HomeMy WebLinkAbout1855 KENTUCKY PL - Building Permits CITY OF COSTA MESA
oe , BUILDING DIVISION
1;1
IAI 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714)754-5626
*-'"°'"`°fi •
PERMIT NUMBER: P09-00147
PERMIT TYPE PLUM STATUS: ISSUED
APN: 13904117 DATE ISSUED: 11/17/2009
ISSUED BY: RMD
JOB ADDRESS: 1855 KENTUCKY PL CM Suite/Unit:
Vicinity:
SCOPE OF WORK: PLUMBING PERMIT FOR WATER HEATER CHANGE OUT, SAME LOCATION.
OWNER: HOUCK, PAULA S TR Address: 1855 KENTUCKY PL
PHONE: 714-434-7014 City/State/Zip: COSTA MESA,CA
APPLICANT: LITTLEFIELD, SCOTT Address: 24707 SAN FERNANDO RD :
PHONE: 888-611-4328 City/State/zZip: SANTA CLARITA,CA
•
CONTRACTOR: AFFORDABLE WATER HEATERS AND PLUMBING License No. 627368
Address: 24663 RAILROAD STREET
PHONE: 661-259-7131
City/State: NEWHALL,CA ZipCode: 91321-1742 CELL:
ARCHITECT: License No. PHONE:
ENGINEER: License No. PHONE:
PLUMBING PERMIT FEE SUMMARY
PLAN CHECK FEE: $0.00
PERMIT FEE: $35.80
TOTAL FEES: $35.80
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord.No.92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
CODES. INSPECTION TYPE DATE INIITIALS CODES INSPECTION TYPE DATE INTITIALS
1616 FixedlpSa tem Final Fire Prevention 206 Final Mechanicalmbi
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver s license. ❑Yes ❑No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the
performance- of the work for which this permit is issued.
ft- 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a
number are: person is required to descend,will be made in connection with work authorized
-r.C1�-''� by this permit,and that no building structure,scaffdding,falsework,or demolition
Cartier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
(This season need not bbecompleted
dii the permit is valued atone hundred dollars($100)or less.) 2 Art 2.Sec.341,Title 8,California Administrative Code).
L
Policy Number: O(e7 p i e- 70
0 As owner-builder, I will not employ anyone to do work which would
❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above, unless
issued,I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of California, and agree that if I should
become subject to the workers'compensation provisions of Section 3700 of gpptrant's Signature Date
the Labor Code I shall forthwith comply with these provisions
lf�J'ircr
Jr�/'7 /ai Division of Industrial Safely Permit Number:
Applicant's Signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST. AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. Department by every business which has at any one time during a reported
year a quantity of hazardous materials equal to or greater than a weight of
LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in full force and effect, a registration form for acutely hazardous materials? 0 Yes 0 No
Lic.# (poi3 bo Class#_� �/o ,(2& (Section 25533 of the California Health and Safety Code, with some
id—P r// exceptions, requires registration with the Costa Mesa Fire Department by
e each business which at any one time has on hand a quantity of acutely
pntractors Signature Date hazardous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? 0 Yes 0 No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: Costa Mesa Fire Department may require the preparation, certification and
filing with the Fire Department of an RMPP by businesses which are required
to register acutely hazardous materials with the Fire Department.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the Califomia
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No
issuance,also requires the applicant for such permit to file a signed statement
that he or she is licensed pursuant to the provisions of the Contractors (Section 65650.2 of the California Government Code requires that the requested
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be furnished on applications for non-residential building permits).
Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No
applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation. WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No
thereon,and who does such work himself or herself or through his or her own
8. (If'Yes",attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
LICENSED CONTRACTORS to construct the project(Sec.7044, Business and
Professions Code: The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection.
Signature of L al Owners .rte Date
Signature Date g . y///7/y
3057-46(3/07)
And/ r ized Applicant Date
PR0.1!eADDREss: 1855 KENTUCKY PL UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 065990
°WPM'S NAME: MICHAEL COLEMAN M
i ADDRESS: 1855 KENTUCKY PL PERMIT NO: B 065990 PLAN CHECK NO: N GOVT: N SUPP: N
COSTA MESA,CA 92626
CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: OTH
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/O RESHEATH 6 REROOF W/COMP , SHINGLES SQ FT; 3, 700
ADDRESS: UNIT:
CLAIM VALUE: 3, 700 , 00 CALL—VALUE: 3, 700 . 00 GROUP OCC : R-3 /M-1
PERMITTEE: RAINPROOF ROOFING ( 714 ) 536-8702
ADDRESS: 369 P .O. BOX COMMENTS: SMOKE DETECTORS ARE REQUIRED AS PER 1991 U. B .C.
HUNTINGTON BEACH CA 92648 ****+Ex*�r�r�E�Ear*****+Ey ****ar***+r***+E+ESE******aF*aE**+ESE******* **+reE********************
LICENSED CONTRACTOR DECLARATION: I hereby a 'm that lice d under provisions of C. pier• r• • •ncing with Section ZONINGS EREQUIREMENTS7000)of Division 3 of the Business and Profession ode.and m li • se is in full force and •
CITY L STATE LIC.:rj q 9 q — cuss: C—3
MAIN BUILDING
Si.nat :. �_ ACCESSORY BUILDING
WORKERS'C
_zip,/
SATION DECLARATION: I hereby affirm that I have a c: ificale of co enc to self-insure or a certificate of Workers' FRNT: FT I N REAR: FT I N FRNT: FT I N REAR• FT I N
Compensation Insurance.or a certified copy thereof(Section 3800, Lab. LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
POLICY No.: 118 2 4 4 7-93 EXP.DATE: 04 /01 /94
COMPANY: STATE FUND / PARKING REQ• PROV: PARCEL: 13945316 ZNE: REF NO:
r] Certified copy heree furnished. 04 Certified Py is filed wi 1 city Buildi . Divitr PLANNING NOTES>
' >
a APPlirnt: / *******************************************************************************
EXEMPTION F'OM WI KERS'COMPENSATION OECLA ATION: is ection need not be completed it the permit is for one hundred($100)or less). D EV ELOP M ENT SERVICES REQUIREMENTS
I certify that in the performance of the work for whit emit is issued,I shall not employ any person in any manner so as to become ••
subject to the Workers'Compensation Laws of Cali ornia. ZONING APPROVED BY ,•
DATE:
Date: Signature:
NOTICE:If,alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY DATE;
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y:
DATE : Al I
which this Permit is issued(Section 3097.Civ.C). *********************************
LENDER: ********************************************************************* '*********
ADDRESS: LEGALIZATION: N F E E 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 63 , 00
repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed5 0
pursuant to the provisions of the Contractors'Slate License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMIP/NON—RES
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
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE
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
❑ structure is not intended or offered for sate(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS——--> 63 . 50 0 . 00 0 . 00 63 , 50 63 . 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 safe.If,however the building or
improvement
LDGPMTPLUMBING ELECTRICMECHANICFIRESMIP/TOT
within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENU BDIVISION —
_ OD63. 50
OVER/SHORT:
forthepurpose of sale). GRADING PLAN—CHECK
I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 63 . 00 . 5 0 .
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts ter such p•olectswith a Contractors)license pursuant to the Contractors'State License Law).I am aware *******************************************************.*.)E**,*,.x.****.***.µ***,**1(-***,If
that proof of their Worker's Compensation insurance should be provided to me. IND I V IDUAL F E E BR EAK DOW N
❑ I am exempt under Section: B.&P.C.
for this TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: OwnerSFR 3700 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 3, 700 , 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES
25534 and that I 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.
Date. dslate
SMOKE DETECTOR
I hereby certify that I have read this applicationnand state t •above i. r'anorn on is cI agree to comply with all city and county
ordinances and sl le laws hating to building construction d here. au .rile epres•• .Y ; his city to enter upon the above-mentioned
/p'r'operly farm ection uses. / ` •� 0 CQ' 1 RED T -
/Ae1e: 2 V Sign me: / L G'./— �_ G u 01 00155170-00155171 T 1-7 T 63.50
l DATE: 02/09/94 TIME: 09:43
Driver's License or Social 7521 /
1641-46 White—Building:Green—Code Enforcement;Canary—Applicant;Pink—Revenue;Goldenrod—Assessor
CONSTRUCTION AND PLANNING POO. 313A,
4 Date Inspector Date Inspector
APPROVALS Permit # , APPROVALS Permit #
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. - 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing& Pressure Test
B. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap. 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap - 63. Heater & Vent-Final
13. Roof Drains _ 64. Plumbing System • Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
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
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 2_-10-Ile(.G-41- 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
i .
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
•
34. Final Heating& Air Conditioning ' 1- ~
35. Final Gas Pipe-Test : I 1••i
36. Hood or Canopy
-
37. Final Factory Fireplace -
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventers
43. Backf low Irrigation
44. Landscape Irrigation System
45. Sound Attenuation 2. -(Q a?[!_ $- 4 -. G�,,,/ee.,9
46. Handicap Regulations ��O"- �`'`P-
47. FINAL STRUCTURE& BUILDING b 179 jord ,I iii,
48. FINAL PLANNING •7
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
. r i
Gi
40114.5: CITY OF COSTA MESA. '% 9
47 4, , ,+ (y. CALIFORNIA 92628-1200 P.O.BOX 1200
.014
).i, .0
J a, DEVELOPMENT SERVICES DEPARTMENT
e
October 2 , 1994
Dear Costa Mesa Property Owner:
In reviewing past permits, we find that work has been done on your
property located at 1855 Kentucky Place, Permit No. B65990, for a
roofing permit. The permit is valid for 180 days from issuance or
your last inspection, per Section 303 (d) of the 1991 Uniform
Building Code. Should we not hear from you within 10 days, your
permit will expire as stated herein and additional fees will be
required to finalize the permit. Failure to final a Building
Permit could possibly impact the future sale of your property.
To activate the above permit, please follow these steps:
1. Telephone (714) 754-5626 or 754-5627 .
2. Request an inspection; stat,e address, permit number, and type
of inspection.
3. Be sure to have working smoke detector ' s as required per
Section 1210 (a) of the 1991 Uniform Building Code.
4. Have an adult present at the property at the time of
inspection to provide us access.
Should you have any questions regarding this process, please
contact me at (714) 754-5273 .
Thank you for your cooperation.
Sincerely, �(�QIQ�j�.�
"_' 1 U
lkdlanda Huapaya
Permit Processing Specialist
77 FAIR DRIVE
Building Division(714) 754-5273 • Code Enlorcemenl (714)754-5623 • Planning Division(714)754-5245
FAX(714)556-7508 • TDD(7141 7545244
FEE RECEIVED
1203 k,;. MAY 16 1960
COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT.
P. O. BOX 917 COSTA MESA. CALIFORNIA CITY 0�. COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING 1855 Kentucky Place
ADDRESS
COSTA MESA. CALIFORNIA For Office Use Only
OWNER Vermont Avenue Land Co. I RECEIPT NO. PERMIT NO.i On?)"7
MAIL RICE! • Orrelesbio
ADDRESS 419 E. 17th St• I ."JD714J
1,111Y 1 13E
CITY Costa Mesa
TEL- . 8-115 BUILDING
< ADDRESS
&I
a=
07aSOS & I4iddlebrookNo, COSTA MESA. CALIFORNIA /�
ADDRESS Garden Grave FIRE '/ 1 , —
FIRE TYPE P' GROUP �(/J})j�
CONTRACTOR Dike & COlP APPROVED
grove, Inc. BY DATE
ADDRESS 419 E. 17th St. ZONING qq
II
CITY Costa Mesa ZONE NO.OF USE OF NEW511161. Ill
R-1 I PLANS 2 I BUILDING W/ att gar.
STA
LIC. 167293 rio: Li 8-1159 LEGAL 49, Tract 3648
DESCRIPTION Lot
SIZE
OF LOT 781 X 971 Iwo. OF BLOBS.
NOW ON LOT none A.P.NO. none
USE OF none . YARDS EVES
EXISTING BLDG. APPROVED ALLOWS
SETBACK LINE FROM 551 MI (CENTER UNE ST.) Ii I t?/1_,.
CENTER OF STREET / REAR YARD GGVV FRONT 1)-7) FT. fi IN.
SIDE YARD I LEFT 71 I RIGHT 101 R.SIDE to FT. pit_ IN.
DESCRIPTION OF WORK 7
L.SIDE FT. IN.
NEW I X 1ALTERATION I II ADDITION I REAR FT. IN.
REPAIR I II MOVING I II DEMOLISH I APPROVED W. L. D.. DATE 5-13-60
BUILDING, NO. OF /���//��//]]
SIZE 1LI.5O SO.ft ROOMS 6 STORIES 1 L/ '/
EXTERIOR WALL ROOF (//
COVERING StUCCD I COVERING comp•
USE OF BUILDING AND WORK TO BE PERFORMED
Single family residence with
attached garage.
Plan 40C
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 AGREE TO COM- PURPOSE OP ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION. VALUATION
SIGNATURE OFDike & Colegrove, Inc. RMIT FEE $ 35•00
•
PERMITTEE a
//•},��-"' $ 15,045.00 PLAN CHECK $ 17.50
AUTHORIZED AGENTVTOTAL FEE $ 52.50 2