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HomeMy WebLinkAbout2609 WESTMINSTER PL - Building Permits A 44 51111 MF 9 r • CITY OF COSTA MESA1111 BUILDING DIVISION > DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER j4 J PERMIT - / acaeowmw6. 1/B04-01755 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTAYYYMESA,CA 92626 BUILDING PERMIT Job Address: 2609 WESTMINSTER PL Status: ISSUED Suite: Applied: 10/12/2004 Vicinity: NEW SINGLE FAMILY RESIDENCE Issued: 03/04/2005 Parcel Number: 43920103 Zoning: ` Applicant: BEEK, CHARLES F ISSUED BY: Dl-(.4-0 Address: 2609 WESTMINSTER PL 1 Phone: 949 548-7975 COSTA MESA,CA Zip: 92627 Owner: BEEK, CHARLES F Address 2609 WESTMINSTER PL Phone: COSTA MESA,CA Zip: 92627 Contractor: OWNER-BUILDER Address: Phone: Zip: License: 000000 Arch : Eng: BORUM STRUCTURAL ENGINEERS Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT CONSTRUCT NEW 2,564 SF SFR-1ST FLOOR IS 1,683 SF AND 2ND FLOOR IS 881 SF.ALSO CONSTRUCT 126 SF 2ND STORY DECK&614 SF 1ST FLOOR COVERED PORCHES. EXISTING DETACHED GARAGE TO REMAIN. 3 BEDROOM-4 BATH HOME REF: B04-01756 FOR HOBBY ROOM ADDITION TO EXISTING GARAGE PLANNING: LOT SIZE=8,400 SQ.FT. RESIDENCE=1,684 SQ.FT. • DETACHED GARAGE=366 SQ.FT. DETACHED HOBBY SHOP=579 SQ.FT. PAVING/DRIVEWAY= 1,563 SQ.FT. • • LOT COVERAGE=4,192 SQ.FT.(50%) REAR YARD COVERAGE=450 SQ.FT.(38%;50%ALLOWED) OPEN SPACE=4,208 SQ.FT. (50%) 2ND-1ST FLOOR RATIO=50%(818 SQ.FT./1,625 SOFT.) FEE SUMMARY Plan Check: $1,188.30 Calc Valuation: $248,968.40 Permit: $1,828.15 Claim Valuation: Moo SMIP Res: $24.90 SMIP Corn: $0.00 Other: $0.00 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 1 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) L 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. ❑ 1 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 at one hundred dollars($100)or less.) edify 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 of ' rnia,and agree that If I should become subject to the workers'compensation provisions of Section 700 of the Labor Code,I shall forthwith comply.with.th s ro i ' s. / ASignature: rale:--- / 4 WARNING:FAILURE T SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO cRiwl PE TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS 100,1100),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF 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.# 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 Code). 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 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 fore permit subjec the applicant to a civil penalty of not more than five hundred dollars($500).): (Ta , 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.). • ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044.Business and Professions Code:The contractors •nse 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 pursu.I`tot • C. tractors License Laws.). ❑ I am exempt kJ .er s_1 _ Business and Professions Code for this reason: d (Sr-anature:�r" II S I 1 CERETpires:i- I.5 5 Verification of Ownership by(type of d. ument,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? ❑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 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 El No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U 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? ❑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 ❑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 c ly with all state laws and city or ' ces relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described pro y for i pection purpo es.I agr a to occupy or allow occupancy of any building authorized by this permit until trial i pec' 0'- .,Sgnatlre.O1 Legal'Owher(s). T.m • And/Or Authorized Applicant Date ' CODE I INSPECTIONTYPE ME tNTn'IAI$ CODE r INSPECTION TYPE PATE INrlrAlg 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 1 /4 9/' /n S ArAe,4...o- ` a • _ - - - NEWPORT-MESA UNIFIED SCHOOL DISTRICT N9 5422 CERTIFICATE OF COMPLIANCE OF DEVELOPMENT FEES PURSUANT TO AB 1600 AND AB 181 To: (>( ) City of Costa Mesa District Receipt No. r7�LZ ( ) City of Newport Beach ( ) County of Orange Plan Check No. 1304-0(1SS Applicant: CAI-Al2LeS K Address: 2-&061 V1/41 tr.ISTZEfL FL- �Pr 1-'I tic , GA- 12-f&27 Telephone Number: (14cl) Glete - 1611 Tract/Parcel and Lot Number(s): Q 'ft - 2-D( -03 Location of Project: 20061 V'J 1=_ert-4INS'( _ Ft_ &91 Mesh 0A Z 62l Number of Square Feet of: Residential Space 14t' x $1.84 Total $2-6) .2--- - S o Commercial and Industrial Space x $ .30 Total Commercial/Industrial Project is: (Check One) Warehouse _ Motel _ Preschool R & D _ Bank _ Auto Repair Movie Theater _ Neighborhood Shops _ Hospital Mini-storage Racquet/Health _ Large Office Heavy Industrial _ Hotel _ Office Bldg. Regional Shops _ Medical Office _ Restaurant Light Industrial _ Office Park _ Fast Food This project is exempt because This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code sections 53080 and 65995. The Building Permits for this square footage in this proposed development may now be issued by your jurisdiction. Checks are to be made payable to Newport-Mesa Unified School District. By: (z- HEL,orD 3-4— Ot Authorized Representative The above representation as to square footage is true. Applicant agrees that if it is later determined that such representations are not true,then this certificate shall automatically terminate and the appropriate City/County shall be notified. Date: 3/4/Jc Appheant 9- F;-NAGE--04 -ts : a co35S Sof- 017s6 foy - 31751F BOHVSTRUCTURAL ENGINEERS August 3, 2006 Mr. Chuck Beek Beek Residence 2609 Westminster Place Costa Mesa, CA 92627 Re: Beek Residence Subject: Revise 2x10 rafters to 2x8 rafters Plan Check Number: B04-01755-56, City of Costa mesa Dear Mr. Beek: Upon reviewing the roof framing for this project, we find that it is structurally acceptable to use 2x8 roof rafters in lieu of 2x10 roof rafters throughout. Keep the 24" o.c. spacing, except at the Master Bedroom and Patio. Use at-2x8 at 24" o.c. over the Master Bedroom, and 2x8 at 16"o.c. over the patio. The content of this letter is understood to be an expression of professional opinion by.this engineer, which is based on his best knowledge, information and belief. As such, it consists of neither a guarantee, not a warrantee expressed or implied. Costa Mesa,CA If you have any questions regarding this reply, please do not hesitate to contact our office at (714) 513-7500. Thank you for your cooperation. Modesto,CA Very truly yours, Pleasanton,CA BORM ASSOCIATES, INC. Roseville,CA ristina R. Silva, P.E. Sr. Construction Administration Engineer Las Vegas,NV crs:(/5767 080306 revison to rafters Distribution: (3) Addressee,your pick up Phoenix,AZ (1) File 5767 ?ROPES ���E AGE S/o/o2'�j � O Tucson,Az • 098Yvr\ 8 0630/la Denver,CO ° IL Beijing.PRC CALIF 555 Anton Boulevard Suite 850'Costa Mesa CA 92626'TEL 714.513.7500'FAX 714.513.7555•www.borm.com • `, •4., CITY OF COSTA MESA • 4 BUILDING DIVISION Y•4t •�4 DEVELOPMENT SERVICES DEPARTMENT PERMI NUMBER b. t PERMIT Soir0.0„an. Ire V4-01756 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2609 WESTMINSTER PL Status: ISSUED Suite: Applied: 10/12/2004 Vicinity: ADDITION TO EXISTING WORKSHOP Issued: 03/04/2005 Parcel Number: 43920103 Zoning: Applicant: BEEK, CHARLES F ISSUED BY: Address: 2609 WESTMINSTER PL Phone: 949 548-7975 COSTA MESA,CA Zip: 92627 Owner: BEEK, CHARLES F Address 2609 WESTMINSTER PL Phone: COSTA MESA,CA Zip: 92627 Contractor: OWNER-BUILDER Address: Phone: Zip: License: 000000 Arch : Eng: BORUM STRUCTURAL ENGINEERS Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT CONSTRUCT 581 SF ADDITION TO EXISTING 363 SF DETACHED GARAGE/WORK SHOP BUILDING.ALSO CONSTRUCT 290 SF PATIO COVER.STRUCTURE IS CONSIDERED NON-HABITABLE. REROOF EXISTING GARAGE WITH ASPHALT SHINGLES TO MATCH ADDITION. REF:BO4-01755 FOR CONSTRUCTION OF NEW RESIDENCE PLANNING: LOT SIZE=8,400 SQ.FT. RESIDENCE= 1,684 SQ.FT. DETACHED GARAGE=366 SQ.FT. DETACHED HOBBY SHOP=579 SO.FT. PAVING/DRIVEWAY= 1,563 SQ.FT. LOT COVERAGE=4,192 SQ.FT. (50%) • REAR YARD COVERAGE=450 SQ.FT. (38%;50%ALLOWED) . OPEN SPACE=4,208 SQ.FT.(50%) 2ND-1ST FLOOR RATIO=50%(818 SQ.FT./1,625 SQ.FT.) FEE SUMMARY Plan Check: $208.81 Calc Valuation: $19,293.10 Permit: $321.25 Claim Valuation: $0.00 SMIP Res: $1.93 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 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 2446.6(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: Cartier: Polity Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) t'certify that in t : perfo.••. ce 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 . -of I all .mia,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith complywithi : : .r0 •i• F" _ )).��, ,{ cArrYff TI1.Signaure. A V ('Date; `T WARNING:FAILURE TO & RE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIM P NALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOUARE($1%,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF 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.# 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 Code). Lender's Name: Lenders 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 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 subjects the applicant to a civil penalty of not more than five hundred dollars($500).): I ! as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. Fl 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or Improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). O I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044.Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license�r rsua he Contractors License Laws.). o I am e pt c. -71317--- Business and Professions Code for this reason: �� s' Ileture:y. • LGB ar :'J(4 I Oher'iDVen' •-y driver's license. TT�� �$. 0 No D It vets License No°, ('�.,- Expi_es;-;I�( S/ Verification of Ownership by(type of docui.e.-property tax bill or deed): r / 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 ❑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 ❑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 Califomia 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 ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 No (Section 65850.2 of the Califomia 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? 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: I CERTIFICATE OF -c PLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application end state that the information given is correct. I agree t• . ).ly w yyyyyy,,,all state taws end city ordln ces relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described. ..± to .pection purposes.I agree o occupy or allow occupancy of any building authorized by this permit u iI fin I int pection. I ..f71§{1.—ft.- r-Igpature gal-Owners -- Y_ -345 o" . c a . And/Or Authorized Applicant Date CODE I INSPECTION TYPE PAIL RfinALS CODE I INSPECTION TYPE an INTmALS 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 Signm 222 Final Site )7/n �A pW • 204 Final Demolition 250 Final Building/Occupancy /"r � � !fib n�i/�,a 1 • ^ tU M6 CITY OF COSTA MESA BUILDING DIVISION > i Ar DEVELOPMENT SERVICES DEPARTMENT PER NUMBER t 1 w�ws� r 4 PERMIT Roaarco`��• B05-00353 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2609 WESTMINSTER PL Status: ISSUED Suite: Applied: 03/04/2005 Vicinity: EXISTING SINGLE FAMILY RESIDENCE Issued: 03/04/2005 Parcel Number: 43920103 Zoning: Applicant: BEEK, CHARLES F ISSUED BY: Address: 2609 WESTMINSTER PL Phone: 949-548-7975 COSTA MESA,CA Zip: 92627 Owner: BEEK, CHARLES F Address 2609 WESTMINSTER PL Phone: 949-548-7975 COSTA MESA,CA Zip: 92627 Contractor: OWNER-BUILDER Address: Phone: Zip: License: 000000 . Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT DEMOLISH EXISTING 1144 SF SINGLE FAMILY RESIDENCE. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $4,000.00 Permit: $97.25 Claim Valuation: $4,000.00 SMIP Res: $0.00 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $97.25 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 Existinq: 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 • 2446-46(800) i t 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 at one hundred dollars($100)or less.) x�9 r 1' I certify that in t erform:.:-of the work for which this permit is issued, shall not employ any person in any manner so as to become subject to the workers' compensation •f Ca ji '.,and agree that If I should become subject to the workers'compensation provisions of Se ion 3779 0 of the Labor Code,I shall forthwith ,�comph/:with th:'p ovisi•is. , ion/ -ilp'plica Signature: + - l - Dale:— • /' WARNING:FAILURE T•SE ••E WO' RS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO IMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE( 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. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter g(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.If Class If 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 Code). 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 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 for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): as 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.). • ❑ I,a owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions C.. The c•y ract• ',rise Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) tic. -(purs t to he•.ntractors License Laws.). ❑ I a : .mpt der ec. _ Business and Professions Code for this reason: QSap en�\ ' �1 1��: Exoue@i 1" -I-FJ'//5-- Verification of Ownership by(type of docum.nt,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: O 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). O 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 ❑No (Section 25505 of the Califomia 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 0 No (Section 25533 of the Califomia 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 ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit 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 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 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? 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 MP ANCE 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 t o ith all state laws and ciTM inances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described o •,. inspection purpo es. ag a not to oc upy or allow occupancy of any building authorized by this permit /u7til fi al inspection. Sign r&1'Legal Owner(s) 7/ L / _t14 And/Or Authorized Applicant Date CODE• INSPECTION TYPE QM INTRIAL$ COGEN INSPECTION TYPE ME IBTRIALS 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 p/k. 4 9V/ 250 Final Building/Occupancy ccr0--vn + it 43 SOUTh .:OAST AIR QUALITY MANAGEMENT (STRICT NOTIFICATION OF DEMOLITION OR ASBESTOS REMOVAL 21865 E.Copley Drive,Diamond Bar,CA 91765-4182 (909)396-2000 "'AQMD; MAIL FORM AND FEE TO SCAQMD,ASBESTOS NOTIFICATIONS,FILE#55641,LOS ANGELES CA 90074-5641 `AQMD USE ONLY: SCREEN BY RECEIVED POSTMARK( ENTERED BY _ NOTIFICATION# COMPLETED BY COMPANY PHONE DATE 3/'7/� CHECK# FEE$ 15 PROJECT# 'f?jL- -LNC_ ReS(h C- NOTIFICATION TYPE OR'GIi AL REVISION DATES PENSION OTHER(highlight) CANCELLATION PROJECT TYPEEMS; ORDERED DEMOLITION RENOVATION(removal) EMERGENCY REMOVAL PLANNED RENO(annual) SITE INFORMATION SITE NAME SITE ADDRESS 2-c �� L�.L 1�-i---) ) 13 -t-- CROSS STREET CITYCrc {lc2a1 STATE v� ) ZIP -L I COUNTY c..2-c-1 i- DESCRIBE WORK LOCATION .b ti--y‘C, L 1-r L N BUILDING SIZE(SQ FT) ( r 44 NUMBER OF FLOORS f BUILDING AGE(YEARS)5-2 NUMBER OF DWELLING UNITS BLDG PRIORI PRESENT USE COMMERCIAL HOSPITAL INDUSTRIAL Other OFFICE PUBLIC BLDG. HOUSE SCHOOL SHIP UNMCOLLEGE SITE OWNER a+kis E' L L`-� �Z--_ ADDRESS z_ �� =�,7� I lJS .jrc CITY 6._t r.�.� L 7jTE� Gia Elf' �.� �4Z-?L,ONIAGf PHONE.iik9l�— &r --79.7;v REQUIRED BUILDING ASBESTOS YES 411110 ASBESTOS YES(0) ASBESTOS YES BUILDING TO BE CtS NO INFORMATION PRESENT? SURVEY? REMOVED? /VA DEMOLISHED? PROJECT DATES START ..3/•7 I . END WORK SHIFT(am/pm) ASBESTOS AMOUNT TO BE FRIABLE CLASS I CLASS II TOTAL REMOVED(add row) REMOVED(in square feet) ASBESTOS REMOVED FROM SURFACES PIPES COMPONENTS DESCRIBE TYPE&AMOUNT OF ACOUSTIC CEILING LINOLEUM INSULATION FIRE PROOFING DUCTING STUCCO MASTIC ASBESTOS(in square feet) FLOOR TILES(VAT) DRY WALL PLASTER TRANSITE ROOFING OTHER (describe) CONTRACTOR INFORMATION CSLB LICENSE# OSHA REG# AQMD ID# NAME HYLA 1.M�_-72 ADDRESS CITY STATE ZIP SITE SUPVR PHONE WASTE TRANSPORTER#1 LANDFILL ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP Asbestos Demolition/Renovation Notification Form REV 990601 Page 1 of 2 Forms,instructions,and the Rule 1403 can be obained from AQMD web site httpJ/www.agmd.gov Ak • SCAQMD NOTIFICATION OF DEMOLITION OR ASBESTOS REMOVAL MAIL ORIGINAL TO SCAQMD,ASBESTOS NOTIFICATIONS,FILE#55641,LOS ANGELES CA 90074-5641 WASTE TRANSPORTER#2 WASTE STORAGE SITE ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP CONTROLS: DESCRIBE WORK PRACTICES AND CONTROLS TO BE USED AT THE RENOVATION AND DEMOLITION SITE. Procedure#1,2,3,4,5 or Other. For asbestos removals circle the combination of Rule 1403 procedures used. Procedure 4 and 5 submit plans for AQMD prior approval. ASBESTOS DETECTION PROCEDURE: CIRCLE THE PROCEDURES AND ANALYTICAL METHODS USED TO DETERMINE ASBESTOS IN THE BUILDING: Bulk Sampling,Inspection,Survey,PLM,PCM,TEM,Assumed as Asbestos,Describe Other. FOR DEMOLITIONS GIVE THE COMPANY NAME AND DATES OF THE ASBESTOS REMOVAL: FOR ORDERED DEMOLITION SEND A COPY OF THE ORDER AND GIVE THE AGENCY NAME&PHONE# AUTHORIZING PERSON: TITLE DATE OF ORDER: I DATE ORDERED TO BEGIN: FOR EMERGENCY ASBESTOS REMOVAL GIVE THE NAME AND PHONE NUMBER OF THE PERSON DECLARING/AUTHORIZING THE EMERGENCY, DATE AND HOUR OF EMERGENCY AND DESCRIBE THE SUDDEN,UNEXPECTED EVENT: EYotAIN HOW THE EVENT WOULD CAUSE UNSAFE CONDITIONS,EQUIPMENT DAMAGE OR UNREASONABLE FINANCIAL BURDEN: CONTINGENCY PLAN: DESCRIBE ACTIONS AND PROCEDURES TO BE FOLLOWED IF UNEXPECTED ASBESTOS IS FOUND DURING DEMOLITION OR NONFRIABLE ASBESTOS MATERIAL BECOME CRUMBLED,PULVERIZED,OR REDUCED TO POWDER. TRAINING CERTIFICATION: I Certify that an individual trained in the provisions of regulation AOMD Rule 1403 and NESHAP will be on site during the removal and evidence that the required training has been accomplished by this person will be available for inspection during normal business hours. Company Name Print name of owner/operator Signature of owner/operator Tittle of owner/operator Date INFORMATION CERTIFICATION: I certify that the above information is correct and I have enclosed any required attachment& Company Name Print name of owner/operator Signature of owner/operator Tittle of owner/operator Date Notifications are not accepted without the required asbestos fee(AQMD Rule 301). Removals of less than 100 square feet are exempt from notification and fees. Please make checks payable to'SCAQMD'. Fees are per notification,not refundable,and vary according to the asbestos amount to be removed. Fees are as follows: COMMERCIAL DEMOLITION/RENOVATION RESIDENTIAL REMOVALS $ 26.20 FROM 100 TO 1,000 SQUARE FEET $-16r.20- 3Q,e)0 REVISION OF NOTIFICATION $ 10.60 FROM 1,001 TO 5,000 SQUARE FEET sato. CANCELLATION OF NOTIFICATION $ 0.0 FROM 5,001 TO 10,000 SQUARE FEET $167.10 PROCEDURE 4 OR 5 PLANS $294.00 MORE THAN 10,000 SQUARE FEET $294.00 RETURNED CHECK CHARGE $ 26.00 DEMOLITION OF LESS THAN 100 SQ FT $26.20 SPECIAL HANDLING FEE $ 25.00 ATTENTION: Keep a copy of your notification. State law requires that you provide a copy of the demolition notification to Building and Safety before issuance of a demoliton permit. For questions call 909-396-2335. For your convenience please mail the form and fee and do not hand carry to AQMD. MAIL FORM AND FEE TO: SCAQMD,ASBESTOS NOTIFICATIONS,FILE it 55641, LOS ANGELES CA 90074-5641 TELEPHONE: (909)396-2336 FAX: (909)396-3342 Asbestos Dernolition/Renovation Notification Form REV 990601 Page 2 of 2 Forms,instructions,and the Ruts 1403 can be obtained from AQMD web site. http://www.aqmd.gov W.agf11d.gov 4`4 PF 9 CITY OF COSTA MESA BUILDING DIVISION F SII' DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER Ta. Ira PERMIT IY E05-00181 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT t Job Address: 2609 WESTMINSTER PL Status: ISSUED Suite No Applied: 03/04/2005 Vicinity: GARAGE/WORKSHOP Issued: 03/04/2005 Parcel Nunmber: 43920103 A-13 Applicant: BEEK, CHARLES F ISSUED BY: I Address: 2609 WESTMINSTER PL Phone: 949-548-7975 COSTA MESA,CA Zip 92627 Owner: BEEK, CHARLES F Address 2609 WESTMINSTER PL Phone: 949-548-7975 COSTA MESA,CA Zip: 92627 Contractor: OWNER-BUILDER Address: Phone: Zip: License:000000 SCOPE OF PERMIT ELECTRICAL PERMIT FOR ADDITION TO EXISTING GARAGE/WORKSHOP.INSTALL 6 LIGHT FIXTURES, 14 RECEPTACLE OUTLETS,5 SWITCHES,8 ELECTRICAL SERVICE TO 200 AMP. REF: B04-01756 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 $6.60 6 up to 50 kva/kw $0.00 0 Recept Outlets $15.40 14 up to 100 kva/kw $0.00 0 Switches $5.50 5 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 1hp $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 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 at one hundred dollars($100)or less.) 0'411i,.:rtiy 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 s o ornia,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 t pr Ap� tnaignatur �k It WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO Cr MINA PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LA:•R 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.# 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 Code). 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 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 for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): "Costner 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. 044,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 p rs ant • : Contractors License Laws.). ❑ I am exen•t und:( 5: . _ Business and Professions Code for this reason: ' Signatuia�r' dir -3-r Date`:r:.. 'AP Owner ID verified by driver's license. ocu Yes 0 No Drive%s:Cice se_Nor- • SKI•P'C,Ma •Verification of Ownership by(type of dent,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,Gm 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 ❑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 ❑No (Section 25533 of the Califomla 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 this application appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? II 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 Califomia 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 ❑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 • 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 agr:: co •1with all state laws and cit ' ances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-descri.:.,Irop: for inspection purposes.I gr not to Occup or allow occupancy of any building authorized by this permit until fin4nalnspection. C '. ':,OLLegal Owher(s) • 3�D3j '--,.,.`. And/Or Authorized Applicant Date CODE# INSPECTION TYPE PATE INTRULS CODE# INSPECTION TYPE PATE INTRUL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing ,N 200 Final Re-Roof 210 Final Electrical /t-e- 7 c(37 201 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 0111 Itte CITY OF COSTA MESA 49 BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT P RMIT NUMBER k 1pj PERMIT ` ,q , M05-00107 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 2609 WESTMINSTER PL Status: ISSUED Suite No Applied: 03/04/2005 Issued: 03/04/2005 Vicinity: NEW SFR ��' ISSUED BY: Jt-�( Alai Parcel Number: 43920103 Applicant: BEEK, CHARLES F Address: 2609 WESTMINSTER PL Phone: 949-548-7975 COSTA MESA,CA Zip: 92627 Owner BEEK, CHARLES F Address: 2609 WESTMINSTER PL Phone: 949-548-7975 COSTA MESA,CA Zip: 92627 Contractor: OWNER-BUILDER Address: Phone: Zip: License:000000 SCOPE OF PERMIT MECHANICAL PERMIT FOR NEW SINGLE FAMILY RESIDENCE.INSTALL 1-85K BTU FAU. REF:B04-01755 • 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 50.00 0 Other Mechanical Fee Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 • 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: 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. 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 at one hundred dollars($100)or less.) IScertify 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' C "°�—c h pensation I of'. omia,and agree that if I should become subject to the workers'compensation provisions of Se tion 3700 of the Labor Code,I shall forthwith ip comply with'th •ro '5'.. . pp calgnejure: IN - - - D`etel-=-�` I ft,‘,,.--- WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P NALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND COLLARE($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. 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# 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 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 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 subjects the applicant to a civil penalty of not more than five hundred dollars($500).): I, itowner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. —7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work I himself or herself or through his or her own employees,provided that such Improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ' ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors license Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) licen pursu to the Contractors License Laws.). i▪ I am m er sec. Business and Professions Code for this reason: /� I��- Slgne""tore: -"')" " �, Expirs$;;.i / )�/ Verification of Ownership by(type of tlocumenl,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,talsework,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 Cale), ❑ 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 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 greeter than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at 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 agermll 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 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 0 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 ❑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 C• LI' E 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 ' •• wi all state laws and city ordi an s relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described p ••_ 'tor ppection purposes.logreT atopy o allow occupancy of any building authorized by this permit until lintel ins ecti/own. Signature"01 eDal.Owner(s)""'" "--2 et -.?a And/Or Authorized Applicant Date 161E 0 Sys TYPDAIS 7fNTRIAlS 206 JNSPEFinal ec ni / Q6� A 1616 Fixed System Final Fire Prevention 206 Final Mechanical r1�-), ,�(}�-'Q girg- 1266 Pool Spa Final 208 Final Plumbing _ ce 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 CITY OF COSTA MESA 4 - BUILDING DIVISION > %f `r1 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER Te. 004 F PERMIT + a • re P05-00167 mnia (714)754-5273 • Fax(714)754-4856 • www.ci.cosla-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 2609 WESTMINSTER PL Status: ISSUED Suite No Applied: 03/04/2005 Issued: 03/04/2005 Vicinity: NEW SFR ISSUED BY: Parcel Nunmber: 43920103 Applicant: BEEK, CHARLES F Address: 2609 WESTMINSTER PL Phone: 949-548-7975 COSTA MESA,CA Zip: 92627 Owner: BEEK, CHARLES F Address 2609 WESTMINSTER PL Phone: 949-548-7975 COSTA MESA,CA Zip: 92627 Contractor: OWNER-BUILDER Address: Phone: Zip: License: 000000 SCOPE OF PERMIT PLUMBING PERMIT FOR NEW SINGLE FAMILY RESIDENCE.INSTALL 1 BATH TUB, 1 DISHWASHER, 1 GAS SYSTEM, 1 WASHER, 1 SEWER CAP FOR DEMO, 1 SEWER CONNECTION,2 SHOWERS,3 WASH BASINS, 1 WASH BASIN SET,4 WATER CLOSETS,8 1 WATER HEATER. REF:B04-01755 FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $9.80 1 Sump Pump $0.00 0 Backflow irrigation 50.00 0 Landscape Irrigation $0.00 , 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $9.80 1 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System 50.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $29.40 3 Dishwasher $9.80 1 Sewer Cap for Demo $9.80 1 Wash Basin Set $9.80 1 Drain,Floor $0.00 0 Sewer Connect $24.65 1 Waste and Vent System $0.00 0 Drain, Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $39.20 4 Drain,Roof $0.00 0 Shower $19.60 2 Water Heater/vent $12.30 1 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Ins(or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) 56.15 1 Sink,kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 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 • 244636(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: Carrier: Policy Number: ..(TT hiis section need not be completed it the permit is valued at one hundred dollars($100)or less.) ,t01.'.11'certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so es to become subject to the workers' •LI/" compensation : .of I omia,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comp) with t :Si .ro ,1 nt,Signature . tit-felDate:_-_ )/41 WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EM WVERTO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),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.4 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 Code). Lender's Name: Lenders 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 tile 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 for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): , asywner 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 Cade: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 ere not Intended or offered for sale.IL 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 uan e Contractors License Laws.). ❑ I awe pt un e Business and Professions Code for this reason: Signature:— ^ Expires:ti/l5/ Verification of Ownership by(type of document,i.e.-property tax bill or deed): ti 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 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 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 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 thisapplication a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes IJ No (Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits). T 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 0 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? 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 OFCAND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is 23 correct. I agree to c wit a state laws and city orrdinan aging to building construction,and authorize representatives of the Cityof Costa Mesa to enter upon the above-described pro rt4 for) s ction purposes.Iagr a not o upy orc� allow occupancy of any building authorized by this pepermitin�l f)tal> pection. ,.S'ig`nature Of Legal Owner(s) 'T(L�1^ And/Or Authorized Applicant Date CODE r INSPECTIONTYPE PATE 1NNNALS CODES INSPECTIONTYPE 26Th ILLS 1616 Fixed System Final Fire Prevention 206 Final Mechanical An 1266 Pool Spa Final 206 Final Plumbing - G incr 200 Final Re-Root 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 • 0511/ F CITY OF COSTA MESA 44.As, BUILDING DIVISION ._' l if DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER> i , , s , Jy /` PERMIT 'agra .o E05-00180 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 2609 WESTMINSTER PL Status: ISSUED Suite No Applied: 03/04/2005 Vicinity: TEMP POWER POLE Issued: 03/04/2005 Parcel Nunmber: 43920103 r Applicant: BEEK, CHARLES F ISSUED BY: A� Address: 2609 WESTMINSTER PL Phone: 949-548-7975 COSTA MESA,CA Zip 92627 Owner: BEEK, CHARLES F Address 2609 WESTMINSTER PL Phone: 949-548-7975 COSTA MESA,CA Zip: 92627 Contractor: OWNER-BUILDER Address: Phone: Zip: License:000000 SCOPE OF PERMIT INSTALL TEMP POWER POLE FOR DEMOLITION OF EXISTING SINGLE FAMILY RESIDENCE. REF:B05-0353 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 $0.00 0 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 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 . 244646(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: 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 t 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 of Calif. a,a•d agree that if I should become subject to the workers'compensation provisions of Sec on 00 o 'Labor Code,I shall forthwith �f��comply wi :to .rovisio - }�,Ly''7 >tBppecant Signature: _ �7L� pate:• 5 5 WARNING:FAILURE Ti ECUR 0 K - COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND OWL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(Ste r,v..),IN ADDr1ON 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.Lk.4 Class 4 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 Code). 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 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 for a permit sub'ects the applicant to a civil penalty of not more than five hundred dollars($500).): F` FFhs 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.). • ❑ I.as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:Th' ontrac• -'cense 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. - ant I ontractors License Laws.). ❑ I am ex: .I unde Business and Professions Code for this reason: — _ . iS7�R+re:,vp l ---.) Nit r--- LExpires_.) /'J'/r Verification of Ownership by(type of doe ent,i. eTsli 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? ❑Yes 0 No (Section 25505 of the Califomia 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 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 Safely 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 aggermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 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 tc be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 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? 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 COMP CE 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 agr a comp ith all state laws and city. .i -. ces relating to building construction,and authorize representatives of the Cityof Costa Mesa to enter upon the above-desc r ec1 ) SfLeOw r inspection purposes.I :g =:. of to occupy•r allow occupancy of any building authorized by this eserml fi I ins action. rS a er(s) lz And/Or Authorized Applicant Date CODE I INSPECTION TYPE DAM INTRIALS CODF I INSPECTION TYPE PATE INTRIAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical '5-2--9-a5— A , 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 . ; a. • e , ' - - - CITY OF COSTA MESA - >ta. BUILDING DIVISION ll) DEVELOPMENT SERVICES DEPARTMENTi. PE IT NUMBER IIIIPW,11-•1 PERMIT E105-00677 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca,usDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2609 WESTMINSTER PL tl Status: ISSUED Suite: Applied: 04/25/2005 Vicinity: SIDE PROPERTY LINE Issued: 04/28/2005 Primary Occ: R-3 Dwellings/Cong Res<10 Type of Construction: V-N Parcel Number: 43920103 Zoning: Applicant: BEEK, CHARLES ISSUED BY: Address: 2609 WESTMINSTER PL �- Phone: 949-548-7975 COSTA MESA,CA - Zip: 92627 Owner: BEEK, CHARLES F Address 2609 WESTMINSTER PL - ' • Phone: EXTENSION COSTA MESA,,CA, Zip: 92627 Contractor: OWNER-BUILDER ALLOiyEB • Address: PER Phone: Zip: - •� License: 000000 EXPIRES ���)�06 Arch : , - . Eng: Address:_ Address: - Phone: Phone: • .Zip: , License: License: SCOPE OF PERMIT ' 70 LINEAL FT.OF 8 FT.HIGH BLOCK WALL ALONG THE RIGHT SIDE PROPERTY LINE. BLOCK WALL BEGINS 26 FT.BEHIND FRONT PROPERTY LINE. REF: MM-05-14 . . FEE SUMMARY ` - Plan Check: $45.01 Calc Valuation: $2,000.00 Permit: $69.25 Claim Valuation: $2,000.00 SMIP Res: $0.50 SMIP Corn: $0.00 . ' • Other: $0.00 , Inspection: $0.00 - Total: .$114.76 ' ' PLANNING &ZONING: SETBACKS • . MAIN STRUCTURE Front 0-0 Rear 0-0 • Left . 0-0' I, Right 0-9 ACCESSORY Front 26-0 Rear 44-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: ' 0- 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 160 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(WOO) a. ti • , DECLARATIONS (�l - • WORKERS'COMPENSATION DECLARATION: ' I hereby affirm under penalty of perjury one of the following declarations: - ❑ .1 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: Carrier: Policy Number: (Th' section need not be completed if the permit is valued at one hundred dollars($100)or less.) _ I certify that in the perfomiance of the work for which this Permit is issued,I shall not eni to ah .,—c fy p p y y person in any manner so as to become subject to the workers' C compensation laws +alit° d agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith A comply with these • .0 tion ,q' 2� PP_Ii;canb Sl nate,- Si- / ,s,..--Date:!, "� Il WARG: NIN 'FAIIURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE rflST 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.It 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 Code). 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 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 for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): \EDI,as 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.). ❑ 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 p uant to the Contractors License Laws.). 'LI-tam ex:m und:r :c. Business and Professions Code for this reason: ,y,Dat -Owns D eri ••b n'e wense. �Fes"�p No -Odvers License.No.� DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feel 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 ❑No (Section 25505 of the Califomia 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 0 No (Section 25533 of the Califomia 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? 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 ap_ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Ll 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? 0 Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia 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 ❑No 8 Of'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//////����11��h all st. e laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described propertykq/Jinspecti I burp• I agree not to occupy or allow occupancy of any building authorized by this a it until fi I in ction. ,Signat:ni L•ga:•wner(s) .' .- {_D te�) And/Or Authorized Applicant Date CODE T INSPECTION TYPE ' .. " PATE" 'MURALS 'CODEI INSPECTION TYPE " ' ' DATE INID16L8 1616 Fixed System Final Fire Prevention 206 Final Mechanical • 1266 Pool Spa Final 208 Final Plumbing ' 200 Final Re-Root 210 ' Final Electrical' 201 Final Block/Retaining Wall 2-7`s r - 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 • ' C le.. And kttr i ' is r. J . � a 1909 Wesi ins4-er rkce.. 03 r it APPROVED 3 CITY OF COSTA MESA PLANNING DIVISION SU I.JECT TO BLDG. DEPT. REG. NO' : ADDITIONS, DELETIONS, O' CORRECTIONS SHALL BE APP.40VED BY THE PLANNING DIV./ E</ZTh5 .1 M -'• 5511l -FnrR {uAJ,(pckwa • O, C156.5=-`•obi 7-1,1 oao - I tiia 0)(01 k 0 h_Q,-.- . to 0 17, 4 dell . - TYPICAL 8" CONCRETE BLOCK FENCE ♦ s ofYI W>Froo 'eft .o "I Cement Coping Optional I � GENERAL - NOTES Channel block with one 5/81 Mortar: One Port Plostic Cement, Horizontal lop at all Fences - - and Three Ports Sand For Fences 8'high / 2 2 2 2 Grout: One Part Cement,Three I and One Hail Parts Sand Vert.Bars 5/8"0 all 6'O.C. c All Cells Solid Graouted �' �' Coping: One Part Cement,and w �. Three Ports Sand x m I Reinforcing Steel Shoff a o I Concrete: Well Mixed 1:2- 1/2:3.1/2 Conform to Sec,A-1539 A.S.I.M. d -a Max or 7-1/2 Gallons of I Au Steel to be lgpped VII „..1: r I I I Water Per Sack of Cement 24'or to Code 11oriz.Bars 5/8 0 at 32"O.C. e I 2 l l 12 • _ I Grout may be poured from thenc _ NATURAL GRADE top of the fee. V Cells and areas of horizontal reinforcement shall be clear, 1/ I I clean and free of all mortar - debris.etc. Iwo 5/6'0 Bars i IivI T Continuous lop -►I 11.1 I1 B 0 C "^^x ,► NOTE and Bolton) Width Horiz. Steel must be tied In place See Chart wall in excess of 6 feet In height at lime of trench Inspection Below I 136" require discretionary review and - l+ approval process through the _ Planning DMsion and ore not — T' automatically approved. Please 14.2310.1 I. 2 ♦ 2'—*I 14— consult with the Planning DMsion. • c)(007 \��Mn JAS FOOTING th eREQUIREMENTS CHART. lrj 1"K Nall Height 6'i08' \gi Ca � /' v`—' a r a4 Thickness 16' Depth of Eadhtooth 36' Spacing of Earthlooth 8' Diameter of Earthtooth 12" Cril BUILDING DIVISIONea 2705-46 Nov. 22. 2005 9: 23AM BrnKFIELD HOMrS 11141521-7313 N 0115 P. '1 • I � � � I • 2609 Westmin ter PI. Costa Mesa, C1 92627 November 22, '905 Mr. Ed Petros, Chief of Inspections City of Costa Mesa Building Division 77 Fair Dr. I j Costa mesa, CA 92628 (by fax 714 754 4856) Subject: permit # 505-00677 it Dear Mr. Petros, I � i The above permit for the block wall on our property is about to expire I request to have it extended for another six months. The wall has been builta d grouted but we have not installed the coping on top of it, and although the co ping is shown on the standard detail as optional, I do •:t feel it is ready to fins I without the coping. The last inspection on this wall w-s 5/24/05. If you feel that the wall can be fina -d without a coping, then my request is to have the final inspection scheduled fo � I Yours truly, ' Chuck Beek • • I I I I j I 1 � 10. MINOR MODIFICATION Reference No.: SOA' — 01755 Status: APPROVED Applied Date: 06-24-2005 Approved Date: 06/24/2005 Denied Date: MINOR MODIFICATION NO.: MM-05-23 Project Address: 2609 WESTMINSTER PL Suite: Parcel Number: 43920103 Project Applicant: BEEK, CHARLES F PROPOSED MINOR MODIFICATION: MINOR MODIFICATION FOR PORCH POSTS TO ENCROACH 2 FT. INTO THE REQUIRED 20 FT. FRONT SETBACK (18 FT. FRONT SETBACK). DISTANCE BETWEEN MAIN BUILDING AND ACCESSORY STRUCTURE WILL BE 19 FT. JUSTIFICATION: APPROVAL IS FOR PORCH POSTS ONLY, WHICH WILL PROVIDE VISUAL INTEREST TO THE BUILDING ELEVATION. THE RESIDENCE COMPLIES WITH 20 FT. FRONT SETBACK. REQUIRED FINDINGS:Y The improvement will not be materially detrimental to the health, safety and general welfare of persons residing or working within the immediate vicinity of the project or to property and improvements within the neighborhood. Y The improvement is compatible and enhances the architecture and design of the existing and anticipated development in the vicinity. This includes the site planning, land coverage, landscaping, appearance, scale of structures, open space and any other applicable features relative to a compatible and attractive development. PROJECT PLANNER: NGb'tC \NT -7 NOTES: 4`On MF CITY OF COSTA MESA t) BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER V lin PERMIT "°"9 E05-00182 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 2609 WESTMINSTER PL Status: ISSUED Suite No Applied: 03/04/2005 Vicinity: NEW SFR Issued: 03/04/2005 Parcel Nunmber: 43920103 Applicant: BEEK, CHARLES F ISSUED BY: 44-k Address: 2609 WESTMINSTER PL Phone: 949-548-7975 COSTA MESA,CA Zip 92627 Owner: BEEK, CHARLES F Address 2609 WESTMINSTER PL Phone: 949-548-7975 COSTA MESA,CA Zip: 92627 Contractor: OWNER-BUILDER Address: Phone: Zip: License:000000 SCOPE OF PERMIT ELECTRICAL PERMIT FOR NEW 2564 SF SINGLE FAMILY RESIDENCE. REF: B04-01755 • 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) $143.58 2564 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 $0.00 0 Misc.Conduit $0.00 0 Service to 1000a $0.00 0 Misc.Conductor 50.00 0 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0 Motors to 1hp $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 - NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia 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 penally 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: Carder: Policy Number: (This section need not be completed it the permit is valued et one hundred dollars($100)or less.) N . that in the erformance 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' mpensation la f C la,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 thes ovis �) AppflC USignature: �/C fDatehF; j • SER TO CRI Na. S WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL'P ALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE(S10p,D 0),IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF 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.# 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 Code). 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 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 for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ' '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, /t444,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.). • ❑ 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 rsua he Contractors License Laws.). ❑ I am e pt u d sec.�5 Business and Professions Code for this reason: C _Signature:' ' /�QI Cat9:- -?/4 l ..Owner') rifie y dnver's license. (-'mss' 0 No Drivertticonse'N9: k ' Expires-1�_{_y/� Verification of Ownership by(type of d iuumenent,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: I 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 Califomia 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,ora 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 Califomia 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 end 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 Califomia Health end 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 apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 0 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 Califomia 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? 0 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: CERTiFICATE OF OMP ANCE AND AUTHORIZATIO OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree t c pl with all state laws and ci o finances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described r rty r inspection purposes. agre of to occypy Or allow occupancy of any building authorized by this permituntil,f�I ipsp n. Signature O egal:Owner(s) L-'` '1//Oat4J/tN--^-;yam _ And/Or Authorized Applicant Date CODE I INSPECTION TYPE PAIS INTlTIAL$ CODE( INSPECTION TYPE PSIS INTRIAI$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 44 -67 1p 200 Final Re-Root 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 S CITY OF COSTA MESA P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 Y1i`V� S. DEVELOPMENT SERVICES DEPARTMENT OFFICIAL PUBLIC NOTICE OF ZONING APPROVAL February 16, 2005 RE: ZONING APPROVAL (B05-01755 & B05-01756) 2609 WESTMINSTER PLACE, COSTA MESA The Planning Division has completed its review of the above-referenced project. Based on the following project description, the project has been approved. PROJECT DESCRIPTION: The property owner proposes to demolish the existing residence and build a new, 2,565 square-foot, two-story, single-family residence. The existing detached garage behind the residence will remain. The property owner also proposes a new, 579 square-foot, one-story, hobby shop attached to the garage. A minor design review is not required for the proposed two-story residence because the second-floor complies with the City's Residential Design Guidelines. Privacy of the adjacent neighbors will not be impacted because of the proposed second-story window setbacks and locations. The second- floor balcony at the front of the residence may have potential privacy impacts to the left neighbor; however, the neighbor has reviewed the proposed project and is in support of it. The zoning approval will become final at 5 p.m. on February 23, 2005, unless appealed by an affected party (including filing of the necessary application and payment of the appropriate fee) or by a member of the Planning Commission or City Council. If you have any questions regarding this notice, please feel free to contact the project planner, Hanh Tran, at (714) 754-5640, between 8 a.m. and 12 noon, Tuesday through Friday. Distribution: File Charles Beek David Gardner .•t-4cuQ,.w`- 2609 Westminster Place 2611 Westminster Place ( ,> , �, (n•`> Costa Mesa, CA 92626 Costa Mesa, CA 92626 Jackson Douglas • Harold Lundell 2605 Westminster Place 2608 Fairway Drive Costa Mesa, CA 92626 Costa Mesa, CA 92626 Ronal and Christine Cramer 2614 Fairway Drive Costa Mesa, CA 92626 Building Division(714)754-5273 • Code Enforcement(714)754-5623 • Planning Division(714)754-5245 FAX(714)754.4856 • TDD(714)754-5244 • waw.ci.costa-mesa.ca.us 11 5© 5,F, ,)S "--14241- ) -Ra41- z 2 4 99 PROJECT ADDRESS: •`��c1 'WESTMINSTER PL19.25UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: BP 061495 OWNER'S NAME:BEEK, CHARLES ADDRESS: 2009 WESTMINSTER PL PERMIT NO: BP 061495 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA, CA 92627 CONSTRUCTION TYPE: PERMIT TYPE: PLU STR PURPOSE; DEM ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : DEMOLISH GUNITE SWIMMING POOL SQ PT: o ADDRESS: UNIT: CLAIM VALUE: 1 , 000 . 00 CALC—VALUE; 1, 000 . 00 GROUP OCC: R-3 / PERMITTEE:CHARLES BEEK ( 714 ) 548-7975 ADDRESS: 2009 WESTMINSTER PL COMMENTS: X C.M. CA 92627 **************,E* ¢DF***+k**Dr********N*********+F***** ¢x*n****T6 sE****N*x*********n* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z O N I N G REQUIR E M E N •P S 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SE TB ACK S CITY LIC.: STATE LIC.: CLASS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR : FT TN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.Cl- LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ: PROV; PARCEL: 00000000 ZNE: REF NO: rl Cenlhed copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> > .tete: Applicant: *****!f****7(-*******xfF***iE*****************!E*****1k***********!t**#*k***********Mi(* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(3100)or less). D EVELOPMEN T SERVICES REQUIR EMEN T S I certify that in the performance of the work for which this.er i i• sued.I shall n. •toy any person in any manner so as to become Datsubject tothe Workers'Compensation Laws of Calibre ZONING APPROVED BY DATE / Dale: 3 L4 Signature: — NOTICE:If.after making this declaration.you should become subject to the Workers' sa .t provisions of the Labor BUILDING APPROVED BY DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. a . CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the pert ice of the work for APPLICATION ISSUED B Y• / DATE: -IZ y (1 3 which this permit is issued(Section 3097.Civ.C). ************************lrxx****x*x*xlt}e***ffx *x**xlrxlf lF**OF*******!i-**tr***** xto*t(* LENDER: *****************************7E*****************-d*******ie*********************** ADDRESS: LEGALIZATION:N FEE ' SUMMARY STRUCTURAL SEGMENT: Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish.or PERMIT 2 5 . 0 0 7 • 00 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 2 5 SM Z P/NON—RES 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/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN • , 50 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(8500). ISSUE FEE 20 . 00 I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ;a structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 32 . 50 20 . 00 0 . 00 52 , 50 52 . 50 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale.II,however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED : 52 . 50 OVER/SHORT; 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 25. 00 27. 00 •' . 50 ❑ 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 such projectswith a contractors)license pursuant to the Contractors'State License Law).I am aware *****************'********************B(.***.****************ii****************-it*le X'* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: 8.6 P.C. Alifor this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Dale: 312-4 Owner: PLU 1 SEWER CAP / DEMOLITION EACH 7 , 00 7 • 00 I do hereby ally that am aware of and understand the requirements of California Health and Safety Code Sections 25505,25 a,and END—OF FEES 25534 and that or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. Dale: Applicant: _ I hereby certify that I have read this application and stale that the ab" •information is correct.I agree to comply with all city and county . _ordinances and state laws relating to building construction 0erebyj Drize repress atm =f this ow to enter upon the above-mentioned I property for 2inspeclion purposes. • J Dale: J/O� Signature: Driver's License or Social Security": 1641-46 While—Building:Green—Code Enforcement:Canary—Applicant,Pink—Revenue:Goldenrod—Assessor • • CONSTRUCTION AND PLANNING POOL APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector "l 1. Temporary Electrical Service or Pole 52. Pool & Equ'pment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. • 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding -' _ w 5. Steel Reinforcement • 56. Rough Plumbing & Pressure Test ` 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-G.. '•! '. 7. Footings 58. Electrical Conowt-Undrgrna__ 8. Foundation - 59. Gas Pipe, CJ Undrgrnd , Ttst 9. Water Pipe-Undrgrnd. 60. Backwash Lincs,P-Trap. Fi Undrgrnd 10. Structural Floor System 61. APPROVAL TO DECK i -- 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final -t 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains • 64. Plumbing System - Final 14. Rough Piumbing 65. E!cctrical•Firai 15. Rough Electrical-Conduit / 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING -- I --� 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit 21. Ducts,in Structure 70. Underground Hydro I __ 22. Ducts, Ventilating I 71. Product P:p!np ::Gas E Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank '-!Gas . . Oil 25. Roof Sheathing 74. Overhead Hydrc ,--- 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical - 27. Frame and Flashing 76. Dry Standpipe 28. Lathan & Siding . 1 -- - - 9 • 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL ?- 30. Drywall Nailing HEALTH DEPT. REQUIREMENT• C 31. Piaster Brown Coat 79. FINAL INSPECTION { 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating& Air Conditioning 3- c . 35. Final Gas Pipe-Test 36. Hood or Canopy - 37. Final PFireplace - - - - 38. Final PlumbingF-nl_ 39. Water Service-Final • 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer i 43. Backf low Irrigation -~ 44. Landscape Irrigation System - -� 45. Sound Attenuation 46. Handicap Regulations • -1I 47. FINAL STRUCTURE & BUILDING I I 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date MAIN OFFICEA . _. , BRANCH OFFICES 937 SANTIAGO ST.,SANTA ANA - 1635 WEST GAYLORD ST.,—P.O. BOX 9085 LONG BEACH 10, CALIFORNIA KIMBERLY ] 66.d HEMLOCK 5.7493 37615 N. 6TH ST. EAST— P.O. BOX 970 SPRUCE 5-2091 PALMDALE— WINDSOR 7-5911 Twinin • Laboratories of soui zzt2 Ca/i/o¢nfa, enc. 'Inspection. and Testing Enyineeis • - • Sok.Foundaiion Analysis • Chemical Analysis • IFebruary 22, 1960 GUN ITE REPORT OF ICUPE TEST CYLINDER Examination No. C60-2/41 Project For - Al Shields, 2609 Westminster Place, Costa Mesa, Calif. Sample from - SWIM P001. - 2609 Westminster Place, Costa Mesa, Calif. Architect Contractor Fiesta Pools Mix Water, gal./sk. cement Slump Date cast 1-25-60 • Date tested 2-1-60 2-22-60 Cylinder No. 1 2 3 "Hold" �Q D COMPRESSION TEST 7 Days 28 Days 4/ Total load to destruction, lbs. 63,000 85.E 1*Pounds per square inch 2,230 3.005 3: Cylinder made by % rill.'" 3 -j .\v- �� • Cylinder delivered by C. Cribbs (-C':. Rkg,0 N , , 1\ r Cylinder received by 1-26-60 i _; VE.B .24 }co` 4 cc: Shields .• \ Fiesta Pools ' ' _ 1i. Costa Mesa BIdg.Dept. TWINING LABORATQRilt, O, SOU -HERN CALIFORNIA, INC. SA Lab i1X// ALL REPORTS ARE SUBMITTED AS THE CONFIDENTIAL PROPERTY OF CLIENTS. AUTHORIZATION FOR PUBLICATION OF OUR REPORTS. CONCLUSIONS, OR E%. TRACTS FROM OR REGARDING THEM IS RESERVED PENDING OUR WRITTEN APPROVAL AS A MUTUAL PROTECTION TO CLIENTS. THE PUBLIC AND OURSELVES. Costa Mesa Building Department 111 EAST 20th STREET + ♦ (� APPLICATION FOR PERMIT. `9 COSTA MESA, CALIFORNIA ■ ,- . - - -_ B_U_I L DING �'_ l' FOR OFFICE USE ONLY • FOR APPLICANT TO FILL IN Receipt N Per it No. Building�%' / "ac- - - U •C r/ I Receipt it Address -. � / t . '.- r i C��((��yy to Mesa, California Recei d.byDate Recd. D e I ed Nearest ///�// /� MAR l V 19541 f Cross St. -.1 /,'74� ; Building L 9 • ry„ i Address K! MailOwnCosta Mesa, California Mail24<tte."001„dent„ /�Addressr if r Nearest Tel, Cross St. City No. lop,/ I No.of I Typq/ I Groyp_ *7 Architect or Lic. �F"� Plans (/ _! Engineer _ No. Approved by Date Address ��j RS p CORRECTIONS �(/ I l City Lic. _ / ,t �/ contract i r irNl'AA No. 4,e ' e ✓✓C. ,&tr U.,G"J� �. r / Y Add$ess��j. '6ca2+�'� `�Lf /42 '7d Legal Lot aoI ) _ Description I No.�! Block, Trac J . / (Attach Metes and Boundfj q-1(17 j l N..l� a1 Aix-a S-/ry S. No.of Bldgs. �S.t-u1et-ea,-.7 Uft-,-c - aR X T/ Size of Lot_oe7 /Fe; I Now on Lot - - - - - O Use of I No.of / I No.of <• �_ 9 Existing Bldg. ,` Families Rooms' Setback Line from Rear Yard , - - - - Z Center of Street _jet Side Yard .2,✓ 5 .... y DESCRIPTION OF WORK r New I I Alteration I I Addition I V- II Repair I �I Moving I I Demolish I �— Building No.of J • '54 Size r Rooms Stories Exterior Wale Roof r 'Covering .„/„_,,, �,e I Covering `, 6L• A APPR Use of New ���/��y ,I/ In= G1 Building ���,/y—'!'✓. T Foundation Loca[i�q�yt�t�/ In • - e �•!!!��rl�M��yy������ Forms,Mater' ,, .11 %4.4 r / Under-Pinning Frame: Fire Stops, r'w/ Bracing,Bolts y eta �f^I��li�st</. elftr_ . I hereby ackrf wledge that I have read thi..Application Lath. Int. and state that the abpvyis‘correct and agree to comply Lath. Ext with, all City 0 n and State Laws re_ lating 'building construe�• Signature of �c�� / Plaster, Int. Permitte ���a -- - i-v-—. Plaster,Ext. Authorized Agt. - Masonry Reinforced Valuation Permit Fee $ 1_ \ Plan Check $ ` Bond Beam $ 6 Total �!J � v Fee $ •� FINAL 43-n, 204 G. IM 12-53 - c o 0 J C 0 J o. -' .. .. -'..r + 0. , a f. , Street • PLOT PLAN Show location and distances from property line and between buildings, IOWNER R. H. Thompson DATE 3_2_5¢ JOBADDRESS 269Y Westminster P1, BUILDING PERMIT NO. 116 GENERAL CONTRACTOR :.,D. Doverspike VALUE $ 8,250.00 %rt LOTAP # 119-1611 BLOCK TRACT Dwelling & detached garage GROUP 1 - J TYPE V ZONE R-4 FIRE DISTRICT 119 .INSPECTIONS DATE. SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Footing Trench /G�16 ' ' at/ Foundation Forms andSGrade to Garage Rough Framing .4/6.02t6 / 4 Plumbing,Rough to Slab Son/1 NO air 2J J. /D Plumbing, Rough Complete >/48 f i' - . . AD I ; . .•_ - ifipS as Wag. . y C Temporary Pole /2' -4-3 .)9 't I y1. y .. Wiring, Rough T1-//✓�' / /2 1 J- / ✓ __.--- 1/ _ ` Heating, Rough 1 -25 -4 AN- / - - /" ._ Ce-21—j-p _3 D - Heating, Final L . • •c • A Sewer c5.7 - eo a6N ' - Mr a S- C 7 Septic Tank or Cesspool �%/ .a N`O •Lathing /.� , I , ,e-(se� `�ivi Plastering i , 28dY C /1 _ - e A., .a �91� � e Plumbing,Final,Fixtures Complet. /' )4ir LC.2_� u 131 1 - / I_ v /Plumbing, Final Gass7 Te��st -� �` �Y{/t��f- / • `L/ 6 �r - "� ? 7Wiring,Final /n` _'3 S` �3 ,� / r Occupancy i Form 210 0-H 161 12-69 1111r — INSPECTION REEQUESTry TO: Building Inspector Date cirtc�.JI/ -2 195JZ'Hoouur Asst. Buildin Inspector .. V �,a o1—,.2G a Plumbin pectur .. 4 :c.Tii.4 ✓/c' Job: Name.� ely Contractor.r�iry diy • Permit No..._! /ee Type • peetlon n / Rough or Final • O.K.'d by 7/y X \1f Date ❑ TRENCH 1 /.le J/ O FOUNDATION &GRADE TO GARAGE /.'�!Z! , FRAMING................ .... Y yy-- r} //}} �- PLUMBING -!Ilia �..�� -.1-f..1.7 Ne. 7 4� /e't,!4... 4 ❑ SEWER , / /T ❑ HEATING �� 4C..+ a ap rbc—c.. WIRING ❑ LATHING ❑ PLASTERING... .... 1t BLDG.FINAL.. Ai I ISGELLANEO 5..... --0 7 • Signed Form 213 G-H 10M 12-53 OWNER SHIELDS, L. DATE 1-6-60 JOB ADDRESS 2609 Westminster Pl. BUILDING PERMIT NO. 11214 GENERAL CONTRACTOR Fiesta Pools VALUE $ 2,900.00 AP. No.119-163-03 L•T TRACT FIRE ZONE DESCRIPTION OF WORK Pvt. Swim Pool I -.{,PECTIONS ;„r /,'.,. ' ha, , . TE I GROUP J TYPE ZONE R-1i';,'�"i-.=rground Soil U. . Water PERMITS ISSUED Unuerground Gas / .` SUBCONTRACTOR / DATE NUMBER Overhead Water and Gas 9 . .IYS r, :__ e L•0/ - -WO.le Rough Heating ' J Rough Plumbing -',n...z G,t- frig' , / rc 'f,iffi/, rAr L'r y. Miscellaneous:(c<<p sic :.�G i i 4t. =lartin S.,C4 ` Prop. Swr. Line 'House Con. St. Swr. Sprinkling System Heating, Final - Plumbing Fixtures Final Gas Test _ J/ • 9 a I/. / -Cna Construction Pole Underground Power • Rough Wiring • ' 7 O 111MEIMEMEMEN /-4 -L, /7*6'3 Trenches Forms Steel Floor System Steel Reinforce Chimney Re-Rod Bond Beam Sheathing - F,,4?,e and Flashing - t 1 `gig, In Out Plaster, brown coat Plumbing Fixtures, Final -p.m %-/ - 'r 'Ma= Electric Fixtures, Final f'r}-1 L-z Building, Final [ � OCCUPANCY /1 J k a • I Form 210-5M-11-59 S-B F' - 11211 • _k' "� FEE RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT Y//4.(1 / - -Sro P.O.BOX SI? COSTA MESA. CALIFORNIA ED PT. :t FOR APPLICANT TO FILL IN COMPLETELY APPLI9� III A dt ? M!w IT TYPE OR PRINT BUILDING BUILDING �n /O/�/?. 0.n , 314 ADDRESS16 3Tj J+-G, CO TA MESA. CALIFORNIA FOR OFF/CE USE ONLY `I_`�•� ,I RECEIPT NO. MIT / OWNER NVMAIL '//��.h/ Jr ADDRESS /2111-'1.-r--51.— Rr�e /•BY DATERECEIVED 0 I ,MTE IyUDEO�y" TEL. BUILDINGRESS � .��� Car /G (e/CC / CITY NO. ADDRESS �//J e�C '�+ n-c......> Z/ , ARC' 3 LIC. !�OSTA MESA,/,CALIFORNIA OR NEER ,��� - NO. �/ I K ✓ rrn ADDRESS606 0 CT ' / % > ZONE , �� PEnL•f/ GROUP -1 STAT' ; d APPROVED �] �//iT//(�_,w' / j/4/) CONTRACTOa(j• _ �. IC.Nk . BY (� / TE ADDRESS 1 36 • iv ; . /� ZONING LEGAL III LOT 77 X TORE NO.OF USE OF NEW 'I y,✓,y DESCRIPTION I NO. (�/ /I BLOCK ACT lJ '�� / �/ I�FLANS T�I BUILDING /IA/1/N /` L IT • A.P.NO. / I I E �..///6 3.- o3 APPROVED W .- DATE 1 — 4f -6 V SIZEOF LOT 6 0 /` I LIO NOW ON LOTS YARDS ALLO ' lll"'::: REQUIRED ALLOWED USE OF •I ��J (CENTER LINE ST.) �///Y �� �,/j EXISTING BLDG. �1Z/k��/, .}<I f FRONT / FT. • La--(7,--INT— SETBACK Jt/( IN. SETBACK LINE FROM V /�1• [ CENTER OF STREET REAR YARD �•/ R.SIDE i ).,-FT. IN. :' SIDE YARD I LEFT 11 r I RIGHT '�0 l \ L.SIDE I I FT. IN. DESCRIPTION OF WORK • 7[/] REAR /OFT. IN. • NE IgIALTERATION I I ADDITION I • REPAIR ,,, /`I II MOVING II DEMOLISH I ' BUILDING 1 ` t--.1,10.OF SIZE �+ J ROOMS STORIES U EXTERIOR WALL ROOF : COVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMED p ' , rte) • I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREETO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CIT'''YOOORDINANCES AND STATE S R ULATIN BU) EONFTRµ.,gry, VALUATION SIGNATURE OF -�{V`Ty-i t..bPERM17 FEE $ /6 PERMITTEE /] J� $ f'�!/J(�j/) PLAN CHECK $ �/' �- +, AUTHORIZED AGENT TOTAL FEE $ j V - I v __ = I_ -- ? t h ,1 • _ T, I N o /�`� __ me t-- E 0 A. _______....,...4 - 1I r a I _ -• -4_ go - .�. sbz�-'r .. , — ' . tlanni Woe a _ fro ec f' Adder flannin9 relates-is for _ __ a 6 09 we�sfrninshr- Place.. les+ ' hbor slave. _ t_ =. _ boy -oil 5 5 I -ice show al- he hew, no — - - 8a 4 - b 17 5 b concern re-: 2nr1 balco . -The co ndi4to» fie& 1n place on 4l+isf(a�- ' — -flan does no+ p1 ` �S "er atanoA "flt As Fa.tzWs '. 1 (d� © A. tzE To S,C-e TAZI) .� -(0�� . .. i`IOTE etl4D. Pll„SS nor does he has al,ul�l�or f on �o{ ha 1�tc i 5 sem- --'j 3 s uow 11415 c-Cvr sl a)-.! , 4o place umdtt •Zher red k1"11 :I/ Two su :,eec (See. to �E c2En�ovbo p�ann�n s ea�o� �s � % I�/�05 L W �-319b exv-r a, . , . ,� . w To $g Rrnmw,�v NIL I/. ` 6) ('ic.0 . et, 9czC44 A S To J rL-N ,I• E S'-op 9Er 8Pec kt 5ca `,J :, i G n Rio?!E w o p 2 tea' S'rop.7 W ir4pe w • -Ai e M r (IJ SEop..00,14 *3 REtJM1`12 To Two £)(ISTIN 4 W: : .,;,. 5 © Qtkelsro4 & .Ft-F.c.T'Iv£ N?Wf - cit AtrAt._ P.arirtdLti 1