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Home My WebLink About272 16TH PL - Building Permits • • . T CITY OF COSTA MESA 44 • BUILDING DIVISION :jY',. ''�ti, DEVELOPMENT SERVICES DEPARTMENT PER NUMBER CiliT1011411 1141111 i PERMIT -"M 605-01251 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa..V ILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 272 16TH PL Status: ISSUED Suite: Applied: 07/28/2005 Vicinity: Issued: 07/28/2005 Primary Occ: R3 Dwellings/Cong Res<10 Type of Construction: V-N Parcel Number: 42522218 Zoning: Applicant: MIKE BURKE ISSUED BY: Address: 1653 SUPERIOR AVE Phone: (949)642-7222 COSTA MESA,CA Zip: 92627 Owner: GOODRUM, CATHERINE M ET Address AL - - NEWPORT BEACH,CA Phone: P O BOX 1734 - -- Zip: .92659 Contractor: LEE ROOFING OF COSTA MESA Address: 1653 SUPERIOR AVE Phone: (949)642-7222 COSTA MESA,CA Zip: 92627 License: 349686 Arch : - Eng: Address: - Address: Phone: • Phone: Zip: - License: - License: SCOPE OF PERMIT.. TEAR OFF BUR OF-THE GARAGE AREA AND COMP.OFF THE HOUSE. INSTALL 1.BASE 2 PLY AND CAP SHEETONTHE GARAGE AND 2-15 FELT AND 30 YEAR COMP..SHINGLES ON-THEHOUSE. 'r FEE SUMMARY Plan Check: '. $0.00 ' . Calc Valuation: $8,694.00 Permit: $167.25 Claim Valuation: $8,694.00 SMIP Res: $0:87 SMIP Corn: $0.00 Other: , $0.00 Inspection: $0.00 Total: $168.12 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0- ACCESSORY Front 070 - Rear 0-0 Left 0-0_ . Right 0-0 PARKING Existing: 0 `-H.. 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 241&46(&00) DECLARSTIONS 1 • WORKERS'COMPENSATION DECLARATION: • r I hereby affirm under penalty of perjury one of the following declarations: / 0 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 performange of the work for which this permit is Issued. IC 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. • • •rkers' 0 pensatio surance car and p Ilcy number are: / n -� artier: . �r� f1{if ft Rz_2� r. OOc/7 9- �'� S (This tion need not be completed if permit Is valued et one hundred dollars($100)or less.) ❑ I certify that in the performance of the work • which this permit Is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws o ag .t if I sh• Id become subject to the workers'compensation provisions of Section 700 of he Labor Code,I shall forthwith �wirIr-".se rovl // �J // T'- :nl Signator P a,' Date' / otg ei 7--- •r; "NTN • TIRE TO SECURE W ERS'•• ENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT TO CRIMI PENAL ffEES AND CIVIL FINES UP TO ONE HUNDRED THOUSANDCOLLARE(5100.0001. 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:• .11 :m licensed under provision of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force;y , �1 .a "4H /Pk - i mess • G Contr: gnature: /di. .'� � own obit.: _....r./ ` 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: 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.). ❑ 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 Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more 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,faisework,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 tiled 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? 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 agermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? IYes LI 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 eir 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 purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. a. Adill' r E�e :..`A ner(s) _ /Aer, s Y ate An.0–•• horized Appli -nt \ CODE r id, A DATE INTBIALS COM/ INSPECTION TYPE PAIS =Aka 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Finales 208 Final Plumbing 200 Final Re-Roof / Z L`— 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 Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. . ;CITY Ot COSTA MESAPERM NO. TRACT NO. LOT NO. •BLDG.NO. - • - CIONSTRUCTION PERMIT 4815 ,, • _ � I j'T 2447 8/04/81 540 TI- Project Address 7 2.- �li'CI. A_ Ir g+' TYPE OF CONSTRUCTION ,i -. < ( - Ownerpm � s C/P"'Phone 0/NEW 0 ADD 0 ALTERATION - - : Address " - L ' PAIR 0 CONVERSION 0 DEMOLISH Arch/Eng. License No. - 0 OTHER .. ' _ _ ZONING REGULATIONS 46 _ _ DESCRIPTION OF WORK A.P. Address ZONE PLNG. REF.le • Contracto�i a..t y.. • Phone 4-kr TYPE OF PERMIT - - - BS D s- ] BI ILDING J SETBACK C/L ST. Pr.OPE RTY LINE Address /C� ...r..-4-2.---i•-•1/4 / ❑ GRADING 0 FOUNDATION 0 STRUCTURAL SIDE YARD - - • LICENSED CONTRACTORRATION • • - ❑ TENANT El-ELECTRICAL I[1 PLUMBING• OMECHANICA LLEDE V• •a I hereby affirm that I am licensed under provisions of Charter 9(com- RIGHT mencing with section 7000) of Division 3 of the- Business and ❑ OTHER . Professions Code, and my license is in full force and effect. 'REAR YARD(TO P/L) ��q�� ., PROJECT DESCRIPTION _ Licensed❑plass - License Ny,Y�S3.fcL PKG.SPACE REQ. PROVIDED Date ?1 •-11-11.0. Signature es•-•-r—eS QfS� SQ. FT. - WORKERSCOMPENSATION D RATION .7 - OCCUPANCY_CONSTRUCTION TYPE 'STREET WIDTH PARK FEE$ A I hereby affirm that I have a ce icate of consent to self-insure or a ZONING APPROVED BY DATE certificate of Workers' Compensation Insure e, r a certified copy VALUATION ZONE )CI thereof(Sef�l,�j�80,2,Wb.C.). GRADING CU.YDS. ACRES SPECIAL CONDITIONS: Po"''* No t7"/b �ad Company . E :ified copy is hereby furnished. - REMARKS: . - _ - 1 �, Alfieri copy Is filed with the city Building Division. \ EXEMPTION FROM WORKERS' COMPENSATION DECLARATION , , - (This section need not be completed if the permit Is for one hundred - - - _ • _ 1 ($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 PLUMBING PLAN CHECK ELECTRICAL - PLAN CHECK - ` subject to the Workers'Compensation Laws of California. - UW ELLINO - GARAGE - V Date Signature BATHTUBS SHOWERS SO FT SO FT N. NOTICE: If after making this declaration, you should become subject TOILETS - • URINALS • GENERATOR 0-1 KW_1-10 KW • _S1 to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER • forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS APPLIANCE - 10.50-KW 50+ KW revoketl. - - - - KIT.SINKS DISHWASHERS - MOTORS CONSTRUCTION LENDING AGENCY • 0-1 HP 1-10 HP I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS (INC.SOLAR) 10-50 HP 50+ HP ' ' - formance of the work for which this permit is issued (Section 3097 Civ. C.). FLOOR •SINKS - FLOOR DRAINS - FIXTURES OUTLETS SWITCHES-- - ' Lender's Name -. - - Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS • - - - OWNER BUILDER DECLARATION - -- INTERCEPTORS CLARIFIERS POLE LIGHTS ' ' I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP- - LUNS I NUL I itiN Any city or county which requires a permit to construct, alter, POLES METERED SUB improve, demolish or repair any structure, prior to its issuance,also re- WATER SERVICE ALTERATION PANELS - MAIN - SUB quires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law GAS SERV ICE OUTLETS — SERVICE AMP (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that-he-Is exempt therefrom and the WATER HEATERS ' BTU OUTPUT - - bask for the alleged exemption. Any violation of Section 7031.5 by ar 'piicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS - ' o' more than five hundred dollars ($500). ' ❑ ., as owner of the property, or my employees with wages as their SOLAR TANK - COLLECTORS - - • , sole compensation, will do the work, and the structure is not intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ' ISSUE FEE - Contractor's License Law does not apply to an owner of a property - APPLICATION APPROVED BY - DATE who builds or improves thereon, and who does such work himself or ISSUE FEE - through his own-employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES• is sold within one year of completion, the owner will have the burden BUILDING • of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU PERMIT $ SMIP $ fre ❑ I, as owner of the property, am exclusively contracting with AND DUCTING - • . licensed contractors to construct the project (Section 7044, Business 100,000 +BTU PLAN CHECK $ �.' PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU 'PLUMBING $ tracts from such projects with a contractor(s)- licesned pursuant to SYSTEM GRADING '$ the Contractor's License Law). 100,000+BTU PLAN CHECK $ •-. ,k 1 0 I am exempt under Section B.& P.C.for this ELECTRICAL $ $ `U BOILERS BTU reason PLAN CHECK $ MICROFILM $ lb SYSTEM REPAIR,ALTERATION - I Date Owner TOTAL FEE$' • I hereby certify that I have read this application and state that the above EXHAUST SySTEM MULTIPLE MECHANICAL $ - \ "� LESSANEP ' information is correct. agree to comply with all city and county 'PLAN CHECK $ -VANCE PC $_ representatives and state laws relating to erconstruction,on and hereby authorize representatives of this city t nter upon the above mentioned property ecti�purp s. _ '9 o "^ Signature,,,.-/ '�+"'� Date1` /rl FINAL FEE $ Drivers' L nse or SS sr .? ISSUE FEE - - - CMF 0865-46 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor .-.7,--r- CONSTRUCTION AND PLANNING POOL'&SPA`,•- J . APPROVALS Permit# Date Inspector- APPROVALS. - - - - ,Permit# - Date Inspector 1. Temporary Electrical Service or Pole _ 43. Pool & Equipment Location - - - 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms - 4. Electrical Conduit-Undrgrn __ 46. Electrical Bonding . 5. , Steel Reinforce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn - - 48. APPROVAL TO COVER-GUN ITE -- - . 7. Footings ... 49. Electrical Conduit-Undrgrn • 8._ Foundation -. 50. Gas Pipe, ❑Undrgrn,Test • 9. Water pipe-Undrgrn - 51. Backwash Lines. P-Trap. ❑ Undrgrn 10. StructuralFloor.System52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final 12. Street Sewer,Connection - - 54. Heater &Vent-Final • 13. Rough Plumbing_ _. - - 55. Plumbing System -'Final - - 14. Rough Electric-Conduit - • - 56. Electrical-Final 15. Rough Electric-Wiring- . - - - -57. Solar System-Final 16. - Rough Heating &•Air Conditioning - - - - • b8. Fencing &Access Approval 17. Ducts, in Structure - ,- - 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating . • 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing 21. Roof Sheathing 22. Frame and Flashing - NOTES: 23. Insulation - . 24. Lathing & Siding . 25. Drywall Nailing •• 26. Plaster Brown Coat 27. Electrical Power Meter-Final ' 28. Final Electric - - 29. Final Heating &Air Conditioning Rio g ��I - 30. Final Gas Pipe-Test 31. Final Plumbing . 32. Water Service-Final - 33. Gas Service-Final - - 34. Solar Domestic-Final 35. Landscape Sprinkling System 36. Sound Attenuation • 37. Handicap Regulations - 38. FINAL STRUCTURE & BUILDING - 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. ¶‘-J)/ L/13 • 42. CERTIFICATE OF OCCUPANCY . No. Date R COSTA MESA BUILDING DEPARTMENT ' .iv1 W5fl P.O.BOX 317 NNANCE DEPT. COSTA MESA. CALIFORNIA IHi• Cr! {Inc'I. M:CA FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT BUILDI ADDRESS 272 - 16th Place, A, B, C BUILDING COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY RECEIPT NO, PERMIT OWNER Santa Ana Patio Homes, Inc, /v///37 MAIL 1555 Placentia, CEIVED BY DATE RECEIVED DDATTE ISSUED ADDRESS SS7 5 /S9 TEL. BU DING CITY Newport Beach, Cal NO. MI 6-3227 ADDRESS ARCHITECT same LIC. OR ENG,NEER NO. COSTA MESA. CALIFORNIA FIRE ADDRL__ same /, ZONE KK W Ke11 Construct. CQ JV LIC. 1217 ZONE NO.OF TYPE GROUP CONK RA TOR NO. n / PLAN ADDRESS same TEL.NO. same APPROVED % , I's ATE /1 ! ! l LEGAL �T • II DESCRIPTION NO. 16 BLOCK TRACT 2996 I ICO1REGT''OJJONpp��S o� , til I .�>, Jt1 ll f A �. hd A.P.NO. C ` 11 SIZEOF LOT 50 X 125 NO.GF BLDGS. •0 tit N ii � 1 t? + (jt NOW ON LOT Si (I L(IIVy� USE OF a V EXISTING BLDG. y`(% _ SETBACK LINE FROM /, (SC �. E^ L! CENTER OF STREET 46I-2^ REAR YAR015 to C/L YHA N� DATE t_^ �r SIDE YARD RIGHT 8 LEFT 16 APPROVED V _s. DESCRIPTION OF WORK NEW • % ALTERATION ADDITION REPAIR MOVING DEMOLISH BUILDING NO.OF SIZE 3123 ROOMS 16 STORIES 2 EXTERIOR WALLROOF COVERING stucco COVERING hot-mop USE OF NEW BUILDING Triplex residence and att. garage. Plan 4-C I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC- TION. VALUATION SIGNATURE OF A / PERMIT FEE S 46.00 PERMITTEE $ 26,378p .00 PLAN CHECK $ 23.00 AUTHORIZE AGENT TOTAL FEE $ 69.00 9.RF