HomeMy WebLinkAbout986 TRENTON WAY - Building Permits, . �
CITY OF COSTA MESA
t �'rtpMFq BIIILDING DIVISION
>�� 77 FAIR DRIVE. COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
� g FOR INSPECTIONS CALL: (714) 754-5626
''°•��"``' PERMIT NUMBER: P10-00138
PERMIT TYPE PLUM STATUS: ISSUED
APN: 14105248 DATE ISSUED: 10/18/2010
ISSUED BY: RMD
JOB ADDRESS: 986 TRENTON WY CM
vicinity:
Suite/Unit:
SCOPE OF WORK: PLUMBING PERMIT TO CHANGE OUT WATER HEATER FOR SFD. COMPLIANCE FORMS ATTACHED TO
JOB CARD AND CITY PERMIT.
OWNER: LANG, CHARLEE JO Address:
PHONE: City/State/Zip:
APPLICANT: PEDROZA, ROBERT Address:
PHONE: 714-635•9026 City/State/zZip:
CONTRACTOR: PRO CONNECT PLUMBING AND ROOTER INC
Address: 1813 S BAYLESS ST
City/State: ANAHEIM, CA 2ipCode: 92802
ARCHITECT:
ENGINEER:
License No.
License No.
986 TRENTON WAY
COSTA MESA, CA
License No. 671498
PHONE: 714-635-9026
CELL:
PLUMBING PERMIT FEE SUMMARY
PLAN CHECK FEE:
PERMIT FEE:
TOTAL FEES:
$0.00
$35.80
$35.80
PHONE:
PHONE:
NOTICE: The work authonzetl by this pertnit shall wmply 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 fnal approval will result in the expiration of this permit.
CODE�. INSPECTIONTYPE ORTE IN7ITIRLS DE� INSGEC➢ONiVPE OATE INP71AL5
1616 Fixed System Final Fire Prevention 206 Final Mechanical ��
1266 Pool Spa Final 208 Final Plumbing �( 1�%-'� �LU l6L ��� �
200 Final Re-Roof 210 Final Electrical
201 Final BIOGk/RetaiNng Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Si�e
204 Final Demolition 250 Final Building/Occupancy
.
WORKERS' COMPENSATION DECLARA N:
I hereby affrm untler penalty ol perjury one of the following tleclarations:
❑ I have and will maintain a certificate of consent to self-Insure (or workers'
compensation, as provitled for by section 3700 of the Labor Code.�for the
peAormance of Ihe work (or which �his permit is issued.
❑ I have and will maintain v,orkers' compensation insurance. as required by
secl'an 3700 0( lhe Labor Cotl@, for Ihe peAormance o! the wurk for which this
permil is issued. My workers' compensation Insurance wrrier antl policy
number aret: I
Carrier/OUh'hP.!'n `�Su(Cnr��-P
(Tnis se[!un need lro! be mmpletMalne pemr! is valued at one nurMmtl tlolWrs (5100) a�ess )
[P..oG"c'y:Nmmber wSioOUiC�S-I–o(
❑ I certity that in the peAOrmance o( the work for which this permit is
issuetl, I shall no[ employ any person in any manner so as to become subject
lo the workers' compensation laws of California, antl agree that if I shoultl
become subject to the worker; compensation provisions of Section 3700 0!
the Labor Cotle, I shall forthyqth comply with Ihese provisions.
—��%/— lo� l�•(o
�nppnern s $ignalur! Date
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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
(5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS qECLARATION:
I hereby affrm Iha[ I am licensed under provisions of Chaprer 9(commencing
with Seclion 7000) of Division 3 0( the Business and Professions Code, and
my license is in full force and eryect.
Lic_n 6`1 t �l`IS Lclass:s--.i36
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l/Cnlraclars ature —�Da�e
CONSTRUCTION LENDING AGENCY:
❑ I hereby aftirtn [hat [here is a construclion lending agency for the
peAormance o( the aork for whir,h this pertnit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's AdOress:
OW NER-BUILDER DECLARA710NS:
I hereby aKrm that under penalry of perjury that I am EXEMPT FROM THE
CONTRAC70RS LICENSE I,AW lor the (ollowing reason (Sec. 7031.5,
Business and Professions Code: Any city or county whic� requires a permii to
construct, alter, improve, demolish, or repair any sWCNre, pnor to its
issuance, also requires Ihe ap{�licant for such pertnit to file a signetl statement
that he or she is licensed pursuant to the provisions ol the Contractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business and Pmfessions Cotle) or that he or she is exempt therefmm and
the basis for the alleged exemp�ion. Any viola�ion of Section 7031.5 by any
applican� for a permit subjects the applicant to a civil penalty o( not more than
fve hundred dollars ($500).):
❑ I, as owner of the propeny, or my employees with vrages as their sole
compensation, WILL DO THE WORK, and the structure is not intended or
oftered (or 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 hersel( or thmugh his or her ovm
employees, provided that such improvements are nol intended or offeretl for
sale. I!, however, the building or improvement is sold within one year of
completion, lhe ovmer-builder will have the burden of proving Ihal he or she
ditl not build or improve !or purpose ol sale.).
❑ I, as ovmer of the propeny, am EXCLUSIVELY CONTRAC7ING WITH
LICENSED CONTRACTORS Ib construct Ihe prqecl (Sec. 7044. Business and
Professbns Code: The contractors License Law dces not appty to an ovmer of
property who builds or improveS thereon, and wfio cont2cts fOr such project with
a contracta(s� ficense pursuant to the Contractors License Laws.�.
❑ I am exempt untler sec.
Business and Professions Code !or this reason:
SignaWre
905]a6 pl0l)
Owner ID verife. .river s license. ❑ Yes ❑ No
Dnver's License No. Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or aeetl):
DIVISION OF.INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certi(y that no excavation fve (5) or more fee� in dep�h into wfiich a
person is requiretl to descend, will be made in conneclion with vrork authorizetl
by this permit, and Ihat no builtling sWCWre, scaF(dding, falsework, or demolition
or dismantling thereof, will be more than thirty-s�c (36) feet high. (Chap. 32, Grp
2, M 2, Sec. 341, Title 8, Califomia Administrative Code).
❑ As ovmer-builtler, I will not employ anyone ro do work which vrould
require a permit fmm the Division of Industrial Satety, as notetl above, unless
such person has a permit ro tlo such vrork (rom the tlivision.
Appllwnl's Signalure
Division o( Industrial Safery Pertnit Number: _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or (uture building occupaN neetl to file antl
certify a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of Ihe California Health and Safery Cotle requires, with some
exceptions, that a Business Plan be filed with the Cosla Mesa Fire
Department by every business which has at any one lime 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 standartl temperature and pressure).
2. Does or will the applicant or present or future building occuDanl neetl to file
a registration torm for acutely hazardous matenals? ❑ Yes ❑ No
(Section 25533 of the Califomia Health and Safety Code, with some
ezceptions, requires registration wim the Costa Mesa Fire Department by
each business which at any one time has on hand a quantity of acutely
hazartlous materials equal to or greater Ihan a weight of 500 pountls, or a
volume of 55 gallons, or 200 cubic fee[ of compressed gas al standard
fempereWre antl pressure).
3. Does or will the applicanl or present or future building occupant neetl ro
prepare an RMPP (Risk Management antl Prevention Program for aately
hazardous materials�? ❑ Yes ❑ No
(Sec6on 25534 of Ihe Calilomia Health and Sa/ety Code provides that the
Costa Mesa Fire Department may require the preparation, certification and
fling with the Fire Department o( an RMPP by businesse5 which are required
to regis�er acutely hazardous materials with the Fire Department.
4. If an RMPP is presenHy required, has Section 25534 of the California
Health antl Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or (u[ure building occupant require for
the work which is [he subject o( this application a permit for such construclion
or modifcation from the South Coast Air Quality Management Disirict or from
any other air pollution con�rol tlistnct or agency? ❑ Yes ❑ No
(Sectbn 658W2 of Ihe Califomia Govemment Code requires thal Ne requeste0
infortnation be fumished on applications (or rwn-resMential building pertnits).
6. Will any part of the (acility to be constructetl under this permit be within
1000 feet from Ihe outer boundanes of a school? ❑ Ves ❑ No
Qf "yes", Ihe (acility must meet the requirement of Sections 25534 antl 42303
of 1he Cali(omia Health antl Safety Code�.
7. If a permit trom Ihe South Coast Air �ualiry Management DisMct or other
air polWtion control district or agency is required for the work which is the
subject of Ihis application, have all of the disclosures prescnbed by Califomia
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. (If "yes", attach certificate of compliance from the appropriate air pollution
control oKcer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
information given above is correcL I agree to comply with all state laws antl
cily ordinances regarding Hazardous Materials and Emissions.
SgnaWre Da�e
GER7IFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalry of perjury that I have read this application and state lhat
the information given is correct I agree to comply with all state lavrs and ciry
orGinances relating to building conswction, antl authonze representatives of
the Ciry of Costa Mesa lo enter upon [he above-0escnbed property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this pertnit until fnal inspection.
Signawre oi Legal Ovmer s) Dale p
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c�n�r���� �r
Residei�rial Alrerario�rs W
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Cuntrue�ur's, (Uucumentation Author's/ResponsiLle Ruilding Uesbner'S/O�vner'S), Ueclar�tiun SWtement
• I certify Ihm this CenificWe ul'CumpliancC ix accur.�icanU complac.
• I am eli�ihle under Uivision 3 0l ihe Califomia Business and Pml'Gasions Code m acecpi mpunsihiliiy for ihc huilding
dcsigo identiGed un A�is Ccnifica�e o! Cuntp7i�nce.
• I reni(r thm ihc cnergy fcawres unJ ptrformuncc spteifip�inn4 for ihc hu�idinp dcsien idemificd un ihie CcrtiGcaic uf
Compli�nce cnn(orm to thr rcquircmcros of Title 2J. P�ns I untl G nf ihe Califnmia Cu[M of Re�ulaiians.
• Thc haiVdinp design feowres idcmiLeJ on this Cenifir�ir n( ComplYance ure consistem wi0i �he in�ormmion provideJ io
ducumenl this huildin� aesipn on the other applicuhle cmnpliance forms. wnrkshccis, c�leulations, plans and specific:niun�
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t ti u...,v C_.a- 9 a 3jv -i �/�'� %y � 3S=
uryu¢niuns rc�;arding iiic G��crgy SwndaNs. romnci t6r fucrgr Hulliur ai: l.ti(IU- 2-DOU.
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Ho[ Water
CN-GR-MECH-01
F,nforccmen[ Accncr. � Permil
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I, WATER HEATING SYSTEMS:
Distribution Rated
CLl' 'I�Ypc I( q ol' Input (kW Tank S�andby
�{ipler Crrtitird MG Nume & Mudrl (Std, Poim-uf- Recireulution, Idcncical °� � Volume ��liciency Losi
'f Num6er Use rtc Comrol T S stems f3m/hr) �ullons (GI', HH) (%)
K,�-e n%.n o .- C
�`" /y� - o �- � �eeo � � � 'S9
�'plp l: /�ar e]nnl! gus 5(Orn,('r (rnte<l in/Jlll lrSs llinn oP Py[tnl l0 75.000 8lIIAlr), Clrc(ric rrSidYnnfe u/]tl lKnl /Am!O wnle! lrrnlrr5, li.al
F.nrrKv Faie�or (EF). For lnrge gns storage �vn7er hva�ers (r<ned i�ipw ojgre<��er drnn 75,000 Htu/hrl. list Recnvery LJficie�ic�� (REI,
77iernnd EJJirienc;x Sinndf{p Loa's nnd Rn�ed lnpur. For ias�mum�enus gw' wa�er hea(eis, lis7 U�e llterma! EJJicie�icv und Rnrr<I Lrpu�.
2. Mandatory Mensures
7'O COMPLY - ALL BOXES MUST 13E CHECKED
❑ 5110-j I 13: Water heaters, showerhead and taucets are certified by lhc California Energy Commission.
$I50(j): Water System Pipe and TanA Insulation. And Cooling Line Insulation
I. Stor,�e tnnk insulation
/
tT A. Storage gas warer heaters rated with an Energy Factor no greater than the federal minim,d sl:mdard are
/ extemally wrapped with insulation having an installed thermal resistance of R-12 or greater, and
/
0 B. Unfired storage tanks or other indirect hot water tanks have R-12 ex�ernal insulation or R-I6 intemal
insulation where ihe internal insulation R-value is indicated on the exterior of the tank.
? W/ater piping nnd cooling system line insulation thickness and conduc�ivity
IJ First 5 feet uf hot and cold water pipes cbsest to�water heater tank, non-recirculating systems, and entire
/ length of recirculating sections of hot wacer pipes are insulated per Standards Table I50-6; and
0� Pipe insulation for steam hydronic heating systems or hot water sys�ems > I S psi, meets the requirements of
�andards Table ]23-A.
Insula�ion is protecred from damnge, including thnt due to sunligh�, moisture, equipment mainteuance, and
wind.
y I51(�8D: If indicated on the CP-I R, �II ho� water piping that runs from the hot water source to the kitchen fistures is
insulated per Standards Table 150-B.
2003 Residenlicd Corripliance Forms Aukus� 2009
3, Central N'�uer Hrating in Buildings with Multiple Dwelling Units (required for prescriptive)
'I'O COMPLti' - ALL 60XES MUST BE CHECKED
❑ All hat water piping in main circulating loop is insulated to requiremenis of § I SOQ)
�entr.�l hot water systems serving six or fewer dwelling units which have ( I) less thun 25' of Jisiribution piping
ouWoors; (2) zero disvibution piping underground; (3) no recirculntion pump; and (4) insulation on distribution
piping that meets the requirements of Section I50(j)
❑ Ccntrnl hot water systems serving more than 6 dwelling units - prescncc of either u �ime cuntrol or a
iime/temperawre control
DECLARATION STATEMENT
• I cenity under �nalty nl'pery'uq•, under the laws of �he Slate ofCnlil'urnia, the intircmalion pmviJed on �his form is true and mrrect.
• I nm eligible under Divisinn 3 uf the Dusiness anJ Prokssions Code w;iccepi rcspunsiAili�y tur cunstruc�ion, or an umhorixed
rcprescm:�ii.c uf thc penun responsible 1'or cmiswction lrespunsible �xrsan�.
• I eenitj• that �hr insmlled ten�ures, materials, components, or manufacmrcd deviees idemified on this eenific.uc �the ins�allatiun)
amfunns to n�l npplicable code> anJ rcgulations, and ihe installmiun is cunsisten� wiih ihe plans anJ s�cilic:ilions :ipproved by the
enforcemenl agency.
• I revicweJ a cop)' ol thc Cerlilicate of Complianm (CP-I R) lonn approvcJ by lhe enfurccntcnl ugency thal idcnliliei Ihe s(Kcilic
rcyuiremem5 I'or the installmion. I crnilj• �ha� ihe rcquiremenu detailed on ihe CP-i R ihai apply �u thc insmllation havc been met.
• I a�ill ensurc Ihni a cumplrfed, signeJ capy of thi� Inslullution Certificale shall be posted, or muJe uvuiluble with Ihe builJing
permil(s) isxucJ fur �hr builJing, unJ muJe ovuiluble Iu lhc enfurecmenl ugcncy fur ull upplicuble inopcclion�. I unJenlunJ
�60� u signeJ cup�� uf this Inslnlla�ion Certifico�e is reyuireJ lu be includeJ wilh ihe Ancumenluliun Ihe buiWer pruriJcs lo
ihc builJing ownrr a� occupancy.
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Lot 13
COSTA MESA BUILDING.SAFETY DEPARTMENi
P.O. BOX 1200 COSTA MESA� CALIFORNIA 9R620
For AppBmM fo FJII In Compl�hly
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