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Home My WebLink About280 16TH PL - Building Permits /4)tp MFSp CITY OF COSTA MESA a ,44_.- BUILDING DIVISION PERMIT NUMBER l•( �•"'-']� 'SiDEVELOPMENT SERVICES DEPARTMENT t. PERMIT P00-00117 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 280 16TH PL Status: ISSUED Suite No Applied: 03/08/2000 Issued: 03/08/2000 Vicinity: APARTMENT B Parcel Nunmber: 42522216 ISSUED BY: cY-nti Applicant: GARY SEELSBINDER Address: 8800 STARDUST LANE Phone: (714)826-4963 ANAHEIM,CA Zip: 92804 Owner MATTHEWS, MATT MC KNIGHT Address 43 CRYSTAL COVE Phone: LAGUNA BEACH,CA Zip: 92651 • Contractor: SEELSBINDER PLUMBING • Address: 8800 STARDUST LANE Phone: (714)826-4963 ANAHEIM, CA Zip: 92804 License: 606458 Arch/Eng : Address: ' Phone: • Zip: License: SCOPE OF PERMIT REPLACE EXISTING GAS LINE FROM METER TO APARTMENT"B"AND GAS REPIPE OF APARTMENT 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 $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 • Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(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 $0.00 0 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 $0.00 0 Water Softener $0.00 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must 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 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 at one hundred dollars($100)or less.) dI certify that in the erformance of the work r which t permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation law,r�California,and agree t t if I sho become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these:i@ ions. Applicant Signature: �/ °/'/ Date: 3 - U�%`20a 0 r WARNING:FAILURE TO SECURE W.RKERS'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 herebyaffirm that I am licensed nder r.visi ns .f ha.- 9(commencingwith Section 7000)of Division 3 of the Busine nd o, ssions ode,,and m,Y licensf5is in full p g i force and effect.Lia# - 6'0 C2 / /,' Class N O � lir,- • J Contractor's Signature: _ii.iiL/.O0 r n� Date: ,� -/ (J e.) _ CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044, Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not-i0tended 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,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature 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 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 Cr future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes U 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 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 end Safety Code Section 42303 been made? 0 Yes ❑No — 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. „kat" Sin ur 1 Legal O r(s) G' j7TtS.•v(J)^ And/Or Authorized Applicant 3`a �Datattee CODE 4 INSPECTION TYPE ' DATE INTITIALS CODE II INSPECTION TYPE PATE INTITIAI.S 1616 Fixed System Final Fire Prevention 206 Final Mechanical �/ ' 1266 Pool Spa Final 208 Final Plumbing s/tel G� T�J 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 2446-46 14 � 'S® : frlAl2t1 , CY-.. 959 L 4` COSTA MESA BUILDING DEPARTMENT I NPJ CE DEPT, P.O. BOX 317 I 'I' ": "rein P1C COSTA MESA. CALIFORNIA ',Icy FOR FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT BUILDING ADDRESS 280 - 16th Place A, B, C BUILDING COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY RECEIPT NO. ERMIT NO.3 OWNER Santa Ana Patio Homes, Inc. �IL7c ) MAIL 1555 Placentia RECEIVED BY LC!?,a-.57 �J DATE ISSUED ADDRESS v ?a-S/ St2/-S7 CITY Netmort Beach, Cal. NO. MI 6-3227 DDRESS ARCHIT—T Same LIC. OR EN 'ER NO. COSTA MESA. CALIFORNIA FIRE ADDRESSsame ZONE l�I K. W. Koll Const. Co. CITY LIC. 1217 ZONE NO.OF TYPE GROUP CONTRACTOR NO. � PLAN$ TEL. APPROVED /!I ADDRESS same NO. same BY / Ar..--CSX/1; LEGAL LOT fffrr CORRECTIONS DESCRIPTION NO. 14 BLOCK TRACT 2996 y ({ A �o /////}'''�� q A.P.NO. �I � II S-? r i] SIZE NO.OF BLOCS. g A t.11 II 1 I\i L OF LOT 50 X 125 NOW ON LOT 0 USE OF �i('kx is-1 fl-jIrT 1 if 9 ti4I4lI EXISTING BLDG. - /j . Li Ii•,yl I_ p ` ; a P i {I O .... SETBACK LINE FROM /, T CENTER OF STREET 4,6'-211 REAR YARD15 to CA Ste/ �q 1 /yl SIDE YARD RIGHT 8 LEFT 16 / ._ DAIF DESCRIPTION OF WORK VAF(. lyg°_b0 APPROVED '� X , X NEW ALTERATION ADDITION REPAIR MOVING DEMOLISH SIZELDING 3123 NO.OF ROOMS 16 STORIES 2 EXTERIOR WALL ROOF COVERING stucco COVERING hot-mop USE OF NEW BUILDING Triplex residence and att. garage Plano-A I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES A STATE LAWS REGULATING BUILDING CONSTRUC. TION. VALUATION / SIGNATURE OF / � PERMIT FEE S�1`L00 PERMITTEE 3 26,878.00 PLAN CHECK s23.00 AUTHORIZED A NT TOTAL FEE S 69.00 '