HomeMy WebLinkAboutF2013-0637 - PermitsCity of Newport Beach - Building Division
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
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FIRE Permit : F2013-0637
Project No : 2868-2013
Inspection Requests Phone (949)644-3255
Job Address: 1 HOAG DR NB
Inspector Area: FIRE
OF LOT
Owner: HOAG HOSPITAL FD&C
Address: 1 HOAG DR
NEWPORT BEACH, CA 92663
Phone:
Applicant: BROOKS CARY
Address: 1 HOAG DR
NEWPORT BEACH CA 92663
Phone: 949-254-1933
Code Edit : 2010
Type of Construction:
Occupancy Group:
Added /New sq.ft. Bldg:
Added /New sq. ft. Garage
No of Stories:
No of Units :
Flood Zone:
Bldg Sprinklers:
V-A- SPR
12.1
0
0
4
0
Y
Description: COMM - VOLUNTARY REPLACEMENT OF (E) FIRE SPRINKLER SYSTEM
Legal Description: 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:
SOUTHWEST FIRE PROTECTION
215 E EL SUR STREET
MONROVIA CA 91016
626-359-0034
190173
09/30/2015
BT300001854
12/31/2014
Worker's Compensation Insurance
Carrier: ZURICH AMERICAN INS CO
Policy No: WC437640709
MONROVIA CA 91016
Expire: 01/01/2014
Issued Date: 12/12/2013
Setback- Front:
Rear:
Left:
Right:
Architect:
Address:
Phone:
Engineer:
Address:
Phone:
Designer: KENZ BRIAN
Address: 215 E EL SUR ST
Phone: 626-359-0034
Special Conditions:
INSPECTOR
State Lic:
State Lic:
1 I4- S S'S--75C5
0
Construction Valuation: $162,860.00
Building PC Fee :
Building Overtime PC Fee:
Building Extention Fee :
Building Investigation Fee :
Fire Commercial PC Fee:
Fire Commercial Permit Fee :
Fire Residential Permit Fee :
Fire Residential Alarm Fee :
TOTAL FEE:
$0.00
$0.00
$0.00
$0.00
$374.71
$1,040.85
$0.00
$0.00
$1,443.56
FEES
Fire Residential Alarm PC Fee :
Planning Counter Review :
Planning Zoning PC Fee :
Public Works PC Fee :
Public Works Traffic Plan Check Fee;
Plan Check Fee :
$0.00
$0.00
$0.00
$0.00
$0.00
Records Management:
$28.00
$0.00
$0.00
$374.71 Fee Due at Permit Issuance : $1,068.85
PROCESSED BY:
ZONING APPROVAL:
FIRE APPROVAL :
OTHER DEPARTMENT:
PLAN CHECKED BY::
APPROVAL TO ISSUE:
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 L) all of or L) 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 issold 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 Iicensure 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, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
Signature of Property Owner or Authorized Agent Date
LICENSED CONTRACTOR'S DECLARATION
I hereby 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 Professions Code, and my license is in full force
and effect. �( _
License Class License No ✓ ' L/. /q`� Contracto ature
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have 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
pe ce of thMop efor which this permit is issued. Policy No.
•
• 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' compensation
ce carrie;'anr.+ ISllicy numberare:
Cwrier• Policy Number
• •
Name of Agent •
DIcay that, irr htspt• formance of the work for which 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, If1 should becomesub' _ workers' compenssaaan provisions of Section 3700 of the Labor Code, I shall forthwith comply with those' provisions.
§i tlll2 oflap�(Iwnt .,� �" pile t 2%:2/ t om
DECLARATIr_STL_I R€GARDtNts GGNS-TRQCTION L -DING AGE
.hsreby•affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
renderg Name Lender's Address
Isy trey signature below, I certify to each of the following:
• •ram the pry perry owner or authorized to act on the property owner's behalf.
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and county ordinances and state laws relating to building construction.
I authorize representatives of this city or cou r-the above -id for inspection purposes.
Signature of Property Owner or Authorized Age 's / Print Property Owner's or Authorized Agent's Nine iP+t-\ V-CN.M,
Expiration Date
Phone #
D e (2—A2-JI}
ACTION
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I Tf
BY
DECLARATION OF COMPLIANCE 1401T1 CODE OF
FEDERAL REGULATIONS PART 61 OF TIR_E40 AND
AQAAD:RULE 7402
FOR I1SfONLY
.
PERMIT EXPIRc'D'.
0 I SUDMI11 tD ASBESTOS NOBHCATION TO:
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PERMIT CANCELLED
PElMITE'XTEN.DEf3
ASBESTOS
PROPOSED DEMOLITION TiON IS NOT APPLIGAFI F TO
SIGNATURE:SIGNATURE:OCCUPANCY
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