The URL can be used to link to this page

Home My WebLink About1741 Tustin Ave - Building Permits (42)(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 MECHANICAL PERMIT Job Address: 1741 TUSTIN AV Status: ISSUED Suite No 12B Applied: 12/23/2002 Issued: 12/23/2002 Vicinity: ATTIC OF UNIT 12B Parcel Number: 93328038 ISSUED BY: Applicant: PARSONS, GORDON Address: 2282 ORCHARD DR Phone: 949-456-0064 NEWPORT DR Zip: 92660 Owner: INGOLD, R KEITH Inst FAU <100 k BTU Address: 2529 LORING ST $0.00 Repair/ Alt Cooling/Heat $0.00 Phone: $0.00 SAN DIEGO, CA Zip: 92109-2363 Contractor: ABC HEATING AND A/C Gas Piping Address: 2282 ORCHARD DR $0.00 Hood w/Meth Exhaust $0.00 Phone: 949-456-0064 $0.00 NEWPORT BEACH, CA Zip: 92660 Appliance $0.00 License: 810481 Gh� OPE OF PERMIT I^'�T^" "T'^ FAI J < 100K BTU IN THE ATTIC OF AN EXISTING CONDO (UNIT ' 12B). . . - - - NO OTHER WORK AUTHORIZED WITH THIS PERMIT. .- Quantity ISSUE FEE $23.50 Inst FAU <100 k BTU $14.80 Inst FAU >100 k BTU $0.00 Repair/ Alt Cooling/Heat $0.00 Inst / Rep. Recess Wall HV $0.00 Refrig Sys <100 k BTU $0.00 Refrig Sys >100 k BTU $0.00 Gas Piping $0.00 Factory Fireplace $0.00 Hood w/Meth Exhaust $0.00 VAV Box $0.00 Vent Fan / Single Duct $0.00 Appliance $0.00 Fire Dampers $0.00 Smoke Dampers $0.00 Inst or Relocate Appl Vent $0.00 Air Handlers < 10000cfm $0.00 Air Handlers > 10000cfm $0.00 Floor Furnace $0.00 Floor or Suspend Heater $0.00 FEE SUMMARY Quantity Repair / Alt Absorbtion Unit $0.00 0 Repair % Alt Refrigeration Unit $0.00 0 Ventillation System $0.00 0 Evaporative Cooler $0.00 0 Commercial Incinerator $0.00 0 Domestic Incinerator $0.00 0 Compressors / Absorption Systems Up to 3 hp / 100k BTU - $0.00 0 3 To 15 hp /500 k BTU $0.00 0 15 To 30 hp / 1,000 k BTU $0.00 0 30 To 50 hp / 1,750 k BTU $0.00 0 Over 50 hp / Over 1,750 BTU - $0.00 0 Boilers - Up to 3 hp $0.00 0 3 To 15 hp $0.00 0 15 to 30 hp $0.00 0 30 to 50 hp $0.00 0 Over 50 hp $0.00 0 Other Mechanical Fee Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 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 2446-46 (6100) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affimt 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 for which this penult 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' cam ensatlon Insurance mer and policy number are: //// t7 Carrier: �L6[� Policy Number: LfP ! 57 3 (This section need net be completed if r permit Is valued at one hundred dollars ($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, and agree that If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these prows' ns. Applicant Signature:_ 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 DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 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. Lie. M !P1 Class Contractors Signature: Date: 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: Lenders 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 fallowing 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 pemlit 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. 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. ❑ 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: ❑ 1 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, TIlle 6, 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 appplicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes 11Jo (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? [:j Yes ❑ 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 eEEem It for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No (Section 65650.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ............................................................................................................................................................................................................................................................................................................................................................................................ 6 Will any pan 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 II a permit from the South Coast Alr duality, 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 _.................._..............................................-....................._._.__-._._._.._._.___.................................__.....................................___.........................................................................._..__......_.....__.............._............__.........._....... 6 (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. Signature Of Legal Owner(s) Date j k� E - 3-O Z_ And/Or Authorized Applicant Date CODE f. INSPECTION TYPE PAU IffIMAL CODE11 INSPECTION TYPE 1616 Fixed System Final Fire Prevention 206 Final Mechanical Z 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retaining Well 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 i I BUILDING SAFETY DEPARTMENT N? 1637 c I P, O. Bo: No. 317 I Costa Mesa, California Dated CITY OF COSTA MESA CERTIFICATE OF OCCUPANCY Building Permit No - S��El!cal Permit,No dumbing P f Use of Building. iflA'Y• The building located a ! 7 Legal Descrlptlo T (See reverse side for Metes nd Bounds) has been inspected.and found to comply wi a provisions of all City of Costa Mesa Ordin- ances applicable thereto for a_Group /Occupancy. ISSU City B_ %IM! iiW�J. �• ding Offl , (Owner of Building) By CC: 0 Original—Owner ❑ 1st copy—Gas Co. ❑ 2nd copy— j ❑ 3 c opy—File Form 208 B -B P 1M 140 t 0 16580 COSTA MESA BUILDING -SAFETY DEPARTMENT P. O. BOX 917 . COSTA MESA. CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT BUILDING ADD RESSIM T"AtiTi- aultu—U u 17 COSTA MESA. CALIFORNIA OWNER MAIL ADDRFsJO Box I CITY 393ipgrt Beach 12L. 04312414 4- ARCHITECT OR ENGINEER Ro ER B�+• mber r NOo$31642 ADDRESS3355 Via Lido Newport Beach CONTRACTOR GeO D C ADDRESS CITY Newport Beach STATE TEL. LIC. NO. NO.OR31240' SIZE p1 _ D1 I OF LOT '�ri66 J NO. OF BLD¢S. RI NOW ON LOT �P USE OF EXISTING BLDG G£NTER OF MSTREETM� -O REAR YARD2/-S - SIDE YARD I LEFT —7C' -O I RIGHT C C' DESCRppIPTION OF 1ry'WORK NEW I IALTERATION I 11 ADDITION I REPAIR I II MOVINQ I II DEMOLISH SUILDI G , NO. OF SIZE .34'-I ROOMS STORIES Z EXTERIOR WAV IROOF COVERING COVERING Hock 710F BUILDING AND WORK TO BE PERFORMED % T - 1 HEREBY ACKNO DG£ TI T N Vg READ THIO LICATIGN AND STATE THAT H ABO G RR£cT A! G TO OOM. PLY WITH ALL 1 RDI! E TIG STATE GULATINO BUILDING co CTION SIGNATURE O PERMITTE AUTHORIZED AGENT 0 r E RECEIVED �`"p 6 1962 FINANCE DEPT. CITYMITA MESA APPLICATION FOR P A, B)Co D BUILDING For Office Use Only RECEIPT NO, BY COSTA MESA, CALIFORNIA Qp ZONE NO. OF 1/ UBE OF NEW y OUILDING LEGAL, LPLANS A. P. NO. & 7 L %I 2 2 2,0 YARDS EVES APPROVED ALLOWED (CENTER LINE ST.)� I, & -IN. FRONT /4 FT. 3o F7. L ��t/yyQ--ti IN. 49�,_ L/L 1 — /V _ -170 ° � - &--1/, A' THE AMOUNT @MOWN UNDER VAL46ATION IB FOR THE PURPOSE OF ESTABLI@MING A PERMIT FEE ONLY. /d S i - OWNER BRAEBURN CONSTRUCTI6N CC JOB ADDRESS 17 GENERAL CONTR, AP No. 117-2131-2 INSPECTIONS Piaster, brown coat ng. 0 —A u Heating, Final Plumbing Fixtures, Final Gas Test Electric Fixtures, F. Building, Final OCCUPANCY FORM M - 5M — 7.61 tI` 28 TRACT IRATIOI L 12R.12L,.,j?fPATE 3-20-62 lits 136,137.138,139 BUILDING PERMIT N( VALUE s 52.602.00 FIRE ZONE DESCRIPTION OF WORK DATE I GROUPH & J TYPE p ZONE PER I: SUBCONTRACTOR ri.mr.� Unit Apt.