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HomeMy WebLinkAbout244 MAGNOLIA ST - Building Permits WS 9 CITY OF COSTA MESA 04 BUILDING DIVISION Y ',- _,•., ,r 7'. DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER o PERMIT wE0 P05-00153 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 244 MAGNOLIA ST Status: ISSUED Suite No Applied: 02/22/2005 Issued: 02/.420' Vicinity: / ISSUED BY: /; / Parcel Nunmber: 42540211 r Orr Applicant: CARLOS ALVIDREZ Address: 259 LILAC LN Phone: (714)646-7569 COSTA MESA,CA Zip: 92627 Owner: STEVENS, CAROLEE BURDICK Address TR COSTA MESA,CA Phone: 244 MAGNOLIA ST Zip: 92627-2805 Contractor: BEACHWOOD CONSTRUCTION -. Address: 259 LILAC LN Phone: (714)646-7569 COSTA MESA,CA Zip: 92627 License: 456742 SCOPE OF PERMIT PLUMBING TO INCLUDE: 1 SHOWER AND 1 WATER CLOSET. FEE SUMMARY' - AMT QTY AMTQTY . AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation - $090`, 0 Swimming Pool $0.00 • 0 Backflow Preventer $0.00 0 P-Trap . $0.00 0 . Trap Primer, - $0.00 0 Bathtub $0.00 0 Pressure Regulator - $0.00 0 Urinal - $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft)- _ $0,00 0 Vacuum BrkrBkflow(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 $0.00 0 Dishwasher $0.00 0 - 'Sewer Cap for Demo - $0.00- :0. . • .- ' Wash Basin Set $0.00 0 Drain,Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 0 Sewer Private Line $0.00 , 0 Water Closet(Toilet) $9.80 1 Drain,Roof $0.00, 0 . Shower $9.80 1 - Water Heater/vent • $0.00 0 Drinking Fountain $0.00 0 ' Sink,bar $0.00 0." Water Piping(Inst 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) $0.00 0 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 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 - - - REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 - - - - TOTAL CALCULATED FEES: $43.10 , 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 C) ( 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 end policy number are: Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) &�cemty that in the performance of the wo- .. @ issued,I shall not employ any person in any manner so as to become subject to the workers' .' iro'Inpensation laws of Califo ' and t/f��'t if - e subject to the workers'compensation provisions of Sectio 3700 of the Labor Code.I shall forthwith comply with these pro '.e e / Ap Ilce (,Signature: Date — / - rS -mow - WARMNG! ALU? RE TO SECURE WORKERS'COMPENSATION••/ •n GE IS UNLAWFUL AND SHALL SUBJECT AN EMPLEPFERTO CRIMI PENALTI--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 provision of epter 9(comma ting with Section 7000)of Division 3 of the Business and Profession C..e,and my license Is In full force a d.affectrj ic:.C_^ -�'4 'L7 A �.Cless.#.- .� Crnmact ignature;r)----.. ��(A�' ant �D - . �-- iii--nrrei i ce— •vs 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).): ❑ 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. 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 sate.). ' ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Om 2,Art 2,Sec. 341,Title B,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: • 1 Will the'applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,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 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? 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 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? 0 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 comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. , /Signature��•r I Owner4dieD to A e.moi anar--fla 1 -O%p •%.rthoiiie. d]IR�,:,s; W:rat:.----" .. CODE r INSPECTION TYPE PATE INTTRALS CODE r INSPECTION TYPE On tN'MAALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing f-12I-o S BEV EV 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place - 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy OWNER BURDICK H C DATE -2 - • JOB ADDRESS 244 Nag/1011a BUILDING PERMIT NO. 8874 tG��rrE'' NTN�_ElRAL CONTRACTOR Owner - Builder VALUE $ 150.00 'AY r2-11 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Patio Wall I UP TYPE ZONE PLAN NO. 8874 INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Trenches roma Swig 'rv� Floor System Steel Reinforce Chimney Re-Rod Bond Beam _ Frame and Flashing Lathing, In Out Plaster, brown coat Underground soil W/G Pipe Test Top Out _ Furnace Gas Vents Rough Plumbing Cesspool Septic Tank Prop. Swr. Line House Con, St. Swr. Sprinkling System Heating Final F ing Fixtures, Final Pu.... Gas Test Construction Pole Underground Power Rough Wiring Fixtures, Final ^OCCUPANCY Form 210-5M—I-57 88711 tfEE RECEIVED 88104a ,.,�,s �A� COSTA MESA- BUILDING DEPARTMENT / P.O. BOX 317 FINANCE DEPT. COSTA MESA. CALIFORNIA WY OF COSTA yte, FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT BUILDING 1'1ii .4,740.1.16-( ti, J . . BUILDING ADDRESS COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY ��/. /5 j/ J RECEIPT NO. -E�MIT Nj OWNER �T` ` I/�E_��-��/i(`JI Rv 7r zN MAIL �h t . RECEIVED /V D3-TE RECEIVED DATE ISSUED 9 '3- 3-5.9 ADDRESS "P /-/,.(_//`l/E/ ^-� i C. CITY i�' tori 7/1/4,(_ TELL/ „ BUILEI NO t/eYV ADDRESS ARCHITECT LIC. OR LATER NO. COSTA MESA. CALIFORNIA FIRE ADL .S ZONE ZONE • - NO,OF TYPE GROUP CONTRACTOR CI:V NI OC. L PLANS TEL. APPROVED' /tic -4 etc 4'I.... '.3/23/53 ADDRESS . NO. BY Qt40— aVON (CA R'Pt FL JCC LEGAL LOT CORRECTIONS DESCRIPTION NO,CJ BLOCK TRACT �]/Y�J ///J ,{/(�' .Qpt A.P SIZE / C] 'y/ rvo�bF BLpcs. Kere3,1 ”/Vie 1)))��/�.f� (�j/,/�C/OF LOT /� NowoNLor 9f ,�y /�USE OF1 `/ 4 /TEXISTING BLDG. 7 SETBACK LINE FROMD, �}/.. a S CENTER OF STREET �L.l / REAR YARD SA�y i. 9�y'/�jry.�`ui�■y 'Yd Y3�,/ CJ 11/ SIDE YARD RIGHT LEFT ��. CITY OF COSTA .iiz.v+: DESCRIPTION OF WORK PLANNI 'G DEPT. :r17BdEo,F -PP M kIG, OEM REG. NEW ALTERATION ADDITION . REPA,_ MOVING DEMOLISH BY721# .. _\LiAt BUILDING NO.OF PLA TE6H. SIZE ROOMS STORIES --.�- EXTERIOR WALL ROOF COVERING COVERING • USE OF NEW • BUILDING J I HEREBY ACKNOWLEDGE TH HAVE READ THIS APPLICATION AND hp Anmuntg'own under 4alu�!U 1 IS for the STATE THAT THE ABOVE IS ORRECT AND AGREE TO COMPLY WITH ALL purpose of establishing p fee CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC- TION. a 2rinit only '`'1 TION. VALUATION u-0 /y�� PERMIT FEE $ SIGNATURE OF �� /-/�� Zy 1 PERMITTEE -F Z/L 00 /j— -� PLAN CHECK $ rl-0 odsAUTHORIZED AGENT _ TOTAL FEE $ • A 4. 7253 . PCOSTA MESA BUILDING DEPARTMENTpCOSTAya *.A.**48.00 P.O. BOX 317 AUG-4-5SPU,yESr�1I COSTA MESA, CALIFORNIA FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT ADDRESS ,:lh//v /!q/1(,-NoA //{ /4ia . . BUILDING COSTA MESA. CALIFORNIA , FOR OFFICE USE ONLY j / /' I� /� RECEIPT NO. �/EMIT NBJ OWNER it L, - ,(J C(/7A/ /c X • L L7 3 MAIL /� �/�y y n/ RECEIVED BY Vg TE RECEIVED_ DATE ISSUE ADDRESS A.-'/,%. fro No A.M /'©./p3ax67 ---2-7---1€21 Cr '� 1��_ e-7 (").- CITY C /1' • , TNO.M/J' /a qa ADDRESS 2 z Ci ' ` ar(lo /d ARC,•,{"rEOT O. R," COSTA MESA. CALIFORNIA =x&" N y .,NEER NO. • FIRE ADL �5 ZONE 9/✓A /_/+ CITY LIC. 20NF.�_ (PLANS TYPE GROUP CONTRACTOR NO. • K /vry -� / O y TEL. BYPROVED /7 - ADDRESS NO. BY - Q/�{t( DATE LEGAL OT f�/\ /3 DESCRIPTION LNO. / BLOCK TRACT rY/./ • A.P.NO. / /� /7.2.••••`4/4/ APPROVED OIF LOT 4L ,T t/(A / a . NOW ON LOGS' / CITY OF COSTA MESA I'Lr KING DEPT. USE OF A9 „�`/_AA. /N4 • SUBJEC BLDG. DFPT PFG-•• EXISTING BLDG. •L SETBACK LINE FROM /�'I' � CENTER OF STREET ,.\ /) /) REAR YARD 2�J//.(/-I I / • (. w 6 T( Bybringe DAT [d S SIDE YARD RIGHT 9. .LEFT PLAN Tif H f DESCRIPTION OF WORK • NEW X ALTERATION ADDITION - REPA... 6- J OV ING DEMOLISH BUILDING /•6"" ir-°- . NO.OF SIZE EXTERIOR WALL J -�esROOFS 7 STORIES / COVERING 7I C/C,i3O COVERING _c ///tti./.Kc 'Al USE OF NEW 177 ��(( ff ,, BUILDING 1/ _ /vii A1_'. Ic / At- nig M To 5x/sr�we mats/_ k / .✓ • /3ryin _ j I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC, TION. VALUATION //y b - PERMIT FEE $ 3�' SIGNATURE OF PERMITTEE / C_ /J "` r"^ /3 / s PLAN CHECK $ /6 $ ! / AUTHORIZED AGENT TOTAL FEE $ c4.1).... I VCNF