HomeMy WebLinkAboutF2008-0202 - PermitsCity of Newport Beach
Building Department FIRE COMBO Permit No: F2008-0202
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 NB
Inspector Area: 7
OF LOT
Owner: HOAG HOSPITAL FD&C
Address: 500 SUPERIOR AVE 8300
NEWPORT BEACH CA 92663
Phone: 949-764-4486
Applicant: READ FIRE PROTECTION INC
Address: P 0 BOX 194
SURFSIDE CA 90743
Phone: 949-337-9679
Code Edit : 2007
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage:
No of Stories:
No of Units :
Flood Zone:
Bldg Sprinklers:
V-BSPR
B
0
0
1
0
N
Description: FIRE SPRINKLERITI 89 HEADS (X2007-3021)
1101-2008
Legal Description: IRVINE SUS 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:
READ FIRE PROTECTION INC
PO BOX 194
SURFSIDE CA 90743
949-337-9679
837553
02/28/2010
BT30006562
11/30/2008
Worker's Compensation Insurance
Carrier: ENDURANCEINS
Policy No: WEN003016701
Expire: 09/15/2008
Issued Date: 06/06/2008
Setback- Front:
Rear:
Left:
Right:
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
State Lic:
State Lic:
INSPECT°
Construction Valuation: $9,000.00
Building Overtime Plan Check :
Plan check Exten Fee:
Building Fire Plan Check Fee:
TOTAL FEE : $306.30
$0.00
$0.00
$130.00
FEES
Fire Plan Check Fee :
Fire Permit/Inspection Fee:
Records Management:
Investigation Fee:
Residential Issuance Fee
Plan Check Fee : $0.00
$0.00
$169.30
$7.00
$0.00
$0.00
Counter Review :
Zoning Plan Check Fee:
Fee Due at Permit Issuance : $306.30
$0.00
$0.00
$0.00
$0.00
PROCESSED BY:
ZONING APPROVAL:
.elle
• FIRE APPROVAL ••• • • • •••
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OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
PERMIT EXPIRES 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 LICENSE LAW FOR THE FOLLOWING REASON
DEMOLISH. OR REPAIR ANY STRUCTURE, RIOR TO ITS ISSEC. 7031.5, BUSINESS AND PROFESSIONS CODE:ANY CITY OR UANCE, O REQUIRESUNTY WHICH T
HEAPPLICANT FOR S A PERMIT TO SUCH PERMIT TO FILENSTRUCT, A SIGNED
STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LICENSE LAW (CHAPTER 9 (COMMENCING
PERMIT EXPIRED
DATE:
BY:
PERMIT CANCELLED
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
NOR MORE THAN FIVE HUNDRED DOLLARS (5500):
I, AS OWNER OFTi1EPROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL OD THE WORK, AND THE STRUG
TUBE IS NOT. INTENDED:OR OFFERED FOR SALE (SEC. 7044. BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES
PERMIT EXTENSION
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.):
FIRE PROTECTION
PERMIT FINAL
t 1- -zj - 0 $'
• 1, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC.
7044, BUSINESS AND PROFESSIONS CODE: THE CONSTRACTORS LICENSE LAW DOES 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 CON-
TRACTORS LICENSE LAW.).
❑ I AM EXEMPT UNDER SEC , B. 8 P.C. FOR THIS REASON
FOR OFFICE USE ONLY
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DATE OWNER
LICENSED CONTRACTORS DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER 9 (COMMENCING WITH SEC. 7000) OF
DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS IN FULL FORCT AND EFFECT.
LICENSE CLASS LICENSE NO.
_
_ TRACTOR
/<%. fY
WORKERS' COMPENSA ION DECLARATION ,
I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS:
III I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONENT TO SELF -INSURE FOR WORKERS' COMPENSATION, AS PROVIDED FOR BY SEC 3700
OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.
111 I HAVE AND WILL MAINTAIN WORKERS' COMPENSATION INSURANCE, AS REQUIRED BY SEC 3700 OF THE LABOR CODE, FOR THE PERFORM-
ANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, MY WORKERS' COMPENSATION INSURANCE CARRIER AND POLICY NUMBERARE:
CARRIER
POLICY NUMBER
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS).
• I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I SHALL NOT EMPLOY ANY PERSON IN ANY
MANNER SO AS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CALIFORNIA, AND AGREE THAT IF 1 SHOULD BECOME
SUBJECT TO THE WORKERS COMPENSATION PROVISIONS OF SEC. 370g.6 BOTH CODE, 1 SHALL FOR�FMfRH COMPLY WITH THOSE
PROVISIONS.
// C
i1 7L -On 4 LICANT: Y
WARNING: FAILURE TO SECURE W. - ERS' PENSATION COVE NLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO S NE HUNDRED THOUSAND DO ,000), IN ADDITION TO THE COST OF COMPENSATION. DAMAGES
AS PROVIDED FOR IN SEC. 37060THE LABOR CODE. INTEREST TTORNEYS FEES.
CONSTRUCTION LENDING AGENCY
I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERFORMANCE OF THE WORK
FOR WHICH THIS PERMIT 15 ISSUED (SEC. 3097, CIV.C).
LENDER'S NAME
LENDER'S ADDRESS
I CERTIFY THAT I HAVE READ THIS APPLCATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITH ALL CITY
ORDINANCESAND STATE LAWS RELATINGR FORNG CONSTRUCTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS
AND COUNTY UPON
COUNTY TO ENTER UPON THE ABOVE -MENTIONED PROPERTY INSPECTION PURPOSES.
RMITTEE NAME (PRINT) % O n (An On
G_
IGNATURE OF PERMITTEE - -� /p/� _6 �U
1/23/07 rev
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