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Home My WebLink About1773 KENWOOD PL - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIH UHIVh, UUS I A MLbA, UA 9z6Zb Job Address: 1773 KENWOOD PL Suite No Vicinity: Parcel Nunmber: 42426211 Applicant: COOTER, LYLE Address: PLUMBING PERMIT ISSUED BY: Phone: Zip: Owner: VAAGE, INGEBJORG Address 1773 KENWOOD PL Phone: COSTA MESA, CA Zip: 92627 Contractor: UNLIMITED PLUMBING SERVICE Address: 2200 HAMNER AV NORCO, CA SUITE 101 Arch / Eng Address: Phone: 800-832-2300 Zip: 91760 _ License: 661392 Phone: Zip: License: Status: ISSUED Applied: 10/31/2000 Issued: 10/31/2000 SCOPE OF PERMIT INTERIOR WATER RE -PIPE TO EXISITING FIXTURES. NO ADDITIONAL FIXTURES PROPOSED. QTY FEE SUMMARY AMT ISSUE FEE $23.50 Backflow irrigation $0.00 Backflow Preventer $0.00 Bathtub $0.00 Clarifier System $0.00 Connect (Ice,Soda,etc) $0.00 Dental Units $0.00 Dishwasher $0.00 Drain, Floor $0.00 Drain, Rainwater $0.00 Drain, Roof $0.00 Drinking Fountain $0.00 Expansion Tank $0.00 Gas Earthquake Valve $0.00 Gas (1-4 outlets) $0.00 Gas (Over 4 outlets) $0.00 Gas Repipe $0.00 Gas Service $0.00 Interceptors (Grease, Oil) $0.00 Interceptors (Sand Auto ) $0.00 QTY FEE SUMMARY - AMT QTY AMT QTY Laundry Tub / Washer $0.00 0 Sump Pump $0.00 0 Landscape Irrigation $0.00 0 -, Swimming Pool $0.00 0 P -Trap $0.00 0 Trap Primer - $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Process Piping (per 10 ft) $0.00 0 Vacuum Brkr Bkflow(i-4) $0.00 0 Receptors $0.00 0 - Vacuum Brkr Bkflow(5+) $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Sewer Private Line $0.00 0 Water Closet (Toilet) $0.00 0 Shower $0.00 0 Water Heater/vent $0.00 0 Sink, bar $0.00 0 Water Piping (Inst or Rep.) $0.00 0 Sink, commercial $0.00 0 Water Re -pipe $9.80 1 Sink, Floor $0.00 0 Water Service $0.00 0 Sink, kitchen $0.00 0 Water Softener $0.00 0 Sink, service/mop $0.00 0 OTHER $0.00 Spa (private) $0.00 0 VIOLATION $0.00 Spa (public) $0.00 0 PLAN CHECK $0.00 REINSPECTION $0.00 0 COMMENTS / SPECIAL CONDITIONS TOTAL CALCULATED FEES: $33.30 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: 1 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' comp saJ;on insurance, as required by section 3700 of the Labor Code, for the performance of the work for w iCh this permit is issued. My workers' Lf�9fisation Insuranc am e d policy number are: Career: Policy Number: (This section need not be complete l ` h permit is valued at one hundred dollars ($100) or less.) ❑ 1 certify that in the performan the work for which this permit is issued, I shall not employ any person in any manner so as to beco I subject to the workers' compensation laws of Celiforpppla, and agtoo that it I should become subject to the workers' compensation provisions of Section 700 of the Labor Code, I shall forthwith comply with these provision✓ / ��)73/�� -Applicent'Slgoature� Ln1 `/�/w Date: � WARNING: FAILURE TO SECURE WORKERSCOMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINALEP NALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37M 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. 9 Class k ConVaclor's5yrtature:_ Date:Liu CONSTRUCTION LENDING AGENCY: ❑ 1 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).): ❑ 1, 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 pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ 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, 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 Industeal 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 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 feel 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 mateeals)? ❑ 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. ...............................................................................................................................o'-f-t....................................................................................................................................................................................................................................................... 4 If an RMPP is presently required, has Section 25534 of the California Health end Safety Code been fully complied with? ❑Ves ❑ No ..................................................................................................................... ildi............................................................................................................................................................................................................................................difi............... 5 Does or will the applicant u present or future building occupant require for the work which is the subject c 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? 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? ❑Yes ❑ No (If 'yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ............................................................................-.................................................................................................................................................................................................. 7 It 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 prescnbed 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 slate laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I cenity under penalty of perjury that 1 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 Of L/gal Owners)/4- 6 /0 to N �And7Or thorized.ApDlicant � Date CODE #. INSPECTION TYPE INTITIALS CODED INSPECTION TYPE PST@ INT�LS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 7� 1266 Pool Spa Final 208 Final Plumbing ) ► - I __00 IJ I Y 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retaming 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 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONS7 RUCTION PERM PE FjpyIT NO. _ TRACT NO. LOT NO. UNIT NO. A P # i ect Address J -7 A ! 7� A,:& -A,, /��n Appll)CAl's Mailing Address �' y LlbT��'.S3' 2= /—_�T Asvner's Name seL -Vhon:_rte Address % Q �%r'7 /l'✓F+ A -e- C. 141 12cd Arch/Eng. License No. Address -� Contractor's Nam as ea•c 0 yil -phone Address (mailing) City License No. S_SL(o— r 1G� S LICENSED CONTRACTOR DECLARATION 1 hereby affirm that 1 am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license iz in II force and effect. Ucense Class Li n Dale �'r��— r 519 t � .{ WORKERS' CO M p E NSATION DE LARATION \ ' hereby affirm that I have a certificate of consent to self -insure or a certificate Workers' Compensation Insurance, Or a certified copy thereof (Section .800, Lab. fffPlllolicy No. Company,'] n,s Cef-tt i�f ietl copy is hereby rh lththecity Buil Ing Divro \r� Date /� -• Applicant �A EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred ($100) or less). 1 certify that in the performance of the work for which this permit is issued I shall -not employ any person In any manner so as to become subject to the Workers' Compensation Laws of California. Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions Of the Labor 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 which this permit is issued (Section 3097 Civ. C.) Lender's' Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/She is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of s Division 3 of the Business and Professions Code) or that he/she is exempt 'erefrom and the basis for the alleged exemption. Any violation of Section '�,�31.5 by any applicant for a permit subjects the applicant to a civil malty 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 (Section 7044, Business and Professional Code: The Contractor's License Law 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. If, however, the building or improvement Is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- prove for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon. and who contracts for such oroiect5 with a Con. tractors) license pursuant to ine Contractor's License Law). I am aware that proof of their Worker's Compensation Insurance should be provided to me. ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that I have rea Information is correct. I agree to Signature ff-si"- Drivers' License or SS 0865-46, rev. 5/88 above TYPE OF CONSTRUCTION U NE ❑ CONVERSION ❑ DEMOLISH DESCRIPTION C-EWORK/USE OF ADD LJ ALTERATION 131 REPAIR TYPE OF PERMIT LJ GRADING LJ FOUNDATION LJ STRUCTURAL' ❑ TENANT ❑ ELE RICAL PLUMBING ❑ MECHANICAL OTHER PROJECT DESCRIPTION SQ. FT.__ ✓ OCCUPANCY CONSTRUCTION TYPE VALUATION S ZONE GRAOINGCU.YDS. ACRES Remarks: ,oc_ _ S A rv' / PA A, A' ,/1s <,- cl ,Z4— Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers rinking Fountains loor Drains loor Sinks as Service Outlets Kitchen Sink Lavatories Roof Drains Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service - Auto -Wash S Main Building: E T Front A Rear C Right K Left Ping. Ref. # Planning Notes: FEES Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electr Fan F.A.U. Fixtures Device Boxes O ut!ets Switches Garbage Disposal Generator ❑05 KW ❑! Reinspection Fee - I $151 I Issue Fee - 1 I $ 3 I .I Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBG dk Heating System & Ducting ❑ 1100,000 BTU ❑ 100,000 BT Reinspection Fee 1 $15 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Hood or Type ❑ Canopy Type 11 ❑ Refrigeration System 00-100,000 BTU ❑ 100,000 BT System Repair/Alteration Fire Dampers Registers Issue Fee FEES $ 3 Zone Parking Req./Provided ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over 100 amps Sub Panel Motors E10-1 HP ❑1115-8 Inc. Solar 09-15 HP ❑16-15+ Microwave , Pole Light Range Standing Sections 15 KIN I Trash Compactor Reinspection Fee $15 Issue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By Application Issued By r A FEES $ 3 O N 1 N G R E Q M T S. 0100010747-00010747 TOT 54.50 DATE: 07/29/88 TIIE: 08:24 SUMM RY OF FEES BUILDING PERMIT $ 570 SMTP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTAL FEE $ PLAN CHECK 25% $ 0100010747-00010747 TOT 54.50 DATE: 07/29/88 TIIE: 08:24 fONSTRUCTION AND PLANNING .:; APPROVALS Permit # Date Inspector POC . SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. : l 53. Steel Reinforcement 3r'Electrical Conduit UEility-Undrgrnd, 54. Forms 4.'Electrical Conduit-Undrgrnd. I I 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ; 6. Electrical UFER GrndJ 57. APPROVAL TO COVER-GUNITE _ •7. Footings 58. Electrical Conduit-Undrgrnd. i 8: Foundation I i r 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. i ; 10. iStructural Floor System - 61. APPROVAL TO DECK 11. I Property% Sewer Line ,& House Connection 62. Backwash & Receptor -Final •12. Sewer Cap , 63. Heater & Vent -Final 13. Roof Drains i I 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final �6,.. 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 194 Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough, Factory Fireplace 21. Ducts, in, Strut:ttire 70. Underground Hydro 22. Ducts,'Ventilatirnrg I I 71. Product Piping 0 Gas ❑Oil 23. Gas Pipe- IRough Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank 0 Gas 0Oil 25. Roof Sheathing r 74. Overhead Hydro 26. T -Bar Ceiling iStruEfurall & Monoccat 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 I HEALTH DEPT. REQUIREMENT 31.,Plaster:Brown Cqat; 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 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 Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING Y 48. Special Requirements Completed \ 49. Electric Release to Edison \ 50. Gas Release to Southern California Gas`Co 51. CEVIFICATE OF OCCUPANCY \ No. - Date Uosta Mesa Building Department' AP LICATION FOR YER1YllT 111 EAST 20th STREET !y BUILDING 2 COSTA MESA, CALIFORNIA " FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY Receipt No. Permit No. "� 3 'ui Address % 7 3 Costa Mesa, California Received by Date Recd. / - -30 _ ' b Date Issued . 3 - 6 Nearest �+ Cross St. J Building Address Owner r ar L .Es Costa Mesa, California Mail Address .✓ 13i¢ Nearest Cross St. Tel City No. Zone No. of I Plans Type Groin Aw,bitedfor" Lie. E n 4/ E T/�: No. Approved by Date Address 6-0-76-AAN044e. CORRECTIONS _ / Lic. Contractor -ate CoNo. Address ---,c _-� Legal Lot Description I No. OZ O I Block I Trwf;t rid (Attach Metes and Bounds) ldg Size of Lot Q Q .•� NowonLots. ~ Inm .'i Use ofNo.of Existing Bldg. I Families I No.of Rooms 700 p - nnTS Setback Line from R -Yard / Center of Street +✓ V Yard J'— _ n�t`I n �0 Y U� (,�UJlft '°"' y r DESC ONO ORK New IJ/1 Alteration I I Addition I - Repair I I Moving I Demolish Building Tt No.of Size ..>'V3 Rooms Stories APPR,QVATC Exterior Wail Covering .S G4 YS/ Roof ('+ overing .7 //Y /.' Use of New Building , 6:4F xV Foundation Location Forms, Materials, Under -Pinning Inspector Date Frame: Fire Stops, Bracing, Bolts I hereby acknowledge that I have read this Application and state that the above is correct and agree to comply with all City Ordinances an tate laws regulating building construction. Signatureof 0� Permittee Authorized Alit. Lath. Int. Lath. Ext. Plaster, Int Plaster, Ext. Valuation Permit Fee $ �' $ / / 70O,'Plan Tota Check $ //� ° O Fee 7-Z, ° d Masonry Reinforced Bond Beam FINAL FORM 204 S -BP 2M 6-55 PLOT PLAN Show location and distances from property line and between buildings CDSTP n 1 30 SSPONEsn d d a d 7 4 2 4 6L Street PLOT PLAN Show location and distances from property line and between buildings CDSTP n 1 30 SSPONEsn