Loading...
HomeMy WebLinkAboutX2012-0631 - PermitsCity of Newport Beach Building Division PO Box 1768 Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288 Combination Type - BLDG/GRAD/ / / COMB Permit No: X2012-0631 PROJECT NUMBER: 0143-2012 Inspection Requests/Telephone (949)644-3255 Job Address: 1 (38) HOAG DR NB Description:SITEWORK, WIDEN BRIDGE & ACCESS UPGRADES ADJACENT TO BLDG (29) (HOSPITAL & 38 PARKING STRUCTURE Inspector Area: 7 OF LOT Owner: Address: Phone: Applicant: Address: Phone: HOAG HOSPITAL FD & C 500 SUPERIOR AVE #300 NEWPORT BEACH, CA 92663 949-764-4486 RODRIGUES MICHAEL 2220 UNIVERSITY DR NEWPORT BEACH CA 92660. 949-574-1325 X760 • Code Edit : 2010 Type of Construction: I-B Occupancy Group: S-2 Added /New sq.8. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 4 No of Units : 0 Bldg Height: 0 Bldg Sprinklers: Y Flood Zone: Issued Date: 04/17/2012 Construction Valuation: $870,000.00 Building Permit Fee: $5,127.60 Plan Check Fee: $3,691.87 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management : $240.00 Energy Compliance: . $0.00 CA Seismic Safety : $0.00 Disabled Access : $803.00 Fee Increase: Fee: $0.00 Additional Fee : $0.00 Hazardous Mat : $0.00 Building Green Fee : $35.00 TOTAL FEE : $21,203.34 Legal Desc.: IRVINE SUB BLK 2 LOTS 169 & 170 POR OF LOTS & BLK 1 172 POR Contractor: Address: Phone: Con State lie: Lic Expire: Bus Lic: Lic Exp Date: B S D BUILDERS INC 8825 REHCO ROAD STE A SAN DIEGO CA p92117 II''•• 858-657-9186 tic Me ice. Phone: 879719 C1�4� fi 06/30/2012 qya. 2'1S' BT30033668 04/3012013 bU'+� Phone: Architect: Address: Worker's Compensation Insurance Carrier: EVEREST NATIONAL Policy No: Expire: Building Setbacks Use Zone: Parking Spaces: Solar System PC : Excise Tax: Grading Permit Fee Grading PC Fee: WO Insp. Fee: Electrical %: Mechanical %: Plumbing %: 7600002685111 07/01/2012 Rear: Front: Left: Right: 0 Engineer: Address: Designer: Address: Phone: REGIER D RANDY 2220 UNIVERSITY DR NEWPORT BEACH CA 92660 949-574-1325 State Lic:CO23842 GHARITSAUS EDMOND T 300 N LAKE AVE 14TH FLR PASADENA CA 91101 626-463-2800 State Lic:S-002942 Special Conditions: PARTIAL SPRINKLERED Fire Hazard Zone : N $0.00 Planning Department - $0.00 Plan check Fee : $687.50 Fair Share : $0.00 SJH Trans : $0.00 $843.80 In -lieu Housing Fee : $0.00 $8,012.00 Public Works Department - $0.00 Park Dedication : $0.00 P/W Plan Check : $1,001.00 San Dlst: $0.00 NMUSD Fee: $0.00 $0.00 $0.00 $0.00 Plan Check Fee : citcr .wlfl Fire Department Fire Inspection: Fire Plan Rev Demolition Fee Building Dept Adm General Service Refund Deposit $0.00 Fee Due at Permit Issuance : $0.00 $738.37 $0.00 $0.00 $0.00 $0.00 $0.00 $21,203.34 00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: C �L i ibu Sly PUBLIC WORKS APPROVAL: N��-- PLAN CHECK BY: APPROVAL TO ISSUE: PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. TPNtLER• 54 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 (_) all of or U 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 of the property, 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 owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ I am exempt from licensure under the Contractors' State License Law for the following reason: By my signature below I 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, I cannot legally sell a structure that I 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, 'a rvailable upon request when this application is submitted or at the following Web site:http:/Awnv.leginfo.ca.gov/calaw.html. &aloes of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hareby,afrm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and ProfessCode, my license is in full force and exact. Lirensn Class ..... License No to 'y.. % 7 '• 1 2.r Contractooignature WORKERS' COMPENSATION DECLARATION v:AR:11:13: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE cosy OF COMPENSA PION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. I,he/ebv,affirm under penalty of perjury one of the following declarations: © I ha‘.-e and 7.v'11 niktain 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 once of the work for which this permit is issued. Policy No. Ve and wll 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 workers' compensatior rance carrier and policy number are: Carrier Expiration Date Name of Agent _ Phone # ❑ I certify that, in the performance of th - ork for ' h 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 subject to the ;` ker . . -nsation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of licant Policy Number ate 'y- 7-% 2, DECLARATIOIA REGARDING CONRUCTI • LENDING AGENCY I hereby affirm under penalty of perj ry that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lenders 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 owners behalf. I have read this application and the information I have provi d is correct. I agree to comply with all applicable city and county ordin.- es and state a s relating to building construction. I authorize representatives of this cit or ounty to enter boy , en' : inspection purposes. Signature of Property Owner or Authorized ent „ Print Property Owner's or Authorized Age a ate /%C/t .Fe ate •/ ACTION DATE / BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL REGULATIONS PART 61 OFTITLE40 AND AQMD RULE 1403. LY FOR OFFICE USE ON PERMIT EXPIRED • I SUBMITTED ASBESTOS NOTIFICATION TO: }' EPA PERMITCANCELLED rl AQMD !SBESTOS NORFIC DON IS T APPLICABLE TO •P05- DDEMOLITI PERMIT EXTENDED PERMIT FINAL /07 i5 l /Z CERTIFICATE OF OCCUPANCY ISSUED SIGNATU • Report of Special Inspection Project Name & Address rleAczZ AU vascvLA& I n/<TI?dre SITE WP2oVC'M errs OvF µoPe, o2.i A tsvoKT I3egc.H CA. cltt,� Permit Number X 7-012- 0 US3 Inspection Type(s) Inspection Date(s) Re INF02LEt> CoivcTG 5-9-It [ ] Periodic [ ,i ] Continuous Describe Inspection Made, including Locations: 0135E2ve.p p&p. gME.vr aF "Owe. 'to cpbie V4c S OP 4Ssoo PSI conic lzeTF "rW (>1s- f02 SGC-,n&G.vT R COU/LT Y. a MhLI Wo1WL&L d.r S$oe7 * Alog AND Detect. K7 /AI.I7. 114E coacraF'E r ,yo want Agr.HANIUtiu-Ye 4-0NSOLi AiEO • List Tests Made• SAMwtF, TeA4PFfaarvgE n-Dine a.✓o csetwoe CS izeivelT14)• Total Inspection Time Each Day: Date 5"9-12 H ours hly. List Items Requiring Correction, include uncorrected items previously listed Comments - To the best of my knowledge, the work inspected was in accordance with the Building Department approved design drawings, specifications and applicable workmanship provisions of the U.B.C. except as noted above. Signed - Print Full Name: 3AGIg TV Ovzo-eco 226 S Date 'q` 12 Registration No N6055H FORM S I-02, 90