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Home My WebLink About171 23RD ST - Building Permits • • • CITY OF COSTA MESA BUILDING DIVISION F ' , PE IT NUMBER ��,,,...' . DEVELOPMENT SERVICES DEPARTMENT • PERMIT 06-00223 %Pooars°se (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.J&DING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 171 23RD ST Status: ISSUED Suite: Applied: 02/09/2006 Vicinity: ROOF Issued: 02/09/2006 Primary Occ: R-3 Dwellings/Cong Res<10 Type of Construction: V-N Parcel Number: 42606407 Zoning: Applicant: MICHAEL A GRAMME III Address: 630 CENTER ST Phone: 949-548-2365 ISSUED BY: COSTA MESA,CA Zip: 92627 Owner PORTER, JOHN C TR Address PO BOX 1333 . . Phone: OCEAN PARK,WA Zip: 98640-1333 Contractor MICHAEL A GRAMME III Address: 630 CENTER ST Phone: 949-548-2365 COSTA MESA,CA Zip: 92627 License: 701442 Arch : - Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 1 LAYER OF 30#FELT,30 YEAR COMPOSITION SHINGLES,AND REPAIR/REPLACE SHEETING AS NEEDED.REPAIR/REPLACE FASCIA BOARD AND STUCCO FOR DUPLEX. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $6,500.00 Permit: $139.25 Claim Valuation: $6,500.00 SMIP Res: $0.65 SMIP Corn: $0.00 - Other: $0.00 Inspection: $0.00 Total: $139.90 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(6/00) 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 if the permit is valued et one hundred dollars($100)or less.) 0_--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 wan these Emmons. Applicant% tore: 7 .e rDate:"----f GR -'7"c 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(5100,000),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 Coge and my license is in full force antl effect.Lic.-#—+ /} Q� �/�[t Class#� f'J - 7 q�� -� Contractor's Signat�'�Jl.`4 groin rune Date:--1C-05- / - 6,6 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 then 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. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work 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,Gry 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 materiel? 0 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? 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. 4 II an 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 apermit for such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency? 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? 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 B (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 COMPUANCE 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. plature Of Legal Owner(s) Date andtO,Authodzed-Applicant ` Date A CODE I INSPECIIQj4 TYPE - OAIF INTTMLS CODE INSPECTION TYPE PATE INTUALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 22 210 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 . Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA •• PERMIT N0. 'l TRACT NO. LOT NO. BLDG.NO. 4J2B ' P/C�3/B4 30.50 TL CONSTRUCTION PERMIT ,j ///,lj-(� 4, r , Project Address 17i e .23 Rd C_osr /7 tSA- TYPE OF CONSTRUCTION H NEW U ADD H ALTERATION H REPAIR ' Applicant's Mailing AA dress : /9- Z/h//l7/C2e1T Coe- -7--ed/A./ ❑ CONVERSION ❑ DEMB LISSH Cl OTHER A.P.# Zone ' Owner's Name {' o4e � -.-Phone 6'�6 9% I•< 27 DESCRIPTION OF WORK ire ooF Rock Do fee Glc - 7 \�' _Si S Main Building: Accessory Building: Z Address i7/ C -2 72 d Co57,� nes"( `I%2 L+2-'7 - E 0 - TYPE OF PERMIT H RADING ,H FOUNDATION ❑ STRUCTURAL T Front N Arch/Eng. .. License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑MECHANICAL A Rear - N -- Address pp CI BOTHER - Contractor'sNamo /VA y5Rrofy4)E co ' Phone 5c/-Vvsb - PROJECT DESCRIPTION SQ. FT. .500.0 OCCUPANCY C Right G • •Address(mailing/ /��/ 6kc&cs/ C/R --7-44/.44/C- ?271V CON ST RUCTION TYPE VALUATION$ no-- $ Left . • R City License No. • ZONE _ GRADING CU.YDS. ACRES •Ping. Ref.# Park.Fees $ _ 0 • U LICENSED CONTRACTOR DECLARATION Remarks: •Parking Req./Provided • I I hereby affirm that I am licensed under provisions of Charter 9(commencing - R with section 7000) of Division 3 of the Business and Professions Code,and • Use of Building: E my license is in full force and effect. License Class C- i L's se No. `jQDy Y. PLUMBING FEES Planning Notes: M Date - - -r2 Signature <� _M .4 E 'YORKERS'COMPENSATION DECLA: •TION Bar Sink Showers • N ereby affirm that I have a certificate of consent to self-Insure or a certificate - - T ^� Backflow Preventer - Service Sink - S 1\ Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.)r�C ns,. � Backflow Irrigation Sewer Cap ELECTRICAL FEES Policy No. pr / 3 -A 3 Company U�l ATe /or' ' A Certified copy is hereby furnished. Bathtubs Sewer Connection • Automatic Washer Transformer 0 15-50 KW • Cart11((ietl oqqy is gg-with the city Bu i g Divisi ❑ 50+ KW Date oL.^ 3'- T Applicant Clarifiers Solar Collectors Construction Pole Sub. _ - EXEMPTION FROM WORKERS'COM PE NS ION DECLARATION , Dishwasher Solar Piping CookingUnit Meter ❑u to 100 amps • (This section need not be completed if the permit Is for one hundred ($100)or P P - Iecs). Drinkin Fountains I certify that in the performance of the work for which this permit is issued, 9 Solar Tank Dishwasher Meter Dover 100 amps shall not employ any person in any manner so'as to become subject to the Workers' Compensation Laws of California. Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel ' Date Signature ' NOTICE:If,1after making this declaration, you should become subject to the Floor Sinks ' Urinal Fan Motors 041 HP 01%-8 Workers' Compensation provisions of the Labor Code, you-must forthwith - comply with such provisions`or this permit shall be deemed revoked. Gas Service Outlets. Water Closet CONSTRUCTION LENDING AGENCY F.A.U. Inc.Solar ❑9-15 HP ❑16:15 + • I hereby affirm that there is a construction lending agency for the performance interceptors - Water Heater Fixtures ' •Microwave .- of the 'work for which this permit is issued (Section 3097 Civ. C.) . - -- Lender's Name Kitchen Sink - • Water Service -. Device Boxes Pole Light Lender's Address Lavatories OWNER BUILDER DECLARATION - - •• ' Outlets Range I hereby affirm that I am exempt from the Contractor's License Law for the P-Trap reason (Section 7031.5 Business and Professional Code: Any city or p _ Switches 'Sign county which requires a permit to construct,alter,improve,demolish or repair r • any structure, prior to Its issuance, also requires the applicant for such permit Roof Drains - Garbage Disposal Standing Sections to file a signed statement that he/she is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 (commencing with Section 7000) of Generator ❑05 KW ❑5-15 KW Trash Compactor ) , Division 3 of the Business and Professions Code) or that he/she Is exempt - P yerefrom and the basis for the alleged exemption. Any violation of Section •u31.5 by any applicant for a permit subjects the applicant to a civil Reinspection Fee 3 enalty of not more than five hundred dollars($500). Pa I $25 Issue Fee $ - • LJ I, as owner of the property or my employees with wages as their sole MECHANICAL Reinspection Fee $25 Issue Fee $ 3 compensation will do the work,and the structure is not intended or offered FEES for sale (Section 7044, Business and Professional Code: The.Contractor's - PUBLIC SERVICES REQUIREMENTS: License Law does not apply to an owner of a property who builds or improves Boiler Hood or Type I 0 thereon, and who does such work himself/herself or through his or her own Zoning Approved By Oate • employees, provided that such Improvements are not Intended or offered for Canopy Type II 0 sale. If, however, the building or Improvement is sold within one year of com- Duct-Under Ground Building Approved By Date' • elation,the owner will have the burden of proving he/she did not build or im- rz� lOove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By -�J O LJ9 V PP f)atet .2�3 I,as owner of the property, am exclusively contracting with licensed ❑0100,000 BTU ❑100,000 BTU con- tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY OF FEES The Contractor's License Law does not apply to an owner of property who - s' builds or Improves thereon,and who contracts for such projects with a con- Exhaust System ❑ Multiple❑ System Repair/Alteration BUILDING PERMIT $ •OO SMIP : $ r SC-) tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT ❑ I am exempt under Section B. & P.C.for this reason Firepl/Fact.Bit. ICBO# PLUMBING $ ISSUANCE $ Date Owner •- Heating System&Ducting ENERGY P.C. $ • PLAN CHECK 25% $ I hereby certify that I have read this application and state that the above ❑0100,000 BTU-0100,000 BTL— - - GRADING $ Information is correct. I agree to comply with all city and county ordinances ELECTRICAL '$ • and state laws relating to building construction,and hereby authorize repro- $ MICROFILM $ inspection of this cityyy...,,,to en r upon the above-mentioned property for PLAN CHECK 50% pp Inspection purpose a 1 Y'S M MECHANICAL $ TOTAL FEE $ 4f6•5-6 Signature Date Drivers' License or SS - Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK 25% $ , . CMF 0865-46 rev.12/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor \ • CONSTRUCTION AND PLANNING • : POOL 1SPA .- -. APPROVALS .. Permit# ' Date, Inspector APPROVALS Permit# Date Iri'spector 1. Temporary Electrical Serviceor Pole 52. Pool & Equipment Location - , I .2.. Soil Pipe-Undrgrnd. _ 53. Steel Reinforcement . r3: Electrical Conduit.Utility-Undrgrnd. - 54. Forms 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding, 5. Steel Reinforcement. - r - 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE - • - 7. Footings • 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undigrnd., Test - 9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, 0 Undrgrnd. . 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection , 62. Backwash 8/Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final - ' 13. Roof Drains 64. Plumbing System - Final . 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final - - • 16: Rough Electric Wiring . 67. Fencing & Access Approval - -"- - 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough•Factory Fireplace APPROVALS Permit# ' 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas 0 Oil 23. Gas Pipe-Rough &Test • 72. Underground Flush , 24. Roof Framing 73. Undergrnd.StorageTank 0Gas 0Oil . I 25. Roof Sheathing 74. Overhead Hydro ' 2d. T-Bar Ceiling (Structural) & Monocoat75. Dry Chemical •- ' • • • 27. Frame and Flashing 76. Dry Standpipe • 28. Lathing & Siding , , 77. FIXED SYSTEM FINAL • - - ' 29. insulation - 78. FIRE PREV. FINAL ' 30. Drywall Nailing t - HEALTH DEPT. REQUIREMENT ' 31.4 Plaster Brown Coat C. I 79. FINAL INSPECTION 32. Electrical Power Meter-Final '�. 80. FOOD CERTIFICATE ISSUED ' '33.`Final ElectricNotes: 34. Final Heating &"Air Conditioning • 35. Final Gas Pipe-Test - • , 36. Hood or Canopy - •- 37. Final Factory Fireplace - - 38. Final Plumbing • • 39. Water Service-Final 40. Gas Service-Final i ' ' 41. Solar Domestic-Final • - - 42. Backflow Preventer' r I - , 43. Backflow'Irrigation ' ' 44. Landscape Irrigation System 45. Sound Attenuation I ..• - 46. Handicap Regulations ' - • 47. FINAL STRUCTURE & BUILDING - - - f fij?oEtc_ 44. Sc- 4 48. Special Requirements Completed 1 Ca i• 1 tk 21 -49. Electric Release to Edison i ' 50. Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY - - • No. ` ' Date •' '