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Home My WebLink AboutF2002-0096 - PermitsCity of Newport Beach Building Department PO Box 1768/3300 Newport Blvd., Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288/3289 Inspection RequestsTelephone (949)644-3255 FIREPROT Permit No: F2002-0307 Job Address: 1 HOAG DR Bldg: 1 Floor Suite: Inspector Area:7 Legal Desc.: Description of Work: ADD (1)/RELOCATE (3) FIRE SPRINKLERS SEE 0661-2002 zncL FIt Owner. HOAG HOSPITAL Contractor: ALERT FIRE PR Architect: Address: 1 HOAG DR Address: 5200 E HUNTER AVENUE STE B Address: NEWPORT BEACH CA 92663 ANAHEIM CA 92807 Phone. Phone: 714/779-7911 Phone: State Lic: Applicant. LOONEY SHEILA Con. State Lic 316324 Engineer: Address: 520 E HUNTER AVE Lic Expire. 04/30/2004 Address: ANAHEIM CA92807 Bus Lic.. BT01102410 Phone: 714/993-2822 Lic Exp Date. 09/30/2002 Phone: State Lic: Edit Code: 97 Workers' Compensation Insurance - - Designer: Type of Construction: Carrier: STATE COMPENSATION INSURANCE F Address: Occupancy Group: Policy No: 1589876 Added /New sq.ft. Bldg : Expire: 10/01/2002 Phone: Added /New sq ft Garage: No of Stories.: Issued : 08/30/2002 Special Conditions: SEE PMT F2002-0096 No of Units . FOR ADDTL VAL FOR 2ND FLR FEES Construction Valuation: $500.00 Fire Plan Check Fee : Fire Permit/ Inspection Fee: Record Management : Investigation Fee: $0.00 $110.00 $0.50 $0 00 $0.00 $0.00 TOTAL FEE : $110.50 TOTAL PAYMENT : $0.00 TOTAL DUE : $110.50 PROCESSED BY: ZONING APPROVAL: FIRE APPROVAL: - OTHER DEPARTMENT: PLAN CHECK BY: APPROVAL TO ISSUE: Paufcd C &et& WORK MUST BF STARTED WITHIN A PERIOD OF 180 DAYS FROM THE DATE OF VALIDATION OR THIS PERMIT BECOMES NULL AND VOID. APPROVALS DATE BY COMMENTS OW R DECLARATION FIRE PROTECTION I HEREBY AFFIRM UNDER PENALTY LTY OF OF PERJURY THAT I AM EXEMPT FROM THE CONTRACTORS LICENSE LAW FOR THE FOLLOWING REASON 7031 UNDERGROUND ROUGH PIPE (SEC 5, BUSINESS AND PROFESSIONS CODE ANY CITY OR COUNTY WHICH REQUIRES A PERMIT TO CONSTRUCT. ALTER, IMPROVE, DEMOLISH. OR THRUST BLOCKS EXCAVATION REPAIR ANY STRUCTURE, PRIOR TO ITS ISSUANCE. ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE IS UCENSED PURSUANT TO THE PROVISIONS UNDERGROUND PIPING FLUSH OF THE CONTRACTORS LICENSE LAW (CHAPTER 9 (COMMENCING WITH SEC 7000) OF DN 3 OF THE BUSINESS AND PROFESSIONS COOE)I OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS UNDERGROUND HYDRO TEST FOR THE ALLEGED EXEMPTION ANY VIOLATION OF SEC 70315 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TOA CIVIL PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (3500) UNDERGROUND/BACKFLOW APRV. I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION WILL DO THE WORK. AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE SPRINKLER HYDRO TEST (SEC 7044, BUSINESS AND PROFESSIONS CODE THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON, ANO WHO DOES SUCH WORK SPRINKLER FLOW TEST HIMSELF OR HERSELF OR THROUGH HIS OR HER OWN EMPLOYEES, PROVIDED THAT SUCH SPRINKLER ROUGH PIPE 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 1 I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (SEC 70M, BUSINESS AND PROFESSIONS CODE THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF THE PROPERTY WHO BUILDS OR IMPROVES THEREON MID WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(S) LICENSED PURSUANT TO THE CONTRACTORS LICENSE LAW ) I AM EXEMPT UNDER SEC N i P C FOR THIS REASON STANDPIPE HYDRO TEST STANDPIPE FLOW TEST STANDPIPE ROUGH PIPE CHEM SYSTEM FUNCTION TEST CHEM SYSTEM APPROVAL DATE OWNER FIRE ALARM SYSTEM LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER 9 (COMMENCING WITH SECTION ]000) OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSE IS IN FULL FORCE AND EFFECT LJCENSE CLASS LIC NO ROUGH WIRING SYSTEM FUNCTION TEST CENTRAL STATION MONITOR q��J DA �IS ^ 3 EC) AmYJ / ..CONTRACTOR WORKERS' COMPENSATION DECU/RATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS I NAVE AND WILL MANTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' C MPENSAHON, AS PROVIDED FOR BY SECTION 3700 OF THE LABOR CODE. FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED I HAVE ANO WILL MAINTAIN WORKERS' COMPENSATION INSURANCE AS REQUIRED BY FIRE MISC TANK REMOVAL TANK I NSTALLATION/TEST TANK PIPING PRESSURE TEST MEDICAL GAS PIPING TEST 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 CROSS CONNECTION TEST POLICY NUMBER MISC. INSPECTIONS: (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS D1U0) OR LESS) I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED,1 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 `x1 CODE, I SHALL FORTHWITH COMPLY WITH THOSE PR II5II NS GATE / \S — %0 - C,7 AP'I PANT '-�= WARNING FAILURE TO SECURE WORKERS' COMPeNSn N .:ON. RAGE IS UNLAWFUL, AN HALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTFF /4O DML F VIES UP TL ONE HUNDRED THO SAND DOLLARS (5100,060), IN ADDITION TO THE CC3T OF 30l0j'EPS"TIO4, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,. d 3MTN/NETS FEE", CONSTRUCTOR LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY FOR THE PERF-PYINCE OF THE WORK ,FOR WHICH THIS PERMIT I5 ISSUED (SEC 3097. CIVC) LENDERS NAME - LENDERS ADDRESS I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT I AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION. AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS COU TO ENTER UPON THE ABOVE'A—NTIOKRO PROPERTY FOR INSPECTION PURPOSES st al. FINAL 97d {/{//,/ M EE NME(PRIN City of Newport Beach Building Department FIREPROT Permit No: F2002-0096 PO Box 1768/3300 Newport Blvd., Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288/3289 Inspection RequestsTelephone (949)644-3255 Job Address: 1 HOAG DR Bldg: 1 Floor: 1 Suite. Description of Work: ADD (1)/RELOCATE (4) FIRE SPRINKLERS 0661-200Z Inspector Area:7 Legal Desc.: Owner: HOAG HOSPITAL Contractor: ALERT FIRE PR Architect Address: 1 HOAG DR Address. 5200 E HUNTER AVENUE STE B Address: NEWPORT BEACH CA 92663 ANAHEIM CA 92807 Phone. Phone: 714/993-2822 Phone: State Lic: Applicant: LOONEY SHEILA Con. State Lic.: 316324 Engineer: Address: 520 E HUNTER AVE Lic Expire: 04/30/2004 Address: ANAHEIM CA92807 Bus Lic.: BT01102410 Phone: 714/993-2822 Lic Exp Date: 09/30/2002 Phone: State Lic: Edit Code: Type of Construction: Occupancy Group: Added /New sq ft. Bldg : Added/New sq ft. Garage. No of Stories. : No of Units : 0 Workers' Compensation Insurance - - Designer Carrier: STATE COMPENSATION INSURANCE F Address: Policy No: 1589876 Expire 10/01/2002 Phone: Issued . 08/28/2002 Special Conditions: FEES Construction Valuation: $1,100.00 Fire Plan Check Fee : Fire Perrnitl Inspection Fee Record Management/ Investigation Fee: $106 00 $106.00 $2.50 $0.00 $0.00 $0.00 TOTAL FEE : $214.50 TOTAL PAYMENT : $106.00 TOTAL DUE : $108.50 PROCESSED BY: \ ZONING APPROVAL: FIRE APPROVAL: - OTHER DEPARTMENT - PLAN CHECK B APPROVAL TO 1 -OCR, J WORK MUST BE STARTED WITHIN A PERIOD OF 180 DAYS FROM THE DATE OF VALIDATION OR � PERMIT BECOMES NULL AND VOID. Da 3«3d APPROVALS DATE BY COMMENTS OWNERWUILDER DECLARATION - I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 AM EXEMPT MGM 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, DEMO. ISH, OR REPAIR ANY STRUCTURE, PRIOR TO ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED STATEMENT THAT HE OR SHE 15 UCENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LICENSE LAW (CHAPTER 9 (COMMENCING WITH SEC 7000) OF ON 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 70315 BY ANY APPLICANT FOR A PERMIT SUBJECTS THE APPLICANT TO A CML PENALTY OF NOT MORE THAN FIVE HUNDRED DOLLARS (f500) I, AS OWNER OF THE PROPERTY. OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS 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 IMPROVEMENTS ARE NOT INTENDED OR OFFERED FOR SALE IF, HOWEVER, THE BUILDING OR IMPROVEMENT 15 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 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 IMPROVES THEREON, AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(S) LICENSED PURSUANT TO THE CONTRACTORS LICENSE LAW) I AM EXEMPT UNDER SEC B & P C FOR THIS REASON FIRE PROTECTION UNDERGROUND ROUGH PIPE THRUST BLOCKS EXCAVATION UNDERGROUND PIPING FLUSH UNDERGROUND HYDRO TEST UNDERGROUND/BACKFLOW APRV. SPRINKLER HYDRO TEST SPRINKLER FLOW TEST SPRINKLER ROUGH PIPE p// ` i Jam//N STANDPIPE HYDRO TEST STANDPIPE FLOW TEST STANDPIPE ROUGH PIPE CHEM SYSTEM FUNCTION TEST CHEM SYSTEM APPROVAL DATE OWNER FIRE ALARM SYSTEM LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT 1 MA UOENSED UNDER PROVISIONS OF CHAPTER 9 (COMMENCING WITH SECTION 7000) OF OMSION 3 OF THE BUSINESS AND PROFESSIONS CODE, AND MY LICENSEEN�IS IN FULL FORCE AND EFFECT 7 LICEN CLASS e / COLIC NO 3/63 ROUGH WIRING SYSTEM FUNCTION TEST CENTRAL STATION MONITOR 0-2-14-0 Z C0 of tern-k..4 - -- - - ---- - WORKERS' COMPE ION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PE JURY ONE OF THE FOLLOWING DECLARATIONS I HAVE AND LMLL MAINTMN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS COMPENSATI N, AS PROVIDED FOR BY SECTION 3700 OF THE LABOR CODE, FOR THE FIRE MISC. TANK REMOVAL TANK INSTALLATION/TEST PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED I HAVE AND WILL MAINTMN WORKERS' COMPENSATION INSURANCE, AS REQUIRED BY TANK PIPING PRESSURE TEST MEDICAL GAS PIPING TEST 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 NUMBERARE CARRIER CROSS CONNECTION TEST POLICY NUMBER MISC. INSPECTIONS: (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT 15 FOR ONE HUNDRED OOLURS ($100) OR LESS) 1 CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I SHALL NOT EMPLOY ANY PERSON IN MIY MANNER SO AS TO BECOME SUBJECT TO THE WORKERS' COMPENSATION LAWS OF CAUFORNIA AND AGREE THAT IF 1 SHOULD BECOME SUBJECT TO THE WORKERS COMPENSATION PROVISIONS OF SECTION 3700 OF THE LABOR CODE. �/Z�� FORTHWITH COMPLY WITH THOSE PftOI(y15• A DATE PLICANT JICOV �l�'r''/Cifer WARNING FAILURE TO SECURE WORMERS' AMFIENSATIOP COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL ENAL-IES AND ONIL FINES JP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE C JJT C ` COI.(1ENSATIOI., nAMurS AS PROVIDED FOR IN SECTION 97013 OF THE LABORBOR CODE, INl CRES1 AN.i AT,bRNEPS FEcS CONSTRUCTION LENDING AGENCY 1 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 (SEC 3097, CNCI LENDERS NAME LENDERS ADDRESS _ _ - 1 CERTIFY THAT 1 .AVE READ THIS APPLICA,ION AND °TATE TnAT THE ABOVE IN.-ORMATION 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 COUNTY TO ENTER UPON THE ABOVE -MENTIONED PROPERTY FOR INSP/CTION PURPOSES S71 iL119 1--aCAIt'/ FINAL GT- ��j. ITIEE NAME RI! 0 / X iRIGNA OF I E