HomeMy WebLinkAboutF2012-0092 - PermitsCity of Newport Beach
PO Box 1768 Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288
Building Division FIRE COMBO Permit No: F2012-0092
PROJECT NUMBER : 0379-2012
Inspection Requests/Telephone (949)644-3255
Job Address: 1 (44) HOAG DR NB St: 1 FI: 3 Unit: 380
Inspector Area: 7
140
Owner: HOAG HOSPITAL FDS:C
Address: 500 SUPERIOR AVE #300
NEWPORT BEACH CA 92663
Phone: 949-764-4486
Applicant: ALL PRO FIRE PROTECTION INC
Address: 22310 SAN JOAQUIN DR W
CANYON LAKE CA 92587
Phone: 951-244-9836
Code Edit : 2010
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:
II-A-SPR
B
0
0
3
N
0
Description: FIRE SPRINKLERITI 11 HEADS (X2012-0080)
0379-2012
Legal Description: RESUB OF CORONA DEL MAR LOT 6 BLK 140(AND E 12 FT LOT 7 BLK
Contractor:
Address:
Phone:
ALL PRO FIRE PROTECTION INC
22310 SAN JOAQUIN DR W
CANYON LAKE CA 92587
951-244-9836
Con State Lic: 629993
Lic Expire: 12/31/2013
Bus Lic: BT30029935
Lic Exp Date: 08/31/2012
Worker's Compensation Insurance
Carrier: GRANITE STATE INS
Policy No: WC003129234
Expire: 03101/2012
Issued Date: 03/06/2012
Setback- Front:
Rear:
Left:
Right:
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
State Lic:
State Lic:
INSPECTOR
6000
0000
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•
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fld)
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Construction Valuation: $1,100.00
Building PC Fee :
Building Overtime PC Fee:
Building Extention Fee :
Building Investigation Fee :
Fire Commercial PC Fee:
Fire Commercial Permit Fee :
Fire Residential Permit Fee :
Fire Residential Alarm Fee :
TOTAL FEE : _ \
$69.12
$0.00
$0.00
$0.00
$0.00
$69.12
$0.00
$0.00
$142.24
FEES
Fire Residential Alarm PC Fee :
Planning Counter Review :
Planning Zoning PC Fee :
Public Works PC Fee :
Public Works Traffic Plan Check Fee;
Plan Check Fee :
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Records Management
Fee Due at Permit Issuance :
54.00
$0.00
$0.00
$142.24
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL :
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' 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 to construct, 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 L) all of or L) 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 oitheproperty, 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 owrlP Q(BrEperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
P•I•arn exempt frorrylicensure under the Contractors' State License Law for the following reason:
y my s•IgnaturCbf3LpgM acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, 1 cannot legally
OIL Structure that 1 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.
SignMure of Prp15giff Qwner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
dhelapy affirm tilespenalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 70 0) of Division 3 of the Business and P fessions Code and my license is in full force
.Lice C- "t �f & Z 9l c«1 & � 31062 � I d 0
+t•icen� Class License No atetrector Signature r ' c" '^' "
WORISERS' COMPENSATION DECLARATION
ygtJLNP.: 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 ($100,000(, IN ADDITION TO THE
COsl'bj COMPENSATION+ DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
rr- Aby affirnfyrlder Penalty of perjury one of the following declarations:
e 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
ance of the work for which this permit is issued. Policy No.
ve and wi maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which thl permit is issued. My workers' compensation
is ance carrie p, Iigy4nnfimber are: ')% t 61-7 3 /a, ( 1
arrier FELL lA�/ Policy Number V3LI Expiration Date L
Name of Agen Phone #
❑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 I should become s act to the workers cpr[tpensation provisions of Section 3700 of the Labor Code I shall forthwith comply with those provisipnn. /l/I/ll yl I//I).C// II
DI
ure of Applicant A/j' A/
l M,3 to t Z
LARATION REGAR CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (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 rdinances and state laws relating to building construction.
I authorize representatives of this city or county to ter the above fiff��/rQperty for inspe n purposes. I /,y
nature of Property Owner or Authorized Agent Wit/ ! I��' H�" Y 617 Per �r perty Owner's or Authorized Agent's Name Y't�V ���"" 1
J
ACTION
DATE
BY
`� DECLARATION OF OOAPUANCE 117T1J CODE OF
FEDERAREGULATIONS PART 61 OF TITLE40 AND
AQMD RULE 1403.
FOR OFFKi USE ONLY
PERMIT EXPIRED
■ J SUBMITTED ASBESTOS NOTIFICATION TO:
• EPA
rs AQMD
PERMIT CANCELLED
PERMIT EXTENDED
d'tf'LAr c , �
ASBESTOS NOTIFICATION IS NOT APPIJrARI F TO
PROPOSED DEMOLITION.
SIGNATURE:
PERMIT FINAL
A-} - L{' • l Z
CERTIFICATE OF
OCCUPANCY ISSUED