LATH EXTERIOR LATH SCRATCH (PLASTER) (2 DAY) MASONRY PRE -GROUT C MPENSATI , AS PROVIDED FOR BY SECTION 3700 OF THE LABOR CODE. FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. I 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 IS ISSUED. MY WORKERS' COMPENSATION INSURANCE CARRIER AND POLICY NUMBER ARE' CARRIER MISC. INSPECTIONS: POLICY NUMBER (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS WOO) LESS). I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED I PERMIT EXTENSION SHALL NOT EMPLOY ANY PERSON IN ANY MANNER 50 AS TO BECOME SUBJECT TO THE WORKERS COMPENSATION LAWS OF CALIFORNIA, AND AGREE THAT IF I SHOULD BECOME SUBJECT TO THE WORKERS COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR CODE. I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS. WARNING: FAILURE TO SECUle/AUtEf�S' CPEQ5�1IP0S1 COVERAGE I5 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO C INA1•PE TI AIA CIVI;FWES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000), IN ADDITION•'S &HE«ST QF COMPENSSATION. DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE, IICERIST ISTOR MY'S FEES. 1ST EXP. LETTER 2ND EXP. LETTER BUILDING FINAL 17r\o-c? CONSittUCT1ON tENONG AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE 15 A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC.3097, CIV C.). • • • ••• • ••• ••• LENDFA's • •• • • • • • • •• • 'r"i CERTIFICATE OF OCCUPANCY TENANT NAME: OWNER / BUILDER AGENT INFORMATION NAME: • • LENDER'SADLtSS� • • • • • • •• • • • I CERTIQY•THAT I SAVE READ THIS413PPLICA I41T�E THTLIIE WE INFORMATION IS CORRECT. 1 AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION. AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS CITY TO ENTER UPON THE ABOVE -MENTIONED PROPERTY FOR INSPECTION PURPOSES. / p '• •JL7`es�•/• • • ••• • ADDRESS: TYPE OF BUSINESS USE: DRIVERS LIC. NO. P TTEE NAME II; •; . : .• / g •,•�1•.- ..51 SIGNATURE OF PF MITTFE j DATE Shared\Permits Dep\BldgPermit(Back)B/04 City of Newport Beach Building Department PLUMBING Permit No: P2007-0186 PO Box 1768 Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288 Inspection Requests/Telephone (949)644-3255 Job Address: 1 HOAG DR Bldg: 1 Floor: Suite: Description of Work:PLUM/SEWER B2006-1984 Inspector Area: 7 Code Edit 2001 Legal Description: IRVINE SUB BLK 2 LOTS 169 & 170 POR OF LOTS & BLK 1 172 POR OF LOT Owner: HOAG MEMORIAL HOSPIT Address: 361 HOSPITAL RD, S NEWPORT BEACH C Phone: 949/764-4467 Issued Date: 03/16/2007 Processed By: Bathroom Fixtures Toilet: Bidet Urinal Bath Tub: Shower Stall: Wash Basin: Hydro -Mass Tub: Floor Sink: floor Drain: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Contractor: Address: Phone: Con State Lic: Lic Expire: Bus Lic: Lic Exp Date: Kitchen Fixtures Kitchen Sink: Garbage Disp: Bar Sink: Vegetable Sink: Ice Maker. Dishwasher: Lndry/Trap: Regulator: Lawn Sprinkler: T R C SOLUTIONS INC 21 TECHNOLOGY DRIVE IRVINE CA 92618 949/727-9336 409606 07131 /2007 BT00004143 05/31/2007 Inspector Notes: FEES Misc. Misc. $0.00 Water Piping: $0.00 Roof Drain: 0 $0.00 $0.00 Water Softener. $0.00 Grease Trap: 0 $0.00 $0.00 Water Heater $0.00 Grease Interceptor. 0 $0.00 $0.00 Gas up to 4 outlets: $0.00 P-Trap: 0 $0.00 $0.00 Gas over 4 outlets: $0.00 Sewer $0.00 Backflow up to 2": $0.00 Sewer. 1 $24.10 $0.00 Backflow over 2": 80.00 Sewer Alter/Repair. 0 $0.00 $0.00 Hose Bibb: $0.00 Sewer Abandon: 0 $0.00 $0.00 Drinking Fountain: $0.00 TOTAL: $56.13 PAYMENT: $0.00 BALANCE: Other Record Mgmt Fee: Investigation: Plan Check: Issuance: Supplemental Fee: $56.13 $0.00 $0.00 10.50 $0.00 $6.03 $25.50 $0.00 NSE CONTRACTORS DECLARATION I h by affirm under penalty of penury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions code, 0 my license i5 in full force and effect. License No: 409606 Class: Date: Contractor : T R C SOLUTIONS INC WORKERS' COMPENSATION DECLARATION: 1 hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the labor code, for the performance of the work for which this pemut is issued. have and will maintain workers' compensation insurance, as required by Section 3700 of the labor code, fo the performance of the work for which this permit is issued. My workers' corpensadon insurance carter and policy number is: Carrier: TNINCITY FIRE Policy number:20WNMF5434 Expire : 07/01/2007 (This section need not be completed if the permit is for one hundred dollars ($100) or less. I certify that in the performance of the work for which this permit is Issued, I shall not employ any person in ny manner so s to become subject to the workers' compensation laws of CaltforMa, and agree that if 1 should become subject to the workers' compensation provisions of in 3700 of th I or code, 1 shall forthwith comply with those provisions. • • • • • • • •• 3�I470/fsJ ng: Failure to Secure workers' compensation coverage is unlawful, and shall subject a0•efiployer to cdmrel penalties and civil fines up to one hundred thousa..d dollars• ($100,000), in addition to the cost of compensation.damages as provided for in Section 3 6 of the labor code, interest and atomey's fees. •.. • • Applicant Signature : • •• • •• I hereby acknowledge that I have read this application; lhal the information given is correct; and that I am the owner, or duly authorized agent of the owner. I agree to comply with city and slate 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 eel es. • OM .--bEaJ Pennittee Name (Print) Signature of permitt€e: • •• • • • • Address : • • • • • • • Date. j 1L4t57.: ••• • • •• Approvals Soil Pipe (ground) Sewer Water Pipe (ground) Gas Pipe (ground) Plumbing (rough) Gas Pipe (rough) InspectorlDate • • • tlfaSr celer • • Gas PSI: est Gas Co Notified • RIP • • PERMITS EXPIRE 180 DAYS AFTER ISSUANCE •• • Ojt3,AST VALID INSPECTION City of Newport Beach Building Department GRADING Permit No: G2005-0118 PO Box 1768 Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288 Inspection Requests/Telephone (949)644-3255 Job Address: 1 HOAG DR Bldg:1 Floor: Inspector Area: 7 Code. Edit : 2001 OF LOT Owner: Address: Phone: Applicant: Address: Phone: HOAG MEMORIAL HOSPITAL 361 HOSPITAL RD, STE 229 NEWPORT BEACH CA 92663 949/764.4467 HAMEDANY DAVID 361 HOSPITAL RD, STE 229 NEWPORT BEACH CA 92663 949/764-4467 Geo Tech. Engineer: Address: 251 E IMPERIAL HWY FULLERTON CA 92835 Phone: Valuation: Yardage FILL: Yardage CUT: Suite Description of Work: PREC GRADING/SITE IMPRV B2005-1423 (1107-2005) Legal Description: IRVINE SUB BLK 2 LOTS 169 & 170 POR OF LOTS & BLK 1 172 POR LOWNEY ASSOC/BASTANI SEVED 000,000.00 0 105900 Contractor: T R C SOLUTIONS INC Address: 21 TECHNOLOGY DRIVE IRVINE CA 92618 Phone: 949/727-9336 Con State Lic:409606 Lic Expire: 07131/2007 Bus Lic: BT00004143 Lic Exp Date: 05/31/2006 Worker's Compensation Insurance Carrier: Policy No: 02WNMF5430 Expire: 07/01/2006 Issued Date: 04/13/2006 Architect: Address: Phone: Engineer: Address: Phone: State Lic: BARAR PIROOZ 124 GREENFIELD AVE SAN ANSELMO CA 94960 415/259-0191 State Lic: S-002502 Designer: HARTFORD INSURANCE Address: Phone: Special Conditions: Grading Permit: Y Plan Check: Permit Fee: WQ Inspection Fee: Investigation Fee: Fee Increase: WQ Plan Review Fee: PROCESSED BY: PLANNING: • • • TRAFFIC : SUBDIVISION $6,628.50 $13,257.00 $0.00 $0.00 $532.93 • • • • • • • •zOJAL FE • •. As• ••• FEES Drainage Permit: N SJH Trans Corridor:: Park Dedication: Records Management: Fair Share: P/C P/C $0.00 $0.00 $0.50 $0.00 $2,388.00 $2,088.00 Planning Department Counter Rev: Zoning Plan Ck: 24,894.93 TOTAL PAYMENT : $6,628.50 TOTAL DUE : $18,266.43 • •• ••• .. • • • • • • • • • • • •• • • • • Other DEPARTMENT: PLAN CHECK BY: APPROVAL TO ISSUE: • • • • •• •• • PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION • • • .•• •• $0.00 $0.00 9431 \\\57 j APPROVALS WATER QUALITY BMP'S PREGRADE MEETING GRADING INSPECTION AREA DRAINS ROUGH GRADE REPORT APPROVED ROUGH GRADE APPROVAL PREPAVING MEETING CURB AND GUTTER PAVEMENT SUBGRADE DATE BY M ENTS )3/0o -• yN� TES ��1�' 10-3-06- P.w - D2Asw 10-I3-OC 10'li-vC 11•LS G L• •A 1, Lcl1S/06 Vra,h I4Le4 r Tvv c t>n C. Iv C, /'a i- Vb l-Nij(er -tt.5 nc-c 11•74.\- OC • ? W IS)flgt.) L1 kL v'^A.k AGGREGATE BASE FLATWORK STORM DRAIN c4 •t' ta_tb>`n1 Latwfi 61c i1+1u 1.30.07• cZn,T of GHicr ca rno (za,c) LSIZ•7S-(SIN FE17p; RoucH c tg4E GomP. RPt (rstc� CATCH BASIN EROSION CONTROL OTHER OWNER -BUILDER DECLARATION .-1 I HEREBY AFFIRM UNDER PENALTV JF PERJURY THAT I AM 0XEMP7 FROM THE CONTRACTORS UCENSE LAW FOR THE FOLLOWING REASON (SEC. ALM S. H'JSIN4 S3 AND PROFESSIONS COOL: +NY 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. 7031S BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT MA OWL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS ASSORT O 1, AS OWNER OF THE PROPERTY. OR MY EMPLOYL3 WITH WAGES AS THEIR SOLE COMPENSATION. WILL 00 THE WORK. AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC. 7044, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW O0ES 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 INTENOE.; OR OFFERED FOR SALE. IF, HOWEVER. THE BUILDING OR IMPROVEMENT IS SOLD WITHIN ONE YEAR OF 'OMPLETION, THE OWNERAUILDER WILL HAVE THE URON 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 ,NTRACTORS TO CONSTRUCT THE PROJECT (SEC. 1044, BUSINESS AND PROFESSIONS COOE: THE CONTRACTORS LICENSE LAW O0ES NOT APPLY TO AN OWNER OF THE PROPERTY WHO BUILDS OR IMPROVES THEREON. MIS WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(S) LICENSED PURSUANT TO THE CONTRACTORS LICENSE LAW). ❑ I AM EXEMPT UNDER SEC. DATE OWNER B & P.C. FOR THIS REASON LICENSED CONTRACTORS 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 LIC NO CONTRA WORKERS' COMPENSATION DECLARAT!' J I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLGNO•:GG DECLAR`T10NS. 1 HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS C MPENSATION. AS PROVIDED FOR BY SECTION 3700 OF THE IABOR CODE. FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED PRECISE GRADING •NSPECTION DOCUMENTS FINAL GRADING REPORT APPROVED FINAL I L-3 41? CERTIFICATE TYPE NAME OF ENGR. FIRM RECEIVED BY ROUGH GRADE REPORT FINAL GRADING REPORT CIVIL CERTIFICATE SLAB ELEVATION CERTIFICATE (FEMA; "1" tkC 3 fl o'CLo t. S IRC SmL.uSZo%U5 PSRA02 $RRglc. Ct tClo1 REVISED 11/6/03 1 HAVE AND WILL MAINTAIN WORKERS COMPENSATION INSURANCE, AS REWIRED BY 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 (1 HIS Ste NUN NEtL NUI HG OUMYLEIEU IF 1 HG Y[NMI 115 run UNt HUMMtl3 JULWH5 (5100) OR LESS/. I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.1 NO E OY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE WORKERS COMPENSATION LAWS OF CALIFORNIA, AND AGREE THAT If I SHOULD BECOME SUBJECT TO THE WORKERS COMPENSAI ION PROVISIONS OF SECTION 3700 OF THE LABOR CODE. I SHALL FORTHWITH COMPLY WITH THOSE PROVISIONS, DATE: APPLICANT: WARNING: FAILURE TO SECLIflWORKERS COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TC•Ch(LI NAL�ENC LIES AM CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION jO jL1E C T ME COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR•U,, INNFBREY. ANC AI'I:RNEYS FEES. SQI�4T8UC 'NTFIN•OMG AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCT/O.:' :ENDING AGENCY FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUE& (5EC.309T, CIV.C.). LENDE•S IMF• • • ••• • LENDERlAB0RE3 1 CVO( TTMRAyg HME REAM TM.% PP TION k, STATE 1�IAT•THhINFORMATION ABOVE IS CORRECT.I AGREE TO COMPLY•WITH AL,SITY gy1O COIMMORQQINN�ANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION, AND HEREBY AUTHORIZE'REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE -MENTIONED PROPERLY FOR INSPECTION PURPOSES.