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Home My WebLink About370 LA PERLE LN - Building PermitsAttributes Property Address Address 1 370 LA PERLE LN Address 2 COSTA MESA CA 92627 Parcel Information Assessor Parcel Number 42531202 Legal N TR 1175 LOT S Range Township Sedion Quarter Section Area Acres Owner Owner Address 1 Owner Address 2 Year Built Building Square Feet Building Count Stories Number Parking Spaces Number of Units 9arage Square Feet Front Footage Depth Footgae Bedrooms 7199.81531 0.1653 Owner Information RYAN CRAIG M 268 MORNING CANYON RD CORONA DEL MAR CA 92625 Property Specs 1948 882 2 1 3 Page 1 of 1 http://mesagi s2x/website/costamesa/parcel/popup. asp?opt=Attributes&HistoryID= {B 873... 02/24/2003 ;. . : . a . � ': , . CITY OF COSTA MESA BI/ILDING DIVISION F � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • ww�v.ci.wsta-mesa.ca.us �.+� FOR INSPECTIONS CALL: (714) 754-5626 � �'*�.e.m'P . , PERMIT NUMBER: BX08-00012 PERMIT TYPE B MISC STATUS: ISSUED APN: 42531125 DATE ISSUED: 02/12/2008 Zoning: , ISSUED BY: BJK JOB ADDRESS: 370 LA PERLE PL CM a - _,- Suite/Unit: Viclnity: DETACHED GARAGE Primary Occ �-�,� �:`� SQ. FT: 600 � " ValuaGon, 1' „_� $22 000 00 f '-� SCOPE OF WORK: �' 'r, - REFRAME ROOF STRUCTURE OF;DETACHED GARAGE DUE TO FIRE DAMQGE WORKIII DETACHED , �;`�, � ". � GARAGE. REF#: BX08-00001?(DEMO) ELEC.�5'LIGHT FIXTURES, 20 OUTLETS, 6 SWITCHE w... z PLUMBING UNDER SEPARATE PERMIT'(P08-00047). � '�+''--. OWNER: City/State: Phone: Const Type :?? SHOWER ROOM IN s F� �'� "r`�+'� � -: t-t � . � •S MINER, LILLY A TR'" ,:' Address: .;.2677 SANTA'ANA AVE UNIT'B�k" COSTA MESA CA; ` Zip Cade:; ;92627 4638 ,- , � �r ` a t T �' � t � �., � .." �; 1: � . - ..,• - APPLICANT: LAVINE{iALAN ��'-F - - Address 2906 E�CORONADO{ " Pho etate: 714 81E5 35 A �� : '"_ .,-'� ;., �':,...._ ' ,, Zi . Code� _ .92,806 ,� Y P f CONTRACTOR: Address: Ciry/State: Zip Code: • ARCHITECT: Phone ENGINEER: Phone . . . : - :.i <t : r , .. . . EME�RCOM�CONSTRUCTION �. - LicenseNo �152`590 2906 E CORONADO ST - _ 4, •— _f==� , -- . --, , r � � ANAHEIM,.CA : �. '...; � r'=. � =:. � a'_. 92806-250�1-" .�.. ' � " ��- � -i Phone 714-630c9615 �� n��: �: _ : .t � `; , License No. _� f =.t . WISS JANNEY, ELSTNER:ASSOCIATES�INC � ��,License No -,C63496 818-303-1300.'- %` � ' , �, . .-."� - .: : - y:., r "' FEE SUMMARY,.' � ''' Building Plan Check `"'�$22P.01 ��--'f` � � � . Building Permit: - " ,$34925 ? ��'� Electrical Permit: � � �:`$88:10 -� ''` `'�� SMIP Residential - ... . $2.20 . "� - . SMIPCommercial �" � ��-"�-$0.00��` . - $O.00TOTAL FEES $666.56 . , EL TO 200A; Unit �4 Unit ;?0� l ��: 'i Unit NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulalions. (Ord. No. 92-28, § 1, 72-21-92) . � EXPIRATION: PERMIT EXPIRES 160 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. 0� INSPECTION TYPE 1616 Fised System Final Fire Prevention 1266 Pool Spa Final 200 FinalRe-Root 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition DATE IN1111RL5 �' COOE 0 INSGECiION TYPE 206 Final Mechanical 208 F' I Plumbing 210 Final Eleclrical P/�. 212 Final Fire Prevention 220' Final Planning Approval 222 Final Site 250 Pinal Building/Occupancy �/n K UATE ' IN1171AL5 � �i� 5 n ff �i�'"'' �' WORKERS' COMPENSATION DECLARATIG. � I hereby aKrm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of wnsent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for Ihe pertormance of the vrork for which this permit is issued. � I have antl will maintain worker5' compensation insurance, as required by sectbn 3700 of the Labor CoCe, for the peAormance of the v.ork for which�this permil is issued. My workers' compensalion Insurance carrier and policy number arp � . Carrier. L � �yw�� ✓�'1 ��`I (TlutseCiunnee0nof rompleletlalf�epermtavaNeJalmehunCretl�llars(E100)wless) PolicyNumber: �C � �� 6�S�j —OI% ❑ I certify Ihat in the pertortnance o( the work (or which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should bewme subject to the workers' compensation pmv' ns of Section 3700 of the Labor�shall forthwith comply ' se provisio . Ap�nt's&B^a�ure � Date � WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE L4BOR CODE, IMEREST, AND ATfORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirtn that I am licensetl under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my licenLs.e is in tull force and effect. )�/�I Lic. # J'Z J �� Class # `LJ �/ �.-� �Z �� Conlractor'sSipnaWre . Date CONSTRUCTION LENDING AGENCY: ❑ I hereby affum that there is a construclan lending agency for the peAortnance of the work fa wfiich ihis pertnit is issued. (Sec. 3097, Civil Code). Lentler's Name: Lender's Address: SignaNre Da�e OWNER-BUILDER DECLARATIONS: I hereby aKrm that untler penalty of perjury lhat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for [he following reason (Sec. 7031.5, Business an0 Professions Code: Any ciry or coun�y which requires a permit to consWct, 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 Iicense0 pursuant to the provisions o( Ihe Contractors License Law (Chapter 9(commencing with Section 7000) o( Division 3 of the Business and Pmfessions CoCe) or thal he or she is exempt therefrom anC the basis for the allegetl exemption. Any violation of Section 7031.5 by any appliwnt for a permit subjects the applicant to a civil penalry ot not more than five hundred dollars ($500).): � I, as owner of the property, or my employees with wages as their sole wmpensation, WILL DO 7HE WORK, and the structure is not intended or oftered for sale (Sec. 7044, Business antl Professions Code: The Contractors License law Coes not apply to an ovmer af property v+ho builds or improves thereon, and who does such vrork himself or herself or Ihmugh his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold wiihin one year o( completion, the owner-builder vrill have the burden of provinq that he or she did not build or improve for purpose of sale.�. ❑ I, as owner of lhe property, am EXCLUSIVELY CONTRACTING WI7H LJCENSED CON7RAC70RS to consWcl Ihe project (Sec. 7044, Business and Professions Code: The wntractors License Law dces not apply to an owner of propeny vmo builOs or improves [hereon, and v.ho conlracis for such project with a cantracla(s) license pursuant tothe Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: 3057�a6(3/Ol) , Owner ID verifie0 by tlr�.,,, s li� .. ❑ Yes ❑ No Dnver's License No. Expires: Verification of Ownership by (type of document, i.e. - property [ax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: -❑ I hereby cerTrfy thal no excavation frve (5) or mme teet in tlepth into wfiich a person is required to descentl, will be made in connecibn v,itti v.vrk authorized by Ihis permit, antl that no building strucWre, scaffdtling, falsev.ork, v demolition or tlismantling thereof, will be more than ihiRy-six (36) feet high. (Chap. 3.2; Grp 2, M 2, Sec. 341, Title 8, Califomia Administ2tive Cade). ❑ As ovmervbuiltler, I will not employ anyone ro do vrork which would require a pertnit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. APd��s SignaWre Dale Division of Industrial Safery Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or (uture builtling occupant need to fle and certify a Business Plan for emergency response to release or threatened release of a hazartlous matenal? ❑ Yes ❑ No (Section 25505 0/ the California Health and Safety Code requires, with some exceptions, that a Business Plan be filetl with the Costa Mesa Fire DepartmeM by every business which has at any one time during a reported year a quantity of hazartlous matenals equal to or grea[er than a weight o( 500 pountls, or a volume ot 55 gallons, or 200 cuhic feet of compressed gas at standard [emperature and pressure). 2. Does or will the applicant or present or future building occupant need to file a registralion form for awtely hazartlous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Sa(ety Code, vrith some exceptions, requires regisVation with the Costa Mesa Fire Department by each business which al any one time has on hand a quantiry of acutely hazardous matenals equal to or greater than a weight of 500 pounds, or a volume o( 55 gallons, or 200 cubic feet of compressed gas al standard temperaNre 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 Calitornia Heallh and Safety Code provides Ihat Ihe Cos[a Mesa Fire Department may require the preparation, certifcation and filing with Ihe Fire Depariment o! an RMPP by businesses which are requiretl to register acu[ely hazardous ma[erials vrith the Fire Department. 4. If an RMPP is presently required, has Section 25534 0! the Calitomia Health and Safery Code been fully complied with? ❑ Yes ❑ No 5. Does or will Ihe applicant or present or fuNre builtling occupant require for the work which is the subject o( this application a pertni[ (or such conslruction or modification from the South Coast Air Quality Managemenl Dis[rict or (rom any other air polWtion control district or agency? ❑ Yes ❑ No (Secl'an 658502 of the Cali(omia Govemment Code requires that the requestetl information be fumishetl on applications fa non-residential building pertnits). 6. Will any part o( Ihe facility to be wnstructed under this pertnit be within 1000 (eet from Ihe outer boundanes of a school? ❑ Yes ❑ No Qf'yes", Ihe (acility must meet Ihe requirement of Sections 25534 and 42303 of the Califomia Heallh and Safety Code). 7. If a permit fmm Ihe South Coast Air Quality Management DisMct or other air polWtion control district or aqency is required for the work which is the subject of ihis application, have all of the disclosures piescnbed by Calitornia Health and Safety Cotle Section 42303 been made? ❑ Yes ❑ No 8. Qf'yes", attach certifcate of compliance from the appropnate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certity that under penalty of perjury tha intormation given above is correct I agree to comply wiih all state laws antl city ordinances regarding Hazardous Matenals and Emissions. oa�e CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:. I certify under penalty of perjury that I have read this appliwtion and state that the information given is wrrect I agree to comply with all s[ate laws and city ortlinances relating to builtling constmction, and authorize representatives of the Ciry of Costa Mesa to enter upon the above-describetl property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by Ihis permit until final inspection. Signawre o! Legal Owner(s) Date �� `('�"'J� u�M1onzetl Applitanl Date v � Ins Requested Inspect Date: Thursday, May O8, 2008 Site Address: 370 LA PERLE PL CM DETACHED GARAGE A/P/D Information Activity: BX08-00012 Type: B_MISC ConstType: Occupancy: Owner: MINER LILLYATR Engineer: WISS fANNEY, ELSTNER ASSOCIATES, INC Plan check: SHA Dev coor: RMD Applicant: LAVINE, ALAN Planner: HN Contractor: EMERCOM CONSTRUCTION D�scriplion: REFRAME ROOF STRUCTURE OF DETACHE Requestedlnspectionlsl Item: 250 FINAL BUILDING / OCCUPANCY Requestar: Assigned To: "•"•«»,•• Action: Time Exp: _ Comment: nee s ina e ec. and plumb. Inspection Historv Item: 1 BLDG F Item: 3 JOB SI" Item: 4 FOOTIP Item: 6 SLAB Item: 1Q ROOF Item: 12 ROOF Sub Type: Use: Phone: 818-303-1300 Phone: 714-981-5135 Status: ISSUED Insp Area: Requested Time: 08:00 AM Phone: Entered By: TEMPEMP K ( /7 ' � 1� HEIGHT "Approved" //�� GWH Action: AP APPROVED � Comment: Item: 13 BUILDING HEIGHT / RESIDENTIAL Item: 18 FRAME 8 FLASHING ' ALproved *" 03/11/OS Inspector� (�WH Action: CO Correction(s) Required Comment: NEEDS TO INSTALL ROOF AND OBTAIN ROUGH ELEC _03/21/08 Inspector: HM Action: AP APPROV�D Item: 20 LA Item: 24 Item: 30 Item: 31 Item: 32 Item: 38 Item: 42 Item: 44 " Approved " or: GWH " Ap roved " or: �WH - WIRING " Approved " Action: AP APPROVED Action: AP APPROVED 03/13/OS Inspector. RHB Action: CAN CANCELLED � � -� - Comment: 03/17/OS Ins ectoc RHB Action: CO Correction(s) Required Comment: TO�MANY TO LIST 03/18/OS Inspector: RHB Action: CO Correction s Required Comment: ADD GROUND FROM MAIN SERVICE TO GARAGE SUB �NEL. UFER ACCESS. REMOVE UFER FROM NEUTRAL AND CONNECT TO GROUND BUSS 03/20/08 Inspector: RHB Aclion: AP APPROVED Comment Item: 50 ELEC. POWER FINAUMETER RELEAS Item: 150 MISCELLANEOUS INSPECTION Item: 201 FINAL BLOCK/RET WALL(use 250� Item: 210 FINAL ELECTRICAL Approved ' 04/28/08 Inspedoc RHB Action: CO Correction(s) Re uired Comment: SUPPORT OUTLETS. BUBBLE COVER. PROVIDE LADDER AN� EXTENSION CORD 04/30/08 Inspeclor: RHB Action: PA Partial approval Comment: REPT131 Run Id: 8921 t � Item: 222 Item: 250 Item: 16 Item: 26 /OCC and plumb. )WN COAT "Approved " Inspector. GWH Inspector. GWH Action: CO Correction(s) Required Aclion: AP APPROVED Action: NR Not Ready Action: AP APPROVED REPT131 Run Id: 8921 CITY OF COSTA MESA BUILDING D/VIS/ON 77 PAIR DRIVE. COSTA MESA, CA 92626 • p14) 754-5273 • Fax (714) 754-4856 • www.ci.wsta-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER P08-00047 PERMITTYPE PLUM STATUS: • -ISSUED APN: 42531125 DATE ISSUED: 02/12I2008 ' . , 'ISSUED BY: BJK JOB ADDRESS: 370 LA PERLE PL CM ,, 'Suite/Unit Vicinity: FIRE DAMAGE TO DETACHED GARAGE'��- �� - SCOPE OF WORK: FIRE DAMAGE�REPAIR�TO A DETACHED GARAGE WITH A SHOWER-ROOM. PLUMBING: 1 BACKFLOW PREVENTER, 1 GAS OUTLET (1;4), 1 GAS'PIPE REPLACEMENT WATER HEATER ��-� . ,� TO WASHER/DRYER, 1 LAUNDRY TUB/WASHER, 1 SHOWER; 1 WASH BASIN, 1 WASTEB VENT, 1�.WATER CLOSET, 1 WATER - - ;�.:� ,., , HEATER REF:BX08-00012` ` OWNER: MINER, LILLY A TR �`?^; `�� Address: �" -; 2677 SANTA ANA�AVE UNIT�B- PHONE: . . "" ` . City/State/Zip: COSTAMESAi�CA„ :.- . , APPLICANT: ALANLAVINE� � ,,. '.� . - � Address: PHONE: 714-630-9615 � . �� _ , City/State/zZip: CONTRACTOR: EMERCOM CONSTRUCTION � Address: 2906 E CORONADO ST .. � City/State: ANAHEIM, CA � ; ZipCode:--92806-2501 . � ARCHITECT: � . ", ENGINEER: - � PL'UMBING PERMIT FEE SUMMARY. ; PLAN CHECK FEE: '� $O OO s'��' PERMIT FEE: . - $110:55 TOTAL FEES: $110.55 License No. license No. 2906 E CORONADO ST , : � ANAHEIM,CA' - - License No. 525903 PHONE: �714-630-9615 ... �� CELL: , ,'PHONE:.� - � , ; ,. ,PHONE: 1 `, . �.' t'_ � � 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, antl all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE /. INSPECTIONTYPE DATE INTI71AL5 COOEt INSPECIIONTYPE �ATE ,� j INTITIRLS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Poo15pa Final 20B Final Plumbing '�'''� � 200 Final Re-Roof 270 Final Electrical 201 Pinal BIocWRetaining Wall 212 Final Fire Prevenlion 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 204 Finai Demolition 222 Final Site 250 FinalBuilding/Occupancy WORKERS' COMPENSATION DECLARATION: - I hereby aKrm under penalty o! perjury one o! the follpwing declarations: ❑ I have antl will maintain a certifwte o( consent to sel4lnsure for workers' compensation, as providetl for by section 3700 of ihe Labor Cotle, (or the �pedor ance o( the work for which Ihis permit is issued. have antl will maintain wnrkers' wmpensation insu2nce, as requiretl hy � sec[ion 3700 of the Labor Code, (w lhe peRortnance of the �+ork fa which lhis permit is issuetl. My wvrkers' compensation Insurance carrier and policy number are: Carrier. �j�-��l ��y��- (rnrs seaon nree na oAm.ripeteen me perme m vax,ee at a�e nuneree eonars (Sioo/ m�ess ) Policy Number. �-�i 2 ) 6 � i�i6`'�S� �� ❑ I certify that in the peAortnance of the work for which lhis permit is issued, I shall not employ any person in any manner so as ro become subject to Ihe workers' compensation laws of Califomia, and agree [hat if I should hetome subjeq to the workers' compensation provisions of Section 3700 of the Labor e, I shall foAhwith comply with these provisions. Z -1 Z-� Appliranl's S9^alure Dale WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,0p0), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF 7HE lABOR CODE, IMEREST, AND ATfORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirtn thal I am licensed under provisions of Chap[er 9(commencing with Section 7000) �f Division 3 of (he Business and Protessions Code, antl my license is in lull (orce and eHect. Lic, it � C�i Class # �_ �T ./1 �- �—/Z'�� CorSl/5�c a s 9gnatwe Dare CpNSTRUCTION LENDING AGENCY: ❑ I hereby a(fum ihat Ihere is a cons[ruction lending agency for lhe peHortnance of the �+ork ta which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: SignaWre OWNER-BUILDER DECLARATIONS: I hyreby a(frm that untler penalty of perjury ihat I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for the (ollowing reason (Sec. 7031.5, Business and Professions Code: Any ciry or county which requires a pertnil to constmct, alter, improve, tlemolish, or repair any stmcture, prior to its issuance, also requires the applicant (or such permit ro Ne a signed statement Ihat he or she is IicenseC pursuaN to Ne pmvisions of the Contracrors LiCense Law (Chapter 9(wmmencing vrith Section 7000) of Division 3 of the Business antl Pmlessions Code) or that he or she is exempt therefrom and th� basis for the alleged exemption. Any violation o( Section 7037.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than fve hundred dollars ($500).): ❑ I, as owner of the propeAy, or my employees with vrages as Iheir sole compensation, WILL DO THE WORK, and the strucNre is not in[ended or oKeretl for sale (Sec. 7044, Business antl Professions Code: The Contractors LiCense Law dces not apply to an owner of property who builtls or improves thpreon, and who does such vrork himself or herself or Ihrough his or her own employees, provided Ihat such improvements are not intentled or offered for sale. If, however, Ihe building or improvement is sold within one year of complefion, the ovmer-builder will have the burden of pmving that he or she ditl not build or improve for purpose of sale.). � . ❑ I, as ovmer of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRAC70RS to construct the projecl (Sec. 7044, Business and Pro�essrons Code: 7he conlractas License Law dces na apply to an ovme� of property who builds or improves thereon, and who coniracts for suc� project with a r,ontractor(s) license pursuant to the Cont2ctors License Lav.sJ. ❑ I am exempt under sec. - Business and Protessions Code for this reason: SgnaNre Oate 305'/-46 (3/0]) -Owner ID verified by tlrive� nse. ❑ Ves ❑ No Driver's License No. Expires: � Verification of Ownership by (type o/ tlocument, i.e. - property tax bill or deed); DIVISION OF INDUSiRIAL SAFETY PERMI7 CERTIFICA710N: � ❑ I hereby certify that no excavation frve (5) or more fcet in tlepth into vAiich a per5on is required to tlescend, will be made in connection with work authorizetl by this pertnit, and that no building strucWre, scafidding, falsework, or demolition or dismantling �hereof, will be more Ihan Ihirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Califom'ra Administrat'rve Code). ❑ As owner-builtler, I vrill not employ anyone [o do wnrk which vroulq require a permit from the Division of IndusMal Safety, as noted above. unless such person has a permit to do such work from the tlivision. Applicanfs Signalure Date Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future builtlinq occupant need to file antl certify a Business Plan for emergency response to release or threatenetl release o( a hazardous matenal? ❑ Yes ❑ No (Seclion 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire DepaAment by every business which has at any one time tluring a reportetl year a quantity of hazardous materials equal to or greater than a weight o( 500 pounds, or a volume of 55 gallons, or 200 cuhic teet ot compressed gas at standard temperature and pressure). 2. Does or wi11 the applicant or present or fufure building occupant need to file a registration fortn for acutely hazardous matenals? ❑ Yes ❑ No (Section 25533 0( the Califomia Health and Sa(ety Code, with some exceptions, requires registra�ion with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materiats equal to or greater than a weight of 500 pounds, or a volume of 55 gallons. or 200 cubic feet of compressed gas at standartl temperature and pressure). 3. Does or vnll the applicant oi present or fuNre building occupant neetl [0 prepare an RMPP (Risk Management and Prevenlion Program for acutely hazardovs ma[erials)? ❑ Yes ❑ No (Seclion 25534 of Ihe Cali(omia Health and Safety Code provitles that the Costa Mesa Fire Departmen[ may require the preparation, certifiwtion antl filing with lhe Fire Department of an RMPP by businesses which are requiretl to register acutely hazardous ma[erials wiN the Fire Department. 4. If an RMPP is presently requiretl, has Section 25534 0( ihe California Healih and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or future building occupant require for the vrork which is the subject of this application a permit for such construction or modification from the Sou[h Coast Air �uality Management Districl or from any other air pollu[ion control dislricl or agency? ❑ Ves ❑ No (Sectbn 658502 0( (he Califomia Govemment Code requires ihat the requesletl in(ortnation be (umished on applications (or rqn-residential building pertnits�. 6. Will any part ot the facility to be constructed under this permit be within 1000 feet from [he outer boundanes of a schooi? ❑ Yes ❑ No (I('yes", lhe facility must meet lhe requirement of Sections 25534 and 42303 of the Calitomia Heallh antl Safety Cotle). 7. If a permit from the South Coast Air Quality Management Districl or other air polWtion contml distnct or agency is required for the urork 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. Qf'yes", attach certificate of compliance from the appropriate air polNtion control oKcer). � � ' CER7IFICATE OF COMPLIANCE: I certify'that under penalry of perjury Ihe information given above is correcL I agree to comply with all state laws and city ordinances,regarding Hazardous Materials and Emissions. , , SignaNre Date CER7IFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and slate that Ihe information given is correcL I agree to comply with all state laws antl city ordinances relating to building cons[ruction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property tor inspection purposes. I agree not ro occupy or allow occupancy of any building authorizetl by this permit until final inspection. Signawre ol Legal Owneqs) Date S� -z� ,z-�� Antllor AulhonzeE AppL�anl Date ORANGE COUNTY BUILDING DEPARTMENT APPLICATION FOR PERMIT �tt , 636 North Broadwuy ' -' ' ' ��'� SANTA CALIFORNIA � I L D I�� r FOR APPLICANT O FILL I1� FOR OFFICE USE ONLY RE EIPT NO. PERI 3UILDING � � 6 O / 4OORE55 SCHOOL OIST. ` �y ECEIVEO BY - DATEREC'O. DATE OR TOWN � V NEAREST - �`yy �/J S/3 6 yf� 1/� GRO55 ST. ��,A� � � / � � -/ lJ OWNER . A DDRE55 .�/ D n/� � V� ��-� i MAIL �w _ � � , ��— _ SCHOOL DIST ADDRES .� OR TOWN C.�O'dC �4 // �l�C�� TEL. �� CITY Q NO. NEAREST C_'{RyOV55 ST. ENG N'EERT OR NO. {J El / I P ANS I TYpyT"I GF � A/ �' .�.� y AODRESS /� � APPROVEO `�- - -� LIC. BV ��'��V(/� DATE CONTRACTOR �_ � NO., w ADDRESS �] 7�i . � ' f//�B �J�y A CORRECTIONS USE OF EXISTING BIOG J, SETBACK LINE FROM� EXTERIOR W, COVERING USE OF NEW BUILDING ' I F� i�es II ROOMS / REAR YARD � SIDE YARD 1 OF WORK oN I I nooiriorv 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORREGT AND AGREE TO COMPLY WITH ALL GOUNTY OROINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. SIGNATURE OF " -PERMITTE AUTHOHIZED AGT � + r �I �. ' .' �PEFMIT FE`QS � � VALUATION r.,• $ ` Y .i� `! J y r �.� O/� PLRN CHECK $ l/ TOTAL FEE �S I 9-90-59 '��APPROVALS JDATION: LOC "�ION }� SPECTOR DATE FORMS, MATE@ :ALS, }� /] 6, UNOER-PINNIt�� \�IN.v �E: FIRE STO I ' � ,/_ BRACING, BO S `f I. INT. 1 FXT \�� FINAL � ■ . _ _ : -_ _,� _ - . . � - � : _. .. ' . -- . •� , . �, . �; . I" STREET� ' _ �• . ' . ' PLOT PLAN ' Show'location and distances from � property lineand betweenbuildings. J , _ � ,. . . � . . �i ,. . ' . _ . . „i;��'+ . . ' � . ' - ' . . . _ �,�III'86 -' £S-6 taeP_1500� 00�� l—n . ; . .__ . �. y 43676 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING 57..d"I � P�RI� ADORESS 3� ( .OWNER P�7 iJG/'i/Y/N MAIL .7.1,�, Y 71 h_ .-, I_ . _� . F � 0+ a .�.. � 'S' F G W F Q � .� Q � �' � P�. W a 0 �i 0. z � 3 CITY BRANCH ADDRESS ARCHITECT ADDRESS CITY STATE L10. NO. S12E OF LOT TEL. NO. L. TEL. NO. CITY LIC. NO. NO. OF BLDGS. NOW ON LOT EXISTING BLDG. �t„'� % mf l.�^ (� Separate permits are required for , electric, plumbing and heating work. USE OF B DIN�AND WOfiK TO BE PERFORMED w � I hereby acknowletl8e that I hava reatl this application and state that the abova info�mation is correct antl ag�ee to comply wlih ell Iews re0ulatin8'building construction, antl I shall not employ any person in violacion of the workman's compensation laws of the Stete of California. � I hereby certify thet I am p�operly Iicensetl es a conttactor untler t�e Steta of Celitornia Bustness and P�ofessions Code, Division 3, Chapter 9, and thet such licenses ere in full forca end effect, or I am exempt from che provisions of the State of Callfornia Business and Professions Code, Divislon 3, Chaptar 9. Permlttee 7 / Authorlaetl � R Pt.Sll ,.,�r,,, �� „a.n te-�r�„S.O��r,oe��. ,., .�+7.._ti FORSTRUCTURALPERMIT OATERECEIVED D EI SVE� �� . A.P.NO.I%%�Z�nZ—O� ADDRESS 3 /O L� TRACT��7'3 L N W A D AL P OWNE j ['�(J � 5 FIRE ♦' , . � s_ I BLOCK DATE N NO.OF USE OF NEW � Z p�qry$ Z BUILDING VARDSAPPROVED VAROSAPPROVED MAIN BUIL�ING ACCESSORV BUILDING iOM C/L STREET) JM Z'� t FT�. �� FT. I �ry�F�T.� � `�� FT YDE L FT. ^ FT. .. �'l�c% l �iT '_ DISiANCE BET. BET. MAIN & `_ MAIN BLOGS. ACCE55.8LDGS. VAR � DATE C.V.P.� APPFOVED APPROVED ��'Y nn�r� � •�I6 —%( . �.. � n m i d SQ. FT. N THE AMOVNTSHOWN UNDER VALUATION IS FOF m THE PURP�E OF E5TABLISHING A PERMIT FEE ONLV: � VALUATION PERMIT FEE $ a N � m PLAN CHECK $ "� 0 $ � TAX $. � LL • �V (� V � TOTALPAID $ 2� � I . r 43675 COSTA MESA BUILDING-SAFETY•DEPARI P.O. BOX 1200 COSTA MESA, CALIFORNIA 9 For Applicant to Fill in Completely — Use Ink BUILDING —�O � � �l � ADORESS r OWNER N �'IN MAIL Gf]DRE55 .�%Q �^H PER�E Lw} . � � CW. a .�i y F � F � � Q > r .� a w a � �i C. z w. 2' 3 CITV LENDERV v `�_ BRANCH ADDFESS ' ARCHITECT � , , ADORESS CONTRACTOF ADDRESS � cirv _ �{ STATE LIC. NO. SI2E m O OF LOT 7� USE OF EXI5TING eLDG. No ' (�46-013'1 ��ueR - 13�„ldct� �PE2�G tSA No.` 646-0 CITV IIC. NO. :C I OO /�[C� I NO. OF BLDGS. � NOW ON LOT [ Separate permits are required for electric, plumbing and heating work.` BUIIDING A D W�7/q K TO BE PERFORMED �AJ/ /�l i � � 1 . _ /� I hereby acknowledBe ihet I have reetl this application and state that the above Informatlon Is correct entl agree to comply with ell lews reBulating building�construction, and I shall not employ any person in violation of the warkman's compensation laws of Me State of Californla. i he�eby certity ffiat I am prope�ly Iicensed as e contractot untler the State of Callfornia Business antl Profess(ons Cotla, Division 3, Chapter 9, antl that such Iicenses are in full force antl effect, or I am exampt from the D�e��sions of tha Sxete of California Business end Professlons (C�/j la, Divislon 3, Ch/apte�) 9. Sipnamre of /lGe�� 1/'� I _/A/NO \ `_ Parmittee ,' — _ - Authorizetl ABent � Falu "1R tb-?7t,570Q1�G6" ::**:�48.50 FOR STRUCTURAI. PERMIT DATERECEIVED n T iecimr A.P.NO./�7—Z�Z,� UZ I PERMITNO. BUILDING �v3�O �� E�C= LA/ AODRE55 i TRACT �I7� . LOT� BLOCK J , ZO ' NO.OF USE OF NEW 3ta//�E —Z PLANS Z BUILDING /�{�fy,� VARDSAPPROVEO VARDSAPPROVED R. SIDE Z / ��lC L. SIDE � REAR �� DISTANCE BET. MAIN BLDGS. VAR. �W 0.U.P. ay-` APPROVED � BET. 3—/.(-77 � n m ' d �� SQ. FT. � ' N THE AMOUNTSHOWN'UNDER VALUATION IS FOR m THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: " e VALUATION PERMITFEE $ ' M N (J-�/ PLAN CHECK $ '1O �/ � � � TAX $ � LL / �J U TOTALPAID S �� ,.. 42204 ." � COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUIIDING f^�. � n -��/� ADDRESS �/')' � OWNER MAIL �l, /� �� /' ADDRESS L,J �� - CITY ,C� C'� NOL�3/-3�' CONSTRUCTION ` ` 7l+ , LENDER V L. BRANCH ADDRESS �.+� OF ENGINEER ��K� " +"��'rR7NEL.C�s/o]��sy+ ADDRESS � y �.J�� " �nf� G.�C'�DG� CONTRACTOR / /�%�f(��_ F � W a Q H y `� F G w F Q L] .a a > r � x w a 0 C(. a Z W .T. 3 ADDRESS TEL. CITV NO. STATE CITV LIC. NO. LIC. NO. S12E NO.OF BLDGS. OF LOT NOW ON LOT USE OF EXISTING BLDG. Separale permits are required for electric, plumbing and heating work. I hereby acknowledBe that I have read this appliceiion and state that the ebove information Is corract and aprae to comply with all lews reguleting builtlin8 �onctruction, and I shall not employ any person in violatlon of the workman's compensallon laws of the Stete ot California. I hereby ce�tify thai I am properly ��ensatl as a contracior untler the State of California Business antl P�ofessions Code, Diviston 3, Chapter 9, and that such IlcenSes are In tull force antl effect, or I am axempt from the p�ovi5ions of tPe State of Calitornia Business and Professions Code ivision 3, ChdPter 9. Signatura ot � �� Permittee �XJ r' Authorized Agant �L�,!?'v-76PA:�,C�3821' ',�•�'��42.5G c„�r FOR STR[JCTURAL PERMIT A.P. NO. I � BUILDING ADORESS �j TRACT FIR� ZONE APPROVED BY E NO.OF J PLANS VARDS APPROVE MAIN BUILDWG VAR. # C.U.P. # DATE VARDS APPROVED BET. MAIN & THE AMOVNTSHOWN UNDER VALU THE PURPOSE OF ESTABLISHING A PERA VALUATION PERMIT FEE $ y. PLAN CHECK $ �� -Ja� TAX $ \/ TOTALPAID $ n m i d m N IS FOR m ONLV: � a ' N n m 0 LL f U