HomeMy WebLinkAbout268 16TH PL - Building Permits •
p ' 9 CITY OF COSTA MESA
4
BUILDING DIVISION
> -_ , DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
Ft .1141
PERMIT
P02-00283
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
PLUMBING PERMIT
Job Address: 268 16TH PL Status: ISSUED
Suite No Applied: 05/08/2002
Issued: 05/08/2002
Vicinity: UNITS A,B,C
Parcel Nunmber: 42522219 ISSUED BY:
Applicant: ST CLAIR, WILLIAM DENNIS
Address: 268 16TH PL
Phone: 949-290-6333
COSTA MESA,CA Zip: 92627
Owner: ST CLAIR, WILLIAM DENNIS
Address 268 16TH PL
COSTA MESA,CA PhoZip: 92627 0- 6333 �I*ct '
0�r04
36
•
Contractor: OWNER BUILDER
Address:
Phone:
Zip:
License: 000000
Arch / Eng:
•
Address:
Phone:
Zip:
License:
SCOPE OF PERMIT
REHAB WORK FOR TRIPLEX.UNITS ARE ATTACHED.CHANGE OUT WINDOWS AND PATIO DOORS IN
UNITS A,B,AND C.ALL BEDROOM WINDOWS SHALL COMPLY WITH EGRESS REQUIREMENTS.
REPLACE THE KITCHEN SINKS IN UNITS A AND C ONLY. REPLACE 1 BATHTUB IN UNIT C.
REPLACE TWO WASH BASINS IN UNIT C.
FEE SUMMARY
AMT QTY AMT QTY AMT QTY
ISSUE FEE $23.50 " Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0
Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0
Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0
Bathtub $9.80 1 Pressure Regulator $0.00 0 Urinal $0.00 0
Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkfiow(1-4) $0.00 0
Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0
Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $19.60 2
Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0
Drain,Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0
Drain,Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0
Drain,Roof $0.00 0 Shower $0.00 0 Water Heater/vent $0.00 0
Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0
Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0
Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0
Gas(1-4 outlets) $0.00 0 Sink,kitchen $19.60 2 Water Softener $0.00 0
Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00
Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00
Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00
Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0
Interceptors(Sand Auto) $0.00 0
TOTAL CALCULATED FEES: $72.50
NOTICE: The work authorized by this permit stfiaMMOItrafieraleghralatigtirgal,Cequirements 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
2446-48 tool
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.
❑ 1 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.In nce car .1-and policy number are:
Carrier: /`L X/) CJ.t Policy Number: V
is section need not be completed if the p it is valued at one hundred dollars($100)or less.)
rtify 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,a agree that if I should beyome s workers'compensation provisions of Section 3700 of he or Code,I shall forthwith
comply with then ov Ions. �/// A �/ p'
Applicant Signature: . �2I4 . V Date: D /
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAG S UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML RNES UP TO ONE HUNDRED
THOUSAND DOU.ARE($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.# Class#
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 d 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
ubj 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,Businessland 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 fierself.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.).
❑ 1,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 riot 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 Con ctors License Laws.).
❑ I am axe/m/pt u der sec. r1hC-, nd Professions Code for this reason: �//
Signature: !f V/.13 J + Date: ',}'�//a 2 ,
Owner ID verified by drivers license. es o Driver's License No. Expires:
Verification of Ownership by(type of doge.-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,Califomia 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 and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 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 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 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? 0 Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be fumished 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 ordinanc relati - %building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-describe rop rty for insp• purposes.I'gree not oc • •r;�;p • cupancy of any building authorized by this perm' until opal inspection.
71-171
•na re Ot Legal Owner Date
And/Or Authorized Applicant Date
RODE I INSPECTION TYPE Phil LLS RODEf INSPECTION TYPE Phil IfImWL5
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
p CITY OF•COSTA MESA +
4 BUILDING DIVISION
F • a,,, ,i DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
k IPP411
PERMIT
602-00634
%titan ane
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 268 16TH PL Status: ISSUED
Suite: Applied: 05/08/2002
Vicinity: UNITS A, B,C OF TRIPLEX Issued: 05/08/2002
Parcel Number: 42522219 Zoning:
Applicant: ST CLAIR, WILLIAM DENNIS ISSUED BY: r91/4Z
Address: 268 16TH PL -
Phone: 949-290-6333
COSTA MESA,CA • Zip: 92627
Owner: ST CLAIR, WILLIAM DENNIS
Address "268 16TH PL - � do
� -�
Phone: 949-290-6333 //
COSTA MESA,CA Zip: 92627
Contractor: - 3 6 rP
Address: - O4`fr
r
Phone:
Zip: License:
Arch : - - Eng:
Address: Address:
• Phone: • Phone:
Zip: ' License: License:
SCOPE OF PERMIT
REHAB WORK FOR TRIPLEX. UNITS ARE ATTACHED.CHANGE OUT WINDOWS AND PATIO DOORS IN UNITS A,B,AND
C.ALL BEDROOM WINDOWS SHALL COMPLY WITH EGRESS REQUIREMENTS. REPLACE THE KITCHEN SINKS IN UNITS A
AND C ONLY.REPLACE 1 BATHTUB IN UNIT C. REPLACE TWO WASH BASINS IN UNIT C. •
– FEE SUMMARY
Plan Check: $0.00 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: $182.25
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
NOTES:
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
2446-48(6/00)
DECLARATIONS 1 c
' WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one 01 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'coma=ns>ltion insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workers'comper�''}t�io/n�lnsuraw• arnerr.nd policy number are: n�/n�
Carrier: v' \ .� • Policy Number: C—._Q' M
This section need not be completed if th- if is valued at one hundred dollars($100)or less.)
•
I certify that in the performance of the ork 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,•nd agree that if I slit Id b'•-• bject to the workers'compensation provisions of Section 3700 the L bor Code,I shall forthwith
comply with these;oVsions / ^LSJ �E
Applicant Signature: / /2 air Date: [�
Ota
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND IVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE(S100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060E THE LABOR CODE,INTEREST,AND ATTORNEYS 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#
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 pe alty,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
Ausiness an Professions Code)or that'he prshe_is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
ubjects 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 C• tractors License Laws.). �/
❑ I am ems�''"" t oder s- s and Professions Code for this reason: // �1
Signature:a/PA �/ Date: "-�(/ U�
Owner ID verified by driver's license. ❑Yes El No Driver's License No. E pires:
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? ❑Yes ❑No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑No
(Section 25533 of the Califomla 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).
.ta ..l.cant..r...
3 Does or will thee 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? ❑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 Quality Management District or from any other air pollution control district or agency? LJ 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 ❑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: Dale:
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 comp) with all state laws and c ty ord' nces elating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
abovepcnbbed pro..- or inspection purposes a cupy or allow occupancy of any building authorized b7is�errrit until fi nal inspection.
�//7 Signature eget (Ir// Date
And/Or Authorized Applicant Date
CODE I INSPECTION TYPE PAM INTIML$ CODE I INSPECTION TYP[ PAM R IS
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
attributes : Costa Mesa Parcels — Page 1 of 1
•
c - Property Address
Address 1 268 E 16TH PL
Address 2 COSTA MESA CA 92627
Parcel Information
Assessor Parcel Number 42522219
Legal N TR 2996 LOT 17
Range
Township
Section
Quarter Section
Area 6264.7671700000001
Acres 0.14000000000000001
Owner Information
Owner ST CLAIR WILLIAM DENNIS
Owner Address 1 408 E 16TH ST
Owner Address 2 COSTA MESA CA 92627
Property Specs
Year Built 1960
Building Square Feet 3123
Building Count 1
Stories Number 2
•
Parking Spaces 0
Number of Units 3
garage Square Feet 520
Front Footage 50
Depth Footgae 125
Bedrooms 0
http://mesagis2x/website/costamesa/parcel/default.asp?opt=attributes&sessid={50924820-52CC-427C-9... 02/19/2004
Property Profile Page 1 of 1
DataQui\cks
land and property data Ito Cittl bulk;on-
Property Profile
Primary Owner: ST CLAIR,WILLIAM D & LISE A
Secondary Owner:
Mail Address: 408 E 16TH ST
COSTA MESA, CA 92627
Site Address: 268 16TH PL , #A
7 COSTA MESA, CA 92627
t a Telephone Number:
Reference APN:
1, APN: 425-222-19
�..
4.
CA`IFORMA Census Tract: 633.007
Housing Tract Number: 2996
Geo Level:0
Lot Number: 17
Page Grid Old: 31-03
Page Grid New: 888-J5
Legal Description: N TR 2996 LOT 17
Subdivision:
Property Characteristics
Bedrooms: Year Built: 1960 Square Feet: 3,119
Bathrooms: Garage: Lot Size: 6,265 sq ft/0.14 acres
Total Rooms: Fireplace: Number of Units:
Zoning: Pool/View: Use Code: Multi-family Res(5+Units)
Heating/Cooling:
Sale& Loan Information
Transfer Date: 04-20-2001 Seller: Document:_00.002.37.6.19
Transfer Value: $540,000 Cost/Sq Feet: $173.13 Title Co.:
First Loan Amt: $425,400 Lender: Washington Fsb Last Trans W/O$:
Loan Type: Interest Rate Type: F - Last Trans W/O$ Doc:
Assessed& Tax Information
Assessed Value: $561,816 Percent Improvement: 17.64 Homeowner Exemption:
Land Value: $462,712 Tax Amount: $6,439 Tax Rate Area: 15007
Improvement Value: $99,104 Tax Status: current
0 2004 DataQuick Information Systems.This information is compiled from public documents and is not guaranteed.
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4`p5tsi t4 CITY OF COSTA MESA
BUILDING DIVISION
F •'triali DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
o 411 PERMIT
`"Moto 11302-00385
f it
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 268116TH ft PL Status: ISSUED
Suite: Applied: 03/19/2002
Vicinity: ROOF �1 Issued: 03/19/2002
Parcel Number: 1125�1'1'e^ �252�i� Zoning:
Applicant: WILLIAM DENNIS ST. CLAIR ISSUED BY:
Address: 408 E 16TH ST ,
Phone: 949-290-6333
COSTA MESA,CA ' . • Zip: 92627 '
Owner: ST CLAIR, WILLIAM DENNIS
Address 408 E 16TH ST
' Phone: 949-290-6333
COSTA MESA,CA Zip: 92627
Contractor: OWNER-BUILDER •
Address:
Phone:
Zip: License: 0 .
. -
Arch : -
Eng: •
Address: Address:,
. Phone: - . , Phone:
•
Zip: License: License:
SCOPE OF PERMIT.
REPAIR DRY ROT STUDS, RAFTER TAILS AND ROOF SHEATHING.REPAIR SECTION 4'X 8'SF.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $3,000.00
Permit: $83.25 -- - Claim Valuation: $3,000.00
SMIP Res: $0.50
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00
Total: • $83.75 .
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
NOTES:
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.
❑ 1 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'compeesation Insurance carrier and policy number are:
Carrier: Policy Number
(This se ' n 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'
compensation laws of Califomia,and agree that if I should be oma ubject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions.
PPligant Signature: r / - -.� deft., r,� IDa19^ —/9— n
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER.TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,000).IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 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 x - - •
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
subje 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.).
I2T 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 e;gmpt under se mess and Professions Code for this reason:
i ignature: 't'2/r /h/h x AT- 3-19 -0Z
wU ner ID verified by driver's license. Ves 0 No overs CicenseNo1c Erel7dr 3/—o6
Verification of Ownership by(type of d ment,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,Gm 2,Art 2,Sec.
341.Title 8,Califomia 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 ❑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 ❑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 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑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 application apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ 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 ❑No
(If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia 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? ❑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 co ly with all slate laws and city o ances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-•ascribed pr.• ,, for inspection purpo•-s.I :• yr:occupy or allow occupancy of any building authorized by this permit until final inspection.
: d : •'"e•-i
fitSighwner(s)r-: i'
And/Or Authorized Applicant Date
CODE E tNSPEO➢ON TYPE RAN IIITITIAL$ CODES INSPECTION TYPE Q9TE IGL.R
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing -.
200 Final Re-Roof `1' ^OL 210 Final Electrical
201 Final BlocldRetaining 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
rvnnrn w/10/77
JOB ADDRESS 268 E 16th Street BUILDING PERMIT NO. 1)331
GENERAL CONTRACTOR Qmar hvi1dar• VALUE $ 765.80
r No. 117-191-5 &6 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Ret. wall & fence
h ECTIONS a _� DATE GROUP TYPE ZONE R)1
Underground Soil U.G. Water PERMITS ISSUED
Underground Gas — SUBCONTRACTOR DATE NUMBER
Overhead Water and Gas
Rough Heating
Rough Plumbing
Miscellaneous
Prop. Swr. Line House Con. St. Swr.
Sprinkling System
Heating, Final
Plumbing Fixtures
Final Gas Test
Construction Pole
Underground Power
Rough Wiring
Trenches Forms Steel b-n '%,3J „/
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam
S Sing
Flame and Flashing
Lathing, In Out
Plaster, brown coat
Plumbing Fixtures, Final
Electric Fixtures, Final A. .- ,l ' —
`�."7"�71r ��`� . Anil m
9303
COSTA MESA BUILDING DEPARTMENT ems'
P.O.BOX 317 I;fI;'1 SCE-DEPTs
COSTA MESA, CALIFORNIA
ynl' rile'A, Pi:Q..k
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
BUILD
ADDRESS 268 - 16th Place, A, 'B, C BUILDING
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
RECEIPT NO. PERMIT NO.
OWNER Santa Ana Patio Homes Inc. 7,37 3
MAIL 1555 Placentia R CEIVED BY DATE RECEIVEDECnDATE ISSUED`)
Cail
ADDRESS n b/ 31/4-
C'--s7 S-�/s,✓
CITY Newport Beach, • TNO. MI 6-3221r� A DREISS
ARCHITECT 98me O,
ENGINEER
N
OR ENTICTER NO, COSTA MESA. CALIFORNIA
FIRE
ADD,. .S same ZONE
Kj( Y! Roll Const. Co. CITY LIC, 1217 ZONE NO.OF TYPE GROUP
CO�J ')TRACTOR• NO, /Ryj PLANS
TEL. APPRO EO
ADDRESS same NO, s e BY DALE �(
LEGALO
DESCRIPTION NOT 17 BLOCK TRACT 2996CCAIryJ a6 py�`l
A.P.NO. {/V� fff.A 44 A A,4 c .V
SIZEFNOW SLOGS. O I {!!1 P '! I Li p I, ' n
OF LOT SQ x 125 NOW ON LOT ..1 ytJ IN,� i�(•
fr
USE OF sI di 'L L i
EXISTING BLDG. •y')/�
SETBACK LINE FROM 581_8n '-`[ A i .
CENTER OF STREET REAR YARD'S tp C/I YYY ~'✓1-�'P�l �
DA E
SIDE YARD RIGHT 5 LEFT 71-611 f I . No. J APPRnVco c-_S/
DESCRIPTION OF WORK
NEW,- 7 ALTERATION ADDITION
(\
REPAI.. MOVING I DEMOLISH
1 SZIEDING 3123 ROOMS 16 STORIES 2
EXTERIOR WALL ROOF
COVERING stucco COVERING hot-Top
USE OF NEW
BUILDING
Triplex residence and att. garage.
Plan 4-XDR
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
CITY ORSINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC-
TION. / VALUATION
SIGNATURE OF A✓/i. - C/J/ PERMIT FEE 5 46.00
PERMITTEE
5
261378.00 PLAN CHECK 5 23•00
AUTHORIZED AGENT TOTAL FEE 5 69.00 9Ar
111, 5/erer3 pA ,4/oto il.L'a-,- C .-.c.. e.C....
0. \PR 29-76Put 001742 vo
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely— Use k Only RECEI DATE RECEIVED
/ /rBUD E I S
ADDRESSLDING
In✓c .' (t�IL y 9/ y7 P 4/q("/��
OWNER -/Gl . r I aa..7GN A.P.NO. I/,� "// ! I / /fes/,(M/JON/ U
MAIL BUILDING / o� // a/L
ADDRESS ' ADDRESS " / (Q ted/ - -
TEL. TRACT, as r CYJT 7 BLOCK
CITY NO.EI C
CONSTRUCTION NEW 1ADD(ALTER IR P• , ,a INC
LENDER
nEMOLLSH
/��
i ' V J
BRANCH , /
4
�., OWNER ,0 I / / /
ADDRESS ^^ �y VA/ E /� ,sem
ARCHITECT TEL. USE-A /It L-1TR / •A /0,vV `�4
OR ENGINEER N V
FIRE
ADDRESS ZONE TYPE / , GROU
��J /''/� APPROVED /,/
CONTRACTOR �(I[���i/U 16
BY /` DATE
ADDRESS
TEL. ZO NO.OF USE OF N
CITY NO.
�. I PLANS A BUILDING'
- STATE CITY YARDS APPROVED Y; ' APPRO ED
LIC. NO. LIC.NO. MAIN BUILDING
(FROM C/ STR -T) SORY BUILDING
{U SIZE NO.OF BLDGS. Ii I�r/ �/
/ ! / �r
4 OF LOT NOW ON LOT FRONT T. I,t! 4/ FW ,��/y/
Q USE OF + U�
,-. EXISTING BLDG. R,S r.. I ' '�� Q#T.r
FSeparate permits are required for • L.SI l;: ' 1 T. g FT t2 .f/--
electric,plumbing and heating work.
REAR I I c2 FT.
u: USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
I r MAIN BLOCS. ACCESS.BLOCS.
/•6 VAR.if‘ DATE �}�yJ/'
..1E�� c` 2� C.U.P.$ APPROVED 4/1 yr
)' 2/�nCe� 04 A d/� APPROVE, %Pa— nA F ✓ oo � L/
V/01a S3/�
IQ p
o I hereby acknowledge that I have read this application and state n
C that the above information is correct and agree to comply with 4_co /Qr m
L all laws regulating building construction, and I shall not employ /A/7%
Z any person In violation of the workman's compensation laws of f+ a
k] the State of California.
• I hereby certify that I am properly licensed as a contractor under ` SO. FT. // w
the State of California Business end 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:
to
am exempt from the provisions of the State of California Business VALUATION PERMIT FEE S eE/eoe-/s a
and Professions Code,Division 3,Chapter 9. in
Signature of '''''SLA em �s r� PLAN CHECK S c
Permittee �-' `^' �s �✓`�s� --- $ /a 000 TAX S
U
Authorized Agent • TOTAL PAID 5 / / /