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Home My WebLink AboutH2002-0309 - PermitsCity of Newport Beach Building Department MECHANICAL Permit No: H2002-0309 PO Box 1768/3300 Newport Blvd., Newport Beach, Califomia 92658-891 Permit Counter Telephone (949)644-3288 Inspection RequestsTelephone (949)644-3255 Job Address: 1 HOAG DR Bldg: 1 Inspector Area; 7 Code Edit: Owner: HOAG HOSPITAL Address: 301 NEWPORT BLVD NEWPORT BEACH CA Phone: 714/646-8901 Issued Date: 04/05/2002 Processed By: 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 & Packaae Units up to look Btu/hr 0 $0.00 up to 500k Btu/hr 0 $0.00 up to 1M Btu/hr 0 $0.00 up to 1.75M Btu/hr 0 $0.00 over 1.75M Btu/hr 0 $0.00 97 658 Floor: Suite: Legal Desc.: Contractor: Address: Phone: Con. State Lic.: 275506 Lic Expire: 10/31/2002 Bus. Lic.: BT98028611 Lic. Exp Date: Description of Work: INSTALL HEAT EXCHANGER WICHILLER (2014-2001) REPLACES PMT H2001-0861 INSPECTOR NOTES UNIT CONSTRUCTION 8 MAINTENANCE COMPANY 1580 W CARSON ST LONG BEACH CA 90810 3101233-3000 Boilers & Compressors up to 3HP 0 $0.00 over 3HP to 15HP 0 $0.00 over 15HP to 30HP 0 $0.00 over 30HP to 50HP 0 $0.00 over 50HP 0 $0.00 Misc Items Fire Dampers Gas Line Metal Fireplace ICBO App.#- O $0.00 O $0.00 O $0.00 FEES Ventilation Bathroom Fan 0 $0.00 Exhaust Pan 0 $0.00 Attic Fan 0 $0.00 Down -Draft Fan 0 $0.00 Residential Hood 0 $0.00 Commercial Hood 0 $0.00 Repair/Alter/Add 0 $0.00 Air Handling Units up to 10k cfm 0 $0.00 over l0k cfm TOTAL: $67.28 PAYMENT : $0.00 BALANCE: $67.28 0 $0.00 VAV Box Other CHILLER Record Management Fee: Investigation fee Plan Check Issuance Supplemental Fee 0 $0.00 $46.33 $0.00 $0.50 $0.00 $0.00 $20.45 $0.00 SO CONTRACTORS DFCLARATION I rebyafirm under penalty of perjury that l 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. cense No' 2T55d6 Class: Dote: Contractor: LIMIT CONSTRUCTION & MAINTENANCE COMPANY WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the lollowing declaralions: I have and will maintain a certificate of consent to self insure for workers' compensation, as provided for by Seal on 3700 of the labor code, for the performance of the work for which this pemilt Is Issued. I haw 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 worker's compensation Insurance carrier and policy number Is : Carder: EAGLE PACIFIC INS CO Policy number. 180102339 Expire: 11/3017002 (This section need not he 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 .0 the worrer' aornpensetton laws of Callingrr7 agree tilt If should become subject to the workers' compensation provisio tlo 37 abpOtgde,J.e h) with comply with those p,avisions. DME/ 05 (0 2- Applicant Siynalayei- an'. Warning: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and rivil fries ep'ao 0 hundred thousand dollars ($100,000), In addition to the cost of compensallon,damages as provided for In Section 3706 of the labor code, Intere-t, and alto, nays fees. I hereby acknowledge that I have read this application; that the Infornutlon given is correct; and that I am the owner, or duly authorized agent of the ow-,er. I apree m comply with city and state laws regulating construction and In doing the work authorized thereby, no person Mil be employed In violation of the labor code of the state of - California relating to workmen's compensallo(lnsprance. Permittee Name (Print) Signature of permit‘ Address : Datey Approvals Underslab/Floor HVAC1Hood - Rough Fireplace -Rough Gas Test Fireplace - Final HVAC/Hood - Final Inspector/Date WORK MUST 8E STARTED WITHIN A PERIOD OF 180 DAYS FROM THE DATE OF VALIDATION OR THIS PERMIT BECOMES NULL AND VOID. City of Newport Beach Building Department MECHANICAL Permit No: H2001-0861 PO Box 1768/3300 Newport Blvd., Newport Beach. California 92658-891 Permit Counter Telephone (949)644-3288 Inspection RequestsTelephone (949)644-3255 Joh Address: Inspector Area: Owner: Address: Phone: issued : 1 HOAG DR Bldg: 1 7 Code Edit: 97 HOAG HOSPITAL 301 HEY/PORT BLVD NEWPORT BEACH CA92658 714/646-8901 Processed By: HVAC items �( Furnaces up to 100k Btu/hr 0 $0.00 over 100k Btu/ hr 0 $0.00 Hall/Floor Heaters 0 $0.00 Heat Pumps & Package Units up to 100k Btu/hr 0 $0.00 up to 500k Btu/hr 0 $0.00 up to 1M Btu/hr 0 $0.00 up to 1.75M Btu/hr 0 $0.00 over 1.75M Btu/hr 0 $0.00 LICENSED CONTRACTORS DECLARATION I herby affirm under Penalty of perjury that I am licensed under provisions delis and my license Is M full forte and affect License No: 2755a Class: Dale: Floor: Suite: Legal Desc.: Description of Work: INSTALL HEAT EXCHANGER W/CHILLER 2014-2001 INSPECTOR NOTES Contractor: UNIT CONSTRUCTION 8 MAINTENANCE COMPANY Address. 17000 MARQUARDT AVENUE CERRITOS CA Phone: 562-404-8433 Con. State Lk. : 275506 Lic Expire: 10/31/2002 Bus. Lac.: BT98028611 Lic. Exp Date: 12/31/2001 Boilers & Compressors up to 3HP over 3HP to 15HP over 15HP to 30HP Over 30HP to 50HP over SOAP Misc items Fire Dampers Gas Line Metal Fireplace ICBO App.R- 0 $0.00 O $0.00 O $0.00 O $0.00 O $0.00 FEES ''spoofor Ventilation Bathroom Fan 0 $0.00 Exhaust PAP 0 $0.00 Attic '! $0.0 Down2D aft Fan :0 „Wield tiaha1go• , , $0.00 Commie inlA-tie od 0 $0.00 0 $0.00 e i /Ater/A. 0 $0.00 0 $Deb ndlin Units 0 OO.00 1 / to 10k cfm 0 $0.00 over 10k cfm 0 $0.00 TOTAL: $151.26 a PAYMENT : 20.139!�P/I E$130.57 y'. WORKERS' COMPENSATION DECLARATION: 1 herby ulnae I have and will motto a certificate of consent 10 aeffa for which this permit is issued. I have and will maintain worker' conapeaatton My worker's compensation Insurance r and Cardec T.__ •e3�° (This section n(e�e'd� �n��r�a bp_ I certifythat In tMww.aena nokn:/ o Ee• • ••. Ca , and pR:tiwsl.lpukl bsearn• subject to DaterLZ-o 1 r onkactor: n 3faP8R'Mnlness and professions code, MAINTENANCE COMPANY penally of pepury one 01 the blowing declarations: Sr workers compensation, as provided for by Section 3100 nci, as required by Section 3700 of the labor code, Inc the Icy number Is : Paley number: d If the or which ee •• • • •H Wa,arnl•nsP Ilure %tc. t wart anpsnsatMQ c.�o•rraay Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred to tat tl�Isrs mama In addlfo9 a ti„•fore o%cornParrnulon,damages as provided for In Section 3701 of the labor code, Interest and attomeys fees. a • • • • pj • • •• • • • • •• liharey r� c arr3 state ier rod this cgplIca ill: and In information given N correct; and tat lam therainier,or duly authored agent of Lip owner. I sate to city regulating eonsbralAion and In doing the work authorized thereby, no parson will be employed In violation of the labor cede of the state of California relating e,Yr1ef1�to workmen's compensation Insurance. ��//�� Permitte1erPryltj• _Jette /r'/c.AUc-hy) • • • • • • • • a • Signature of P IWee'. 0 compensation Ions Applies gnof re: or less). person in any manner so as to become subject to the workers' compensation la Law! of the tabor code, Inc the P omMq�rD11D•iv�rla teefo 1Q. pesrmiti issued. _ I shall forthwith comply nth epee pr0vlalorm. ddress: i 90 (42So. Si, i4^1( I44c�f I D e: 9'2Z -B/ VAN/ Box 0 $0.00 Other CHILLER $92.65 $0.00 Record Management Pee: $15.00 Investigation fee $0.00 Plan Check $23.16 Issuance $20.45 Supplemental Pee $0.00 Aoorovais Inspector/Date Underslah/Floor plegRood - Rough Fireplace -Rough Gas Test Fireplace - Final HVAC/Hood - Final WORK MUST BE STARTED WITHIN A PERIOD OF 180 DAYS FROM THE DATE OF VALIDATION OR THIS PERMIT BECOMES NULL AND VOID.