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Home My WebLink About237 16TH PL - Building Permits ,#„,.4„:0- Y _ ` e ITV OF COSTA MESA c B{I'ILDING DIVISION ,�'a ..� F ( `rte I DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 4PERMIT B06-01007 � (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.etnLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 237 16TH PL Status: ISSUED Suite: Applied: 06/23/2006 Vicinity: Issued: 06/23/2006 Primary Occ: R Type of Construction: V-N Parcel Number: 42520110 Zoning: Applicant: ALVAREZ, SERGIO Address: PO BOX 472 Phone: 714-750-5000 ISSUED BY: HUNTINGTON BEACH,CA -. - - Zip: _ 92648 Owner: SCHLUTZ, MICHAEL-AND-GERALDINE - , Address 237 16TH PL-'i '% 5 -' / -? ' Phone: i i ----,;--,5.--. COSTA MESA,CA — . , Zip: 92627A ; -L N , /�A , Contractor OWNER=BUILDER w,A Address:- -�/,� / , - _ _ :.� -, \\ ' � / / ,,:,5,,, Phone: - " �, - 2 \ •5 \ ,Zip: ,� / License: 000000 v�,�\v '.vA � " Arch / - Eng: Address:, Address: Phone: - \ Phone: , ' .,e ,Zip: License: - _— License:. '— / ' ',` / SCOPE OF-PERMIT__ STUCCO TRI-PLEX // --,5'.: - - - �� , • \ FEE SUMMARY N. ` Plan Check: $81.41Calc Valuation: / $6,000.00 // Permit: '$125.25 / ' r ' / %"Th '-" '707'::>. "''' ''Claim Valuation: $6,000.00 SMIPRes: $0.60 L SMIP Com: . $0.00 �� Other: $0.00 �� 1 \--,'57,3-;-: i. �" .. ' Inspection: . $0.00 _ .�' (2 �� 1 ./, c r� - � , Total: , $207.26 /�V , --_:7 -_ '/ : i PLANNING-& ZONING /,',/f// ' :TY SETBACKS ' / /- / MAIN STRUCTURE Front - 0-0 Rear 0-'0-" - _Left`'. 0-0 Right 0-0 1,7 - ACCESSORY • Front ,0-0 Rear 0-0 Left_ 0-0 ,._,_Right -0=0 5 / / 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 2446-4619'00) 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 ice led. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed If the permit I-valued et one hundred dollars(5100)or less.) C certify that in the rf once of the w.rk for h' this permit is Issued,I shall not employ any person in any manner so as to become subject to the workers' compensation law of allfomla,and:tree that - ould become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with th e r slons. f PpiIcant:Signature:- ...&q !.•� Date:—r.(7 7i/��0-L ARNI� _EARURE-T ECURE V/ORKERS'COMPENSATION COVE-'1E IS UNLAWFUL AND SHALL SUBJECT Ni EMLOVERTO'CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED 111111 D DOLLAR ($103,000),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.Lk.a Class 0 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). 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 subje5s the applicant to a civil penalty of not more than five hundred dollars(5500).): -Qc 1,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 Cade: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 ne 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 ow er of a property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code: e co rectors Lice..: ,w does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursu nt to the C. tract. : Laws.). FI l'em e m under sec. S Business and Professions Code for this reason: _�12,510FSIgna lucre: /(. I Date: C. :Owner b-cil rifled b drivers license. 0 Yes ❑No Driverr�skicenseNo. Expires:,F///(O' Verdi ion of Ownership by(type of document,i.e.-property tax bill or deed):t.. :' . 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,Tltle 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 hes 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 end 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 end 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 filo 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 0 N (Section 25534 of the California Health and Safely 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. sets .�.. __...... ...._..._......_..._....._..._ sets..._. 4 If en RMPP is presently requiretl,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No _ ..such construction ...__ _.. 5 Does or willo the icAir or present or n building District o at other for the work onim is the subject age c this application apg�arit for such coor 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 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). — .._._.t..._C__ ___...__...___. her .tie is 7 application,If a porfrom the South Coast s Quality by Califo is Healthal or n Safety egold tion controloon district03 or agency is required for the work which the subject of this have all of the disclosures prescribed by Celifomia and 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. Signe -• Date: CE' CA -OF COMPLI• E AND A •-r•TON OF ENTRY:I certify under penally of perjury that I have read this application and state that the information given is corre t.I a. ee to comply w h all state la try ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the abov.-de• Jibed property fo inspectio• . :..I agree not to occupy or allow occupancy of any building authorized by thi rmii til final inspection. // 7Sh,afore Ol.Legal Ovate.=) [ Dat 1- And/Or Authorized Applicant Date ;ODEA PNSPEOTIONTYPE PAIL ROIDALR CODE! INSPECTION TYPE PATE EMU 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 -er" - r r 403757PA,d 'T: —7-75c,--R700 515=- ****97.n COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT a ��t/ /r A REC Eyy F,�BY L�.TE RECEIVE9I DATE 1/UE0. Al DR DIESNS RaG [?I,7�{/.. /c 14'' P/I 4G.Q /v7/~I •�/r ay�7 /^/V� R //,! OWNER iia Ld h./ (F4 L--4. C. A.P.NO.// —/S/// P T4j MAIL ADORESQ pr /L 4 /^`C ADDRESS �S3 ( yl'ir 4i/rt/4 ADDRESS c 1 L Z . p a U CITY We 41104 '{ TEL. ire` TRA�`f—JLf/ �10 s BLOCK Z ✓✓ /r` CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMO)ISH I- )/LENDER ritY 403 J O BRANCH if/ J to OWNER i / mJ ADDRESS //////�� ////�^111I /�j1� ALOE '/Q J m ARCHITECT /,J II TEL. USEace„ /l�'a /t W nor Q OR ENGINEER /(AL 1. ) r 0 rl P NO U Q FIRE Z • w ADDRESS 4't'& ( E 4N/£J�_e..a.. S t- t.:/r}gtfq,/ ZONE PE /C FOUP t///�� / J O CONTRACTOR t 1�I /Iif� APPROVED ,', DATE9�/ q' / f` 0 Z / ` J et ADDRESS N,E - Z F CITY --- NOTE. ZONE•s .-lipLANS _/- USE OF BUILDING'/n �f'( Z9tt /J O STATE CITY ryn(� YARDS APPROVED YARDS4;1;0V ten cc LIC. NO. LIC. NO. ! ,/ MAIN BUILDING ACCESSORY BUILDING DO (FROM C/L STREET) SIZE 7 NO.OF BLDGS. OF LOT O X( 3NOW ON LOT -1 RONT £ /,'L - 1 FT. USE OF ....-(J EXISTING BL(D��G. o /C C J _ .SIDE 6 FT, FT. I— SIZE OF Z NEW BLDG. f/.I(/ I ROOMS STORIES t L.SIDE 023FT. FT. Q EXTERIOR WALL ! ROOF U COVERING Lt.-el sc1 I COVERING Ca"T(0 REAR !0 FT. FT. 1J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& -n a / I /' -t / 1 _MAIN BLOCS. / ACCESS BLOCS. d� Q DATE Q4 c0t ^S a.T d le i+, 11 I-L C.U.P. Of'75 3 APPROVED --/7-73... /j ,wl/�� to eX: st . c j c ; L 5 �f IAS-.. (y / ROVE RN� DATE /a-/� /•� ZHOLD FOR SPECLAL RE It ENT,a F -- a IA I _ V I at the acknowledge FT. - thatI— SIreadandthat is correct and agree to comply with LCall laws regulating building construction, and I shall not employ 3 l F any person in violation of the workman's compensation laws of (o the State of California. zs�� 7 Z I hereby certify that I am properly licensed as a contractor under frJl AX SQ. FT. o the State of California Business nd Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such lice are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: CC am exempt from the provisions of the Sta of California Business VALUATION and Professions Co e, iv' Ion 3,Ch ter co J//// �/f PERMIT FEE $ Signature of �1 ^' y^ B Permittee $ ' /%) —, PLAN CHECK $ % rsi6 E Authorized Agent (/'Q�/ o LL TOTAL FEE $ ;i. PIU Q 3�� CFP 19-75f„sr OO 935 0*** 187 r( COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 • ' 'LI A 'ION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only L' nt.- Rf I ED :Y DATE RECEIVED D•iE I/UED,, BUILDING I,// ADDRESS �z. / /� yy �Ef�� J•� OWNER noT/1 C .. ate), � A.P.NO. rf///�C�M 7J BUILDING Q E iG 4 y/ ADD ADDRESSa37 �'L ADDRESS (!(( TEL. CITY NO. TRACT LOT BLOCK CONSTRUCTION NEW ALTER REPAIR MOVING nen/1(11)9H LENDER i (� BRANCH OWNER 166V Aust ADDRESS - VALUE al ARCHITECT TEL. SE 2 UNi rs $ OR ENGINEER NO FIRE / ADDRESS . ZONE /ilT E GROUP APPROVED / CONTRACTOR • - BY C DATE 717-7s ADDRESS TEL. ZONE NO.OF USE OF NEW CITY NO. PLANS BUILDING .F+ STATE CITY YARDS APPROVED YARDS APPROVED LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING IR SIZE NO.OFBLDGS. (FROM C/L STREET) LL, OF LOT NOW ON LOT FRONT FT. FT. USE OF y EXISTING BLDG. R.SIDE FT. FT. CA E Separate permits are required for L,SIDE FT. FT. electric,plumbing and heating work. -- W - REAR FT. FT. [.., USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 0C MAIN BLOCS. ACCESS.BLOCS. VAR.# DATE QC.U.P.# APPROVED APPROVED >. _BY DATE FR P. I hereby acknowledge that I have read this application and state N. n t,Y., that the above Information is correct and agree to comply with m Q+ all laws regulating building construction, and I shall not employ O Z any person in violation of the workman's compensation laws of o the State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. of the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY; e am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $17/7v and Professions Code, Division 3,Chapter 9. en ,n PLAN CHECK $ re Signature ofC Permittee $ A TAX $ 2 Authorized Agent TOTAL PAID $/Y7 CITY OF STA MESA PAhaFEES N° 13 0 Fee Payment Receipt �y Project Addresc � It( �C • Park Area �7 A. P. No. //(] L—//67—r-- 1/ / �e Building Permit No. 6 375 Owner's Name �deryt l/zZ2e/ - Mailing Addres/ _ k• t t O i / : ./.a • • ar G� FEE Single Family * No. of Units @ $455.20 = / Multiple Family ** No. of Units % - @ $321.32 = 6//1F„1, Total Fee J 4�'�.•61 Planning Department Appr I ate —/ %�S By t/.!//c P6 9' / Applicant's Signature • City Ordinance 72-44 •• City Ordinance 72-45 ••• City Resolution 74-124 pRo)j i ti White-Planning;Canary-Planning;Pink-Finance;Goldenrod-Applicant CMF 0174-26 IU'