HomeMy WebLinkAbout1741 Tustin Ave - Building Permits (9)40 <<q'� MFq CITY OF COSTA MESA
BUILDING DIVISION
_ DEVELOPMENT SERVICES DEPARTMENT
J f
•� PERMIT
(714) 754-5273 • Fax (714) 754-4856
BUILDING PERMIT
Job Address: 1741 TUSTIN AV
Suite: 11
Vicinity: ROOF AREA
Parcel Number: 93328034 Zoning:
Applicant: JOHN SMITH
Address:
Owner: ORLEAN COMPLEX
Address
Phone: 909.657-5600
Zip:
Phone:
Zip: 92661
PERMIT NUMBER
B99.01651
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 10/12/1999
Issued: 10/12/1999
Contractor:
JOHN SMITH ROOFING
Address:
3410 IA SIERRA
F149
Phone: (909)657-5600
RIVERSIDE, CA
Zip:
92503
License: 443878
Arch :
Eng:
Address:
Address:
Phone:
Phone:
Zip:
License:
License:
SCOPE OF PERMIT
T/OFF AND
REROOF 2700 SF DUPLEX W/COMP SHINGLES.
FEE SUMMARY
Plan Check:
$0.00
Calc Valuation: $4,700.00
Permit:
$111.25
Claim Valuation: $4,700.00
SMIP Res:
$0.50
SMIP Com:
$0.00
Other:
$0.00
Inspection:
$0.00
Total:
$111.75
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 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 inspectlons 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
DECLARATIONS
WORKERS' COMPENSATION DECLARATION:
ffir
I hereby am 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 permit 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 workers' componsati In InstVanCeMngJ and policy number are: y
Carder. /C ��!1�J ((l�% Policy Number.
(This section need not be Completed it the permit /s valued at one hundred dollars (5100) or less.)
❑ 1 Certify that in the performance ol the work forwl' qq this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws o liforma, d agre that if s 6uld become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
on
comply with these pr vl s.
Applicant Signature: Date: 7—
WARNING:
WARNING: FAILURE TO SECUWORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
THOUSAND Dp11ARE (st ), 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 Iicen e r r vis' s of Chapter 9 (Commencing with Section 7000) of Division 3 of the Buslnes a✓d-0 as ons Code, and my license is in full
force and effect. Lic. p Class k C f�f
Contractors Signature:— Date: % —r
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 Cade).
Lender's 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).):
❑ 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 (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. It, 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.).
❑ 1, 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 contractods)
license pursuant to the Contractors License Laws.).
❑ 1 am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. ❑ Yes ❑ 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 more feet in depth into which a person Is required to descend, will be made In connection with work aumonzed 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:
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 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, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this aRJplication apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? L7 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 prescribed 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 state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE 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 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.
An Authonzed Applicant Date
CODE INSPECTION171PE INTITALS CODE/ INSPECTION TYPE Q9g INITIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof I L—r 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
2446.46
I
OWNER BRAEBURN CONSTRUCTION CORPORATION 'h A I g
DATE 3-20-62
K/
JOB ADDRESS 1741 Tustin Ave.,
Bldg.11, Units 134,135
BUILDING PERMIT NO.
16579
GENERAL CONTRACTOR Geo. D.
Buccola
VALUE $ 20,715,00
A 0.117-281-2 27 *ff 28
TRACT FIRE ZONE
DESCRIPTION OF WORK
2 Unit Apt.
INSPECTIONS
ISignatureI DATE I GROUP P¢
J TYPE V ZONE
R-2
Soil
Gas
K/
I G. SUBCONTRACTOR
PERMITS
DATE
ISSUED
NUMBER
Water
Rough Com. Refrig. ❑ Air Cond. ❑
Rough Heatingr7'
Rough Plumbing
OL
Miscellaneous.����
Prop. Swr. Line Q" ouse Con.
Sprinkling System
Q'St. Swr. ❑
p W
f
Construction Pole
Underground ❑ Power ❑
Rough Wiring
,(/
_ Q_
�•' %�� 6
1
rent es ❑ Forms 0 Steelem
.
a.y
Floor System
Bond Beam ❑ Steel Reinforce ❑
Sheathing
y
Fr—eand Flash'
a
y
I �g — In Out6
G7..
Plaster, brown coat
efng. ❑ Air Cond. ❑
Final
Heating, Final
0 /)
Plumbing Fixtures, FinalL�sel
/ �• A
Final Gas Test
i�stiv-
_,4/
.('�-+
Electric Fixtures, Final
Building, Final
10 _Z -6 a
OCCUPANCY
COSTA MESA BUILDING -SAFETY DEPARTMENT
P. O. BOX 3I7 COSTA MESA. CALIFORNIA
For Applicant to Fill In Completely
TYPE OR PRINT
BUILDINGy
ADDRESS 1741 TnetinF Bldg.",$11 ,;7,
COSTA MESA. CALIFORNIA
RIECEIVED
IQ
�
F�QCE1962 DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
n Corp.RECEIPT
OWNER Braun Const CIF`C�%(�
NO. PIRMIT NO.
MAIL 8 FO Box 3
MAIL 7'
RECE{Yp.D 0Y I DATE EC$IVB�_I ° fAAR 2 0
YL� S +/I✓ > 19
CITyBerport Beach - No. 0$31240
BUILDING
ADDRESS
ARHIORCENTE EER B.L. B.DIDberger NO. M316�I'
COSTA MESA. CALIFORNIA
ADDRESS 3355 Via Lido Newport Beach
FIRE ./
ZONE TYPE VI GROUP J/'
y
CONTRACTOR deo. D. Bwoola
APPROVED DATE 's Ary 6
ADDRESS 3700 Newport Blvd.
IONING
ZONE NO.OF USE OF NEW T Kti,-�A moi'
OC - PLANS BUILDINGSTATE
DES CRI
A P NO. // 7
CITY 1]Y rt Beach
��n
LIC.NO• ANO. 1240;
SIZEI NO. OF BLDGS
OF LOT330z 660 Now ON LOT d
USE OF
EXIST( G. SLOG.
YARDS EVES
APPROVED ALLOWED
SETBACK LINE FROM(CENTER
=MM OF STREET,?/- r/ REAR YARD .9 -'
LINE ST.)
FRONT FT. ( IN.
SIDE YARD I LEFT
I RIGHT /P'D
R. SIDE Z FT. IN.
L. SIDE FT. s IN.
DESCRIPTION OF WORK
NEW I ,` II ALTERATION I ((ADDITION I
REAR z 7 FT. ` IN.
REPAIR I II MOVING I n DEMOLISH I
APPROVED DATET.-
BUILDING "NO. OF
SIZE -X -�o ROOMS STORIES
E%TER IOR W LL 1 ROOF
COVERING COVERING Rnn
USE OF BUILDING AND WORK TO BE PERFORMED
7 OV1 y '
ACKNOW G TH I I;A BAD THIS A CATION
IA
AND STATE THAT T r OV [is HERESY
CT AND AGR TO COM-
PLY WITH ALL CI IN S STATE S OULATINO
THE AMOUNT SHOWN UHDE ALUATION IS FOR THE
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
VALUATION
}/
$��/�""�✓ 7
PERMIT FEE $ -7/0—
BUILDING CON ION.
SIGNATURE
PERMITTE
PLAN CHECK $ 4Q/ 0—
TOTAL FEE 6-0 —
AUTHORIZED AGENT
Iti