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Home My WebLink About3105 LINCOLN WAY - Building Permits S1 4`p5ll MCITY OF COSTA MESA • 6 9 @@ BUILDING DIVISION :r ..4r DEVELOPMENT SERVICES DEPARTMENT PERMIT BER F 1 �..+.. t PERMIT �• R ` BO -01465 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.buiLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 3105 LINCOLN WY Status: ISSUED Suite: Applied: 09/18/2000 Vicinity: Issued: 09/18/2000 Parcel Number: 14165248 Zoning: R1 R1 Applicant: ROGER COON c A Address: ISSUED BY: Phone: 714-534-6205 Zip: Owner: SURUKI, JAMES F TR Address 3105 LINCOLN WAY Phone: 714-534-6205 COSTA MESA,CA Zip: 92626 Contractor: R C ROOFING COMPANY Address: 11782 REVA DR Phone: GARDEN GROVE CA Zip: 92640 License: 456490 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT T/OFF SHEATH AND REROOF 2800SF RESIDENCE W/COMP SHINGLES,SMOKE DETECTORS REQ PER 97UBC. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $7,000.00 Permit: $139.25 Claim Valuation: $7,000.00 SMIP Res: $0.70 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $139.95 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced}vithin 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 end final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)7545626 2448-46(8'00) WORKERS'COMPENSATION DECLARATION: I hereby.afflml 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 pernnit 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 works compensation 1�Sgrance carder and policy number are: / '�f�r /�r,, 1 Carrier: 3 rex-7-c /-- V-n ( Policy Number: D J _✓v firm 1 t I b 7 K.- (This section need not be completed If the perm I Is valued at one hundred dollars(S f 00)or less.) ❑ I 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 Californl ,and agree that if I should become subject to the work is'compensation provisions of Section 3700 of the Labor Code,I shall forthwith oomph/with these provisions. � 'CoApplicant Signature: err '/Date: I — is " o r .--'-r 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 DOLLARE($ttO.000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed unser•rovisions of Chapter 9(commencing with Seco 000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Uc.# Itr ` _ Class a C-3 `9 Contractors Signature: :a. i, i / Date: g —)S-0a 7` CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is Issued.(Sec.3097,Civil Code). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to Its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500).): ❑ 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 tor 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 driver's license. 0 Yes 0 No Drivers 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 moro feet in depth into which a person Is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes ❑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 cubicfeet of compressed gas at standard temperature and pressure). _ 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department, 4 If an RMPP is presently required,hasSection 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication°kerma for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? la 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 California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPUANCE 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 mply 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-descri perry for Inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ear Signa�/ty Of Legal— Owners) / Dat � T And/C r Autho d Applicant !/ /�_ Date CODE L INSPECTION TYPE DISE MALS CODE 4 INSPECTION TYPE PAIS ItlImAL5 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final ��f �/� 208 Final Plumbing 200 Final Re-Roof JO —d"' 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 Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. 14315 2/15/64 sJeOU Tl, CITY OF COSTA MESA - - PERMIT NO. - TRACT NO. `"LOT NO. - BLDG.NO. - CONSTRUCTION PERMIT j9-7/35-9 • . • Project Address 3105 Linrnln Wy TYPE OF CONSTRUCTION Li NEW U ADD LJ ALTERATION Li REPAIR • 0 Applicant's Mailing Address 10477 TTA 9k .41,vP (:Arden (rnVe ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# I Zone Owner's Name _ Mr_ 'Sttrtlki Phone546-1$Q4 DESCRIPTION OF WORK Replacement of Water Heater S Main Building: Accessory Building: Z Address 1105 L co1n 14y Cnsta Meca • TYPE OF PERMIT ❑ GRADING U FOUNDATION U STRUCTURAL E Front N Arch/Eng.. License No. 0 TENANT ❑ ELECTRICAL ® PLUMBING ❑ MECHANICAL B Rear N Address • - 0 OTHER Contractor's Nemr A-ames Plumbing-Heatin;hone 530-2440 PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right GR 10422 Trask Ave. Garden Grove CONSTRUCTION TYPE VALUATION$ $ Left Address(mailing) E City License No. 6664 • ZONE READY FOR CU.YDS. ACRES - Ping. Ref.# Park.Fees $ - Q LICENSED CONTRACTOR DECLARATION • Remarks: - FLfn INSPI_ �ON Parking Req./Provided - u I hereby affirm that I am licensed under provisions of Charter 9 (commencing _ ss R ,-yl with section 7000) of Division 3 of and Pro :s ons Code,and Use of Building: • E my license is in full force and effect. License Class C-36 _ Lice. 2-.307 PLUMBING FEES Planning Notes: • M Date 2-8-8y) Signature r��- ✓-_� ,�� N (}) WORKERS'COMPENSATION r E LARATI Bar Sink Showers (/ ' hereby affirm that I have a certificate of coo. nt to self-insure or a certificateT Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Prevente • r Service Sink $ 00, Lab. C.) Backflow Irrigation Sewer Cap ELECTRICAL I FEES Policy No.WP83076419 Company Fremont ❑ Certified copy is hereby furnished. • Bathtubs Sewer Connection Automatic Washer' ,Transformer 0 15-50 KW L Certified copy is filed with the city Building Division. 0 50+KW Date 2-8-R4 Applicant !1-amPc plumbing-$eAtine • Cla•rifiers Solar Collectors Construction Pole Sub. • EXEMPTION FROM WORKERS'COMPENSATION DECLARATION. Dishwasher Solar Piping ❑u to 100 amps (This section need not be completed if the permit is for one hundred ($100)orP 9 Cooking Unit Meter p p less). DrinkingFountains - I certify thatm in the performancepersonn the work for which thio permit is t I Solar Tank •Dishwasher Meter [lover 100 amps Wort not employ any person of any Manner so as to become subject to the Workers' Compensation Laws California. Floor Drains Swimming Pool w/Spa Dryers OGas ❑Electric Sub Panel Date Signature NOTICE:If,after making this declaration,you should become subject to the Floor Sinks Urinal Fan Workers' Compensation provisionsofthe Labor Code; you must forthwith - _ Motors❑0.1 HP r-, Motors comply 'with such provisions or this permit shall be deemed revoked. - Gas Service Outlets Water Closet F.A.U. -Inc.Solar 09-15 HP 016-15+ • CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance Interceptors 1 Water Heater 2100 Fixtures of the work for which this permit is issued (Section 3097 Clv. C.) - Microwave Lender's Name Kitchen Sink - Water Service Device Boxes Pole Light Lender's Address OWNER BUILDER DECLARATION Lavatories - •Outlets • Range • I hereby affirm that I am exempt from the Contractor's License Law for the p-Tfa following reason (Section 7031.5 Business and Professional Code: Any city or - p Switches Sign 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 Roof Drains - Garbage Disposal Standing Sections to file a signed statement that he/she Is licensed pursuant to the provisions ofthe Contractor's License Law(Chapter 9 (commencing with Section 7000)of nivision 3 of the Business and Professions Code) or that he/she Is exemptGenerator 00.5 KW 05-15 KW Trash Compactor • efrom and the basis for the alleged exemption. Any violation of Section - • - i 5 by any applicant for a permit subjects the applicant to a civil i-�.alty of not more than five hundred dollars($500). , Reinspection Fee $25 Issue Fee- $ 3 LJ I, as owner of the property or my employees with wages-as their sole , Reinspection Fee $25 Issue Fee , $ 3 ' compensation, will do the work, and the structure is not Intended or offered - MECHANICAL FEES for sale (Section 7044, Business and Professional Code: The- Contractor's PUBLIC SERVICES REQUIREMENTS: License Law does not apply to an owner of a property who builds or improves Boiler Hood or Type I Elthereon, and who-does such work himself/herself or through his or her own ' - Zoning Approved By Date employees, provided that such improvements are not intended or offered for Canopy Type I I ❑ sale. It, however, the buildingor improvement is sold within oneyear of tom- Duct-Under Ground , Application Approved By Date Motion, the owner will have the burden of proving he/she did not build or im- prove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By 0-i-, Date r-�" y -�� UI, as owner of the property, am exclusively contracting with licensed con- ❑0.100,000 BTU ❑100,000 BTU 'tractors to construct the project `Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY OF FEES The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT O lam exempt under Section B.& P.C.for this reason Firepl/Fact.eft. ICBG# PLUMBING $ 7 en0 Si ) ISSUANCE $ 3R) Date Owner Heating System& Ducting i PLAN CHECK $ ENERGY P.C. $ I hereby certify that I h. : read this applicat'on and state that the above ❑0.100,000 BTU 0100,000 BTL - GRADING $ information Is corre agre• o comply h .II city and county ordinancesELECTRICAL $ and state laws r. . mg to bus •Ing c•- .c ••n,and hereby authorize repre- MICROFILM $ PLAN CHECK $ neof is ci •- ter ... t abo e-mention cop I. or� inspection • .. - -•� MECHANICAL $ TOTAL FEE $ 5 00 Signature .x — _ - - Da Drivers' cense or,SS -•IK� CMF 0865-46 rev. 7/83 White-Building;Canary- •pplicant:Pink-Accounting:Goldenrod-Assessor - CONSTRUCTION AND PLANNING POOL 'PA APPROVALS Permit ?rt 3h`� Date Inspector APPROVALS Permit# Date Inspector 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 6. Electrical LIFER Gr'nd. 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. Sola? 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 Fireplacd APPROVALS Permit# C. 21. Ducts, in Structure r 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 -�J 74. Overhead Hydro 26. T-Bar Ceiling (Structural)(&-Monocoat 75. Dry Chemical 27. Frame and Flashing Lao76. 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 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 2/4/gq 9 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 48. Special Requirements Completed 49. Electric Release to Edison - • 50. Gas Release to Southern California Gas Co' U • 51. CERTIFICATE OF OCCUPANCY . No. Date - .. ,. 18772 FEE RECE;v tD COSTA MESA BUILDING-SAFETY DEPARTMENT FEB t-9 19 P. O. BOX 817 COSTA MESA. CALIFORNIA FINAPICE DEPT. For Applicant to Fill In Completely OF COMESA PP � P Y APPLICATIONCITY FOR PERMIT STA TYPE OR PRINT BUILDING BUILDING ADDRESS 1105 LLnco.ln Way COSTA MESA. CALIFORNIA For Office Use Only �T RECEIPT NO. PER I OWNER 1/CC en fll� I nu n Cn np n/I �� MAIL RECEIVED INT 1 DATE RECEIVED DATE ISSUED ADDRESS 3225MMa.boa /3.lvd. , rco I o 196 r.FrI 1 Inca TEL CITY nAti2 Mena No5460505 AEI DDILRESS . ARCHITECT TEL. COSTA MESA. CALIFORNIA OR ENGINEER NO. '/ (((��/ FIRE ADDRESS Alpert A ZONE. TYPE GROU Cr CONTRACTOR Al ped A. &sL4o/rn APPROVED DATE `(//// ADDRESS 2iO1 Bendiest C°yon 1i2ive ZONING Bee./7.2y !/iCA-A�, CQ.CLLORR.La ONF�-� INO.OF I USE OF NEW ., ��r CITY J pI K PLANS BUILDING S'7' E LICSTA.NO. 141355 • NEO CR-68940 LEGAL 4,,,f- /6 �f ÷,6.-÷,6.-6,8 DESCRIPTION SIZE I NO. OF BLOCS. OF LOT NOW ON LOT A.P.NO. • USE OF YARDS EVES EXISTING BLDG. [' 11 7 APPROVED ALLOWED SETBACCENTERKOF LINEPROM55 REAR YARD..)‘• ,J// FRONT LINE ST.l�.-C FT. IN. SIDE YARD I LEFT 5 I RIGHT 5'. R.SIDE FT. IN. DESCRIPTION OF WORK L.SIDE r FT. IN. NEW I X IIALTERATION II II ADDITION I1 REAR _ 30 FT. .3 IIN.G/ ZZZ) REPAIR I II MOVING 11 DEMOLISH I APPROV�t.A.,WI DATE 2-i — SUILDING 52 X 49 ppOMS 6 STORIES 7 75-/-- EXTERIOR 7� SIZEUI1 1 '`.' �,� COTERIWALL Set RCOOVERINGWOod & Rocuk COVERINGR JJ..CC ((QQ1J USE O€BUILDING AND Wp9K TO BE P RF RMED 1- Iain. /.en. /a.t.tac e 4anal e. _ t-/730 _- /7 72 a i m.atz.t d d 4 F 38d 4: I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- THE AMOUNTSHOWN UNDERVALUATION FOR THE PURPOSEE PLY WITH ALL CITY ORDINANCES AND STATE LAWS TING OF ESTABLISHING A PERMIT FEE ONLY. BUILDING CONSTR�T•N. ///(//�J� VALUATION PERMSIGNAITURE O i i 1:7( / �./� PERMIT FEE S f/1 r� H S I?,,,o2�l PLAN CHECK S 010-5-0 F AUTHORIZED AGEN V/�77 E TOTAL FEE $ 6 /`/ ; u