HomeMy WebLinkAbout2394 WESTMINSTER AVE - Building Permits 1 • T r i
•
4`, 'F 9 CITY OF COSTA MESA
BUILDING DIVISION
F • r''z ,i DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
PERMIT
BOO-01929
q.,
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.usNG PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDIJob Address: 2394 WESTMINSTER AV Status: ISSUED
Suite: Applied: 11/29/2000
Vicinity: HOUSE&ATTACHED GARAGE Issued: 11/29/2000
Parcel Number: 11913406 Zoning:
Applicant: SALVINO, CARRIE ISSUED BY:
Address: 2394 WESTMINSTER AVE
Phone: (949)515-7806
COSTA MESA,CA Zip: 92627
Owner SALVINO, TIMOTHY & CARRIE ��'
Address 2394 WESTMINSTER AVE A
Phone: (949)515-7806 �4,•(`I 11
COSTA MESA,CA Zip: 92627air ,c '
Contractor: OWNER-BUILDER -
Address:
Phone:
Zip: License: 0
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
REROOF EXISTING SINGLE FAMILY RESIDENCE&ATTACHED GARAGE.TEAR OFF EXISTING ROCK ROOFING&
RESHEATH WITH 1/2"CDX PLYWOOD. INSTALL 1 LAYER OF 30#FELT UNDERLAYMENT&REROOF WITH 30 YEAR
COMPOSITION SHINGLES.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $3,000.00
Permit: $83.25 Claim Valuation: $3,000.00
SMIP Res: $0.50
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00
Total: $83.75
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
NOTES:
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: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work Is suspended or abandoned
for a period of 180 days.
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.
FOR INSPECTIONS CALL: (714)754-5626
2446<e(6/00)
DkCLARATIONS
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
O I have and will maintain a certificate of consent to self-Insure for workers'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 section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workers'compensation Insurance carder and policy number are:
Carrier: Policy Number:
(This section need not be completed if the permit is valued at one hundred dollars($100)or less.)
❑ I certify that in the performance 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 if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions.
Applicant Signature: Date:
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 37060F THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm 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.Lic.q Class#
Contractor's Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Cede).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or 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
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of DNision 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
sub'ects the applicant to a civil penalty of not more than five hundred dollars($500).):
Lasowner of the property,or my employees with wages as their sole compensation.WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such 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 he or she did not build or improve for purpose of sale.).
O 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 property who builds or Improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
0 t.am.e/�p�m��pt u�nd��er�s�ec. Business and Professions Code for this reason: --
Signature:-t -4J• C (pate:__L3tt9/O.)
Owner ID verified by drivers license. 0 Yes 0 No Drivels Ucersse.Nor' ( Expires: 4����
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a 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 or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No
(Section 25505 of the Celifomia Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire 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 500 pounds,ore volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely 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 et standard temperature end pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? -
❑yes ❑No
(Section 25534 of the California Health and Safety Code provides that the 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.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apPemit for such construction or modification
from the South Coast Air Duality Management District or from any other air pollution control district or agency? U Yes LJ No
(Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No
(If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Cale).
7 a permit from v the South—Coast res Duality Management Californiaeal or dhSr airpollution controldistrict or agency is required for the work wMch i5 the subject of this
application,have all of the disclosures prescribed by Calitoia Health and Safety Code Section 42303 been made? ❑Ves 0 No
8 (If'yes',attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penally of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penally of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-dew/Bed property for ins tion urposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
f Joruz_ _ tiI?r'1
tSignature Of Legal Owner(s)_ i ( Date ~7
And/Or Authorized Applicant Date
CODE t IIISPECTION TYPE DATE JNTNIALS CODES INSPECTION TYPE DAIS IITTTIDLm
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/Occupency
•
CITY OF COSTA MESA -
40I BUILDING DIVISION
>y�,,, ' DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
1. 1 it,..!.._,.. 1.
J PERMIT E00-01135
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
ELECTRICAL PERMIT
Job Address: 2394 WESTMINSTER AV Status: ISSUED
Suite No Applied: 11/29/2000
Vicinity: REAR YARD Issued: 11/29/2000
Parcel Nunmber: 11913406
Applicant: SALVINO, CARRIE
ISSUED BY:
Address: 2394 WESTMINSTER AVE
Phone: (949)515-7806
COSTA MESA,CA Zip: 92627
Owner: SALVINO, TIMOTHY & CARRIE
Address 2394 WESTMINSTER AVE 0t
Phone: (949)515-7806 421
Wit
COSTA MESA,CA Zip: 92627 S � (I-'iii ��I tp •
itt
Contractor: OWNER-BUILDER 9�
Address:
Phone:
Zip:
License: 0
SCOPE OF PERMIT
UPGRADE ELECTRICAL SERVICE TO 200 AMPS.
FEE SUMMARY
Quantity Quantity
ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0
Temp service test $0.00 Busway/100 ft $0.00 0
Res. a/c package $0.00 Standing Section $0.00 0
New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0
New Res(3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0
Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0
Lighting Fixts $0.00 0 up to 50 kva/kw $0.00 0
Recept Outlets $0.00 0 up to 100 kva/kw $0.00 0
Switches $0.00 0 over 100 kva/kw $0.00 0
Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0
Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0
Service to 200a $30.50 1 Misc.Conduit $0.00 0
Service to 1000a $0.00 0 Misc.Conductor $0.00 0
Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0
Motors to 1 hp $0.00 0 Circus(mech ride or lights) $0.00 0
Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0
Motors to 50hp $0.00 0 Fireworks Stand $0.00 0
Motors to 100hp $0.00 0 Other Electrical Fee $0.00
Motors over 100hp $0.00 0
Communication drops $0.00 0 Investigation Fee $0.00
Sub panel to 200a $0.00 0 Plan Check Fee $0.00
Pole Light Pkg $0.00 0 Reinspection Fee $0.00
Sign Circuits $0.00 0
Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $54.00
Intermed Pole $0.00 0
COMMENTS/SPECIAL CONDITIONS
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: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work Is suspended or abandoned
fora period of 180 days.
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.
FOR INSPECTIONS CALL: (714)754-5626
2446.46(6/00)
DECLARATIONS `,
WORKERS'COMPENSATION DECLARATION:
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,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 section 3700 of the Labor Code,for the performance of the work for which this permit is Issued.
My workers'compensation Insurance carrier and policy number are:
Career: Policy Number:
(This section need not be completed If the permit is valued at one hundred dollars($100)or less.)
❑ I certify that in the performance 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,end agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions.
Applicant Signature: Date:
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED
THOUSAND DOLIARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Uo.ft Class$
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code),
Lenders Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or 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
to file a signed statement,that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Profession's Code)or that he or she is exempt therefrom 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).):
8' i
,_.I,as.owner of the properly;Or.my',employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not Intended or offered for sale(Sec.
V 7044,-Business and Professions CodeilThe Contractors License Law does not apply to an owner of property who builds or Improves thereon,and who does such work
himself or herself or through his of herxown employees,provided that such 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 he or she did not build or improve for purpose of sale.).
❑ 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 property who builds or Improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
IO—Lame mpt under sec. Business and Professions Code for this reason:
Signature: bate: .� I L I L')I o
Owner ID verified by driver's license. ❑Yes 0 No DriversLicense•NoT (Expires:-41t7*)03
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a 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 or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title B,California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire 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 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely 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 temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? .
❑Yes ❑No
(Section 25534 of the California Health and Safety Cade provides that the 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.
4 If an RMPP Is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application aggermit for such construction or modification
from the South Coast Air Quality Management District or Irom any other air pollution control district or agency? D Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No
(If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No
B (If"yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
f
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-dyepribed prop rty pest n purposes.I agree not to occupy or allow occupancy of any building authorized by this permit ntil final inspection.
l/JI [I 1#7 ‘,/
Signature 01 Legal Owner(s) i-Date—- '
And/Or Authorized Applicant Date
CODE 6 INSPECTION TYPE PATE IIRITIAL$ CODE( INSPECTION TYPE PATE IKEMAL$
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
F CITY OF COSTA MESA
4 BUILDING DIVISION
g DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
I. 1 '''+`� r
� PERMIT
%/rows°le
M00-00518
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
MECHANICAL PERMIT
Job Address: 2394 WESTMINSTER AV Status: ISSUED
Suite No Applied: 11/29/2000
Issued: 11/29/2000
Vicinity: CLOSET
Parcel Number: 11913406
ISSUED BY:
Applicant: SALVINO, CARRIE
Address: 2394 WESTMINSTER AVE
Phone: (949)515-7806
COSTA MESA,CA Zip: 92627
Owner: SALVINO, TIMOTHY&CARRIE
Address: 2394 WESTMINSTER AVE
Phone: (949)515-7806
COSTA MESA,CA Zip: 92627
Contractor: OWNER-BUILDER
Address:
Phone:
Zip:
License: 0
Arch/Eng:
Address:
Phone:
Zip:
License:
SCOPE OF PERMIT
CHANGEOUT EXISTING FAU.
•
FEE SUMMARY
Quantity Quantity
ISSUE FEE $23.50 Repair/Alt Absorbtion Unit $0.00 0
Inst FAU<100 k BTU $14.80 1 Repair/Alt Refrigeration Unit $0.00 0
Inst FAU>100 k BTU $0.00 0 Ventillation System $0.00 0
Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0
Inst/Rep.Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0
Refrig Sys<100 k BTU $0.00 0 Domestic Incinerator $0.00 0
Refrig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems
Gas Piping $0.00 0 Up to 3 hp/100 k BTU $0.00 0
Factory Fireplace $0.00 0 3 To 15 hp/500 k BTU $0.00 0
Hood w/Mech Exhaust $0.00 0 15 To 30 hp/1,000 k BTU $0.00 0
VAV Box $0.00 0 30 To 50 hp/1,750 k BTU $0.00 0
Vent Fan/Single Duct $0.00 0 Over 50 hp/Over 1,750 BTU $0.00 0
Appliance $0.00 0 Boilers
Fire Dampers $0.00 0 Up to 3 hp $0.00 0
Smoke Dampers $0.00 0 3 To 15 hp $0.00 0
Inst or Relocate Appl Vent $0.00 0 15 to 30 hp $0.00 0
Air Handlers< 10000cfm $0.00 0 30 to 50 hp $0.00 0
Air Handlers> 10000cfm $0.00 0 Over 50 hp $0.00 0
Floor Furnace $0.00 0 Other Mechanical Fee
Floor or Suspend Heater $0.00 0 Investigation Fee $0.00
Plan Check Fee $0.00
Reinspection Fee $0.00
TOTAL CALCULATED FEES $38.30
COMMENTS/SPECIAL CONDITIONS
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: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
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.
FOR INSPECTIONS CALL: (714)754-5626
2446-46(6/00) .��
DECLARATIONS
WORKERS'COMPENSATION DECLARATION:
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,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
O I have 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 Insurance carrier and policy number are:
Carrier: Policy Number:
(This section need not be completed if the permit is valued et one hundred dollars($100)or less.)
❑ I certify that in the performance 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 If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions.
Applicant Signature: Date:
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED
THOUSAND DOLLARS(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm 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.Lic.# Class P
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or 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
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant fora permit
subjects the applicant to a civil penalty of not more than five hundred dollars(5500).):
{ -L� I,asas owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such 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 he or she did not build or improve for purpose of sale.).
O 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 property who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am e mp under se � Business and Professions Code for this reason:
Signature:- • LA.t'.l-E4JLMt.1AAT
9Expires: 41PI2/3IQ-a
Verification of Ownership by(type of document,i.e.-property tax bill or deed):----f
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a 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 or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire 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 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely 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 temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the 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.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of thisa�ppplication appermit for such construction or modification
from the South Coast Air(Duality Management District or from any other air pollution control district or agency? LJ Yes U No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No
(If yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Duality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No
8 (If yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given Is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-describ roperty for inspec ion p oses.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Al I 29
Signature Of Legal Owner(s) _ r Date_!,.
And/Or Authorized Applicant Date
CODE 0 INSPECTION TYPE DATE IHTRIALS CODE INSPECTION TYPE
1616 Fixed System Final Fire Prevention 206 Final Mechanical Lamt-o l
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
OWNER MATRANGA, (}F()Rf,F. P. DATE 7_7G_C6 .
JOB ADDRESS 239h Westminster Ave. BUILDING PERMIT NO. 111309
GENERAL CONTRACTOR Dike & Colegrove VALUE $ 8.858.00
L' 114 BLOCK TRACT 2959 Single res. & gar.
•
GROUP I & J TYPE V ZONE 9) FIRE DISTRICT 3333
PERM ITS ISSUED
INSPECTIONS }1/ 'vL/TEL SUBCONTRACTOR
DATE NUMBER
Footing Trench
��`J =L
Foundation Forms and Grade to Garage j—�J
Rough Framing , �/S/ %/,7/
.7+7--r* :A- �Il
Plumbing,Rough to Slab_,` _ , ,7 ,�1 illi 2 p ea, ,,,k, 0-v,, 7-/A- c .5-9 op --
Plumbing, Rough Complete
if 6 3
Temporary Pole //,%/1 q-/• ci A tLi^/ - C_3_1956 r2 7(?' —
Wiring, Rough ` .,r Q'A d.-, '�/tfAr nt-.,-• R - '2,0 - 57- 6 C ,)'�
Heating,Rough ,i 0 S.• ..e.,_& -C�.1,/.��Cif-E 9-a2 /- .c Co -gm
Heating, Final el? _/
Sewer,-Ho a Sewer,St. Odd. %7- 7 - J�/,/...tfi,{-, e,_ 77_ (2 6- G , O —
Septic Tank or,Cesspoo / ` / O // 0 h- ,,2 7_ - - C /s O
Lalling, InArrn41011 7i-7
P ring i /J/V/ l
Plumbing,Final,Fixtures Complete �Jq eb/(/
Plumbing, Final Gas Test / •.r � 'js�(„ (L Lett ,->4‘-J //-d- 1 4, r `f-'-'1,
Wiring,Final n1,/A �7 �t�f- ,t �� ,, -r2- n. - ,tee-
Occupancy .P 7
FORM 210 3M 10-05 •
ista Mesa Building Department APPLICATION FOR PERMIT
P. O. 3333 BUILDING I
COSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
Buildin Receipt No. Pe mit• No.3
Address 2394 Westminster Ave 43 Je
Costa Mesa, California
ce✓
Received by Date Recry
'd. Date Issued
Nearest ! / �7-- ‘-(6 /��� - _G
Cross St. Wilson Building
Owner George F. Matranga Address
Mail 419 E 17th St Costa Mesa, California
Address Nearest
Costa Mesa Tel. Li 8-1159 cross St.
City No. Zone a l No.of I Types / Gro
Architect or Lic T Plans
(/
Engineer Carlson & Middlebl}JQk Approved
Address Garden Grove by Date
ty ems_ CORRECTIONS
ci
,: •tractor Dike & Colegrove NO.1Q
Address 149 E 17th St 7 •
Le I Lot
Description I No. 14 I Block I Tract2959 - _ ,
(Attach Metes and Bounds)
No.of Bldgs. - . �--
Size of Lot 72 x 91 I Now on Lot none
0
Use ofNo.of 1 No.of i 1- - .`.r'., 73
Existing Bldg. none I Families I Rooms ST �-
Setback Line from Rear Yard 46t �`)i-. " 2
Center of Street 501 Side Yard 51 -. i\ y _
DESCRIPTION OF WORK T cc, P,nt.--. -- r
New I X I Alteration I I Addition I r.1, ! r
WI
Repair I _ I Moving I I Demolish l
Building No.of
size 998 sq ft Rooms 5T Stories 1
erior Wall Roof —
ering Stucco I Covering Come APPROVALS
Use of New Single familyand gar Foundation Location Inspector Date
Building g res g Forms,Materials,
Under-Pinning
Plan X63B Frame: Fire Stops, .
Bracing,Bolts
I hereby acknowledge that I have read this Application
and state that the above is correct and agree to comply Lath.Int.
with all City Ordinances and State Laws regulating
building construction. Lath. Ext.
Signature of
Permittee Dae
,(&I Colegrove Plaster, Int.
natu-
Authorized Agt. f:, C. C� Plaster,Ext.
Valuation Permit Fee $ a 2 ' Masonry Reinforced
��Vy Plan Check $ /1 — Bond Beam
$ gYSg Total tiV Fee $ FINAL
FORM 204 10.55 D.P. &5.
c u
. r
a
;L ;G�y��cosrn• ��i
33.f
n�sr.'- '•'
r
Street - .. ..
PLOT PLAN
Show location and distances from ,.
property line and between buildings.
r ,
r•
.. . ,
OWNER . SHOOP, L. E. DATE 7-13-72
JOB ADDRESS 2394 Westminster Avenue BUILDING PERMIT NO. 34964
G RAL CONTRACTOR Airflo DESCRIPTION of WORK Patio Cover
4 L
AF .,o. 119-134-06 LOT TRACT FIRE ZONE VALUE $ 370.00
INSPECTIONS Signature Date GROUP ,T TYPE TV ZONE R—I
GAS SUBCONTRACTOR PERMITS ISSUED
Date Number Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE Q HOUSE CON. 0
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND 0 POWER ❑
ROUGH WIRING Heating and Vent.
TRENCHES ❑ FORMS ❑ STEEL REINF. ❑
FLOOR SYSTEM
BOND BEAM [-I STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
Lr 'IG - IN n OUT n
PL .R, BROWN COAT
STRUCTURAL, FINAL Electric
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST n
ELECTRIC, FINAL
_.._ _..._ .-0 d "") 9n T7.
Phi.�,n.1164 5.03
34964LIIIP
1 "' �A *
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant Applicant to Fill in Completely_2et ,(j�/JE�9 l�/� /F�f q�/ S/}J���
e� 3 -1 7 W EST+ //,/nI cte i- RECE/-J/� D /"' iVED D/ IS/✓ 7
BUILDING
ADDRESS
L L . E E . S hoc 11q- 13y -06 PERMIT
OWNER A.P.NO. V//
MAIL BUILDING 9 •
p (4.) act ADDRESS Same ADDRESSQ '7 q a t - ; nl,-te?-
Z . TEG
RU CITY NOL TRACTJQq# 9 LOT /4 BLOCK
H Z C OS'�LC rnCSGL 5�/ft'-6
Z Q CONSTRUCTION NEW ADD ALTER[REPAIR MOVING DFMOI ISH
O a. co LENDER `p
_i D BRANCH ,t/6 n P h1 I,
-I to L OWNER . c , Shoo n
CO , ADDRESS �/�s V LUE de
ARCHITECT TEL. USE tip, VI �-;e1 .CI t kl $ 37 c5
Gen OR ENGINEER F. ft'na l.1 l-eon NO.CAS--�o.?� �_
p / FIRE
ct
W K a-ariADDRESS J 33O ,t l rn/21 RJUrO 3,� ZONE/ ' TVP GROUP CI -�
W Z CONTRACTOR A; r r/d BYP el/o YLGC DATE /13? v
mZ llV�/N�+/��✓✓✓/ /
Z n
:I co ADDRESS /3042 (7 rcn,chaii) I3vli,c
LU IL /' TEL. ZONE( NO.OF USE OF NEW
,p.(.Ii Q
Zi G
CITY- o rCY e nQ 3IF N0. ai-nit? ' PLANS '1 BUILDING ft('U/J1/U C.
wQ STATE CITY YARDS APPROVED YARDS•APPROVED
to CC LIC. NO. Q 3e)on o LIC.NO. MAIN BUILDING A e...: T: . • �a
DO SIZE iNO.OF BLOCS. (FROM /L STREET) MAyCYQ ,ten,r, .--'llOF LOT NOW ON LOT FRONT FT. FT.
USE OF
i .
EXISTING BLDG. Si ngir "in vv.) 1 I Sul,`i 2 nir B.SIDE T. IS FT,
I- SIZE OF cf NO.OF
Z NEW BLDG. ROOMS STORIES L.SIDE F 10 FT.
UEXTERIOR WALL ROOF ^'�
COVERING COVERING REAR FT. 37 FT. _/
I USE OF BUILDING AND WORK TO BE PERFORMED L \
DISTANCE pET. BET.MAIN R Lri c,cp
/t MAIN BLDGS ACCESS. BL�.:AN _
s ' r VAR.# DATE
O ,r X Q 3 /_ `�O /IA' o—t. I a ecinz fly C.U.P.# APPROVED
I— /e` VS
APPROVED 1I -7X._Z _RY W DATE
O STATE
VI hereby acknowledge that I have read this application and state 03�t
D that the above information is correct and agree to comply with / 3
CC all laws regulating building construction, and I shall not employ
F any person in violation of the workman's compensation laws of TAX
N the State of California. pp b
zI hereby certify that I am properly licensed as a contractor under /n y, 0. FT. o
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
m
am exempt from the provisions of the State of California Business
and Professions Code,Division 3,Chapter 9. VALUATION m
PERMIT FEE $ N
D
Signature Ci:
���� I //y/s o(1 al
Permittee y.O//l y)!11 -it,f /� ��I/� Q $ �Q PLAN CHECKS �— E
rr�/% o
Authorized Age �� u
TOTAL FEE $