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HomeMy WebLinkAbout2052 Tustin Ave - Building Permits r Y CITY OF COSTA MESA- F otuEt% BUILDING DIVISION wµ ll. "QQ 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 4. rqh FOR INSPECTIONS CALL: (714)754-5626 PERMIT NUMBER: BC10-00213 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: RES ALT DATE ISSUED: 05/1912010 ISSUED BY: BE JOB ADDRESS: 02052:TUSTIN-AV-CM— Suite/Unit: APN: 42624309 Zoning: , , - Vicinity: KITCHEN/1ST FLOOR BATHROOM Primary Occ: Const Type: V-B SQ. FT: 0 Valuation: $15,500.00 SCOPE OF WORK: KITCHEN REMODEL FOR SINGLE FAMILY RESIDENCE. WORK TO INCLUDE 12 CAN LIGHTS,7 RECEPTACLES 12 SWITHCES, 1 HOOD WITH EXHAUST,1 GAS OUTLET AND ONE KITCHEN SINK. NO STRUCTURAL CHANGES. REVISED: 5/24/10; FIRST FLOOR BATHROOM REMODEL, SCOPE OF WORK TO INCLUDE: 1 SHOWER, 1 TUB, 1 TOILET,AND 1 WASH BASIN. REV: 7/30/10-REMODEL UPSTAIRS BATHROOM: 1 TUB, NEW TILE SHOWER WALLS, 1 TOILET, 1 WASH BASIN.ADD 6 RECESSED LIGHTS TO THE LIVING ROOM. OWNER: EKDAHL, HELANE M Address: 2052 TUSTIN AVE Unit: Phone: City/State/Zip: NEWPORT BEACH,CA APPLICANT: PATRICKBIONDIO Address: Unit: : Phone: 949-650-1408 City/State/zZip: CONTRACTOR: P B PAINTING License No. 831793 Phone: (949)650-1408 Address: 1996 FULLERTON AVENUEUnit: Cell: City/State: COSTA MESA,CA 92627 ZipCode 92627 ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: COMBINATION PERMIT FEE SUMMARY Building Plan Check: $0.00 Building Fees: $265.25 %'40 P Electrical Fees: $67.86 O rV Mechanical Fees: $34.15 Plumbing Fees: $108.05 . 1 SMIP Residential: $1.55 �P'0� SMIP Commercial: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES: $477.86 **Refer to fee receipts for all fees paid for project HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010- PER CMMC Sec. 13-279 Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 8:00 pm. Prohibited all hours-Sundays and the following Federal holidays: New Years Day,Memorial Day,Independence Day,Labor Day,Thanksgiving Day and Christmas Day 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, 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. CODE p. INSPECTION TYPE DATE IN1111ALS CODE f INSPECTION TYPE X/ D TInALS 1616 Fixed System Final Fire Prevention _ 206 Final Mechanical 1266 Pool Spa Final _ 208 Final Plumbing / O'"// 11 thhi 1� 200 Final Re-Roof _ 210 Final Electrical A O — 2.3—11 !1'r r Uy� 201 Final Block/Retaining Wall _ 212 Final Fire Prevention 202 Final Factory Fire Place _ 220 Final Planning Approval 203 Final Sign 222 Final Site '` ,, ,r'^/ 204 Final Demolition _ 250 Final Building/Occupancy 43-9-3-0 H W fli 1 , WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive,a license. ❑Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: El I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized by this permit,and that no building stricture,scaffolding.fatsework,or demolition Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This section need not be completed dthe permit Is valued atone hundred dollars(5100)of less.) 2,Art 2,Sec.341.Title B,California Administrative Code). Policy Number: ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California. and agree that if I should become subject to the workers' compensation provisions of Section 3700 of Applicant's Signature Dale the Labor Code,I shall forthwith comply with these provisions. Division of Industrial Safety Permit Number: Applicant's Signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and It UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons. or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? ❑Yes 0 No Lic.# Class# (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 Contractor's Signature Date 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature _ Date • 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If'yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other Compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044,Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes 0 No thereon,and who does such work himself or herself or through his or her own 8 (If"yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). Completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. ❑ 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 Signature Dale property who builds or improves thereon,and who contracts for such project with CERTIFICATE • OMP ANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under of perj•ry that I have read this application and state that the informa••• give is c• rect. I agree to comply with all state laws and city ❑ I am exempt under sec. nrr-:.rail. -lacing • bu ding construction, and authorize representatives of Business and Professions Code for this reason: th- ityy�''Sasta e . to e - upon the above-described property for i pectis urp..e I .gre- -it to occupy or allow occupancy of any building uthori - thi •- i . til final inspection. g , ,�� ol Legal Owner(s) �^ Signature Date t Eir Z)) 3067d6(3101) An'n Aulhonzed Applicant P.to / •1 CITY OF COSTA MESA os`pfuss. BUILDING DIVISION F411,1 I AI 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 4. FOR INSPECTIONS CALL: (714)754-5626 - PERMIT NUMBER: BC10-00213 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: RES ALT DATE ISSUED: 05/19/2010 ISSUED BY: BE JOB ADDRESS: 2052 TUSTIN AV CM Suite/Unit: APN: 42624309 Zoning: , , Vicinity: KITCHEN/ 1ST FLOOR BATHROOM Primary Occ: Const Type: V-B SQ. FT: 0 Valuation: $12,500.00 SCOPE OF WORK: KITCHEN REMODEL FOR SINGLE FAMILY RESIDENCE. WORK TO INCLUDE 12 CAN LIGHTS,7 RECEPTACLES 12 SWITHCES, 1 HOOD WITH EXHAUST,1 GAS OUTLE AND ONE KITCHEN SINK. NO STRUCTURAL CHANGES. REVISED: 5/24/10; FIRST FLOOR BATHROOM REMODEL, SCFE OF WORK TO INCLUDE: 1 SHOWER, 1 TUB, 1 TOILET, AND 1 WASH BASIN. OWNER: EKDAHL, HELANE M Address: 2052 TUSTIN AVE Unit: Phone: City/State/Zip: NEWPORT BEACH,CA APPLICANT: PATRICK BIONDIO Address: Unit: : Phone: 949-650-1408 City/State/zzip: CONTRACTOR: P B PAINTING License No. t '1793 Phone: (949)650-1408 Address: 1996 FULLERTON AVENUE it: Cell: City/State: COSTA MESA,CA 92627 ZipCode 92627 ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: ` COMBINATION PERMIT FEE SUMMARY r11)1—_] Building Plan Check: $0.00 Building Fees: $223.25 Electrical Fees: $57.60 Mechanical Fees: $34.15 Plumbing Fees: $78.65 SMTP Residential: $1.25 SMTP Commercial: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES: $395.90 —Refer to fee receipts for all fees paid for project HOURS FOR CONSTRUCTION ACTI Y: EFFECTIVE 3/18/2010- PER MMC Sec. 13.279 Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:08 m thru 6:00 pm. Prohibited all hours-Sundays and the following Federal holidays: New Years Day,Memorial Day,Indep dence Day, Labor Day,Thanksgiving Day and Christmas Day NOTICE: The work authorized by this p- it shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21-9 EXPIRATION: PERMIT EXPIRES 188 'AYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the w• authorized under this permit to be considered legal, such work must comply with all applicabl codes, and all required inspections and final .•proval must be obtained.Failure to obtain inspections and final approval will result in the expirati of this permit. CODE A, INSPECTION TYPE OATF INTn1ALS CODES INSPECTION TYPE, PATE iturnmS 1616 Fixed System Final Fi Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Bloc. -etaining Wall - 212 Final Fire Preventi _ 202 Final .ctory Fire Place 220 Final Plannin pproval 203 F' .I Sign 222 Final Sit 204 Final Demolition 250 Fina uilding/Occupancy WORKERS'COMPENSATION DECLARATION: Owner ID verified by drivernse. ❑Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document.i.e.-property tax bill or deed): 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,a demolition Carrier: kil%Cleor dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (The section need not be completer(4 the permit valued al one hundred dollars(St00)or less.) 2 Ane Sec.341,Tolle B,Califomia Administrative Code). Polio umber: 0 As owner-builder, I will not employ anyone to do work which would I certify th- '. e performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued a not empl. $'ny person in any manner so as to become subject such person has a permit to do such work from the division. to - worker ' .- r>- tion laws of California. and agree that if I should .ecome •ject t• •lrkers' compensation provisions of Section 3700 of i Applicant's Signature Date the Lab Ide - fo hwith comply with these provi�sio t�s 1/ Division of Industrial Safety Permit Number: —•: .._ (L� ' HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNI FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UN •WFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEYS FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code,and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? ❑Yes ❑No iif P ,p .��0 a CIS , (Section 25533 of the California Health and Safety Code, with some e �.� /�� exceptions, requires registration with the Costa Mesa Fire Department by jf� [��' each business which at any one time has on hand a quantity of acutely wrin'r-;.17i-awre.. Da 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 r CONSTRUC. 'INC AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes",the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the Califomia Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, end the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes 0 No thereon,and who does such work himself or herself or through his or her own g (If"yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I. as owner of the property. am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of Signature Dale property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that El I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to ent- .on the above-described property for inspection pure.'---'� gr-, • to o upy or allow occupancy of any building authorized b /�it final' spection. Awnegs) signature Date 3057-4613107) S/ /a 0" 9 CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT P RMIT NUMBER f I :. :r. .. t PERMIT B03-02218 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.9efLDINA;PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2052 TUSTIN AV Stattis: ISSUED Suite: Applied: 12/31/2003 Vicinity: RESIDENCE AND ATTACHED GARAGE Issued: 12/31/2003 Parcel Number: 42624309 Zoning: • Applicant: ROBERTS, PAUL ISSUED BY: Address: 24112 EL TIRADORA CR Phone: 949-454-9060 MISSION VIEJO,CA Zip: 92691 Owner: EKDAHL, HELANE M Address 2052 TUSTIN AVE Phone: NEWPORT BEACH,CA Zip: 92660 Contractor: ROBERTS ROOFING Address: 24112 EL TIRADORA CR Phone: 949-454-9060 MISSION VIEJO,CA Zip: 92691 License: 699702 Arch : Eng: LARRY GARRETT Address: • Address: 7612 BESTEL • Phone: Phone: 714-892-2979 W.M. Zip: License: 92683 License: 2366 SCOPE OF PERMIT TEAR OFF EXISTING ROOF,INSTALL SHEATHING,FELT AND COVER WITH EAGLE PONDEROSA TILES. REINFORCE ROOF STRUCTURE PER DETAILS ON PAGE 2 OF ENGINEERING. INCLUDES ATTACHED GARAGE: FEE SUMMARY Plan Check: $117.81 - - Calc Valuation: $10,000.00 Permit: $181.25 Claim Valuation: $10,000.00 SMIP Res: $1.00 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 - Total: $300.06 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 • • 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(N00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under,penalty of perjury one of the following declarations: ❑ I have nd 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 w or which this permit is Issued. I ha •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. ars'compe nsu c and policy number are: Cartier: Policy Number: (This section need not be corn steel it the permit Is valued at one hundred leers($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shal4mot employ any person in any manner so a/to become subject to the workers' compensation laws of California ggreethat if Ishould ecome subject to tik.workers'compensation provisions of ect on 3700 o the Labor Code,I shall forthwith s comply with they ovislons, "` , V ( I Applicant Signature: 1 Date: i 0 WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P NALTIES AND GVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($180,880),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 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.Lic.# Class Class A {{{1---���/ Contractors Signature: ��,&Y 12q_''^/0'1, Date: 4 2� _ CONSTRUCTION LENDING AGENCY: 1 j l� ❑ 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). Lender's 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 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.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 drivers license. ❑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 more feel 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: 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 0 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? 0 Yes 0 No (Section 25533 of the California Health and Safely 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? 0 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 appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? j�Yes ❑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? 0 Yes ❑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 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 properly for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. © �1/[�/ S' um 0 Leg w r(s) 1 L el//t 1 I O to �" \A d/ r Aut orizepplic nt e BODE I INSPECTION TYPE PATE ItInnAla Mil 'Flannel,'nil RAM RCMAL5 1616 Fixed System Final Fire Prevention 208 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof !^ig'°E[ j 1� 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 GA._AETT ENGINEERING ASSOCIA.ES // Consulting Structural Engineers q CLIENT: �oACJ21l G.E.A.JOB NO.: D342N REVISED BY: Joy TLF J2F4", BY: LS' DATE:/Z-6103 DATE: 2a5-Z 774Jrt'v Ove SHEET NO. / OF 7 e2 ',i 71 n , rA 08s/6W Loges (At/ivy,- Fig]TN-4( .oa rieisr) oz t 6LC-' Pv s2oC os3 /o. o lost ico' vsvv) QROFESS/s 9 o Z c4 rat 3o fnz7 ,I 0 te �. /; 2 iGA . 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'Zak)( E7/aIVI 14Doe ince" Pahlrs ) 'I /C./r/z'r#/r; 3os 1222/03- 11:50:20 •••SYSTEMS PROFESSIONAL STRESS-PROGRAM NO. 16.1 REV-310F.F2••• STRUCTURE-20.33 FT.TRUSS TYPE T TRUS204T.ROB TYPE PLANE FRAME NUMBER OF JOINTS 4 NUMBER OF MEMBERS 4 NUMBER OF LOADINGS 1 E LIST LOADINGS NUMBER OF SUPPORTS 2 UNITS POUNDS INCHES TABULATE ALL JOINT COORDINATES 1 0.0 0.0 S S 252.039.0 $3148.0111.0 4 244.0 39.0 S •2 X 4 TIE MEMBER PROPERTIES PRISMATIC AX 5.25 IZ 5.36 4 •DOUBLED 2 X 6 RAFTERS MEMBER PROPERTIES PRISMATIC AX 16.50 IZ-41.6 I THRU 2 •2 X 6 RAFTER AT FRONT HALF OF GARAGE MEMBER PROPERTIES PRISMATIC AX 8.25 IZ 20.8 3 MEMBER INCIDENCES 11 2 S 2 2 3 S 3 3 4 S 4 2 4 • JOINT RELEASES I MOMENT Z$4 I FORCE X •CONTINUOUS CHORDS,PIN-CONNECTED WEBS MEMBER RELEASES 4 START MOMENT Z 2 END MOMENT Z S 3 CONSTANTS E 1700000.0 ALL UNITS FEET LOADING NO. 1 DL+LI. MEMBER LOADS I GLOBAL FORCE Y UNIFORM-45.8 S 2 S 3 UNITS INCHES SOLVE PROBLEM CORRECTLY SPECIFIED,EXECUTION TO PROCEED. (UNITS IN INCHES AND POUNDS) WADING NO. I DL+LL MEMBER FORCES MEMBER JOINT AXIAL FORCE SHEAR FORCE MOMENT 1 I 349.261 465.642 .17 2 -200.411 -267.175 23816.38 2 2 377.001 -15.266 -23815.87 3 -302.201 381.666 .00 3 3 451.008 183.198 -.21 4 -725.808 183.202 .00 4 2 -470.706 .000 .00 4 470.706 .000 .00 REACTIONS.APPLIED LOADS SUPPORT JOINTS JOINT FORCE X FORCE Y MOMENT Z I .024 582.070 .17 4 -.019 582.046 .00 SUM .005 1164.116 FREE JOINT DISPLACEMENTS _ 9 ny JOINT X-DISPLACEMENT Y-DISPLACEMENT ROTATION 2 -.0101 -1.0023 -.0115 3 -.3790 -.5137 -.0009 SUPPORT JOINT DISPLACEMENTS JOINT X-DISPLACEMENT Y-DISPLACEMENT ROTATION 1 -.7611 .0000 -.0234 4 .0000 .0000 .0052 (UNITS IN INCHES AND POUNDS) MEMBER FORCES FOR MEMBER 1 LOADING JOINT AXIAL FORCE SHEAR FORCE MOMENT 1 I 349.261 465.642 .17 2 -200.411 -267.175 23816.38 MEMBER FORCES FOR MEMBER 2 LOADING JOINT AXIAL FORCE SHEAR FORCE MOMENT 1 2 577.001 -15.266 -23815.87 3 -302.201 381.666 .00 MEMBER FORCES FOR MEMBER 3 LOADING JOINT AXIAL FORCE SHEAR FORCE MOMENT 1 3 451.008 183.198 -.21 4 -725.808 183.202 .00 MEMBER FORCES FOR MEMBER 4 LOADING JOINT AXIAL FORCE SHEAR FORCE MOMENT I 2 -470.706 .000 .00 4 470.706 .000 .00