HomeMy WebLinkAbout301 Newport Blvd 08-13-021
Cityof Newport Beach BuildingDepartment FIREALRM Permit No: F2002-0175
PO Box 1768/3300 Newport Blvd. Newport Beach California 92658-8915 Periiit Counter Telephone (949)644-3288 Inspection RequestsTelephone (949)644-3255
Job Address: 301 NEWPORT BLVD Bldg: 1 Floor: Suite:
Inspector Area:FIRE Legal Desc.:
Owner
Address:
Phone:
Applicant:
Address:
Phone:
IRVINE SUB LOT 169 BM 2 POR OF LOT
HOAG MEMORIAL HOSPITAL PRESBYTERIAN Contractor: FACILITIES PRO
301 N REIMPORT BLVD Address: 1150 W CENTRAL # D
NEWPORT BEACH, CA 92663 BREA CA 9266i
Phone: 7141917-4260 i
REIMER CHRIS
1150 W CENTRAL AVE
BREA CA92821
714/257-2244
Edit Code:
Type of Construction:
Occupancy Group:
Added /New sq.ft ;Bldg :
Added /New sq. ft. Garage:
No of Stories. :
No of Units :
0
Con. State Lic.: 592289
Lic Expire: 04130/2004
Bus. Lic.: BT01050438
Lic Exp Date: 01/31 /2003 -
,I
Workers' Compensation Insurancel-
Carrier: TRAVELERS I
Policy No: UB551K1117
Expire: 06/01/2002 .,
Issued Date: 06/07/2002
FEES
Construction Valuation: $6,370.00
`Fire Plan Check Fee :
Fire Permit/ Inspection Fee:
Record Management:
Issuance Fee :
Investigation Fee:
PROCESSED -BY:\
ZONINGAPPROVAL:
FIRE APPROVAL:
$106.00
$114.75
$12.00
$0.00
$0.00
TOTAL FEE : $232.75 TOTAL PAYMEI'T : $106.00 TOTAL DUE : $126.75
Description of Work: ADD (2) SMOKE DETECTORS/RELOC HORN & BELL
1183-2002
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer:
Address:
Phone:
Special Conditions:
Inspector
State Lic:
State Lic:
THER DEP
PLAN CHEC
PROV
WOK MUa I BE STACTLD :YITHIN A PERIOD OF 180 DAYS FROM Mk DATE OF VALIDATION OR
$0.00
$0.00
PE • IT BECOMES NULL AND VOID.
S
APPROVALS
DATE
BY
COMMENTS
Y THAT I AMEX
oMUTY 0 PERJURY
PENALTY OF N (SEC. 7 THAT 1 EXEMPT FROM THE CONTRACTORS
SE HEREBYLAFFIRM 0 FOLLOWING
LAW FOR THE H REQUIRE REASON PER ISET. TC ON, BUSINESS T,A AND PROFESSIONS CODE' ANY
TO ALS REO W_TER IMPROVE DT O R OR
OR WE STRUCTURE.
CTURE REQUIRES RTO I S ISSUANCE, FOR SUCH
ANY STA siGNED TATE1 N TH TEoSALSO PEOED F SLJ APTO THE
STATEMENT SHE LICENSED PUSECMITTOTFHE P. 3 FITHE
CCONTRACTORS
NTFJ0TIGS LICENSE
S AND O PROFESSIONS LIONS CLAW (CHAPTER 8 (OS E IS EX WIPT SEE. EFOF NC 3 OF THE
THEN LLEEDMTI.ANY CR THAT IO HE OR SHE J3 EXEMPT A THEREFROM AUCAN ANC THE BASIS
A BY ANY APPLICANT FOR A PERMIT
THE 1HEGPD EXEMPTION. ANY EN5LTRIN OF SEC MORE
THE APPLICANTTO ACML PENALTY OF NOTMORE THAN FIVE HUNDRED DOLLARS (%OVI'.
I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES. AS THEIR SOLE
WILL DO THE WORK, AND THE STRUCTURE 1S NOT INTENDED OR OFFERED FOR SATE
7044, BUSINESS AND PROFESSIONS CODE. THE CONTRACTORS LCENSE LAW DOES NOT APPLY
OWNER OF PROPERTY WHO BUILDS OR IMPROVES THEREON, AND WHO DOES SUCH WORK
OR HERSELF OR THROUGH M5 OR HER OWN EMPLOYEES. PROVIDED THAT SUCH
ARE NOT INTENDED OR OFFERED FOR SALE IF, HOWEVER, THE BUILIANG OR
IS SOLO WITHIN ONE YEAR OF COMPLETION. THE OWNER -BUILDER WILL HAVE THE
OF PROVING THAT HE DO SHE D10 NOT BUILD CR IMPROVE FOR THE PURPOSE OF SALE).
I:',AS OWNER OF THE PROPERTY. AM EXCLUSIVELY CONTRACTING WITH LICENSED
TO CONSTRUCT THE PROJECT (SEC 7044. BUSINESS AND PROFESSIONS CODE. THE
LICENSE LAW DOES NOT APPLY TO AN OWNER OF THE PROPERTY WHO BUILDS OR
THEREON, AND WHO CONTRACTS FOR SUCH PROJECTS WITH A CONTRACTOR(5) LICENSED
TO THE CONTRACTORSLICENSE LAW)
I AM EXEMPTUNOER sEc. . BS P.C. FOR THIS REASON
FIRE PROTECTION
=
CITYNOR
UNDERGROUND ROUGH PIPE j
Cm
REPAIR
THRUST BLOCKS EXCAVATION I
UNDERGROUND PIPING FLUSH
OF
OF INE
OCRI
FOR
SUBJECTS
COMPENSATION,
(EEC.
TO AN
HIMSELF
IMPROVEMENTS
IMPROVEMENT
BURDEN
CONTRACTORS
CONTRACTORS
IMPROVES
PURSUANT
. UNDERGROUND HYDRO TEST
UNDERGROUND/BACKFLOW APRV.j
..4
SPRINKLER HYDRO TEST
SPRINKLER FLOW TEST 1
SPRINKLER ROUGH PIPE .
(
STANDPIPE HYDRO TEST I
STANDPIPE FLOW TEST
STANDPIPE ROUGH PIPE !
CH EM SYSTEM FUNCTION TEST
CHEM SYSTEM APPROVAL
DATE OWNER
FIRE ALARM SYSTEM
I
CHAPTER
CODE,
LICENNECLPS
/DATE
I HEREBY
LICENSED CONTRACTORS DECLARATION
HEREBY AFFIRM UNDER PENALTY OF PER.AURY THAT I AM LICENSED UNDER PROVISIONS OF
Y (COMMENCING IMAM SECTION ]B00) OF DIVISION 3 OF THE BUSINESS AND PROFESSIONS
AND MY LICENSE IS IN FULL FORCE AND EFFECT.
C7112 LC, No S� ZZec-I
ROUGH WIRING
SYSTEM FUNCTION TEST _4_
CENTRAL STATION MONITOR
ti
�y/ Z FACT. L4Y
10/ ( ° CONTRACTOR TAL[\Y rur.S.IJ
L/may
LLL WORKERS COMP TION DECLARATION
AFFIRM UNDERPENALTY OF PERJURY ONE OF THE
I HAVE AND WILL MAINTAIN ACERTIFICATE OF CONSENT
FOLLOWING DECLARATIONS
TO SELFANSURE FOR WORKERS'
ORBS. OF TbF. LABOR CODE FOR THE
PMIT IS. ISSUED,
INSURANCE, AS REQUIRED -BY
OF THE WORK FOR WHICH
INSURANCE CARRIER AND POLICY
,
FIRE MISC'
,r,_
TANK REMOVAL - - '
1'
INSTALLATION/TEST t
c MPENSAT N. AS PROVIDED FOR BY a
PERFORMANCE OF THE NARK FOP WHICH TR
1 HAVE AND WILL MAINTAIN WORKERS' CD.MIl,NNSATON
DANK
`S'ANK PIPING PRESSURE TEST j
"MEDICAL GAS PIPING TEST 1 I
SECTION 3700 OF THE LABOR CODE, FOR TREI ERFORMANCE
THIS PERMIT IS ISSUED, MY WORKER& COMPENSATION
NUMBER ARE-
CARRIER
CROSS CONNECTION TEST
FOLICY NUMBER
P
MISC. INSPECTIONS:
-
-
(MIS SECTION NEED NOT BE COMPLETED IF THE PERMIT
(SI00) OR LESS).
1 CERTIFY THAT IN THE PERFORMANCE OF THE WORK
I5 R ONE HUNDRED COLLARS
FOR THISPERMIT IS ISSUE01
SO AS BECOME SUBJECT TO THE
AND AGREE T IF I SHOULD BECOME
J5 00 OF THE LABOR
ON510
° -
4
-
_
I
DATE
WARNING'-
SUBJECT
DOWERS
DORS
1
AGENCY
LErvDERs
LENDER'S
SHALL NOT EMPLOY ANY PERSON IN ANY MANNER
WORKERS' COMPENSATION LAWS OF CAUFOR A
SUBJECT TO THE WORKERS' COMPENSATION
J�ODEI SHALL FORTHWITH COMPLY WITH TN
/ / OZ APPLICA
`---"'
--- --- A
j
-
F
,._.
-
-..
ER LFLAIIE TO SECURE WYlPNE PENBAIWN
COVF}FAtdVlaND 8KLJ.
INES UP T EDTMOUGAN0
ATON, D * AS PROVIDED FOR IN
S FEES
arfiatitgFrD CAPpNAL w , AND Cy>'.
(S1000 IN AD0ITOI .TOME COST 6 T ELMAISN',
37116 OF THE LABOROOO "Y'ERETAsAN)ATTORNL
CONST,RUC T10{.LENDING ',MERCY
HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT
FOR THE PERFORM/WEE OF THE WORK FOR WHICH
NAME'
- I
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!_........�.,..._._.e�._..._.°_SECTION
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THERE IS A CONSTRUCTION LEMIING.
THIS PERMIT IS ISSUED ISEC ]00T.
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'•
H 0RESS+ _
I CERTIFY THAT I W VE „EAL?Y'S ADPUCAYIUN Ara J 5T 1.TE THAT THE ABLVE INGOFMATION I5
CORRECT. 1 AGREE TO COM1YPLY MA N ALL 07 ANu O,UNTY 0R^INA'CEs AND STATE LAWS
RE NG TO BWLOING CON UCTION, AND HEREBY 'AUTHOI.0 REPRTSENTATVES OF THIS
CO TO ENTER LATHE BO-MENTGbEDPROPERTY FOR INSPECTION PURPOSES.
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FINAL
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SIG F dJRF 1101