HomeMy WebLinkAbout3058 TYLER WAY - Building Permits V
�SY CITY OF COSTA MESA
BUILDING DIVISION
f44.0a.
% DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
4 PERMIT B06-01954
munso
EXT SION
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.cajLDING P , 7131R DRIVE,COSTA MESA,CA 92626
ALL'al-WE
Job Address: 3058 TYLER WY 1 Status: ISSUED
Suite: PER 1-- Applied: 11/20/2006
Vicinity: d�1Rt rs Issued: 12/13/2006
Primary Occ: R3 Type of Constrct�tt'' 4 I S ,1 •
Parcel Number: 14160452 Zdnn
Applicant: SULLIVAN, JANA
Address: 3058 TYLER WAY
Phone: 714.501.6415 ISSUED BY-L.
COSTA MESA,CA Zip: 92626
•
Owner: SULLIVAN,TIMOTHY J TRUST
Address 3058 TYLER WAY
�' - - Phone: 714-751-6415
COSTA MESA,CA Zip: 92626 •
Contractor OWNER-BUILDER
Address: � F
hone _C EX E
FYDT i •
j. Zip: Li 'n e: 00 000 �s 7
1111
DATE •
Arch : Eng: PIN CHING LI
Address: Address:
Phone: Phone: 905-595-7755
Zip: License: License: 38408
SCOPE OF PERMIT
ADD 431 SF NEW FAMILY ROOM TO EXISTING SFD.WORK ALSO INCLUDES COMPLETE KITCHEN REMODEL.
EXISTING BLDG: 1307 SQ FT
PROPOSED ADDITION:403 SQ FT
GARAGE:420 SQ FT
DRIVEWAY:650 SQ FT - -
LOT COVERAGE:43.4%
' REAR LOT COVERAGE: 12%
• - FEE SUMMARY
Plan Check: $486.69 Calc Valuation: $64,824.40
Permit: $748.75 Claim Valuation: Sono
SMIP Res: $6.48
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $1,241.92
PLANNING &ZONING
SETBACKS` . -
MAIN STRUCTURE Front 0-0 Rear 10-0 Left 0-0 Right 5-4
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Exit: 0 Reouired: 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)754-5628
2446-46(6/00)
p
•
DECLARATIONS
WORKERS'COMPENSATION DECLARATION:
I hereby affirm 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'compensation Insurance carrier and policy number are:
Carrier: Policy Number:
(This section need not be completed ll the permit is valued et one hundred dollars($100)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 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 provisions. L (( � nn
Applicant Signaturei—'1 ( Q.3 • Cf n.TAfQt(ti11J:1t jOate:---/24/3/0
WNININO:'FAILURE'TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER-O CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,000),IN ADDmON 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.if Class N
Contractors Signature: Date:
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: 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:My 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 properly,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 exemptLinder�sec. Business and Professions Code for this reason:
-Signature:—" Vr . ^ Date:12#r3/U � S 4�-- o /
\Owner ID verified by driver's license. es 0 No Drivers License.No. - -- Expires: 2 / /
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? 0 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 end 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 implication aggermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? IU 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 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 ❑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 or allow occupancy of any building authorized by this permit until fin9I inspection.
12413 / 06
ignature Of Legal Owner(s) L
Date
And/Or Authorized Applicant Date
CODE/ IN$PFCGON TYPE 2I JNTRIAL5 CODES INSPECTION TYPE PATE RIIIDELS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing •
200 Final Re-Roof 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
R -
' ti CITY OF COSTA MESA 111/BUILDING DIVISION
Y %�_, ...... DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
j�. 4PERMIT
. M06-00798
t� `
Po/woo le
(714)754-5273 • Fax(714)754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
MECHANICAL PERMIT ®N�
EXit
Job Address: 3058 TYLER WY /� A _ Status: ISSUED
Suite No ALL i ' ED Applied:ppl00
7/2006
Issued: 12/13/2006
Vicinity: KITCHEN PER _- r'i
Parcel Number: 14160452 EXPIRES .9 °
ISSUED BY:
Applicant SULLIVAN, JANA
Address: 3058 TYLER WAY
Phone: 714-751-6415 EXP ,a E p
COSTA MESA,CA Zip:ip: 92626 XY L
Owner: ,SULLIVAN,TIMOTHY JTRUST DATE O• iAddress: " 3058 TYLER WAY r---
'
Phone: 714-751-6415 _tt y
f..
COSTA MESA,CA Zip: 92626 +• :K�
telt
Contractor: OWNER-BUILDER _ TOW . tea .
Address: wr ' �
Phone: '
Zip:
License:000000
SCOPE OF PERMIT
MECHANICAL PERMIT TO ADD 431 SF NEW FAMILY ROOM TO EXISTING SFD.WORK ALSO
INCLUDES COMPLETE KITCHEN REMODEL.
REF#:B06-01954
WORK TO INCLUDE: 1 ALT/REPAIR COOLING/HEATING AND 1 HOOD W/MECH EXHAUST.
- FEE SUMMARY
Quantity Quantity
ISSUE FEE $23.50 Repair/Alt Absorbtion Unit $0.00 0
Inst FAU<100 k BTU $0.00 0 . _ Repair/Alt Refrigeration Unit $0.00 0
Inst FAU>100 k BTU $0.00 0 Ventillation System $0.00 0
Repair/Alt Cooling/Heat $13.70 1 Evaporative Cooler $0.00 0
Inst/Rep.Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0
Refrig Sys<100 k BTU $0.00 0 Domestic Incinerator $0.00 0
Refrig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems
Gas Piping $0.00 0 Up to 3 hp/100 k BTU $0.00 0
Factory Fireplace • $0:00 0 •- - 3 To 15 hp/500 k BTU $0.00 0
Hood w/Mech Exhaust - $10.65 1 - 15 To 30 hp/1,000 k BTU $0.00 0
VAV Box $0.00 0 . ' 30 To 50 hp/1,750 k BTU $0.00 0
Vent Fan/Single Duct $0.00 0 Over 50 hp/Over 1,750 BTU $0.00 0 •
Appliance - $0.00 - 0 Boilers
Fire Dampers . $0.00 0 Up to 3 hp $0.00 0
Smoke Dampers ' . $0.00 :0 3 To 15 hp $0.00 0
Inst or Relocate Appl Vent . , $0.00 . 0 - 15 to 30 hp $0.00 0
Air Handlers< 10000cfm "$0.00 0 - - 30 to 50 hp • $0.00 0
Air Handlers> 10000cfm-\- $0.00 - 0 Over 50 hp $0.00 0
Floor Furnace $0.00 "0 Other Mechanical Fee
Floor or Suspend Heater $0.00 0 Investigation Fee $0.00
_ Plan Check Fee $0.00
Reinspection Fee $0.00
TOTAL CALCULATED FEES $47.85
COMMENTS I SPECIAL CONDITIONS
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(WOO)
DECLARATIONS ( ) `- ) b
WORKERS'COMPENSATION DECLARATION:
I hereby affirm 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 Cala,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'compensation Insurance carrier and policy number are:
Carrier: Policy Number:
(This section need not be completed if the permit is valued at one hundred dollars($100)or less.)
�$ 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'
))rte"—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 provisions.
r-- 3µ C Va
Applicant Signature:I -
De:c
�
j3 0�
LWARMNG:FAILURE.
TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOI.LARE($100,000),IN ADDrION 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.0_ Class 4
Contractor's Signature: - Date:
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).
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.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').
O I am exempt and sec. / Business and Professions Code for this reason: /----.
(Signal ru y if.t/G(ivr ,
Expires:2-.IS-
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 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).
o 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? 0 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 Safety Code,with some exceptions,requires registration with the Costa Mesa Flre 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 en RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification
0
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 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,end authorize representatives of the City of Costa Mesa to enter upon the
above-described property for insinsep Clion pules. agree of to occupy allow occupancy of any building authorized by this permit until final iny�clan.
Signature Of Legal Owner(s) -. • Z�Di ate./ . b
And/Or Authorized Applicant Date
CODE t INSPECTION TYPE •
Pili Rai SODEt INSPECTIONTYPE au Mai
1616 Fixed System Final Fire Prevention _ 206 Final Mechanical 7-/y-09 4' a l
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 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
' CITY OF COSTA MESA
r BUILDING DIVISION
> ,.,,,.riala'"-1I DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
0. Pla PERMIT
�,. E06-01406 twroanTo
(714)754-5273 • Fax(714)754-4856 • www.ci,costa-mesaga.. TRICAL PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
LtUJob Address: 3058 TYLER WY EIXTEN•ION Status: ISSUED
Suite Nodi ALLOY
ED Issupplled: 12/1032006
Vicinity:
Parcel Nunmber: 14160452 PER
Applicant: SULLIVAN, JANA EXPIRES 4 - 7 •
Address: 3058 TYLER WAY ISSUED BY:
Phone: 714-751-641-
COSTA MESA,CA Zip 92626
- IDII
Owner: SULLIVAN;TIMOTHY J TRUST ��
Address 3058 TYLER WAY DATE At d
•
' Phone: 714-751-6415
COSTA MESA,CA • Zip: 92626
, , 2 fir ;
Contractor: OWNER-BUILDER
Address: - P
�' 5 ,
, Phone: 'ay
Zip: •
License:000000
SCOPE OF PERMIT
ELECTRICAL PERMIT TO ADD 431 SF NEW FAMILY ROOM TO EXISTING SFD.WORK ALSO INCLUDES
COMPLETE KITCHEN REMODEL.
REF#:B06-01954
WORK TO INCLUDE: 12 LIGHT FIXTS,2 CEILING FANS,28 OUTLETS,9 SWITCHES,RELOCATE
AND UPGRADE SERVICE TO 200A.
FEE SUMMARY
•
Quantity Quantity
ISSUE FEE $23.50 - Temp Dist System[Lighting $0.00 0
Temp service test $0.00 • Busway/100 ft - $0.00 0
Res.a/c package $0.00 Standing Section $0.00 . 0
New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0
New Res(3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0
Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0
Lighting Fixts $15.40 14 up to 50 kva/kw $0.00 0
Recept Outlets $27.84 28 up to 100 kva/kw $0.00 0
Switches $9.90 9 . over 100 kva/kw $0.00 0
Non Res Appl• $0.00 0 , Low Voltage Equipment $0.00 0
Res Appl $0.00 , ' 0 Low Volt Wiring System/Ckt $0.00 0
Service to 200a $30.50' 1 Misc.Conduit $0.00 0
Service to 1000a 10.00 . 0 Misc.Conductor $0.00 0
Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0
Motors to 1 hp $0.00 0 % Circus(mech ride or lights) $0.00 0
Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 •
Motors to 50hp $0.00 0 Fireworks Stand $0.00 0
Motors to 100hp -$0.00 • 0 Other Electrical Fee $0.00
Motors over 100hp $0.00 0
Communication drops $0.00_ 0 Investigation Fee $0.00
Sub panel to 200a $0.00 0 Plan Check Fee $0.00
Pole Light Pkg $0.00 0 Reinspection Fee $0.00
Sign Circuits $0.00 0
Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $107.14
Intermed Pole 50.00 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 comp! 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
244648(6x00)
DECLARATIONS
WORKERS'COMPENSATION DECLARATION:
I hereby affirm 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.
❑ f have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for wNch this permit Is issued.
My workers'compensation Insurance carrier and policy number are:
Cartier: Policy Number:
(This section need not be completed if the permit is valued at one hundred dollars($100)or less.)
-W-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 provisions. (�
Applicant Sid,e, jdMlti3l :h 'OQAAan, Date: 3..r. (z/13/0 b
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,000),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 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.N Class A
Contractors Signature: d Date:
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: 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).):
0-'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 u der sec. Business and Professions Code for this reason:
_Signature: OA a 8 'WI 1 Date: ^ . 121/3/0 6
Owner ID verified by drivers license. ■ es 0 No Orivers'tacense No. Expires: 'Z—/S-(I
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 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? 0 Yes 0 No
(Section 25505 of the California Health and Safety Cale 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 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.
...P.. presently
q ie.,has
Section
5... ..California
Health n. y e. o.. le with?If an RMPP is presently required, Section 25534 of the California end Safety Code been fully compiled 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 application apPermit 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 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits).
8 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 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 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 purpo es. gree of to occupy or allow occupancy of any building authorized by this permit until final inspection.
/ Signature Of Legal Owner(s) _LLDate
And/Or Authorized Applicant Date
;ODE I INSPECTIONTYP€ PATE INIIDALS CODE 1 INSPECRON TYPE PATE Itm4S
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 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
WI ,
Jana and Tim Sullivan
3058 Tyler Way
Costa Mesa, CA 92626 •
714-751-6415
October 8, 2007
Mr. Ed Petros
Chief of Inspection
City of Costa Mesa
P. O. Box 1200
77 Fair Drive
Costa Mesa, CA 92628-1200
Re: Permit#s B06-01954, E06-01406, M06-00798 Addition
Project Address: 3058 Tyler Way, Costa Mesa
Dear Mr. Petros:
I am responding to a letter we received from Jane Weidenkeller regarding the
above referenced permits. We have completed most of the work designated on
the permits except the drywall and electrical in the kitchen of the house. My
husband has been working in Alaska all year and will not be able to complete the
work until early January of 2008.
Therefore, we respectfully request an extension of our permits until that time.
Thank you for the consideration of our request.
Sincerely yours,
Jana Sullivan
cc: J, Weidenkeller
A
t A
Jana and Tim Sullivan
3058 Tyler Way
Costa Mesa, CA 92626
714-751-6415
October 8, 2007
Mr. Ed Petros
Chief of Inspection
City of Costa Mesa
P. O. Box 1200
77 Fair Drive
Costa Mesa, CA 92628-1200
Re: Permit#s B06-01954, E06-01406, M06-00798 Addition
Project Address: 3058 Tyler Way, Costa Mesa
Dear Mr, Petros:
I am responding to a letter we received from Jane Weidenkeller regarding the
above referenced permits. We have completed most of the work designated on
the permits except the drywall and electrical in the kitchen of the house. My
husband has been working in Alaska all year and will not be able to complete the
work until early January of 2008.
Therefore, we respectfully request an extension of our permits until that time.
Thank you for the consideration of our request.
Sincerely yours,
duttgatHAt
Jana Sullivan
cc: J. Weidenkeller
. ell
._
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Costa Mesa
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OWNER SEAVIEW HOMES, INC. , . DATE 6-19-62
JOB ADDRESS 3058 Tyler Way BUILDING PERMIT NW-7333
GENERAL CONTRACTOR S.V. Hunsaker & Sons VALUE $14,471.00
AP No. LOT 42 TRACT 4565 FIRE ZONE DESCRIPTION OF WORKRes.w/att .Gar.
I 'ECTIONS Signature DATE GROUP I%7 TYPE J ZONE R7.
s,,-- s.‘. A445 P-2-y-l.� S 7-S- z PERMITS ISSUED
Gas r �. R,�„G,y SUBCONTRACTOR DATE NUMBER
Water*� '�-6o-Ge2t / /IS 1?-7--Ca
Rougho . e Ig. ❑ Mr Con . 0 p
Rough Heating fr--/�v(y ��s�'`- _o—/o —3107R-31L----
Rough _
Plumbing 4 ,'f. 3-7--G?. -_. er-: CM-tci. 77.-.2-6 .fie D� IA-
Miscellaneous
Miscellaneous Z r�
Prop.Swr.Line ❑-House Con. t.Swr. ❑ ,3'�'� ' L _py4-.-f� c( (i�- / Y o Y Q j
Sprinkling System " /
Construction Pole /(e(tyf,
Underground 0 Power 0 �/ 2��
ough Wiring W-ase WC-C.--: elt791%6„Q Si/J'.ff7e 7-075-‘a i,,.�tk_
renches ICX Dorms VV Steel Hemf. U ,- ffS 2-/0-62-- _
Floor System
Bond Beam ❑ Steel Reinforce 0
Sheathing effort) . /7-2-
Frame and Flashing eli47743( F',el- 61-
Lathing - In 174- Out Q/ J(Y4t4L da- ,-- 0-
P'- ler, brown coat /Pita (0-c.-CI--
I g. 0 Air Cowl. 0 Final
Heating, Final /14fc <O//-62
Plumbing Fixtures, Final A -i. 1.a i-
Final Gas Test/S— f_/ti -�. V�
Electric Fixtures, Final r Ars /4 -74-4,
Building, Final 1,1/ /A-s e_t L
OCCUPANCY
FORM BUR-5M — 7-61 17182
. FEE RECEIVED
f JUN 151962
COSTA MESA BUILDING-SA ETY DEPARTMENT . FINANCE DEPT.
P. O. BOX 917 COSTA MESA. CALIFORNIA CITY OF COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT Z _ (� BUILDING
ADDRESS 3orpC//n 7 ?L . £4
COSTA MESA. CALIFORNIA For Office Use Only
I RECEIPT NO. I I FB ?3
Jj
OWNER SrAview firmegi Tnr.MAIL l'J]
REC81 D BY DA RE EIVEO D TE ISSUED
ADDRESS 16 2 W. Almond I �_/kZI L'�1 a 1987
Orana TEL. BUILDING
IT
CY g NO. ADDRESS
ARCHITECT
OR 'INEER Ramberg & TEL.
Lowery NO, KI.76131 COSTA MESA. CALIFORNIA /
ADDRESS 2127 N. Main St., Santa Ana FIRE p/ GROUP (//1 (y
ZONE TYPE v i
CONTRACTOR S. V. Hunsaker & Sons APPROVED
BY DATE
ADDRESS 35855 E. Edna P1. ZONING
ZONE", NO.OF USE OF NEW S' �/7j
CITY Irwindale -i I PUNS Z I BUILDING ,`/ _ J.,
STATE
IC No).64929 No. ED. 87361 LEGAL
DESCRIPTION LOr y Z re ei S.-‘r
SIZE TZ x 9 7 I NO. OF BLOCS. 0
OF LOT (� NOW ON LOT A.P.NO.
USE OF — YARDS EVES
EXISTING BLDG APPROVED ALLOWED
SETBACK LINE FROM (CENTER LINE BT.)CENTER OP STREET , "• FRONT &C9 FT. ---- IN.
- /
SIDE YARD I LEFT S� RIGHT U R.SIDE -S—FT, r IN.
DESCRIPTION OF WORK L.SIDE C FT. IN.
NEV IX VVALTERATION I II ADDITION REAR /5 �-
FT. IN.
REPAIR I II MOVING I ((DEMOLISH I APPROVED ie 6/LAL
DATE
SUILDIN
SIZE Oox`'Z-(0NOO
STORIEa.
EXTERIOR WALL stucco I ROOFghD / y0
COVERING girii ng COVERING pomp. 4bd. iC- = /3 0
USE OF BUILDING AND WORK TO BE PERFORMED
eirglP family dwPllina with rige410 = re.- Zp le
attached garage 4261/71 = WS"
C.-1Plan CN -C.-
1
HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT PEE ONLY.
BUY WITH AU. CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION. VALUATION
SIGNATURE OF S. 11II AKER PERMIT FEE S
PERMITTEE _ 7 e
/g
$ f 7/ PLAN CHECK $ -
AUTHORIZED AGENT i �� - 0
JTOTAL FEE 5
OWNER WH.LGtfl', RICILAt{D DATE 3-.5-0)
F JOB ADDRESS 3056 Tyler Way BUILDING PERMIT NO. 236t53
GENERAL CONTRACTOR Anthony Pools DESCRIPTION OF WORK Pvt.Swim Pool
o. 141604-52 LOT TRACT FIRE ZONE VALUE $ Ow°.00
4 INSPECTIONS Signature Date GROL?P J TYPE TTT ZONE Rl
Soil PERMITS ISSUED
Gas SUBCONTRACTOR 1 Date I Number I Signature
Water Plumbing
Rough Plumbing (la?a ,//�S= 3_ -LS f%ii=2-
Prop. Swr. Line Cl House Con.CI
Sprinkling System
MiscellaneousJ /141t)Rough Heating and Air Conditioning
Temporary Service or Pole
Underground p Power ip
Rough Wiring Heating and Vet. ii
Trenches C Forms 0 Steel Reid. .Q
Floor System j
Bond Beam 0 Steel Reinforce 0
Sheathing
Frame and Flashing
Lathing— In i] Out.0 _! I A
F r, Brown Coat ///'''
S..__tural, Final _V Electric
Heating, Vent., Refrig. and A.C., Final
Plumbing, Final and Gas Test 0
Electric, Final
Building, Final
23683
- COSTA MESA BUILDING-SAFETY DEPARTMENT FEE RECEIVED
P.O.BO%517 COSTA MESA,CALIFORNIA MAR[ 1965
For Applicant to Fill In Completely � APPI AEFFa91RMIT
TYPE OR PRINT CITY CPID MESA
BUILDING For Office Use Only
ADDRESS 3058 TYLER WAY
RECEIPT NO. PERMIT NO.
COSTA MESA, CALIFORNIA .2 /7j S3
REC OBY
OWNER RICHARD WEIGHT `V 343RE/ C 3/ '3 /�s
BUILDING
MAIL SAME
ADDRESS 0 (A�j i
a. it.
- ADDRESS �Jri
TEL. FIRE 'y
CITY NO. ZONE ij PE it GROUP
APPROVED
ARCHITECT TEL. -. BY , I / DATE
OR ENGINEER _ • I L NO. -
AL _SS I
F , ✓✓✓
5871 FIRESTONE BLVD. ONING
ZONE,,,,[[[[���� NO.OF ^ USE OF NEW 1
A I PLANS ,!- BUILDING �__7
' CONTRACTOR ANTHONY POOLS p
ADDRESS 5871 FIRESTONE BLVD. DESCRIPTIONLEGAL
I-? / T A. 4 J S
CITY SO GATE A.P.NO. J /11-- a 4 -S )------
NOTE; NO EAVE OVERHANG SHALL BE LESS THAN
: STATE n TEL. �T 30"TO SIDE a REAR P.L.
LIC.NO. 190179 NO. 0132210 EAVES
SIZE in-n 2OX40X9O NO.OF
BUMS. ( ALLOWED (U.B.C.REQUIREMENT)
OFLOTLOT
USE OF --"0-,2 • YARDS APPROVED YARDS APPROVED /�
EXISTING BLDG. I�- MAIN BUILDING ACCESSORY BUILDING L�\\U
(FROM C/L STREET)
SETBACK LINE FROM 5( s FRONT .4 FT. I FT.
CENTER OF STREET _ REAR YARD
SIDE YARD LEFT 51 I RIGHT 3 R.SIDE SST. FT.
DESCRIPTION OF WORK L.SIDE .5 FT. FT.
NE`" ALTERATION ADDITION REAR 6 FT. FT. \\
DISTANCE BET. BET.MAIN a
REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLOCS.
BUILDING 420 NO.OF
VAR.# DATE
SIZE ROOMS STORIES C.U.P.?C APPROVED
EXTERIOR WALL ROOF
rag (/�/ ^� / s
COVERING I COVERING BY (� •ATE "} `�'-'
USE OF BUILDING AND WORK TO BE PERFORMED OLD F R SPEC );�
�� �. /""ez
PRIVATE SWIM POOL /
r.
j N
SO.FT. • G
Iv I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE F'
AND STATE THAT THE ABOVE IS CORRECT AND"AS TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O
• PLY WITH ALL CI --• NCES AND STATE LAWS RE LATINO VALUATION m
BUILDING CO ' -UCTION. • ,+ ] N
PERMIT FEE r L
SIGNATO-. OF -. .—.. m
PERMITTE- ' / • 2400.00 PLAN CHECK $ 6 .
8
AUTHORIZED AGENT' �, / g
TOTAL FEE u.