HomeMy WebLinkAbout2095 WESTMINSTER AVE - Building Permits CITY OF COSTA MESA
BUILDING DIVISION
>uSAIC•a. reit 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714)754-5626
PERMIT NUMBER: E07-00924
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PERMIT TYPE ELEC STATUS: ISSUED
DATE ISSUED: 11/21/2007
ISSUED BY: BJK
JOB ADDRESS: 2095 WESTMINSTER AV CM' Suite/Unit: '
Vicinity: SE PORTION OF STREET:FOR AT AND T
SCOPE OF WORK: NEW 100A SERVICE METER FOR"AT&T." 1 SVS TO 200A
NO OTHER WORK AUTHORIZED WITH THIS PERMIT: •
•
•
OWNER: AT AND T CALIFORNIA SERVICE METER Address: Unit:
PHONE: - - City/State/Zip:
APPLICANT: WILLIS,JANAE Address: 1921 W 11TH ST Unit:
PHONE: 909-946-0905-, I City/State/zZip: UPLAND,CA •
CONTRACTOR: VCI TELECOM License No. 765716
Address: 1921:W 11TH STUnit: PHONE: 909-946-0905-
City/State: UPLAND,CA ZipCode: 91786 CELL: -
ELECTRICAL PERMIT FEES
Electrical Plan Check Fee: ' $0.00 •
Electrical Permit Fee: $54.00
Reinspection Fee $0.00 • -
TOTAL FEES $54.00
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•
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord. No. 92-28,§1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. •
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
CODE A. INSPECTION TYPE DATE INTITIALS CODE r INSPECTION TYPE DATE INITIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's II.. ,J. ❑Yes 0 No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
I have and will maintain workers'compensation insurance,as required by
tion 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a
number are: person is required to descend,will be made in connection with work authorized
,, by this permit,and that no building structure,scaffolding,falsework,or demolition
Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
(This 5-•.n need not be�comcpt tee erne benne is valued at one hundred dollars($100)or less) 2,Art 2,Sec.341,Title B,Califomia Administrative Code).
/
Policy Number: t-0--/DC I I S >(y c&o
❑ As owner-builder, I will not employ anyone to do work which would
❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of California, and agree that if I should
becon- object to the workers'compensation provisions of Section 3700 of Applicants Signature Date —
lode.I shall forthwith comply with these provisio
____-__ )1 �)� 577 Division of Industrial Safety Permit Number:
V a LJ /
Applicant's Signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑ No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. Department by every business which has at any one time during a reported
year a quantity of hazardous materials equal to or greater than a weight of
LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in full force and effect, !� �7 ! ;"� a registration form for acutely hazardous materials? ❑Yes ❑No
Lic.# �. S 71 V2 Class# ` ! (- l lJ (Section 25533 of the California Health and Safety Code, with some
L--e___. ..-
Contractor's 7 exceptions, requires registration with the Costa Mesa Fire Department by
/L�� �- a each business which at any one time has on hand a quantity of acutely
Contractor's Signature Date hazardous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard .
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? 0 Yes 0 No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: Costa Mesa Fire Department may require the preparation, certification and
filing with the Fire Department of an RMPP by businesses which are required
to register acutely hazardous materials with the Fire Department.
signature Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes ❑No
issuance,also requires the applicant for such permit to file a signed statement
that he or she is licensed pursuant to the provisions of the Contractors (Section 65850.2 of the California Government Code requires that the requested
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be furnished on applications for non-residential building permits).
Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No
applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes",the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No
thereon,and who does such work himself or herself or through his or her own 8 (If"yes", attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are not intended or offered for control officer).
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 CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
❑ 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 Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
0 am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by thispermit until final final inspection. /q
And/or of/ I L �.
Signature • Date Z
305]-46(3/0])
Authorized Applicant D. e
CITY OF COSTA MESA
CALIFORNIA P.O. BOX 317
From the Office of the Planning Department
September 30, 1963
2h. Russell Sutton
2091 Westminster Avenue .
Costa Mesa, California
The City of Costa Mesa wishes to advise you that in revising
street addresses, the numbers listed below were changed:
Old Address New Address
245 B. 21st St. . : 2095 Westminster. Avenue
For your convenience we are listing the agencies below that
we will notify of this change. In addition to those listed, you may
desire to notify your correspondents of the change.
Your cooperation in this matter is appreciated.
Very truly yours,
W. L. Dunn
Director of Planning
rlb By:
cc: Southern Calif. Edison Co. Planning Technician
Southern Co. Gas Co. (t0J
Costa Mesa Co. Water Dist.
Pacific Telephone
U.S. Post Office
County Clerk (=4)
Public Works Dept.
Engineering Dept.
Bldg. Safety YJ
Street
File b°1!
Pacific Telephone Facility Man G 1
etic
(,Afr
to
Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA' PERMIT NO. TRACT NO. LOT NO. BLDG.NO. •
CONSTRUCTION PERMIT .._ 9� 1Z� 0574 5/ 18/84 30.50 TL
Project Address 2091 95 "fes trains Ter Ave TYPE OF CONSTRUCTION UNEW IJ ACD LI ALTERATION ❑ REPAIR
Applicant's Mailing Address 126 Commercial , CM ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# I Zone
Owners Name _E1een Dinwiddie Phone 645-24'23 DESCRIPTION OF WORK
:ZC roofing S Main Building: Accessory Building: Z I
Address 431 Glouchester ; C . M. - - - E 0
TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front N
Arch/Eng. License No. 111TENANT El ID ID B Rear I
--
Address ❑OTHER • A N
Crank Bros . R1'g• 548-5565 PROJECT DESCRIPTION SQ. FT. 2926 OCCUPA C C Right G
Contractor's Name Phone p{l /'T,ytq� R
126 Commercial 1}I• r • Iyl• CONSTRUCTION TYPE res . VALUATION$ / s V7l� s Left
Address(mailing) E
OS ZONE GRADING CU.YDS. ACRESplug. Ref.# Park.Fees $ D
City License No.
LICENSED CONTRACTOR DECLARATIONU
Remarks: Parking Req./Provided I •
I hereby affirm that I am licensed under provisions of Charter 9 (commencing - R
with section 7000) of Division 3 of the Business and Professions Code, and Use of Building: E
my license is in full f fce effect. -
License?Ia — t lye n o 4 6 PLUMBING FEES Planning Notes: M
Date l Signature �[ • - E
' 'NORKERS'COMPENSATION D LARATION Bar Sink Showers N
'>.7 iereby affirm that I have a certificate of consent to self-Insure or a certificateBackflow Preventer Service Sink S
+';;:.i Workers' Compensation Insurance, or a certified copy thereof (Section
3800, Lab. C.) Backflow Irrigation Sewer Cap ELECTRICAL FEES
Policy No. 25274' Company Zenith ,
filCertified copy is hereby furnished. Bathtubs Sewer Connection •
Certl r�ag4YA$4ed with the city Bt Sir jisi ros . Roofing ClarifiersAutomatic Washer Transformer 0 15-50 KW
lam/ 0 50+KW
Date Applicant Solar Collectors
Construction Pole Sub.
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher ' Solar Piping
(This section need not be completed if the-permit is for one hundred($100) or Cooking Unit Meter ❑up to 100 amps
less). DrinkingFountains
I certify that in the performance the work for which this permit is t to I Solar Tank Dishwasher Meter Dover 100 amps
orl ' employompeanyiperson in any manner so'as to become subject to the
Workers' Compensation Laws of California. Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel
Date -Signature
NOTICE:If;iafter making this declaration,you should become subject to the- Floor Sinks -. - • - Urinal Fan "
Workers' Compensation provisions of'the Labor Code, you must forthwith - Motors❑0-1 HP ❑1%-8
comply with such provisions' or this permit shall be deemed revoked. Gas Service • Outlets - Water Closet - F.A.U. •Ina Solar 09-15 HP 016-15+ '
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a'construction lending agency for the performance Interceptors Water Heater Fixtures '
of the work for which this permit' is issued (Section 3097 Civ. C.) Microwave
Lender's Name:•- Kitchen Sink -• Water Service Device Boxes Pole Light '
Lender's Address
OWNER BUILDER DECLARATION Lavatories - .. - Outlets Range
I hereby affirm that I am exempt from the Contractor's License Law for the P—Trap reason (Section 7031.5 Business and Professional Code: Any city or p •• . - •• Switches Sign
County which requires a permit to construct,alter,improve,demolish or repair . -
any structure, prior to its-issuance,-also requires the applicant for such permit Roof Drains - . . - Garbage Disposal Standing Sections
to file a signed statement-that he/she is licensed pursuant to the provisions of .
`-.the Contractor's License Law(Chapter 9(Commencing with.Sectlon 7000)of -•
i• -vision 3 of the Business and. Professions Code) or that he/she is exempt ' Generator 00-5 KW 05-15 KW Trash Compactor
„erefrom and the basis for the alleged exemption. Any violation of.Section
-
`,?.'031.5 by any applicant for a permit subjects the applicant to a civil , Reinspection Fee '
eenalty of not more than five hundred dollars($500). pe ., $25 Issue Fee • $ 3
LJ I, as owner of the property or my employees with wages.as their sole tt - MECHANICAL Reinspection Fee $25 Issue'Fee .$ 3
compensation will do the work, and thesstructure is not intended or offered ' I FEES
for sale (Section 7044, Business and'Professional Code: The Contractor's -
- PUBLIC SERVICES REQUIREMENTS:
License Law does not apply to an owner of a property who builds or improves Boiler ' Hood or Type I 0
thereon, and-who-does,such work himself/herself or through his or her own ByData
employees, provided that such improvements are not Intended or offered for I Canopy ' Type 11 ❑ - ZoningApproved -
Sale. If, however, the building or improvement Is sold within one year of corn- Duct-Under,Ground ; i t • Building Approved By Date
pletion, the owner will nave the burden of proving he/she did not build or im- - SJr� 1p�,
Prove for the purpose of sale). I Duct-Structural ' Refrigeration System ' Application Issued By L '& - Date !O C-1
LJ I, as owner of the property,am exclusively contracting with licensed con- ❑0.100,000 BTU ❑100,000 BTU
tractors to construct the Project (Section 7044,Business and Professions Code: . Duct-Ventilating I SUMMARY OF FEES •
The Contractor's License law does not apply to an owner of property who n7'1
builds or improves thereon, and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ �J•� SMIP. 4 •56 •
tractors) license pursuant to the Contractor's License Law). • PLAN CHECK $ PERMIT
O l'am exempt under Section - B.8 P.C.for this reason Firepl/Fact.BIt. ICBG# I
PLUMBING $ ISSUANCE $ r
Date - _ Owner Heating System&Ducting '• •
PLAN CHECK 25% $ ENERGY P.C. '$
I•hereby certify that I-have read-this application-and state that the-above - 00-100,000'BTU 0100;000 BTL - •. -._ - GRADING '$ •
Information is correct. I agree to comply with all city and county ordinances - ELECTRICAL i $
and state laws relating to build 9 constru tion,and hereby authorize repre-
sentatives of this city to upon t above-mentioned property for $
Inspectlo s lLf�� MECHANICAL $ TOTAL FEE $ a-1, 0
Signatur¢� Date) a T Reinspection FeeDrivers' LI nse or SS# - Pe -I __$25 -Issue Fee $ 3 PLAN CHECK 25% $
CMF 0865-46 rev.12/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor .,
• t ONSTRUCTION AND PLANNING - - - POOL ;PA , -
Date ' ,Inspector J - -;Date Inspector,
APPROVALS Permit# -APPROVALS- :Permit,# .
1. Temporary Electrical Service or Pole •'52. Pool & Equipment Location - - '
2. Soil Pipe-Undrgrnd. 53.: Steel Reinforcement - ' - -
3. Electrical Conduit Utility-Undrgrnd. _ 54: Forms CI +, - • ,. - •.
4. Electrical Conduit-Undrgrnd. _ - _ '55: Electrical Bonding' - . - _ - . - _
5. Steel Reinforcement 56. Rough Plumbing & Pressuie Test . .-
6. Electrical UFER Grnd. 5T. APPROVAL TO-COVER-GUNITE -
7. Footings - - . _ '58. Electrical Conduit-Undrgrnd: ; ' , _ - -
8. Foundation 59. Gas Pipe, O Undrgrnd:,Test " - i
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ) Undrgrnd.- -
10. Structural Floor System 61. APPROVAL TO DECK : ' • , ' - .
11. Property Sewer Line & House Connection , .,62. Backwash & ceptReor-Final
12. Sewer Cap 63. Heater &.Vent-Final __ - - :c
_ _ .. _ • -
13. Roof Drains - 64. Plumbing System - Final -
14. Rough Plumbing - 65. Electrical-Final= - . - '
15. Rough Electrical-Conduit - ._ 66. Solar System-Final ' - .
16. Rough Electric Wiring . I:; 67.: Fencing&Access Approval , - - .
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING ,
.
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMSFINAL : - ' ' `- '
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT-, j. - ' r , . _
20. Rough Factory Fireplace APPROVALS' Permit#
21. Ducts,in Structure- 70. Underground Hydro ', : - . . '
22. Ducts, Ventilating71. Product Piping 0 Gas Oil r
23. Gas Pipe-Rough & Test72. Underground Flush - '
24.'Jioof Framing 73. Undergrnd.Storage Tank 0 Gas ❑Oil r' • ' i
25. of Sheathing ' 74. Overhead Hydro - - '
26. T-Bar Ceiling (Structural) & Monocoat , 75. Dry Chemical �, .i i , , I
P . , ;
27. Frame and Flashing 76. Dry Standpipe _:1 .,
28. ,Lathing & Siding -' ,77. FIXED SYSTEM FINAL . ,
29. Insulation '78. FIRE PREV. FINAL '
' 30. Drywall Nailing !HEALTH DEPT. REQUIREMENT
i
31. Plaster Brown Coat 79., FINAL INSPECTION ' I .
32. Electrical Power Meter-Final ' 80. FOOD CERTIFICATE ISSUED '
33. Final Electric .. •.. . Notes:
34. Final Heating & Air Conditioning i
35. Final Gas Pipe-Test 'i , ., z _ ,
36. Hood or Canopy. - c - - .
37. Final Factory Fireplace _ i - ' - ^
38. Final Plumbing - • r -
39. Water Service-Final I .
• --
40. Gas Service-Final ' , ' ' , r -' ' '
41. Solar Domestic-Final • - � - -� -- - -
42. Backflow Preventer - -_ . . ' . . ,•
•
•
43. Backflow Irrigation - - i I
44. Landscape Irrigation System I ' = ' •
45. Sound Attenuation • ' - . - .
c
46. Handicap Regulations - _ - '
47. FINAL STRUCTURE & BUILDING O,t�fr i _ •
48. Special Requirements Completed . +�r'(((///, I , - , . I i
49. Electric Release to Edison - - - - -i . '
•
50. Gas Release to Southern California Gas Co T / I : •
51. CERTIFICATE OF OCCUPANCY - - - - -- -;
No. -. Date - _ '.- .. - . .