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Home My WebLink AboutX2012-0632 - PermitsCity of Newport Beach Building Division PO Box 1768 Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288 Combination Type - BLDG/ ELEC/ PLUM/ MECHI COMB Permit No: X2012-0632 PROJECT NUMBER: 0143-2012 Inspection Requests/Telephone (949)644-3255 Job Address: 1 (38) HOAG DR NB Description:EXTEND ELEVATOR & RESTRIPE PORTION OF UPPER PARKING DECK (BLDG 38) Inspector Area: 7 OF LOT Owner: Address: Phone: Applicant: Address: Phone: HOAG HOSPITAL FD & C 600 SUPERIOR AVE 9300 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: S2 Added /New sq.fi. Bldg: 0 Added (New sq. ft. Garage: 0 No of Stories: 4 No of Units : 0 Bldg Height: Bldg Sprinklers: Flood Zone: Issued Date: 04/17/2012 Y 0 Legal Desc.: IRVINE SUB BLK 2 LOTS 169 & 170 POR OF LOTS & BLK 1 172 POR Contractor: Address: Phone: Con State Lic Lic Expire: Bus Lic: Lic Exp Date: B S D BUILDERS INC • 8826 REHCO ROAD STE A SAN DIEGO CA 92117 . 858-657-9186 ' tI�-- 879719 dell ii 06/3012012 ev-ic1.2i• BT30033668 00 04/30/2913 Worker's Compensation Insurance Carrier: EVEREST NATIONAL Policy No: Expire: Building Setbacks Use Zone: Parking Spaces: 7600002685111 07/01/2012 Rear / Front: / Left: / Right: / 0 me, Architect: Address: Phone: Engineer: Address: Phone: Designer: Address: Phone: INSPECTOR 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 7-4112 Fire Hazard Zone : N • oo(: 000( Construction Valuation: $80,000.00 Building Permit Fee: $931.30. Plan Check Fee: $670.54 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $1.00 Energy Compliance: $0.00 CA Seismic Safety : $0.50 Disabled Access : $80.00 Fee Increase: Fee: $0.00 Additional Fee : $0.00 Hazardous Mat: $0.00 Building Green Fee : $4.00 TOTAL FEE : $2,173.86 Solar System PC : Excise Tax: Grading Permit Fee: Grading PC Fee: WO Insp. Fee : Electrical %: Mechanical %: Plumbing %: $112.13 $80.10 $160.18 Plan Check Fee : $0.00 Planning Department - $0.00 Plan check Fee : Fair Share : SJH Trans : $0.00 In -lieu Housing Fee : $0.00 Public Works Department - $0.00 Park Dedication : $0.00 PNV Plan Check : $0.00 San Dist : $0.00 NMUSD Fee: $0.00 $0.00 $0.00 $0.00 $0.00 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 $134.11 $0.00 $0.00 $0.00 $0.00 $0.00 $2,173.86 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Pu PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. `TI\BfLER - 5 4. 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). 0 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' Stale 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). 0 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 Cody, is, available upon request when this application is submitted or at the following Web site:hltp:/Mvnv.leginfo.ca.gov/calaw.html. Signature of PFoop(ty Owner or Authorized Agent Date LI05,SED CONTRACTOR'S DECLARATION I heretiy affirm under Penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professio C..•e, .nd my license is in full force and Affect. ' License Class License No 0 ,^/7- I 2 Contractor ature • WONKERS''CON'PENSATION DECLARATION v� jWAI RING: 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 J),7.T OF COMPgNSA',IUI., DAMAGES AS PROVIDED FOR IN SECTION 07D0 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. tinraby affirr I ander penalty of perjury one of the following declarations: I }rave 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 F r o anceo.!h° work for which this permit is issued. Policy No. gI IJ'Ave 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 workers' compensatior rRkbrance carrienanb policy number are: Carrier Policy Number Expiration Date Name of Agent DI certify that, in the performance of th that, if I shq d become subject to th Signature plicant ork for e ' . Phone # ch 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 ensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. DECLARATION REGARDING COS TRU 'N LENDING AGENCY I hereby affirm under penally of Fury 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 Lenders Address By my signature below, I certify to each of the following: I am the property owner or authorized to act on the property I have read this application and the information I have prov'. - I agree to comply with all applicable city and county ordi I authorize representatives of thi ity, or county to : "!",• Signature of Property Owner or Autled Agent ott nets behalf. d is corre s sod s la sw relating to building construction. ,�lified property for inspection purposes. �i w' Print Property Owner's or Authorized Age r)k'sd��me, ', /C / 7sfiCeR ACTION DATE , BY' DECLARATION OF COMPLIANCE WITH CODE OF "" I FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403. • I SUBMITTED ASBESTOS NOTIFICATION TO: I EPA �� AQMD 11f: SBESTOS NO71 ATIO IS NOT APPLICABLE TO ��` 'POSED DEMO N. FOR OFFICE USE ONLY" PERMIT EXPIRED PERMITCANCELLED PERMIT EXTENDED PERMIT FINAL I p /IS1 (Z �+.J CERTIFICATE OF OCCUPANCY ISSUED SIGN Project Name & Address Report of Special Inspection I4estRr ANN ✓A5rvtAa no/STITUTE SITE IMQ20VCMPwr e QNE j4OAOn D2.3r NEW021zr QP.A-C-ti-ca. cryhr Permit Number XZo12- 04 3; Inspection Type(s) Inspection Date(s) flew FDacer CONCRETE Periodic Continuous Describe Inspection Made, including Locations: D se-ree ' DF (b) -S d- (3S� t ti Ik43e2E2 to _ELs Fast Etev* o✓I srtAY ,,,,at,L INa-eIcwc Sta-vc.7rize LEVEL se• DD ePLS 1RSIhLLCo v/ •"ct t-IY ISO MAX=rl A per? FS/,S4.DI. List Tests Made- - Total Inspection Time Each Day: Date Hours 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 - Date S-II-It _.Print Full Name: J<+et v j 0 (Itznzap Registration No NR 0554 FORM S l-02, 90 2b Smith Emery Laboratories Field Daily Report 1195 North Tustin Avenue, Anaheim, CA 92807 (714) 238-6133 Project # 50667-1 Job Name: Hoag Hospital Job Address: 1 Hoag Dr. -Heart & Vascular Institute Site Improvements Newport Beach, CA. 92658 Report Date:5/11/2012 Inspector: Jacinto Orozco License: #5276972 Exp Date: January 21, 2012 License Required for Inspection: Reinforced Concrete City: Newport Beach License: NB0554 Client: Hoag Hospital Contact at site: Darrell Swensen Contractor: BSD Permit #: X2012-0633 Jurisdiction: City of Newport Beach TYPE OF WORK: ® Reinforced Concrete 0 Prestressed Concrete 0 Masonry 0 Welding/Bolting ❑ SFRM Description of Work: 1. Per IR # 2, I observed the installation of # 4 & 5 adhered dowels to exiting elevator shaft walls for parking structure level 5 between lines 38-D to 38-E and 38-2 to 38-3. The adhered dowels were installed with an embedment of 8 inches and with HILTI HY150MAX-SD epoxy as per detail F5/54.01. A total of six # 5 were installed at all opening jambs and corners per A9/54.01 and L13/S1.01. A total of thirty five # 4's were installed as per detail F5/54.01. The HILTIHY150MAX-SD epoxy used had the following lot #'s; 111721 IA exp 02/2013 and 111621 L4 exp 02/2013. Note: To the best of my knowledge all work was done per the job specifications and approved documents. DATE TASK # REGULAR O.T. TIME IN TIME OUT 5/11/2012 8 7:00 a.m. 3:30 p.m. Inspector Name: Jacinto Orozco Signature: Koceived: Signature: