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Home My WebLink About377 16TH PL - Building Permits�c�o �-oo�aa E N E R G Y C ODE W O R K S Energy Code Works, Inc. 2005 Title-24 Residential Energy Standards Compliance Report Project: Addition to Exist. Duplex 377 16th Place, Costa Mesa, Ca. 2600 Michelson Drive, Suite 1700 Irvine, Ca. 92612 CEPE Certified Energy Plans Examiners www.eneravcode.com eCworks(a�enerQVCode.Com CHEERS Certified HERS Raters Compliance Summary Project: Addition to Existing Duplex 377 16th Place Costa Mesa, Ca. Building Shell: Existingwalis: Upgraded to R-19 batt insulation Existing ceiling/roof: Upgraded to R-30 batt insulation Existing Windows: Upgraded to Dual pane/non-metal framing/no tint New windows: Dual pane/non-metal framing/no tint New French doors: Dual pane/metal framing/no tint Thermal Mass: N/A HVAC: Minimum heating effic: 80% AFUE Minimum cooling effic: 13.00 SEER Water Heater: (2) Bosch tankless water heaters with an energy factor of 81°/o. What vou need to do: Sign the building designer statement on the Certificate of Compliance where indicated. Submit (2) copies of this report. Place the Certificates of Compliance (CF-1R) and Mandatory Measures checklist (MF-1R) sheets on the plans using .tif files inserted into the CAD drawing files. Page TITLE 24 REPORT Title 24 Report for: BATHROOM ADDITIONS TO EXISTING DUPLEX 377 16TH PLACE COSTA MESA, CA Project Designer: CHRISTIAN BUNTE 23552 COMMERCE CENTER DR. UNIT U LAGUNA HILLS, CA 92653 (949) 285-5651 Report Prepared By: MARK MADISON ENERGY CODE WORKS 2600 Michelson Drive Suite 1700 Irvine, CA 92612 (800)700-0131 Job Number: 203945 Date: 12/9/2008 The EnergyPro computer progrem has been usetl to perform the calculations summanzed in this compliance report. This program has approval antl is authorized by Ihe Califomia Energy Commission for ise with both the Resitlential and Nonresidential 2005 Building Energy Efficiency SWndaNs. 4.4 Gy EnerpySOR Jo0 Number. 203965 User Certificate Of Compliance : Residential (Part 1 of 4) CF-1 R RATHRn(�M AI�I�ITIONS Tn FXISTWC; Dl1PLEX ___ 12/Q/2008 Project 7itle Date �77 1fiTH PI ACF C'nSTA R�FRA — Project Atldress Building Permit # FNFRC�Y CC�nF WnRKS (800) 700-0131 planCheck/Date DocumenWtion Author Telephone n r��Pro CA Climate Zone O6 Field Gheck/Date r....,..r. .., u.,.�.,.a cifmarn �nnn TDV (kBtulsf-yr) Space Heating Space Cooling Fans Domestic Hot Water Pumps Totals Standard Design 9.24 3.67 0.80 23.87 0.�0 37.57 Proposed Design 7.18 1.79 0.68 14.80 �.�0 24.45 Margin 2.06 1.88 0.12 9.07 �.�� 13.12 Building Type: ❑Single Family ❑Addition Total Conditioned FloorArea: � Multi Family [� Existing+ Add/Alt Existing Floor Area: Building Front OrienWtion: (N) 0 deg Raised Floor Area: Fuel Type: Natural Gas Slab on Grade Area: Fenestretion: Average Ceiling Height: Area: 251 ftZ Avg. U: 0.61 Number of Dwelling Units: Ratio: 11.1% Avg. SHGC: 0.66 Number of Stories: BUILDING ZONE INFORMATION # of Thermostat Zone Name Floor Area Volume Units Zone Type Type i i�� a Fai vnr � nan a ��n �.96_ r'o�n�e ��Pn sPrna�n lJn't B FAU/AC 7 172 9 776 _�_p9_ CnnAitioned Sethack OPAQUE SURFACES Insulalion Act. Type Frame Area U-Fac. Cav. Cont. Azm. Tilt J�faILMPeai en �1—E1�_�➢.[L�� Wall WnoA 196 �..1(72_$_7.��p,(L�$_�n Roof WaoA 48 �.p32.�_3f1�➢.fL��2 Wall WnnA 74 �35fi�1•ppE_B.fl_Q_�Zd�p �[yIL—Mptal i�fl �.]$3_�'�.Q�QQ�_�p Wall M.ta� I 280 ��]��p.(L�$(L�p Wall MPtal ?Fift �.]$3._$_],g�p.(Z�fl_�n Wall MPtal 'IA7 �]$3_�]$�p_�p_�p Roof Wood 1 64? �p,32�3R��,p_�_�2 Wall Matal Fi0 �.lg��_79__$,fl_Q_d_�p Wall WnnA 7Afi �]QZ�_l�_gp_p.�ry�p Rnnf WanA 4A �.Q32�_3p_�➢.p__Q,_22 Wall woad 7a ��pp��Q,Q�7p_�Q Wall Mrtal 72I1 �,7,83.�12�=Q,P_��Q Wall Metal �7�,�..Lq3_$_]��p,[Z�$p_�p Wall Metal 756 _�..]$3.�-y2�[L�p_�f1 Wall MPtal 1Q7 �..i$3._$_72�d�7a. �ln Rnn( WnnA i 124 �2_$��p.(L��2 � 2,262 ftZ 2,166 ftZ p ftz 2,262 ftz 8.o ft 2.00 Vent Hgt. Area —2 �/a � n/a Condition Status JA IV Reference Location / Comments Jnw 17-A5 I ln"t A(Fy'ct +AAdU Jaw (19-A3 In't A(Fi st + Add't ) �� 07-A7 tlnfA(Fr'st+Add(a twmnvPd OQ-A'I llnit A(Fsist + Addif � Utered 11-A5( =E 09"A71 llnitA(pvist +AAAit.) Utered 11-A5 (F=09�_A21 lJn'1 A (Fs'vt +AtldW UtPrPd 11-AS (F=0Q.A71 l In't A(Fv'ct +Add'f ) Utarnd 17-AF (F=09-A91 llnit A(Frist + Addif � UtPred 01-A7 ( -�1 lJn't A (�5jct +AAA't ) JPw 71-A5 lJnit R (Frist +Atltlit ) dew 09-A3 l ln f R(Eyjcf + Add't � Jew M-A] I Init R(Frisf +Addit � 2emoved 09-A1 Lln't 8(F�ist + AdA't ) Utored 11-A.5,jF=pg_�1 l lnit R(E i<t + qddi� ) UtereA i'I-A5 (F=OQ�_A91 LJn't A(FYct + AtlA'f ) UterPA 11-AS ( -��1 lJn't B (Erist +Add�t ) \Iferptl 1'I-AF (F=(W'�91 I lnif R (Frisf +Ar1tli� � UtPrPd 01-A7 �Q7-A5�1 I ln'f R(�jct + Add'1 ) Run Inkiation Time: 1Y/09/08 73:24:06 Run Code: 1 22 88 57846 Ena�gyPro 4.4 Ey Energy$o(t User Number: 1562 Jo0 NumEec 203945 PaHe3 ot 13 Certificate Of Compliance : Residential (Part 2 of 4) CF-1 R BATHROOM ADDI710NS TO EXISTING DUPLEX 12/9/2008 Project Title Date FENESTRATION SURFACES True Cond. Location/ # Type Area U-Factor' SHGCZ Azm. Tilt StaL Glazing Type Comments L W ndo�,Fronl MEI _�,g o sm 1 t6-A _Q.6,5 �g$ _3j_ �p_ New N W OP a51 F W1NDO Wfi 11n't A(�jst + Addit J 2 Wndow RiaM (W1 1.5 7280176-A 0.80 116-B 270 90 Removed2emovedwindows UnitA(ExisL+Addit.) � Window Front (M _ 32.0 0_580 116-A 0_65 716� 0 90 Altered NEW OPERABLE VJINDOVJS Unit A(ExisL +Adtlit.l 4 Emstino 1280 7 76-A 0.80 116A E�nst. lMntlows ore-altered for above 5 Window Left fE) 18.0 0.580 116-A 0.65 116-B 90 90 Altered NEW OPERABLE WINDOWS UnitA fExist +Addit.) � Existing � 1.280 11 -A Q8Q 116� Exist NAntlows ore-altered for above Z Wndow Left (E� 14 0 0.580 116-A a ss 116�6 �� Q61jE[ed__NEW OPERABLE WINDOWS nit A(�j�t +qddit ) 8 Existinq 1.280 116-A 0.80 116-B Exist. VNndows pre-altered for above � Window Right (WI 180 o.no 17fi-A 070 716A 270 �QeItE�@�Newfrenchdoars 11ni�A(Exist +qddi{� �q E�nstinp � 1.250 l lfi-A o ao 116� Ex'st French Door ore-altered for a6ove u Window Right (WI 9.0 0_580 116-A 0_65 116-B 270 90 Altered NEW OPERABLE WINDON5 Unit A(Fxist +AddiL) 12 Existino 7.280 116-A 0.80 176-8 Ezist. NAndows ore-altered for above � Wndow Right (N4 16 0 0_580 116-A 0 65 116-B �Q _�j0_Altered NEW OPERABLE WINDOWS in t A(�yjgt +qddit ) 14 Existino 1_280 176-A 0_80 116-8 Exist VNndows ore-altered for above 15 Window Front (NE) 4.5 0.580 176-A 0.65 116� 45 90 New NEW OPERABLE WINDONS Unit B(6cist +Addit.) 16 Wndow Riqht (WI 1.5 1280 176-A 0_80 116-8 270 90 Removed2emoved windows Unit B(ExisL +AddiLl 17 Window Rear (Sl 16.0 0_580116-A 0_65 tif$ 180 90Aflered NEWOPERABLEWINDOWS UnitB(Exist+Addit.) 78 E�nstinq 7.280 116-A 0.80 176-8 Exist. WSndows pre-altered for above 1,Q Wndow Rear (Sl_ 12.0 0580116-A_p§� 116-8 180 _gQ_BIL7g9—NEWOPERABLEWINDOWS Uni[B(Exist+Addit) 1. InEicate source either trom NFRC orTe0le 116A. 2. Intlicate nou¢e eitherfmm NFRC or Te01e 1188. INTERIOR AND EXTERIOR SHADING # FNe�fnr cherlc T�rv.e curr 3 Bug Screen 0.76 5 Buq Screen 0.76 7 Buq Screen 0.76 9 Bug Screen 0.76 11 Bug Screen 13 Bug Screen 15 Bug Screen 16 Bug Screen 17 Buc1 Screen 19 Bug Screen 0.76 Overhanq Len. HaL LErzt. REM Left Fin 0.76 0.76 0.76 0.76 — — — — — 0J6 — — ---- -- — THERMAL MASS FOR HIGH MASS DESIGN Area Thick.Heat Inside Condition Location/ Type (s� (in.) Cap. Cond. R-Val. JA IV Reference Status Comments PERIMETER LOSSES Insulation Condition Loration/ Tvoe Lenath R-Val_ Location JA IV Reference Status Commen� Slab Perimeter 75 None No Insulation 26-A1 New Slab Perimeter 65 None No Insulation 26-A1 Existing Slab Perimeter 15 None No Insulatlon 26-A1 New Slab Penmeter 65 None No Insulation 26-A1 Existing Riqht Fin DisL Len. Hot. User Numbe[ 1562 Jab Numbec 203945 Peoe:4 0� 13 Certificate Of Compliance : Residential (Part 2 of 4) CF-1 R BATHROOM ADDITIONS TO EXISTING DUPLEX 12/9/2008 Project 7itle Date FENESTRATION SURFACES True Cond. Location/ # Type Area U-Factor' SHGCZ Azm. Tilt Stat. Glazing Type Comments 2Q FYicfnq _ 1.2fl011fi-A 080 i16A Fs'ct NAnAnws nrealtPredforahove 21 Window Left (El 18.0 0.580 116-A 0.65 176-8 90 90 Altered NEW OPER48LE WINDOWS Unit B(Exist. +Addit.) 22 Existinq 1.280 116-A 0.80 116-B Exist. VvSndows ore-altered for above 23 Window Left (E) 16.0 0.580 176-A 0.65 116-8 90 90 Altered NEW OPERABLE WINDONS Unit B(Exist +qddit.) 24 Existino 1.280 116-A 0.80 116-8 Exist. NAndows ore-alteretl for above � Wndow Left (El �,Q 0.580 716-A Q6� 116$ _�Q �QAlteretl NEW OPER40LE WINDOWS Unit B(6cist +qddit 1 � Existipy _ 7.280 i l6-A 0 80 116-B Exist VvSndows ore-altered for a6ove 27 Wndow Lefl (E) 14.0 0.580 116-A 0.65 116�8 90 90 Altered NEW OPERABLE WINDOWS Unit B(Exist. +qddit.) �@ Existing _ 1 280�$ 0.80 116-8 __ Exist Wndows ore-altered for above Zg Wndow Riqht (1M�8.Q ano116-A 0.70 11fiA 270 _gp_Altered Newfrenchdaors llnitB(�jgt+qddit) �Q Existina 1.250 716-A 0.80 116-8 Exist French Door ore-alteretl for above 31 Wndow Riaht (N/1 9.0 0_580 7 i6-A 0_65 116$ 270 90 Altered NEW OPERABLE VNNDOWS Unit 8(Exist. +qddit.l � xictinfl 1.280 116-A 0 80 l lfi-8 Exist lMndows nre-altered for a6ove 33 Wndow Riqht (Wi 16.0 0.580 116-A 0.65 116-8 270 90 Altered NEW OPERABLE VNNDOWS Unit B(Fxist. +qddit.) 34 Existina 1280 176-A 0.80 116� EzisL VJndows ore-altered for above 1. Intlicete source ei�her from NFRC or Tabla � 1 fiA. 2. Intlicale aowce eiNer (rom NFRC or TeEle 11 fiB. INTERIOR AND EXTERIOR SHADING Window Overhanq LeR Fin Ripht Fin # Exterior Shade Tyoe SHGC HgL Wd. Len. HgL LEM. REM. Dist. Len. Hg�. Disl Len. Hgt. 21 Bug Screen 076 _ _ _ _ _ _ _ _ _ _ _ _ 23 Bua Screen 076 25 Bua Screen 0.76 27 8ug Screen 0.76 29 Bup Screen 0.76 = _ 31 Bug Saeen 0.76 33 Bug Screen 0.76 � THERMAL MASS FOR HIGH MASS DESIGN Area Thick.Heat Inside Condition Location/ Type (s� (in.) Cap. Cond. R-Val. JA IV Reference Status Comments PERIMETER LOSSES 4.4 Insulation R-Val. Location Run Inkiation Time: 12/0', User Number: 1562 Condition Location/ JA IV Reference Status Comments Job Number. 203945 Sof13 Certificate Of Compliance : Residential (Part 3 of 4) CF-1 R BATHROOM ADDITIONS TO EXISTING DUPLEX 12/9/2008 Project Title Date HVAC SYSTEMS Heating Minimum Cooling Minimum Condition Thermostat Location Type Eff Type Eff Status Type Unit A FAU/AC Central Fumace 80%a AFUE Split Air Contlitioner 13.0 SEER Altered Setback Unit B FAU/AC Central Fumace BO%AFUE Split Air Contlitioner 13.0 SEER Altered Setback HVAC DISTRIBUTION Duct Duct Condition Ducts Location Heatinq Cooling Location R-Value Status Tested? __ Unit A FAU/AC Duclgtl Ducted Atlic 42 Existinq No Unit B FAU/AC Ducled Ducted Atlic 42 Existing No Hydronic Piping pipe Pipe Insul. System Name Length Diameter Thick. WATER HEATING SYSTEMS Rated Tank Energy Tank Insul. Water Heater # in Input Cap. Condition Factor Standby R-Value System Name Type Distribution Syst. (Btu/hr) (gal) Status or RE Loss (%) Ext. Bosch 2400 Tankless Instant Gas No Pipe Insulation 2 199,%9 0 Altered 0.81 420 n/a Multi-Family Central Water Heating Delails Hot Water Pump Hot Water Pipinp Length (ft) Add 1/2" Control # HP Type In Plenum Outside Buried Insulation COMPLIANCE STATEMENT This certifcate of wmpliance lists the building features and specifcations needed to comply with Title 24, Parts 1 and 6 of the California Code o( Regulations, antl Ihe atlministrative regulations to implement them. This cetlifcate has been si9ned by Ihe indivi0ual with overall tlesign responsibiliry. The undersigned rewgnizes that compliance using duct design, duct sealing, veri(cation of refrigerant charge and TXVs, insulation installetion quality, and building envelope sealing require installer testing and certifcation and field verifcetion by en epproved HERS reter. Designer o� Owner (per Business & Professions Cotle) Documentation Authar Name: Name; MARK MADISON 7itle/Firtn: CHRISTIAN BUNTE Title/Firtn: ENERGY CODE �WRKS Adtlress: 23552 COMMERCE CENTER DR. UNIT U Address: 2600 Michelson Drive Suite 1700 LAGUNA HILLS. CA 92653 Irvine. CA 92612 �Telepho . 9 285-5651 Lic. #: Telephone: ' ` � /.� 1/�� (signaNre) ' (date) signaNre) Enforcement Agency Name: Title/Firm: Atltlress: Telephone: ��7Q7 vc CABEC CERTIFICATE # R05-07•5347 Mark Madison CERTIFIED ENERGY PLANS EXAMINER ]005 CelHomh HmlEentisl EnergySrenEaNs Certificate Of Compliance : Residential (Part 4 of 4) CF-1 R BATHROOM ADDITIONS TO EXISTING DUPLEX 12/9/2008 ProJect Tltle Date Special Features and Modeling Assumptions The local enforcament agency should pay speclal attention to the Items speclfled In thla checkllat These Items requlre spaclal written Justlflcatlon and documenaUon, and spedal veriflcaHon to be used wl[h the performance epproech. Tha lowl enforcament aaencv determinwv fhw adeauaev of the lustiflratlon. and mav relect a bulltllna or deslan that othenvlse comolles based on the adequacy of �he speclal justiflcation and documentatlon su6mltted. Plan Fleld HERS Required Verification Itams In thls sectlon requlra fielO testing andlor verlflcation by a caNfled home energy rater untler the supervlslon of a ntns proviaer usmg approvetl tesung anaior venncation metnoos. Plan Fleld User Number: 1562 Job Number: 203945 Paae:B o/13 Mandatory Measures Summary: Residential (Page 1 of 2) MF-1 R NOTE: Lownse residential builtlinBs subject m the StanaeNs must contain Nase measures reeartlless of Ne compliance approach used. More sinnBent wmpliance requirements hom the Certificate ot Compliance supercatle lhe ilems merketl with an aslansk (•) �elow. VJhen Nis c�ecklisl is incorporeteE inb t�e pertnil tlocumenls, ihe (eaWres no�etl shell be consitleretl by all parties es minimum componen� pertormance spaGfiwtions fo� l�e mentlalory meesurea wheNet Ney era a�ovm elsew�ere in ��e Eocumenls or on t�is c1�eUlis� only. DESCRIPTION Check or initial applicabie boxes or check NA it not applicable and included with the ENFOrtCE- permitapplicationtlocumentation. N/A DESIGNER MEN7 Building Envelope Measures 150(a): Minimum R-19 in vrootl ceiling insulaUon or equivalent LLfactor in metal frame ceiling. § 150(�): Loosa fll insulatlon menufecturefs labeletl R-Vatue: t50(c): Minimum R-13 wall insuletion in wootl (remetl walb or evuivelent U-lactor in metal (ame walls (Coes noi app1Y �o extenar mess walls). § 150(tl): Minimum R-13 reisetl floor insulation in frametl floors or aquivalent U-feclor. § 150(e): Instellation of Fireplaces, Decorative Gaa Appliances and Ges Lops. 1. Masonry antl /actory-built fireplaces �ave: e. closable metal or glass doorcovennq the en�re opening of Ihe fra0ox b. oulsitleairintakewithdamperandconirol,Buetlamperanticoniml 2. No continuous Euming gas pilol lip��s alloweE. $ 150(Q: Air retertling wrdp installetl lo comply with §I51 meets repuiremenis speci0etl in ihe ACM ResiGen�ial Manuel. § 15U(g): Vapor Caniers mantletory in Climale Zones 14 antl 18 onry. § 150(p: Sla� eJge insulation - weler absorpGon rele for Rie insulaUon elone witl�out /adnes no Breeter Nan 0 3%, weter vapor permeence 2te no preeter lhan 2.0 peiminch. § 118� Insuletlon specifietl or instelletl meets insuletion instellation qualiry stanaerUs. InEicate rype ena induEe CF-6R Fortn: § 11G17: Feneslration Pmduns, E#enorpoors, anG InfilVaGon/ExflUaGon Contmis. 1. Ooors and wintlows Getween wnEitionetl antl unwntliUonetl spaces tlesignetl to limit air leakage. 2. Fenesird�ion protluIXs (excep� feltl fabnwletl) heve label with certifeE LLFactor, certi�eE Soler Heel Geln CoeRdent (SHGC), enC intiltration ceNfiwtion. 3. Exterior Ooors anG wintlows weaUiersVippetl; atl jointa ana penetretions caulked ena seelea. Conditioning, Water Heating and Plumbing System Measures § 110.13: HVAC equipment, water heaters, showerheatls antl /auceta cenifietl by t�e Eneryy Commission. § 150(h): Hee�inB antl/o� cooling loatls wlcutatatl in accoidance wilh ASHRAE, $MACNA orACCA. § 150(i): SelCeck thermosWt on all appliwble heetin8 antl/or cooling systems. § 150G)� Watersystem pipe entl tank insulaGon ena cooling systems line insulatlon. 1. StoreBe gas water heaters rateG with en Energy Faaor less than 0.58 must be estemelly wrappetl with insulatlon hevin8 an instellatl lhartnal resis�ance o( R-02 0� B/ee�er. 2. Beck-up tanks for aolar systems, unfretl s�orage �enks, or oNer intlireG hotwater lenks �ave R-02 ea�amal insulaGon or R48 intamal insulation antl intliwtetl on �he eMenor of ��e tank showing Ne R-value. 3. The followinB Piping is insulate0 accor0in8 �o Tebla 150.A/B or Equa�on 150-A Inaulation ThiQness: 7. First 5 feet of �ot and colG water pipes closest lo weter heater tenk, nomrecirwlating systems, ena entire lenplh otredrculeting sections of hol waterpipes shall be insule�ed to Teble 1508. 2. Cooling system pipinq (suction, chilletl water, ar Cnne lines), piping insulatetl Eelween heating source antl indirect �ot walertank shall Ge insuletetl to TeCla 150.8 anC EquaUon 150-A. 4. S�¢8f11 hYEf001C IlEe�flQ Sy5I8l119 0f IIOI W8I2f 9y9�Cffl9> 15 psi, mee� �eQuirementa of Table 123-A. 5. Insule6on musl Ge protectetl from tlamege, inclu0inp thet tlue to sunlig�t. moisture, equipment malntenance, antl wintl. 8. Insuletion for chilletl weter pipin8 enC rehigerdnt suction piping inGutles a vapor retardent or is endoseC enUrely in wntlitionetl space. 7. Soler weterheeGng systems/colleclors ere certi(ed by the Solar RetinB end Ce�ifcation Coryoration. 2neravPro 4.4 bv EnemvSatl User NumDer: 7562 Job Number za3sa5 ❑ O � ❑ ❑ ❑ ❑ o 0 ❑ o ❑ ❑ ❑ ❑ ❑ ❑ ❑ 0 0 ❑x ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑X ❑ ❑ � ❑ ❑ 0 ❑ ❑ ❑7( ❑ ❑ O ❑ ❑ ❑X ❑ ❑ ❑x ❑ ❑ ❑x ❑ ❑ ❑ ❑ ❑ ❑ ❑ � ❑ ❑ ❑ ❑ ❑ � ❑ ❑ o/ 13 Mandatorv Measures Summarv: Residential (Page 2 of 2) MF-1 R NOTE: Lownse raelaentiel UuiltllnBa suCject to rtia SlanEeNe must conleln ttiese measures reBeNlms ofthe compllanca eppmach usaC. More stnnpent complience requiremente hom �ha Cetlificeta of Complianca auperteCe Ne Items markea wiN en esletlek (') below. 1Mien ihia chacklist is Inmrpaietetl inb Ne pem�it Oocumenb, Na feawrae notea spall Ce consitlaraE by ell pertiea es minimum wmpanent pertormanca apauficetiom for l�e mantlamry measurea whether Ihay are ehown elsewhe�e in lhe tlocumenis o� on Ihls cliecklis� only. DESCRIPTION �nstructiona: Check or initial applicable boxes when completed or check N/A if not ENFORCE� nnli�nhlw N/A DESICaNER MENT Space Conditioning, Water Heating and Plumbing System Measures: § 150(m): Duda antl Fem 1. All tlucts entl plenums instaped, seeleE enE Iroulatetl to maet Ne requlremenU o/ l�e CMC Sectiana 801, 802, 809, fiO4, ❑ �X ❑ 805, ene StantlarE 8-5; supply_air entl retum-eir Gucts antl plenums are innulatetl to a minumum installetl level ol R-42 or enGosetl enOrely In cpntlitlonetl spece. OpeninB� a�ell be sealatl wilh mastic, lape or oll�er Oucl<losure system Iliet meeU l�e apPliCeEle requiremenb af UL 101. UL 181 A, or UL iB1B or aerosol saelent l�et meeb t�a requirementa of UL 723. II masGc or Iepe is uaetl to aeal opaninpe greeler lhen 1/4 inch. Ne wmbinatlon ot mastic entl either mesh or tepe shall Ee usetl. 2.BuilAlnB�avitlea,aupportplgryortnaforairhentllen,endplenumsGefnatlorwnswneEwithmatetlelsathert�ensealed ❑ %❑ ❑ sheat ma�al, Auct CoarG or Ileqbla EUU shell not Ce usetl /or wnvepng conEiGonetl aic BuilCing cevitiee enC support pleHorma may conlein Cucls. qucb Instelle0 in ceNties ana euppart plattorma s�all no� Ee compresaeE lo ceusa retluqions in lhe croas�sectionel eree of Iha tlucis. 3. Jointa and aeame olEud systema entl lheircomponenis shell not be sealatl with Golli �erk rubber etlhesive EuIX tapea unless suc� �ape is useE in combinetlon with mesuc enU Crew bantla. 4. Exhauat fen systams heve Geck arefi or autometic tlampers. 5. GraNry ventilaunp ryetems �ervinB wntliuonaE epace �eve eiNer autometic or reeEiy eccessible, menuelty oparatlnp Eampen. e. Prolection ot Inaulalion. InsVlalion s�ell be proledetl from tlemege, inclutlinp Nal Eue to sunlig�4 moisture. equipmant meintenenw, enE wind. Cellular foam insulation shell be prolectetl as atova or peinled with e coetlnp lhet is wetar retertlenl enE proWEea ahielGinp (mm aoler redlatlon lhet can cause CepreEeuon o/ l�e metenal. Z FIexI01e0uGscannol�evaparauainnercorea. § 114: Pool enA Spe HeetlnB Syalems antl Equlpment 1. A Nertnal eRdenq Net compllee vnN t�a Appliance E(fitlanq Repuletlons, onoR avntch mwntetl outsiEe o/ t�e �eater, waeNerproal operelinq inalrvctions, no elecVic reaistence �eaUnp antl no pilot light. 2. Syatem is installaC wi�h: e. At leest 38' o/ pipa betw8en fltar enC heater lor NWra sdar �eetinp. C. Camrtor out0oor pools w uutEoor spea. 3. Pool syalem hes Oirectionel inleb antl a circulation pump time switch. ❑ � ❑ ❑ � ❑ ❑ � ❑ ❑ � ❑ ❑ � ❑ ❑ %❑ ❑ � � ■ § 115: Gae fireE len�rype cenVel fumeces, pool �eaten, spe �eeten or householtl cookinp appliencea �ave no conunuwsty � buminp pilol lip�t. (Exceplion: Non-elaclticel wokinp aOPliancee wiN pilat < 150 BNRv) § 118 (i): Cool Rao/ metenal meeb spedlatl cnieria Lighting Measures § 150(k)1: HIGH EFFICACV LUMINAIRES OTHER THAN OUTDOOR HID: cOnleln only IliB� eAitety lemps as ouUinetl in TeGle iSPC, enE Go not conlaln a maEium screw Eeae aocka� (E20iE28). Belleab lor lampa 13 Wana er praeter are elactnc enE �eva en output hequenry no leea ��an 20 kHz. § 150(k)1: MIGH EFFICACY LUMINAIRES - OUTDOOR HID: eonfein anry NB� eRceq lempa ea aWlneC in TaEle 150-C. luminelra �es tactay installetl HID Eellasl. § 150(p2: Pertnanen0y instelled lumineirgy In kitchens s�all be Oigh aRcary lumineires. Up ta 50%of Ne Watlapa, es Cetertninetl in Secuon 130(c), ol pertnene��y installe0luminairas in kilchane mey be In lumineires iliet ere not �iB� eRcaq luminelres, proNEatl tliet Nese lumineires ere tontrolleA by ewitches sapara�a hom Nosa wnVollinp Na hiph et6wcy luminairea. § 150(k)9: PeimenenVy instelled luminaire� in Eethrooma. Barages, IeunEry rooms, Wliry rooms s�ell Ee �iph el�raq lumineires. OR are conimlletl Ey en occupenl aensorts) catl11e0 to comply wiRi Section 119(tl). § 150�q4: Pertnenentiv inslellatl lumineirp� locetetl oNar ihen in kilchene, �aNmoma, BereBes, IaunGry rooma, antl uGlily �oom5 shall0e �iph efficery luminair¢� (excep� Goseu lev Nan 70 fq OR are conWlletl by a Glmmer svitcli OR are conVolletl Oy en ocwpan� sensor Net mmplies wiN Secllon 118�E) Ihet tldes not Nm an eulometicely w heve an elways on option. � ❑ � ❑ ❑x ❑ � ❑ ❑ ❑ ❑ ❑ � ❑ § 150(k)5: Lumineirea NaI am recesseE Ih�o Insuleled cellinps ere eppmvetl for zem Gearance imulatlon wver QC) entl are ❑ cartifietl IOASTM E287 anC IaOeletl aa eir tig�i (AT) lo less t�an 2.0 CFM et 75 Paacab. § 150(k)B: Laminelrea O��Dinp outtloor I�gpynp entl permanen�ly mwntetl lo a residential builCinp or ta other buildings on the ❑ sama lol n�ell Ce �ip� efficary lumineires (no1 intludinp IiBhGnp eroun0 svrimminB P�b/water feeWree w ot�er Mitle 680 IocaUona) OR are convolleE Ey �upanl senwn wiN inteprel p�oto conVol certifiatl to canpN �� $�ion 118(tl). § 150(k)7: LiBhtlnB �or pe�lcing IOU /or 8 0� more ve�iGes shell �eve IiB��np Nat wmplles with Sections 130, 132, anC iQ. ❑ LiphOnp /a Oerkinp perepes for 8 or more vehidea shall �ava IiphGng Net complies wiRi SacUon 130, 131, antl 1d8. § 150(k)8: Pertnanenly instelle0lig�tinp i� Ne endoseA, non4wellinp apaces of low-nse resitlentlal builAinBs �N laarormare ❑ dxellinp units s�ell Ee hip� ett{�ry luminairea OR are controlle0 �y occupent sensor(5) certifie0lo compN �'iN Saction 119(tl). User NumOec 156Y JOE NumGer. 203905 � ❑X � X❑ � ❑ ❑ ❑ ❑ ❑ � ❑ ❑ ❑ ❑ ❑ Paoe:10 0113 Residential Kitchen Liqhtinq Worksheet WS-5R BATHROOM ADDITIONS TO EXISTING DUPLEX 12/9/2008 Project 7itle Date At least 50% of the toWl rated wattage oT permenently insWlled lumfnaires in kitchens must be in luminaires that are high eHicacy luminaires as tlefined in Table 150-C. Luminaires that are not high efiicacy must be swi[ched separetely. KltChen Lighting SChedule. Provitle tha following information tor all luminaires to 6e installed In kitchens. High Efficacy Luminaire Type High Efficacy? Watts Quantity Watts Other Watts 50w Recessed IncantlesceM Ves No X 50.0 x 6= or 300 (1) 26w Compact Fluorescent Quad 2 Pin Yes X No 37.0 x 6- 222 or {11 14w Linear Fluorescent T5 Elec Yes X No 18.0 x 6- 108 or Yes No x - or Yes No x = or Yes No x - or Yes No x = or Vas No x - or Yes No x - or Ves No x - Or Yes No x - or Ves No x - or Ves No x = or Yes No x = or Ves No x - or Ves No x - or Ves No x = or Yes No x = or Ves No x - or Ves No x - or Total A: 330 B: 300 COMPLIES IF A 2 B YES � NO ❑ 9.4 by Energy$ofl Use� Number: 1562 Jo0 Numbac 203945 Pape:11 0113 AC SYSTEM HEATING AND COOLING LOADS SUMMARY ECTNAME DATE BATHROOM ADDITIONS TO EXISTING DUPLEX 12/9/201 EM NAME FLOOR AREA Unit A FAU/AC 1.090 Number ToWI Output per System Total Output(Btuh) ToWI Output (7ons) Total Output(Btuh/sqk) ToW I Output (sqWTon) r System CFM per Svstem 1 0,� Total Room Loads a,o� Return Vented Lighting 55.o Return Air Ducts Return Fan 8,000 Ventilation 8,00o Supply Fan 2.3 Supply Air Ducts z5'� TOTAL SYSTEM LOAD 467.1 Airflow(tfm/Ton) 34z. �— Outside Air (°h) 0.0 Outside qir(cfm/sqft) 0.00 Note: values above given at ARI conditions IEATING $YSTEM PSYCHROMETRICS IAirstrea Latent I I CFM I Sensible 25,199 1.57 21,39 FAU/AC 28,426 0 60,000 Total Adjusted System Output pe,a2s 0 6o,o00 (AGlusletllor Peak Design Contli�ions) TIME OF SYSTEM PEAK Aug 2 pm Jan i2 am 31.O�F 67.4�F 67.4°F 105.O�F Outside Air � 0 cfin Supply Fan Heating Coil 800 cfm s�.a °F 60.5 / 65.7 °F out�� 0 tfin 80.9 / 63.6 °F a.a Return Air Ducts 80.9/63.6°F 80.9/63.4�F 55.0/53.4�F � Supply Fan Cooiing Coil eao cr�» User Number'. 15fi2 Retum Air Ducts Job NumCec 20394° Supply Air Duds � 102.4�F ROOMS �o.o°F I Supply Air Duds � 57.9 / 54.6 °F az.z^ro R.H. ROOMS 78.0/62.6 �F ot 13 AC SYSTEM HEATING AND COOLING LOADS SUMMARY ECTNAME DATE BATHROOM ApDITIONS TO EXISTING DUPLEX 12/9/20i :M NAME FLOOR AREA Unit B FAU/AC 1,172 , �� Total To[al Output(Btuh) 7ota1 Output(Tons) Total Output (Btuh/sqk) Total Output(sqft/Ton) r System CFM per System Airtlow (cfm) Airtlow (cfm/sqk) Airflow (cfmRon� Outside Air ( % ) Outside Air (cfm/sqft) 31.0°F outs— tle Fv� 0 cfrn 672 °F 80.5 / 65.7 �F �� Outside Air 0 cfrn 81.4 / 63.7 �F 4.4 CFM �.o� Total Room Loads �.o� Return Vented Lighting 5i.z Return Air Ducts Return Fan .,000 Ventilation ,oao Supply Fan 2.3 Supply Air Ducts 23'9 TOTAL SYSTEM LOAD Latent � � CFM � Sensible 29,948 1.57 22,89 FAU/AC 28,490 0 60,000 Total Adjusted System Output 28 yso o so,000 (Adlustetl br Peak Design Contlitions) TIME OF SYSTEM PEAK Aug 2 pm Jan 12 am 672�F 672�F 105.O�F � Supply Fan Heating Coil eoo cr�, Return Air Ducts 81.4/63.7�F 81.4/63.5�F 55.0/53.4�F � Supply Fan Cooling Coil aoo orm o_�...._ n:. n.._ User Number 1562 �ab Num�er. 203945 Air Ducts � 102.2 °F ROOMS 70.0°F � �upply Air Ducts `S � 58.4 / 54.8 °F az.,r R.H. ROOMS 78.0 / 62.6 °F � - CITY OF COSTA MESA �` BUILDING DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us FOR �NSPECTIONS CALL: (714) 754-5628 PERMIT NUMBER: BC08-00600 PERMIT TYPE: B COMBO STATUS: ISSUED Sub Type: RES_RRIP DATE ISSUED: 12I2412008 ISSUED BY: BJK �oBa��rtEss: 377 16TH PL CM ` Suite/Unit: APN: 42519107 .'�. Zoning. `� � � � Vicinity: DUPLEXUNITSAAND.B _ - �` PrimaryOcc:�-R-3.- r Const Type: V-B - SQ. FT;� �� 96 - -� � Valuation: $10,000.00 . SCOPE OF WORK: 48SF ADDITION TO�EXTEND 2 BATHROOMS IN AN EXISTING DUPLEX,�UNITS A 8 B. WORK ALSO � INCLUDES REMODEL OF ANOTNER BATHROOM IN UNIT A. UNIT A MECH: 2 VENT FANS; ELEC: 8 LIGHTS, 4 OUTLETS, 4 SWITCHES, 1 SVS TO 200A (UNITS A-&`B), 2 MOTORS TO 1 HP; PLUMBING: 1 BATHTUB,�-1�.,SHOWER,-�t KITCHEN SWK, 3 WASH . BASINS, 2 WATER CLOSETS, 1-WATER HEATER: U,NIT B`. MECH: 2 VENT FANS; ELEC: 6 LIGHTS, 3�OUTLETS, 2 SWITCHES, 1 MOTORTO 1 HP; PLUMBING=1 BATHTUB, 1$MOWER, 1�KITCHEN SWK, 2 WASH BASINS, f:WATER:'CLOSET, 1 WATER HEATER �' ` � �� 9/12/09 UNITS A& B: REVISED PERMIT,TO.ADD��9 LIGHTS TO THE KITCHEN AREA � � .� ° � 2/24/09 UNIT A: ADD T:WATER RIPING;�1 GAS�OUTLET-,(1�-4);:ECEC::I.APPL„ � � � . - ' - , ,' OWNER: BUNTE, CHRISTIAN : � Addressi � 377 16TH PL � � � . - .'.:��Unit: Phone: 949•285-5651 ' - � City/State/Zip:...COSTA MESA,�CA . . -- � � APPLICANT: BUNTE, CHRISTIAN ' '� Address 377 16TH PL � , - � � , - -� UniL : Phone: 949-265-5651", , :� �� City/State/zZip: COSTA MESA, CA . � � CONTRACTOR: OWNER-BUILDER ' �- License No. 000000 �' � Phone: - �, Address --�Uuit:.��-' - -�- � Cell: �� , , . City/State " � . - � : ZipCode ARCHITECT: LAWRENCE R HACONEN � - � License No.C8526 - -- � �� -�PHONE:949-582-5960.. ENGINEER: �.��,� :.�.��:� � �LicenseNo.. ::..:, , - . �' .�-.' PHONE: . . . . " . � . - - -::._�.,r- ,. ,�.� .;, . -�.. . ,,:: r_ .: .,_ ., � . ; , : .. .�F. COMBINATION PERMIT FEE SUMMARY�. , Building Plan Check: ��$117:81 � - ' � �� ' � Building Fees: , $181�.25 � �. ` _ _ . � � � _ Electrical Fees: $112.59 - � � � �� - � � MechanicalFees: $45.25 Plumbing Fees: $196.25 - � SMIP Residential: $1.00 SMIP Commercial: $0.00 Bldg Std Admin Fund ?? TOTAL FEES: $654.15 "Refer to fee receipts for all tees paid for project NO7ICE: The work authorized by this permit shall wmply with all applicable handicap access requirements under Califomia statutes and related regulatlons. (Ord. No. 92-28, § 1, 12-21-92) � � EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable wdes. and all required inspections and final approyal musl be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. COpE/. INSPELTONTYPE � IN7171AL5 fOUEt INSPECTIONTYPE DA � 1618 Fixed Syslem Final Fire PrevenGon 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing - �`� 200 Final Re-Roof 210 Final Eleclncal � 7 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition 212 220 Final Fire Prevention Final Planning Approval 222 Final Site � � 250 Final Building/Occupancy WORKERS' COMPENSATION DECUIRATION: � � I hereby aKrm under penalry of perjury one of the (ollowing decla2tions: : Y ❑ I have and vrill maintain a certificate of wnsent to selt-Insure for workers' compensation, as provided (or by section 3700 of the Labor Code, for the peAormance of the work (or which this Dermit is issued. ❑ I have and vnll maintain workers' compensation insu2nce, as requiretl by section 3700 of ihe Labor Code, for the peAormance of Ihe work (or which this permit is issued. My workers' compensation Insurance carner and policy number are: Carrier: (ihi5 sMon neetl irot be wmplefed �the peim,l a valuetl al one Iruntlied cbllars (5100) w IessJ Policy Numbec ❑ I certify that in the performance of [he work for which this permi[ is issuetl, I shall not employ any person in any manner so as to become subject to Ihe workers' compensalion laws o( CaliFomia, and agree tha[ if I should become subject to the workers' compensa[ion provisions of Section 3700 of �he Labor Code, 1 shall forthwith comply with [hese provisions. Applicanfs SignaWre Date 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 DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrtn thal 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 eHect. Lic. # Class # Conlraclor's Signalum Da�e CONSTRUCTION LENDING AGENCV: ❑ I hereby affrm [hat Ihere is a construction lending agency for ihe peAormance of the work for which ihis permit is issued. (Sec. 3097, Civil Cotle). Lender's Name: Lender's Address: Dale OWNER-BUILDER DECLARATIONS: I hereby aKrm that under penalty o( perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for [he following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to constmct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires ihe applicanl for such permi[ to file a signed statement ihat he or she is licensed pursuant to the provisions of [he Con[ractors License Law (Chapler 9(commencing with Section 7000) of Division 3 of the Business and Pro(essions Code) or that he or she is exemp[ therefrom and the basis for the alleged exemption. Any violation of Sec[ion 7031.5 by any applican[ for a permit subjeds Ihe applicant to a civil penalty of not more than � 7�five h drea tlollars ($500).): j, as owner of the property, or my employees with wages as their sole wmpensation, WILL DO THE WORK, and the structure is not intended or oRered for sale (Sec. 7044, Business antl Professions Code: The ConVactors License law does not apply to an owner of property who builds or improves thereon, antl who Coes such work himself or herself or through his or her own employees, provitled ihat such improvements are not intended or oRered for sale. If, however, the building or improvement is sold within one year of completioq the owneo-builder will have ihe bur0en of pmving that he�or she did not builtl or improve for purpose o( sale.). . � I. as owner of the-propeny, am EXCLUSIVELV CON7RAC71NG WI7H IJCENSED CONTRAC70RS to conswct the project (Sec. 7644, Business and Professbns Code: The contrac[ors License Law dces not apply [o an ovmer of property wfio builds or improves Ihereon, and who con[2cts (or such pmject with a contracta(s) license pursuant tothe Cont2ctors License Wws.). ❑ I am exempt under sec. Business and Professions Code for this reason: LSign NreS. ' ��Da��. Or aon-as �3io» Ovmer ID venfied by ❑ No � /�`!! Driver's_Cicense No. Expires: ____ l� Ven'fcation of Ownership by (rype of document, i.e. - property tax bill y d ed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: .' ❑ I hereby certify thal no excavation (rve (5) or more feet in depth into wfiich a person is required to descentl, will be made in connection with work authonzed by this pertnit, antl that no building structure, scaHdding, falsework, p tlemolition or dismantling thereof, will be more than thirty-six (36) feet hig�. (Chap. 32, Grp 2. Art 2. Sec. 341, Title 8, Califomia Adminislra[ive Code�. ❑ As owner-builtler, I will nol employ anyone [o tlo work which would require a peimit from [he Division of Industrial Safery, as notetl above, unless such person has a permil lo do such vrork from the division. Applicanfs Signa W re Dale Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: i. Will the applicant or present or future building occupant need to fle and cerlify a Business Plan tor emergency response ro release or threatenetl release of a hazardous malerial? ❑ Yes ❑ No (Section 25505 0/ the California Health and Safery Code requires, with some excep[ions, Ihat a Business Plan be fled vrith the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantiry of hazardous materials equal to or greater than a weight o! 500 pounds, or a volume o( 55 gallons, or 200 cubic teet of compressetl gas at standard temperature antl pressure). 2. Does or will the applicant or present or fuWre building occupant neetl to file a registration form for acu[ely hazardous materials? ❑ Yes ❑ No (Section 25533 of the Califomia Health and Safety Code, with some exceptions, requires registration vnth the Costa Mesa Fire Department by each business which at any one time has on hand a quanlity of acutely hazardous ma[erials equal to or grea�er than a weigh[ of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressetl gas at slandartl temperaNre and pressure). 3. Does or will the applicanl or present or future builtling occupant neetl to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous matenals)? ❑ Ye5 ❑ No (Section 25534 of the Calitomia Health and Safely Code provides Ihat Ihe Costa Mesa Fire Departmenl may require the prepara[ion, certification and filing with the Fire Department of an RMPP by businesses which are required [o regis[er awtely hazardous materials wilh �he Fire Department. 4. If an RMPP is presently required, has Section 25534 of the Califomia Health and Safety Code been (ully complied wilh? ❑ Yes ❑ No 5. Does or will Ihe applicanl or presem or future building occupant require for the vrork which is lhe subjecl of [his application a permit for such constmclion or modifcation from �he South Coas[ Air �uality Management DisMct or fmm any o[her air pollution control district or agency? ❑ Yes ❑ No (Section 658502 of ihe Califomia Govemment Cotle requires Iha� �he reques[etl information be fumished on applications (or nornresidential building pertnits). 6. Will any part o( the (acility to be constructed under Ihis permit be within 1000 (eel from the outer boundaries of a school? ❑ Yes ❑ No Q( "yes", the facility must meet Ihe requiremen[ of Sec[ions 25534 antl 42303 of Ihe California Health and Safety Code). 7. If a permit from ihe South Coast Air Quality Management District or other air pollution control district or agency is required for the vrork which is the subject of this application, have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. Q('yes", attach certificate of compliance from the appropnate air pollution con�rol officer). - � � � . CERTIFICATE OF COMPLIANCE: I certify. that under'penalty of perjury.the -information given above is conecL I;agree to comply with all state laws antl city ordinances regarding Hazardous Materials and Emissions. � - Signalure Dale - CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read ihis application and state that the informalion given is correcl. I agree to comply with all state laws and ciry ordinances rela[ing lo building construction, and aulhorize representa[ives Of the Ciry of Costa Mesa lo enler upon ihe above-0escnbed property for inspection purposes. I agree nol lo occupy or allow occupancy of any building authorize rmit � al in5peclion. � .�r- �_ T— ignature o[leBal Qmer(s) F Daie. ._ r Antl/or AulM1orizetl Applicanl ` ;S 1 f , - 1 1 � � ' ' '� ' CITY OF COSTA MESA � � �:'i,'s . '� i BUILDING DIVISION � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • �wwv ci.costa-mesa.ca.us � FOR INSPECTIONS CALL: (714) 754-5626 �o..�o `� PERMIT NUMBER: BC08-00600 PERMIT TYPE: B COMBO STATUS: ISSUED Sub Type: RES_RRIP DATE ISSUED: 12I2412008 ISSUED BY: BJK JOB ADDRESS: 377 16TH PL CM -;� SUlte/Un1Y: ' • nFN: a2519107 -- . . Zoning: , - � � `E Vicinity: DUPLEX UNITS A AND B` _ . Primary.Occ: R3 Const Type: V-B SQ. F,T; 96 Valuation: ;$10,000.00 ' SCOPE OF WORK: 48SF ADDITION TO EXTEND 2 BATHROOMS IN AN EXISTING DUPLEX, UNITS A& B. WORK ALSO "�;_? INCLUDES REMODEL OF ANOTHER BATHROOM IN UNIT A. UNIT A MECH: 2 VENT FANS; ELEC: 8 LIGHTS, 4 OUTLETS, 4 SWITCHES, 1 SVS TO 200A (UNITS A& B), 2 MOTORS TO 1 HP; PLUMBING: 1 BATHTUB,.1 SHOWER, 1 KITCHEN SINK, 3 WASH BASINS, 2 WA7ER CLOSETS,.1 WATER HEATER: UNIT B: MECH: 2 VENT FANS; ELEC: 6 LIGHTS, 3 OUTLETS, 2 SW ITCHES, 1 MOTOR TO 1 HP; PLUMBING: 1 BATHTUB; 1 SHOWER, 1 KITCHEN SINK, 2 WASH BASINS, 1 WATER CLOSET, 1 WATER HEATER � - -��-� - � " - - � - � , -_ . , . , - ... �.r3�nJ 09/12/09 REVISED PERMIT TO ADD 9 LIGHTS TO.THE KITCHEN AREA OWNER: BUNTE, CHRISTIAN .� --- Address: 377 16TH PL � Phone: 94g-285-5651 ", � ,� Ciry/State/Zip: COSTAMESA,CA , APPLICANT: BUNTE, CHRISTIAN . '• Address: 377 16TH PL � . Phone: 949-285-5651 �: ` � � . City/StatehZip: COSTA MESA, CA " � ; ' CON7RaC70fi: OWNER-BUILDER ` License No, 000000 Phone: ' .. � � Address: Unit: . � � Cell: -� � , - Ciry/State: � — � _ ARCHITECT: LAWRENCE R HALONEN� -: - � License No.C8526 ENGINEER: � " � License No. � � � - ' COMBINATION PERMIT FEE SUMMARY Building Plan Check: � � $117.81 � � ' - Building Fees: $18125 � � - - " Electrical Fees: $�pg,7q �� - MechanicalFees: $45.25 Plumbing Fees: $180.30 SMIP Residential: $1.00 SMIP Commercial: $0.00 Bldg Std Admin Fund ?? TOTAL FEES: $632.35 "Refer to fee receipu for all tees paid for project Unit: Unit: : ZipCode _ PHONE:949-582-5960 PHONE: ^;._) �a � K. �3 ':., P�":" :HF3, �I .' �c�. ^ nr:ih�s NOTICE: The work authonzed by this permil shall comply with all applicable handicap access requirements under Calitomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) � ' EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. � � INSPEC710NS: 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 flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this,permit. COpE/. INSPEC110NTYPE DA NTI� TIRLS ��t INSPECTIONIY�F �AT� INIIIIAL 1616 Fixed Syslem Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final Block/ReWining Wall 202 Final Factpry Fire Place 203 Final Sign 204 Final Demolition 206 Final Mechanical 208 final Plumbing 210 Fi I 2 F�I Fir Pr enti 0 inal lanning Approval ' 222 Final Site 2W Final Building�0aupancy - � .� WORKERS' COMPENSATION DECLARATION: � - I hereby affirtn under penalty oi perjury ona of the following declarations: ❑ 1 haVe and will mafntain a tertifcate o( consent to Se141n5ure for vrorker5' compensation, as provided for by seclion 3700 of ihe Labor Code, for ihe pedortnance of the work fOr which this permlt i5 is5uetl. ❑ I have and will maintain workers' compensation insurance, as required 6y section 3700 of the Labor Code, for the peAormance ot lhe work for which this pertnit is issued. My workers' compensation Insurance carner and policy num6er are: Carrier: (ihu secYan neetl rrof 6e mmde�� he permrt is valuetl at one �undre0 cbllars (8f00J w less ) Policy Number: ❑ I certify iha[ in the peAormance of ihe work (or which this permit is issuetl, 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 become subject [o the vrorkers' compensation pmvisions of Section 3700 of the Labor Code, I shall forthwith comply with ihese provisions. Aoplicanl's SignaWre 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 DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrm that I am licensed untler provisions o� Chapter 9(commencing with Section 7000) of Division 3 of the Business antl Professions Code, and my license is in (ull force and effect. Lic. # Class # Comrac�or's SgnaWre Da�e CONSTRUCTION LENOING AGENCV: ❑ I hereby affrm that Ihere is a consWction lending agency for the performance W the work fa which this pertnit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Signalure Da1e OWNER•BUILDER DECLARATIONS: I hereby aKrm ihat under penalry o( perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW (or the following reason (Sec. 7031.5, Busine55 and Professions Code: Any city or county which requires a permit [o construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires ihe applicanl for such permit to fle a signed statement that he or she is licensed pursuaN to the provisions of [he Contractors License Law (Chapter 9(commencing with Section 7000) o! Division 3 0( [he Business and Professions Code) or thal he or she is exempt [herefrom 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 no[ more than fi�� undred dollars ($500).): G�ll, as owner of Ihe pmperly, or my employees with wages as iheir sole c pensation, WILL DO THE WORK, antl lhe sWcture is not intendetl or offeretl 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 oRered for sale. If, however, the building or improvement is sold within one year of tomple[ion, the ovmer-builder will have [he burden of pFoving [hat he or she did not build or improve for purpose of sale.�. .. , . ❑ I, as owner of the property, am EXCLUSIVELY CONTRAC7ING WI7H LICENSED CONTRACTORS to construc[ the prqec[ (Sec. 7044, Business and Professions Code: The contractas License Law dces not apply [o an owner o( property wfio builds or impmves thereon, and who cont2cis for such pmject wi[h a con[racta(s) license pursuant to the Contractors License Laws.). �exempt under sec. Business and Professions Cotle for this reason: ��1�� ♦ � � s � { , , . � Owner ID venfied by dri e cense. �Fes C No Oriver's�L'icenseNo. � . -�erty tax bill or deetl): DIVISION OP INDUSTRIAL SAFEiY PERMIT CERTIFICATION: -. � ❑ I hereby cetldy Ihat no excavation Me (5) or more feet in depth into wfiich a person is required lo descend, vnll be made in connection with work authonzed by this pertnit, antl that no building s[ructure, scaHdtling, (alsev.ork, a demolition or dismanlling ihereof, will be more [han thirty-six (36) feet high. (Chap. 32, Grp 2, M 2, Sec. 341, Ttle 8, Calitomia Adminisl2tive Code). ❑ As owner-builtler, I will not employ anyone to do work which would require a permit (rom the Division of Industrial Safety, as no[ed above, unless such person has a permit to do such work from the division. Appliwnfs SignaWre Dale Division of Industrial Safe[y Permit Number. HAZARDOUS MATERIALS AND EMISSIONS CERT�FICATION: 1. Will Ihe applicant or presen� or future building�occupan� need [o file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Ves ❑ No (Seclion 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed wi[h the Costa Mesa Fire Departmenl by every business which has at any one time during a repohed 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 [he applicant or present or (uWre buildinq occupaN need to file a registration form for acu[ely hazardous matenals? ❑ Yes ❑ No (Section 25533 of the Cali(omia Health and Safery Cotle, with some exceplions, requires registration with the Cos[a Mesa Fire Department by each business which at any one time has on hand a quan[i�y o( aculely hazardous matenals equal to or greater Ihan a weigh[ of 500 pounds, or a volume o( 55 gallons, or 200 cubic feet of compressetl gas at standard temperalure and pressure). 3. Does or will the applicant or present or fulure building occupant need to prepare an RMPP (Risk Managemenl and Preven[ion Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the Cali(omia Health and Safety Cotle provitles [hat the Cosla Mesa Fire Departmen� may require ihe preparation, cerlifica�ion antl fling wi�h the Fire Department of an RMPP by businesses which are requiretl to register acutely hazardous malerials with the Fire Departmen[. 4. If an RMPP is presently required, has Section 25534 of the Califomia Health and Safery Code been fully complied with? ❑ Yes ❑ No 5. Does or will Ihe applicant or preseN or future building occupant require for the work which is the subject of Ihis application a pertnit for such consiruclion or modification fmm the South Coast Air Qualiry Management Distnct or (rom any other air pollution control disVict or agency? ❑ Yes ❑ No (Sec�an 658502 of the Cali(omia Govemment Code requires that the requested information be fumished on applications ta non-residential building pertnits). 6. Will any part of Ihe facility [o be constructed under �his permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No Qf'yes", Ihe (acility musl meet the requiremen[ of Sections 25534 and 42303 of the California Health and Safety Code�. 7. I( a permit from [he South Coast Air Quality Management Dishict or other air pollution control district or agency is required for the work which is the subject of this application, have all o( Ihe disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. Qf'yes", attach certifcate ot compliance from�the appropriate air pollution con[ml oKcer�. � � CERTIFICATE �OF COMPLIANCE:� I ceAity thal under penalry of perjury the information given above is correct I agree lo comply with all state.laws and city ordinances regarding Hazartlous Materials and Emissions.: SignaWre ' Da�e CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify untler penalty of perjury Ihat I have read Ihis application and state that �he in(orma�ion given is cortect I agree to compty with all state laws and city ordinances relating to building construction, and authorize representatives of Ihe City of Costa Mesa [o enter upon �he above-described property for inspection purposes. I agree not lo occupy or allow occupancy of any building authonzed it until fin e tion. �� O_ , - vne s Date An0/or Pul�orize0 AOPI¢ant i HEN LIGHTING WORKSHEET �%�% �� £ � �c�. � . � WS-SR At least 50%of the total rated w'atta�e of permanently ins[alled luminaires in the kitchen must be in luminaires [hat are high efficacy luminaires as defined in Table I50-C. Luminaires that are not high efficacy must be switched separately. Ki[chen Ligh[ing Schedule. Provide the following informa[ion for all luminaires to be installed in ki[chens. Luminaire Tvoe Hieh Efficacv? Watts x Ouanti[v = Hiah Efficacv Watts or Other Watts f Yes � No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ X� _ �c� y o� x _� = 13 c� o� x = or x = or x = or Total: A: Z B: COMPL/ES IFA ? B Yes� No ❑ Rules for Determining Residential Kitchen Luminaire Wattage Screw Base Sockets §130(c)1 (Not containing permanently insYalled ballasts) The maximum relamping rated wattage of the luminaire, as listed on a permanent factory-installed label (luminaire wattage is not based on type or wattage of lamp that is used). � Permanently or Remotely Installed Ballasts §130(c) 2 _ , The operating input wattage of the rated lamp/ballast combination based on values published in manufacturer's catalogs based on independent testing lab reports. Line Voltage Track Lighting (90 through 480 volts) §130(c) 3 1. Volt-ampere (VA) rating of the branch circuit(s) feeding the tracks; or 2. For [racks equipped with an integral current limiter, the higher of; • 7he wattage (or VA) rating of an approved Integral current limlter controlling ihe track system or • 15 watts per linear foot of the track; or 3. For tracks without an integral wrrent limiter, the higher of; . 45 W per linear foot of the hack or • The total wattage of all of the luminaires included in the system. Low VolUge Track Lighting (less than 90 volts) §130(c) 4 Rated wattage of the transformer feeding the system, as shown on a permanent factory-installed label Other Lighting §130(c) 5 (Lighting systems that are not addressed in §130 (c) 1-4) The maximum rated wattage, or operating input listed on a permanent factorv installed iabel, or published in manufacturer's cataloqs, based on indeoende EXAMPLE ' '� ' � � . RESIDENTIAL KITCHEN LIGHTING WORKSHEET Project Title Date of the system, o lab reoorts. W S-SR Ki[chen Ligh[ing Schedule. Provide the following information for all luminaires to be installed in kitchens. High Efficacy Luminaire Type (y/n) Watts x Quantiry = High Efficacy Watts or O[her Watts CFL-1 Yes 26 x 5 = 130 or MRJ6 No 5� x 2 = or !)p or or or Total: A: !30 B: I10 COMPLIESIFA>_B Yese No❑ Rcsiden[inl Compliance Foims December 2005 (' '�� . � r r ` . — CITY OF COSTA MESA � B!/ILDING DIVISION F � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us �, FOR INSPECTIONS CALL: (714) 754-5626 �+.nwmo''�' • PERMIT NUMBER: BC08-00600 PERMIT TYPE: B COMBO STATUS: ISSUED Sub Type: RES_ALT DATE ISSUED: 12124I2008 ISSUED BY: BJK �os nooRess: 377 16TH PL CM ; APN: 42519107 � Vicinity: DUPLEX UNITS A AND B-� Const Type: V-B '.- SQ. FT: Zoning: , , � Suite/Unif: Primary Occ: R3 � - Valuation: $10,000.00 SCOPE OF WORK: 48SF ADDITION TO EXTEND 2 BATHROOMS IN AN EXISTING DUPLEX, UNITS A 8 B. WORK ALSO INCLUDES REMODEL OF ANOTHER BATHROOM IN UNIT A. UNIT A MECH: 2 VENT FANS; ELEC: 8 LIGHTS, 4 OUT�ETS, 4 SWITCHES, 1 SVS TO 200A (UNITS A& B), 2 MOTORS TO 1 HP; PLUMBING: 1 BATHTUB, 1 SHOWER, 1 KITCHEN SINK, 3 WASH �� . � � BASINS, 2 WATER CLOSETS, 1 WATER HEATER. UNIT B:�MECH: 2 VENT FANS; ELEC: 6 LIGHTS, 3 OUTLETS, 2 SWITCHES, 1 MOTOR TO 1 HP; PLUMBING:�1� BATHTUB, 1 SHOWER, 1 KITCHEN SINK, 2 WASH BASINS, 1 WATER CLOSET, 1 WATER HEATER .. �' OWNER: BUNTE, CHRISTIAN Phone: 949-285-565'I APPLICANT: gUNTE, CHRISTIAN Phone: 949-285-5651 CONTRACTOR: Phone: Cell: ARCHITECT: ENGINEER: OWNER-BUILDER LAWRENCE R HALONEN Atldress: 377 16TH PL City/Stafe/Zip: COSTA MESA, CA Atldress: 377 16TH PL CirylState/zZip: COSTA MESA, CA License No. 000000 Address: Unit: City/State: Unit Unit : ZipCode License No.C8526 PHONE:949-582-5960 License No. PHONE: COMBINATION PERMIT FEE'SUMMARY ' � `� Building Plan Check: � $0.00 - Building Fees: � $18125 � � ' Electrical Fess: $97.95 � Mechanical Fees: $45.25 Plumbing Fees: $180.30 � SMIP Residential: $1.00 SMIP Commercial: $0.00 � TOTAL FEES: $505.75 "Refer lo fee reCeipls for all tees paitl for project � NOTICE: The work authonzed by this percnit shall comply with all applicable handicap access requiremenGs under Califomia statutes and �elated regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION; PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order tor 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 fnal approval will result in the expiration of this permit. D 1. INSPECTIONTYPE 1676 Fixed SyStem Pinal Fire Prevention 7266 Pool Spa Final 200 Final Re-Roof 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition �TF� INTITIRLS COOEk INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Fin Elpyira� � � 2y F' Fi re io �/v 0 inal Planning Approval 222 Final Site 25o Final BuildincyOccupancy onre �NnTIpLS WORKERS' COMPENSATON DECLARATION: I hereby aRrtn under penalry of perjury ane of Ne following deGarations: ❑ I have and will maintain a certifwte of consent la self•Insure tor workers' wmpensation, as provided for by sectbn 3700 of lhe Labor Cotle, for the performance of the work for whlch this permit is Issued. ❑ I have and will maintaln v.orkers canpensatbn insurance, as required by secibn 3700 of the Labor Code, fa the peAortnance ot Ihe woAc for wfiich ihis pertnil is issued. My workers' compensalion Insurance carner antl policy number are: Carrier (TnS scrf�Dn neeo iror be mnpeletl slne pe�nu B rawMat me hwMreO Wears f5fo01 a less) Policy Number: ❑ I certiy that in the peAormance of the wvrk for which this permit is issued, I shall not employ any person in any manner so as lo become subject to the vrorkers' compensation laws o( Califomia, and agree thal if I shoultl become subject to the workers' compensation provisions o( Section 3700 of the Labor Code, I shall forthwith comply with these provisions. ApP��nfs SignaWre Dale WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNL4WFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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 aKrm Ihat I am licensed under provisions of Chapter 9(commencing vrith Section 7000) of Division 3 of the Business antl Professions Code, and my license is in full force and eHect. Lic. # Class # Convanors SignaWre Dale CONSTRUCTION LENDING AGENCY: ❑ I hereby aKrm [hat there is a construcibn lending agency (or the pedortnance of the work (a which this pertnit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: �ale OWNER-BUILDER DECLARATIONS: I hereby aKrm lhat under penalty of peryury that I am E7(EMPT FROM THE CONTRACTORS LICENSE LAW for Ihe follovnng reason (Sec. 7031.5, Business and Professions Cotle: Any ciry or wunry which requires a permit to wnstruct, alter, improve, demolish, or repair any swcNre, pnor to its issuance, also requires the applicant tor such permit to fle a signed statemenl Ihat he or she is licensed pursuant to l�e provisions of the Contractors License Law (Chapter 9(wmmencing wilh Section 7000) of Division 3 of the Business and Professions Cotle) or that he or she is exempt iherefrom and the basis (or the alleged eaemption. Any violation of Seclion 7031.5 by any applica or a permit subjects me applicant to a civil penally of not more than five ntlretl dollars ($500).): � I, as ovmer ot [he property, or my employees with vrages as their sole mpensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Cotle: The Contrectors License Law dces not apply to an ovmer of property who builds or improves there0n, and who dce5 Suth work him5elf or herself or through his or her own employees, provided that such improvements are not intendetl or oBered for sale. If, howaver, the building or improvement is sold within one year of wmpletion, the owner-6uilder will have [he burden of proving that he or she did not build or improve for purpose of sale.�. ❑ I, as owner of Ihe propeAy, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS lo conslrucl the project (Sec. 7044, Business and Professbns Code: The contractors License Law dces not apply to an owner of propeAy vfio builds or improves lhereon, and who wntracls ta such project with a cont2cta(s) license pursuant to Ihe Cont2ctors License Laws.). ❑ 1 am exempt untler sec. Business anC Professions Code for Ihis reason: � a ignalure'- ,�pele' JOS]-4fi(3/0]) �y- �� Owner ID verifietl by Ame anse. Yes ❑ No Driv'er's�License�No:- Expires�— Verifwtion ot Ovmership by (rype of document, i.e. • properly Ux bil or eed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certrfy that no excavation frve (5) or more feet in depth into wfiich a person is requiretl lo descend, will be matle in conneclqn with xork author¢ed by ihis permit, arM iha[ no building stmcture, sc�fdding, falsework, or demolitbn or dismantling Ihereof, vrill be more than �hirty-six (36) fee� high. (Chap. 3.2, Grp 2, M 2, Sec. 341, Title 8, Califomia Administ2tive Cotle). � As ovmer-builder, I will not employ anyone to do wvrk which would require a permit from the Division of Industrial Safery, as noted above, unless such person has a permit to tlo such work from Ihe division. Applicanl's SignaWre oale Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 7. Will the applicant or preseM or (uture building occupant neetl to file an0 certify a Business Plan for emergency response to release or Ihreatened release o! a hazarclous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safery Code requires, with some exceptions, that a Business Plan be filed with the Cos[a Mesa Fire Department by every business which has at any one time during a reportetl 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 slandartl temperature and pressure). 2. Does or will the applicanl or present or (uture builtling occupant neetl to file a regislration (orm for acutely hazardous matenals? ❑ Yes ❑ No (Section 25533 of the California Health antl Safery Code, wi[h some exceptions, requires registration wi[h the Costa Mesa Fire Department by each business which at any one lime has on hand a quantily of awtely hazartlous matenals equal to or grea�er Ihan a weigh� of 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressetl gas at slantlard �emperalure and pressure). 3. Does or will [he applicant or present or future building occupant need to prepare an RMPP (Risk Managemen[ and Prevention Program for acu[ely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Heallh antl Safety Code provides that the Cosla Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by husinesses which are required to register acutely hazardous materials wiN lhe Fire Department. 4. If an RMPP is presently required, has Section 25534 of lhe Calitornia Health and Safery Code been fully complie0 with? ❑ Ves ❑ No 5. Does or will Ihe applicanl or preseM or fu[ure building occupant require for the work which is the SuDject of this application a permit (or such construclion or modifcation from the South Coasl Air Quality Management Dislric[ or from any other air polWtion control district or agency? ❑ Yes ❑ No (Setlqn 65850.2 0( the Califomia Govemmen[ Code requires lha[ the mquestetl infortnation be (umished on applications for non-residential DuilCing pertnits). 6. Will any part of [he facility lo be wnstructed untler this permit be within 1000 feet from lhe outer boundaries of a school? � Yes ❑ No (If'yes", Ihe faciliry must meet the requirement of Sections 25534 and 42303 o( Ihe Califomia Health and Sa/ety Code). 7. If a pertnit from the South Coast Air Quality Management District or other air pollulion control district or agency is required for Ihe v.ork which is the subject of this application, have all of the disclosures prescribed by Califomia Healt� and Safery Code Section 42303 been made? ❑ Yes ❑ No 8. (If yes', anach ceNficate of wmpliance from the appropriate airpollution wntrol oKcer). ' CERTIFICATE OF COMPLIANCE: I certi(y that undei penalty of perjury the information given above is correcL I agree to compl�with all state laws and city ordinances regarding Hazartlous Materials and Emissions. ' Signalure Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalry of perjury that I have read this application and sfate t�at the information given is wrtect. I agree to comply with all slate laws and city ordinances relating to building construction, and authorize representatives of lhe City of Cos[a Mesa to enter upon the above-0escribed property for inspection purposes. I agree not to occupy or allow occupancy of any building authorizetl by this permit u� a inspection. �Q �� Signatu e pal�Own2r ) ale �� AnOlw Aut�onzeE ApO�� D01! ti, • � � � w CITY OF COSTA MESA P.O. BOX 1200 • 7� FAIR DRIVE • CALIFORNIA 92628-1200 DEVELOPMENTSERVICES DEPARTMENT New State Law: Swimming Pool Safety Act of 2006 (Assembly Bill 2977) Effective January 1, 2007 California Health and Safety Code Section 115928 "(d) Whenever a buildin� permit is issued for the remodel or modification of a single familv home with an existing swimming pool, toddler pool, or spa, the permit shall require that the suction outlet of the existing swimming poql, toddler pool, or spa be upgraded so as to be equipped with an anti-entrapment cover meeting the current standards of the American Society for Testing and Materials (ASTM) or the American Society of Mechanical Engineers (ASME)." �77 I6� �'I �a6a7 Address/Permit Number Permit Applicant or Contractor's Affidavit (Please check appropriate box): ❑ There is an existing swimming poo1, spa, or toddler pool on this property. I will install an anti-entrapment device that conforms to this law, and I understand that the installation of this device is required prior to final building inspection approval. �There is no swimming pool, spa, or toddler pool on this property. , �_�wf�5�0.r ��..-. Nathe (please ri [) - l/ �'��''��s� �a/a�llof� SignaturelDate Building Division (714) 754-5273 • Code Enforcement (714) 754-5623 • Planning Diyision (714) 754-5245 FAX pta) 754-4856 • TDD Qt4) 754-52a4 • www.ci.costa-mesa.ca.us �-�. ` - CITY OF COSTA MESA 0 p~F BY/LDING DIVISION it�� 77 FAIR DRIVE. COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us r ° ` FOR INSPECTIONS CALL: (714) 754-5626 ��fi PERMIT NUMBER: BX08-00324 PERMIT TYPE B MISC STATUS: ISSUED APN: 42519107 DATE ISSUED: 11/10/2008 Zoning: , ISSUED BY: RMD JOB ADDRESS: 377 16TH PL CM Vicinity: THROUGH OUT HOUSE S�. FT: 0 Suite/Unit: Primary Occ: Const Type :?? Valuation: 57,000.00 SCOPE OF WORK: DUPLEX A AND 8 CHANGE-OUT OF 4 EXTERIOR ENTRY DOORS, 2 GARAGE ENTRY DOORS AND 14 WINDOWS TO BE REPAIRED FOR MAINTENANCE - ONLY. UNIT A: 5 WINDOWS AND 2 EXTERIOR DOORS UNIT B: 9 WINDOWS AND 2 EXTERIOR DOORS OWNER: BUNTE, CHRISTIAN City/State: COSTA MESA, CA Phone: 949•285-5651 APPLICANT: BUNTE, CHRISTIAN City/State: COSTA MESA, CA Phone: 949-285-5651 CONTRACTO R: OW NER-BU ILDER Address: City/State: Zip Code: ARCHITECT: Phone Address:: 377 16TH PL Zip Code: 926273203 Address: 37716TH PL Zip Code: 926273203 Phone License No. 000000 Unik License No. Cell: Unit Unit: ENGINEER: License No. Phone FEE SUMMARY Building plan Check: $0.00 Building Permit: $139.25 Electrical Permit: $0.00 SMIP Residential $0.70 SMIP Cqmmercial $0.00 Bldg Std Admin Fund ?? TOTAL KEES $139.95 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomi st tes and related regulations. (Ord. No. 92-28, § 1, 72-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be consitlered legal, such work must comply vrith all applicable s, and all required inspections and final approval must be obtained. Failure to obWin inspections and final approval will result in the expiration of th ermit. GOOE i. INSPECTION TYPE 1616 Fized System Final Fire Prevention 1266 Paol Spa Final 200 Final Re-Roof 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 FinalSign 204 Final Demolition ORT�F IN7171RL5 OOE� INSPEClIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Elechical 212 Final Fire Prevenfion 220 Final Planning Approval 222 Fina15ite 250 Final Building/Occupancy URTE INTI71RL5 �Y"�� 1 WORKERS' COMPENSA710N DECLARATION: I hereby affrtn under penalty of perjury one of Ihe (ollowing declaretions: ❑ I have and will maintain a certificate of consent to sel4lnsure for workers' wmpensation, as provitletl for by sec�ion 3700 0( the Labor Code, for ihe pertortnance of the work for which this permit is issued. � I have and will maintain wvrkers' canpensation insurance. as required by section 3700 of the Labor Code, for the perfortnance o( the work for which Ihis pertnit is issued. My vrorkers' compensation Insurance carrier and policy numher are: Carrier: (Tnis sedion nee0 rro( oe wmpeted athe permf is valuetl at one huntl.etlOdla�s (St00) wless ) Policy Number: ❑ I certi(y that in Ihe pertormance of Ihe work for which �his permit is issued, I shall not employ any person in any manner so as to become subject to the vrorkers' compensation laws of Califomia, and agree that if I should become subject to the workers' compensa�ion provisions of Section 3700 0( the Labor Code, I shall torthwith comply with Ihese provisions. AOOlicant's SignaWre Dale 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 DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby a(frm Iha[ I am licensed under provisions of Chapler 9(commencing wilh Seclion 7000) o( Division 3 of �he Business and Professions Code, and my license is in (ull force and eRect. Lic. # Class # ConVaaor's SignaWre Date CONSTRUCTION LENDING AGENCY: ❑ I hereby affrtn that Ihere is a conslruction lentling agency for the pedortnance of the �ork fa vmich mis permit is issued. (Sec. 3097. Civil Code�. Lender's Name: Lentler's Address: SignaWre OWNER-BUILDER DECLARATIONS: I hereby affrm that under penalty of p� CONTRACTORS LICENSE LAW far Business and Pmfessions Code: Any ci conslmct, alter, improve, demolish, issuance, also requires Ihe applicant (� thal he or she is licensed pur u2nt License Law (Chapter 9 (com ciogj� Business and Professions C e)y,y,R [h the basis for the alleged mptjoh� applicant for a permit s t he a i five hundred dollars (� i ry tl�`I am EMGT FROM THE (ollowir� san (Sec. �03L5. ��Coun� ' requires a permit to repal a strucWre. prior to its Lh�it to fle a signed statement �pmwsions of the Contractors i ction 7000) of Division 3 of the i or she is exempt Nere(rom and violalion o/ Section 7031.5 by any it to a civil penalty of not more Ihan ❑ I, as ovmer e prop or my employees with wages as their sole compensation, W Lti WORK, and [he strucNre is not intended or oflered for s S . Business antl Professions Code: The Contracrors License Law t apply lo an ovmer of property who builds or improves thereon, and wh o s such vrork himself or herself or through his or her ovm empl provid d that such improvements are nol intended or oftered for sal owever, Ihe building or improvement is sold within one year of co p�,. h owner-builder will have the burden of pmving that he or she did noC�ti7d or impmve for purpose of sale.). ❑ I, as owner of the pmperty, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS ro cons[ruct the project (Sec. 7044, Business antl Professions Cotle: The contractors license Law does not apply to an ovmer o! property vfio builds or impmves thereon, and who contracls tor such project with a cmtractor(s) license pursuant ro the Contrac[ors License Laws.). ❑ I am eaempt under sec. Business and Professions Code for this reason: � o �r SipwWre�— Daie= s 305'/-a6�3/0]� � Owner ID verifed by drivei e license. ❑ Yes ❑ No onver's �icense No. � �� Expire�: 09 %0 � Verification of Ovmership by (rype of document, i.e. - property tax bill or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify lhat no excavation frve (5) or more leet in depth into which a person is required to descend, will be made in connection with wvrk authonzetl by Ihis permii, and that no building sWCWre, scaffolding, falsework, or demolilion or dismantling thereof, will he more than thirty-six (36) feel high. (Chap. 3.2, Grp 2, Art 2, Sec. 347, TiUe 8, Cali(omia 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 ihe division. Appliwnl's SignaWre Date Division of Industrial Safery Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. will the applicant or present or fuWre building occupant need to file and cenify a Business Plan for emergency response to release or threatenetl release o( a hazardous material? ❑ Yes ❑ No (Section 25505 of the Califomia Health and Safery Code requires, with some exceptions, lhal a Business Plan be fled with lhe Costa Mesa Fire Department by every 6usiness which has at any one time during a reportetl year a quanlity of hazardous materials equal to or greater man a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperaWre and pressure). . 2. Does or will the applicant or preseN or (uture building occupant need ro fle a registration form for acutely hazardous malerials? ❑ Yes ❑ No (Section 25533 of lhe Califomia Health antl 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 o/ acutely hazartlous maledals equal to or greater Ihan a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at stantlard Iemperature antl 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 Calilornia Health and Safery Code provides that the Costa Mesa Fire Department may require [he preparalion, certification antl filing with the Fire Department of an RMPP by businesses which are required to register awtely hazartlous matenals vrith lhe Fire Department. 4. If an RMPP is presently requireQ has Section 25534 of the Califomia Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will Ihe applicant or presenl or future building occupant require for the work which is lhe subject of lhis application a permil for such construction or motlifcation from �he Soulh Coast Air Qualiry Management Dislrict or from any other air polNtion control district or a9ency? ❑ Yes ❑ No (Sectbn 658502 0( the Califomia Govemment Code requires that Ihe requested information be fumished on applications fa non-residential builtling permits). 6. Will any part of the (acility to be constructed under Ihis permit be within 1000 (eet (mm lhe outer boundanes of a school? ❑ Yes ❑ No (II'yes", Ihe (aciliry must meel lhe requirement o( Sections 25534 and 42303 of the Cali(omia Health and Safery Code). 7. If a permit (rom the South Coast Air Quality Management District or other air polNtion contml district or agency is required for the work which is the subject of this applicalion, have all of lhe disclosures prescribed by California Health and Salety Code Section 42303 been made? ❑ Yes ❑ No 8. Qf "yes", altach certifcate of compliance from the appropriate air pollution control offcer). CER7IFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correcL I agree to compty with all state laws and city ordinances regarding Hazardous Materials and Emissions. SignaNre CERTIFICATE OF COMPIIANCE AND AUTHORIZATION OF ENTRY: I certify under penalry of perjury that I have read this application and state that the information given is correcL I agree to comply with all state laws antl ciry ordinances relating to building conslruction, and authorize representalives of the Ciry of Costa Mesa lo eNer upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy ot any building authorized 2y-� ' mit urJti ina ' ec' � a �3 v ignaWre o ega q Da�e � , An�lor Authonze0 Apphcam 1 [ • • � � J CITY OF COSTA MESA � +! '•., BUILDING DIVISION F � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • ww�v.ci.costa-mesa.ca.us ��p FOR INSPECTIONS CAtL: (714) 754-5626 PERMIT NUMBER: BXOS-00324 PERMIT TYPE B MISC STATUS: ISSUED APN: 42519107 DATE ISSUED: 11/10/2008 Zoning: , ISSUED BY: RMD JOB ADDRESS: 377 16TH PL CM Suite/Unit: Vicinity: THROUGH OUT HOUSE Primary Occ: Const Type :?? SQ. FT: 0 - " Valuation: E7,000.00 SCOPE OF WORK: CHANGE OUT 14 WINDOWS AND 4 EXTERIOk2 ENTRY DOORS, 2 GARAGE ENTRY DOORS FOR DUPLEX A AND B. NO CHANGEIN � - - HEADER. WINDOWS WILL BE ENERGY EFFICENT AND MEET EGRESS REQUIREMENTS. UNIT A-5 WINDOWS AND 2 EXTERIOR � �� ' ' DOORS, UNIT B-9 WINDOWS AND 2 EXTERIOR DOORS. . OWNER: BUNTE, CHRISTIAN �.'� � �� - . Adilress:: 377 16TH PL � Unit City/State: COSTA MESA, CA Zip Code: 92627-3203 Phone: 949-285-5651 � APPLICANT: BUNTE, CHRISTIAN Address: 377 16TH PL City/State: COSTA MESA, CA ' Zip Code: 92627-3203 Phone: 949-285-5651 � � �. � � - CONTRACTOR: OWNER-BUILDER - '� � License No. 000000 � Address: City/State: Zip Code: Phone � Cell: ARCHITEC7: Phone ENGINEER: Phone Building Plan Check Building PermiC Electrical Permit: SMIP Residential SMIP Commercial TOTALFEES ' License No. ' License No. FEE SUMMARY $o.00 $13925' �$0.00 $0.70 $0.00 $139.95 Unit: Unit � NOTICE: The vrork authorized by this permit shall comply vrith all applicable handicap access repuirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1. 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DAT@ OF ISSUE OR DATE OF LAST INSPECTION. � , INSPECTIONS: In order for Ne work authorized under this permit to be wnsidered legal, such work must eomply vnth all appliwble codes, and all required Inspedions and Tinal approval must be obtained. Failure to obtain inspections and final approval will result in the expi2tion of this permit. COpE 1. INSPECnON TYPE p� 1878 Fixed System Final Fire PrevenGon 1288 Pool Spa Final ^ 200 Final Re-Rool C.��C/ `-� �--� 201 Final BIotWRetaining Wall 202 Final Factory Fire Place 2(13 Final Sign 204 Final pemolition IN L 4QO�F j INSPECTION TYPE D� INi111�L5 208 Final Mechaniwl ZOB Final Plum 'ng Final Ele wl Preven On 220 Final Planning val 222 Final Site 250 Final Building/OccUpanty WORKF�RS' C�PENSATON DECLARATION: I hereby aRrm under penalty of perjury one of Ihe lollowing declarelions: ❑ I have and will maintain a certificate of consenl to self-Insure for vrorkers' compensation, as provided for by section 3700 of lhe Labor CoCe, for the peAormance of the vrork lor vfiich this pe�mit is Issued. ❑ I have and will maintain workers' compensation insu2nce, as required by section 3700 of the Labor Code, fw the peRamance of the work for which this pertnit is issued. My workers' compensation Insurance carrier and policy number are: Carnec (in¢ sM.bn neetl rrol be romdeleC nthe permrt is value0 at one nvntlietl tlollars (SI00) wless ) Policy Number. �I certi(y thal in the peRortnance of the vrork for which this permit is issued, I shall not employ any person in any manner so as to become subject [o Ihe workers' compensalion laws of California, and agree that if I should become subjec� to the workers' compensation provisions of Section 3700 of the Labor e, I shall forthvnth�with these provisi �^ O� ilit � �Appb an�5ig aWre Date 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 DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS UECLARATION: I hereby affirm [hat I am licensed under provisions of Chap�er 9(commencing with Sec[ion 7000) of Division 3 0( the Business and Protessions Code, and my license is in full force and eHect. Lic. # Class # Conuactor's Signalure Date CONSTRUCTION LENDING AGENCY: ❑ I hereby aR�rm that there is a consWction lenaing agency for the perfwmance o/ the v.ork tp wfiich Ws permit is issued. (Sec. 3097. Civil Code). Lender's Name: Lentler's Address: Signaiure Date OWN€R-BUILDER DECLARATIONS: I�y aKrm.(tt�at under penalty o( perjury that I am EXEMPT FROM THE CO RACTORg LI�NSE W for ihe following reason (Sec. 703t.5. BusiCess antl�Pio(es oions Cod . A y ' r counry which requires a permit to wnstriict, alter im�rove�deJn lish, ir an 5tructure, pnor to its issuance, also require6 thflRa�Ont f' s pe i a signed statement that he or she is IicenseC pursuant to he prp i5ions of�tiE ntractors License Law (Chapter 9(commencing�wltl%Sectio� 7000 of Divisi of the Business antl Professions CoOe) or that he or�s�ie is"exeinpt iher f m and t�e basis for Ne alleged exemptioa Any violation of�5ectiart�Z03�by any applicant for a permit subjects ihe applicant to a civil penalty of not more than Yfive hundred dollars ($500).): Q� I, as owner o� the property, or my employees wilh wages as their sole wmpensation, WILL DO THE WORK, and the slructure is not intended or oflered for sale (Sec. 7044, Business and Professions Code: The Contraclors License Law dces not apply lo an owner of property who builds or improves thereon, and who tices such vrork himself or herself or lhrouqh his or her ovm employees, provided that such improvements are not intended or oHered tor sale. If, however, Ihe building or improvement i5 5old within one year of completion, the owner-builtler will have the burden of pmving thal he or she did not build or improve for purpose of sale.�. ❑ I, as owner of Iheproperty, am EXCCUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to conslruct Ihe prqecl (Sec. 7044, Business and Professbns Code: The contractors License Law dces not apply to an owner of property wfio 6uilds or improves thereon, and who cont2cts for such project with a cmtractor(s) license pursuant to Ihe Contractas License Lav+s.). ❑ I am exempl under sec. Business and Professions Code !or this reason: �/ /� � 0 ' SlgnaWre Da�e 305]<6 (1i0'!) i � /' - ' � Ovmer ID verifie0 by dri�vta. _,;e�n1se. es ❑ No /n Driver's License No. Expires: �� !'" �� Verification o( Ownership by (type of tlocument, i.e. - pmperty taz tll or tleed): DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: � ❑ I hereby certify Ihat no excavation frve (5) or more feel in depih into wfiich a person is required to descentl, will be made in connectbn with work authorizetl by Ihis permil, and that no building sWCWre, scaffdding, false�wrk, or demolition or dismantling thereof, will be more ihan thirty-six (36) leet high (Chap. 32, Gry 2. Art 2, Sec. 341, Trtle 8, Califomia Atlministrative Code). ❑ As owner-builder, I will not employ anyone lo do vrork 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 I�e tlivision. AppliWnfs SlgnaWre Date Division of Intlustrial Safety Pertnit 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 threalenetl release ol a hazardous material? ❑ Yes ❑ No (Section 25505 of Ihe Califomia Health and Sa(ety Code requires, with some exceptions, that a Business Plan 6e (led with Ihe Costa Mesa Fire Department by every business which has at any one time during a reportetl 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 wmpressed gas al standard temperature and pressure). 2. Does or will lhe applicaN or present or (uture building occupant need to file a registration lortn for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safery Cotle, with some exceptions, requires registration with Ihe Costa Mesa Fire Department by each business which a[ any one time has on hand a quanti[y of acutely hazardous materials equal �o or greater than a weight o/ 500 pounds, or a volume of 55 gallons, or 200 cubic feet o( compressed gas at standard temperaWre and pressure). 3. Does or will the applicant or present or (uWre building occupant need to prepare an RMPP (Risk Management antl Prevention Program for acu[ely hazartlous materials)? ❑ Ves ❑ No (Section 25534 0( Ihe Califomia Heallh and Sa/ery Code pmvides that the Costa Mesa Fire DepaAment may require the preparation, certification and filing vrith the Fire Deparimenl o( an RMPP by businesses which are requiretl to register acutely hazardous materials wiM Ihe Fire Department. 4. I( an RMPP is presently required, has Sec�ion 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or fuNre building occupant require tor Ihe work which is Ihe suDjecl of Ihis application a permi� for such consUuction or modifcalion from the South Coast Air Quality Management DistdU or (rom any other air pollution control tlistrict or agency? ❑ Yes ❑ No (Section 65850.2 ot the Califwnia Govemmenl CoOe requires that the requested infortnatbn be fumished on appliwtions for non-residential building permits). 6. Will any part o( the laciliry to be constructe0 under Ihis pertnit be within 1000 feel fmm the wter boundaries of a school? ❑ Yes ❑ No Qf yes", the facility must meet the requirement of Sections 25534 and 42303 of lhe Cali(omia Health anC Safety Code). 7. I( a permit lrom the South Coast Air Quality Management DisMct or olher air pollution wntrol tlisMcl or agency is required for the v,nrk which is the subject ol this application, have all of the disclosures prescribed by Calitomia Health and Satety Code Section 42303 been made? ❑ Yes ❑ No 8. Qf yes", altach certificate�o� wmpliance from lhe appropriate air'polWtion tonlrol oKcer). - � CERTIFICATE �OF COMPLIANCE: I certify tFial under penalty of perjury�the information given above is correGL I agree to wmply vrith all slate laws and ciry ortlinances regarding Hazartlous Ma[erials and Emissions. . Date - CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I ceAify untler penalty of perjury that I have read this appliwtion and state that the infortnation given is covecL I agree to comply wi1� all state laws and ciry ordinance5 rela[ing [o building construction, and authorize representative5 of Ihe City of Costa Mesa to enter upon the above-described propeAy for inspection purposes. I agree not to occupy or ellow xcupancy of any building aglliey�d by this ' unti 4iaspection. .�� iD O C� SignaNreofleBalOwner(s) Da�e � Andlor R W hor¢etl Applicanl � CITY OF COSTA MESA � BI/ILDING. D/V/S10N 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 � PERMIT TYPE MECH APN: 42519107 JOB ADDRESS: 377 16TH PL CM Vicinity: DUPLEXAANDB SQ. FT: 0 PERMIT NUMBER: M09-00018 STATUS: ISSUED DATE ISSUED: 02/2412009 ISSUED BY: BJK Suite/Unit: SCOPE OF WORK: DUPLEX UNITS A& B`- - � CHANGE-OUT OF A FAU AND A/C UNIT. 2 HVAC REPLACEMENTS W ITH ENERGY STAR QUALIFIED W ITH A SEER OF 14 OR HIGHER, 2 FAU < 100K BTU,-1 GAS PIPING . � OWNER: BUNTE, CHRISTIAN � � PHONE: 949-285-5651 ' - APpLICANT: BUNTE, CHRISTIAN � PHONE: 949-285-5651 CONTRACTOR: OW NER-BUILDER Adtlress: Unit PHONE: City/State: , ZipCode: MECHANICAL PERMIT FEE SUMMARY MECH ITEM FEE: � $88.65 PLAN CHECK FEE: , , . $0.00 INVESTIGATION FEE: , " $0.00 REINSPECTION FEE: , , � $0.00 TQTAL FEES: $88.65 Address: City/State/Zip: Address: City/State/zZip: 377 16TH PL Unit: � COSTA MESA, CA 377 16TH PL Unit: COS7A MESA, CA License No. 000000 [N��Ri > .:� - � _ � ; �,;� �AY, � � �� ^ �.yu. �� NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulalions. (Ord. No. 92•28, § 1. 1241-92) � EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. . 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 flnal approval must be obtained. Failure to obtain inspections and final approval will result in tha ezpiraGon of this pe� S.Q.OE/ �MSpEClIONiYPE QRyF IN � CppE/ INSPEGIIONTYGE �— 1818 FixeE System Final Fire Prevention 206 Final Mechaniral ��68 PoolSpaFinal 20b Final Re-Roof 201 Final Block/Relaining Wall 202 Final Fattory Fire Place 203 Final Sign 204 Final Demolition 208 Final PlumOirrg 210 Final Eleclncal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Ottupancy . i WOitKERS' COMPENSATION DECLARA710 i hereby aNirtn under penalry of perjury one of Ihe lollowing declarations: ❑ I have and will maintain a certificate of consent to self-Insure for'workers' compensation, as provided for by section 3700 of tha Labor Code, !or the peAormance of t�a work for which this permit is issued. ❑ I have and v.ill maintain v.orkers' wmpensation insurance, as required by section 3700 ot the Labor Cotle, for the peRortnance of the vrork fa which this pertnit is issued. My workers' compensalion Insurance carner and policy number are: Cartier: (Thu sectpn neM rpf De mmpletetlllhe pe�niq is val�etl at one ��rMreO tldlars (5100) wless ) Policy Number: ❑ I certify Iha[ in ihe 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 ihe workers' compensation laws of Califomia, antl agree Ihat if I should become subjecl to ihe workers' compensation provisions of Seclion 3700 of the Labor Code, I shall lorlhwith comply with these pmvisions. ADPlifanfs SignaWre Oale WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALI SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOILARS ($700,000�. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirtn that I am licensed under provisions o( Chapter 9(commencing with Section 7000) of Division 3 of the Business and ProFessions Code, and my license is in full force and eNect. Lic. # Class # Contractor's SignaWre Da�e CONSTRUCTION LENDING AGENCV: ❑ I �ereby affirtn Ihat there is a cons[ruction lending agency fw Ihe peAormance o( Ihe �nork (p wfiich Ihis pertnit is issued. (Sec. 3097, Civil Cotle). Lender's Name: Lender s Atltlress: SigruWre OWNER-BUILDER DECLARATIONS: I hereby aKrtn that under Denalry of p!e J�ury that`I am EXE� P/T FROM T CONTRACTORS LICENSE �AW fo�M1elfollowing�reas�(Sec 7031.5, Business and Professions CotleyAny;dry�o`,county,�wh¢h r uires a pertni[ to construct, atter? improvei demolish, or ,repaiv"-any structure, prior to its issuance, also requires Ihe appliwnt foi'such permit to file a signetl statement that he oi she�.is licensed pursuaN to the provisions o( Ihe Conlractors License Lawp(Chapter 9(commencing with Section 7000) of Division 3 of the Business antl �Professions Code) or that he or she is exempt Ihere(rom and [he basis for the alleged ezemption. Any violation of Section 7031.5 by any applicant (or a permit subjec[s the applicant to a civil penalry of not more than five hundred dollars ($500�.�: ❑ I, as owner of the property, or my employees wilh wages as their sole compensation, WILL DO THE WORK, and ihe stmcWre is not intended or oRered for sale (Sec. 7044, Business and Professions Cotle: The Conlractors License Law tloes not apply to an ovmer of property who builds or improves thereon, and.who does such work himself or herself or through his or her own employees, provitletl that such improvements are not intended or offered (or sale. If, however, ihe builtling or improvement is sold within one year of completion, the owner-builder will have the burden of pmving that he or she did builtl or improve for purpose of sale.). � I, as ovmer of the property, am EXCLUSIVELY CON7RAC71NG WITH ICENSED CONTRACTORS to cons[mcl lhe project (Sec. 7044, Business and Professbns Code: The� contractors License Law dces not apply to an ovmer of property who builds or improves thereon, and v.ho contracts for such pmject with a cmtracta(s) license pursuant to the Contractors License Laws.�. ❑ I am exempt under sec. Business and Professions Cotle for this reason: - SH ure . ' . -Da� i%r� JOS]<fi (3I0]) ,�- - 1 c � Owner ID v,enfieC .e. - properry taa ill or d etl). DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby ceAiFy Ihat no excavation frve (5) or mwe feel in tlepth into which a person is required to descend, will be made in connecibn with wvrk au[honzetl by this permil, and that no building slmcture, scaffdtling, falsev,nrk, or demolition or dismantling Ihereof, will be more Ihan thihy-six (36) feet high. (Chap. 3.2, Grp 2. Art 2, Sec. 341, Title 8. Califomia Administrative Code). ❑ As owner-builder, I will nol employ anyone to do v.ork which would require a permit from the Division ol Industrial Safe�y, as notetl above, unless such person has a permit to do such work (rom the division. AppliWnfs S�gnaWre Date Division ot IndusMal Safely Pertnil Number. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or WWre building occupant need to file antl cenify a Business Plan for emergency response to release or threatened release of a hazardous matenal? ❑ Yes ❑ No (Section 25505 0( the California Heallh and Sa(ery Code requires, wilh some exceptions, Iha[ a Business Plan be fled with Ihe Costa Mesa Fire Department by every business which has al any one time tluring a reported year a quantity of hazardous matenals equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feel of compressed gas at standard temperature and pressure). 2. Does or will Ihe applicant or present or future building occupant need to fle a registration form for acutely hazartlous materials? ❑ Yes ❑ No (Section 25533 of Ihe Cali(omia Health and Satety Cotle, with some exceplions, requires registralion wilh the Costa Mesa Fire Deparlment by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater I�an a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressed gas at slandard temperature and pressure). 3. Does or will the applicant or present or future Duiltling occupant need to prepare an RMPP (Risk Management antl Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the Calitomia Health and Safety Code provitles that Ihe Costa Mesa Fire Departmenl may require Ihe preparation, cerlification antl fling with lhe Fire Department of an RMPP by businesses which are require0 to register acutety hazardous materials with the Fire Departmen[. 4. If an RMPP is presently required, has Seclion 25534 0( Ihe Cali(ornia Health antl Safery CoOe been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or future builtlinq occupanl require !or the xrork which is Ihe subject of Ihis application a permit for such construction or modification from the South Coast Air Quality Management Dislrict or from any other air polWtion conhol districl or agency? ❑ Yes ❑ No (Sectbn 658502 of the Califomia Govemment Code requires that the requested infortnation be tumished on applications for non-residential building pertnits). 6. Will any part of Ihe faciliry to be conslructetl under this permit be wi[hin 1000 (ee[ from lhe outer bountlaries ol a school? ❑ Yes ❑ No pf yes", the facility must meet the requirement oi Sections 25534 and 42303 of the Califomia Health and Safety Code). 7. I( a pertnit from the South Coast Air Dualiry Management DisMct or olher air pollution contml disVict Or agency is require0 for [he work which is Ihe subject of this application, have all of the disclosures prescribed by California Health and Satety Code Section 42303 been made? ❑ Yes ❑ No 8. Qf 'yes", attach certificate of compliance �rbm the appropriate air polWtion coMrol officer). � � ' � CERTIFICATE OF COMPIIANCE: I�certify that under.penalry of perjury the information given above is correcL I agree to comply with all state.laws and city ordinances regarding Hazardous Materials anC Emissions. : CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalry of perjury that I have read this application and state that the information given is correcL I agree to comply with all sWte lav+s and ciry ordinances relating to building consiruction, antl aulhorize representatives ot the City of Cos[a Mesa to enter upon the above-descnbed property for inspection u oses. I agree not to occupy or allow occupancy o( any building autho' hispertni ' inspectjpn. � �.� SignalureollegalOwner�s) Qe1 MCIorAutOmze0A0W�� CITY OF COSTA MESA � BI/ILD/NG DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • vnvw.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 75d-5626 PERMIT 7YPE ELEC APN: 42519107 JOB ADDRESS: 377 16TH PL CM Vicinity: DUPLEX A AND B , I" . i � : 1� ��/��►��11�J��j��1�! 111 '� STATUS: DATE ISSUED: ISSUED BY: Suite/Unit: ISSUED 02I2412009 BJK SCOPE OF WORK: DUPLEX UNITS-A AND.B . . . CHANGE-OUT OF A FAU AND A/,C�UNIT (REAR OF DUPLEX) 2 HVAC REPLACEMENTS WITH ENERGY STAR QUALIFIED WITH A SEER OF 14 OR HIGHER, 2 FAU < t00K BTU -- � _ " . � ELEC: 2 MOTORS LESS THAN 1� HP � - OWNER: BUNTE, CHRISTIAN PHONE: 949-285-5651 �� APPLICAN7: BUNTE, CNRISTIAN PHONE: 949-285-5651 CONTRACTOR: OWNER-BUILDER ' � Address: Unit - PHONE: City/State: . - ZipCode: ELECTRICAL PERMIT. FEES Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $33.00 Reinspection Fee $0.00 TOTAL FEES $33:00 Address: 377 16TH PL Unit: City/State/Zip: COSTA MESA, CA Address: 377 16TH PL Unit: City/State/zZip: COSTA MESA, CA License No. 000000 CELL: � a `.4 � �s ,. aa' . ,3 �',> -:a � irr ��j � e NO710E: 7he work authorized by this permit shall comply with all applicable handicap access requirements under Calitomia statutes and related regulationg. (Ord. No. 92-28. § 1, 12-21-92) � � ' EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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 inspeetions and Flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiratlon of this permit. FpOE /. IN��ON TI'PE 1816 Fined System Final Fire Prevention 1266 Pool Spa Final 200 Final Re•Roo( 201 Final Block/ReWining Wall 202 ' Final Factory Fire Place 203 FinalSign T04 Fiqal Demolition Ji� NlTfilAlS 4� !NS°EClIONTYPE 206 Final Mechanical 208 Final Plumbing 210 FinalElectriWl 212 Final Fire Prevention 220 Final Planning Appmval 222 FinalSi�e 250 Final Building�OccuOancy �Zii��IfiII49 /� .. :..r i . �i WORKERS' COMPENSATION DECLARA710N , I hereby aKrm under penalty of perjury ona of the follovAng tleclarations ❑ I have and will mainlain a certifcata of consent to self-Insure (or vrorkers' compensation, as providetl for by section 3700 of the Labor Code, (or the peAormance of the vrork for which this permit is issued. ❑ I have and will maintain wvrkers' compensation insurance, as requiretl by seclqn 3700 ot Ihe LaDor Code, (w Ihe perfortnance of the work for which this pertnit is issued. My workers' compensation Insurance carrier and policy number are: Carrier: (ihis sed'qn neetl �pf pe cwndefetl d Ma peimR is valuetl af one Iruntlred dollars (5100) w less.) POlicy Number: � I certity that in Ihe peAormance ot Ihe work (or which Ihis permil is issued, I shall not employ any person in any manner so as to become subject to Ihe vrorkers' compensalion laws of California, and agree that if I should become subject lo Ihe vrorkers' compensation provisions of Seclion 3700 of ihe Labor Code, I shall forthwith comply wilh ihese provisions. Appliwnl's Signature Dale 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 DOLLARS ($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 aKrm Ihat I am licensed untler 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 eflect. Lic. # Class # Conlractor's Si8^aWre Oa�e CONSTRUCTION LENDING AGENCY: ❑ I hereby affem that there is a consWction lending agency tw the peRortnante o( Ihe v.ork (or v.fiiCh this pertnit is is5ued. (Set. 3097, Civil Code). Lender's Name: Lender's Address: OWNER-BUILDERDECLARATIONS� �-�� (�f `� I hereby aKrtn that under penaltyyy of pepury,rhat I am EXEMPT FROM THE CONTRACTORS LICENS6 LA�forgthe`°"fQllowirVg reason (Sec. 7037.5, Business and Professions�tle.,Any ciry oc „counry which requires a permit lo consWct, alt mprove, d'emolisli;�o�epair any slrocture, prior to its issuance, als reqwres the app�icant'for such permit to file a signed statement Uiat he or she licensed pursuant to the provisions of the Contrdctors License Law (Chaptei�9 (commencing with Seclion 7000) of Division 3 of t�e Business antl Professions Code) or Ihat he or she is ezempt thereGom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a pertnil subjects the applicant to a civil penally of not more than five huntlred dollars ($500).): ❑ I, as ovmer of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and Ihe slructure is not in[ended or oHered tor sale (Sec. 7044, Business and Professions Code: The Contractors License Law dces not apply to an owner o( properry who builds or improves thereon, antl who does such work himself or herself or through his or her ovm employees, provided that such improvements are not intended or oReretl for sale. If, however, t�e buildinq or improvement is soltl within one year of completion, the owner-builaer will have the burden of proving lhat he or she �did not uild or improve for purpose of sale.). s owner of Ihe prOpehy, am EXCLUSIVELY CONTRACTING WITH v LICENSED CONTRACTORS b cons[ruct the project (Sec. 7044, Business antl Professbns Cotle: The conl2ctas License Law tices not apply lo an ovmer ol property wfio builds or improves Ihereon, and who contracts fw such prqect v,ilh a contracta(s) license pursuant ro �he Contractas License laws.). ❑ I am exempt under sec. Business and Protessions Code for this reason: ��a,�.� � � ,a . — 305]-A6(3IOl) " � r- � Owner ID verified by A� , i.e. - property tax bil y deed): DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: � ❑ I hereby certify that no excavation (rve (5) or more (eet in depth into wfiich a person is required to tlescend, will be made in connec[ion wi�h wnrk authorized by t�is pertnit, and ihat no building strucWre, sc�tdding, falsework, a demolition or dismantling thereol, will be more than thirty-six (36) fee[ high. (Chap. 32, Grp 2, Art 2, Sec. 341, Tlle 8, Califomia Adminisl2tive Code). ❑ As owner-builder, I will not employ anyone to tlo work which would require a permil from the Division of Industrial Safely, as noted above, unless such person has a permit to do such work from �he division. Applipnts Slgnalure Division o( Industnal Safely Permil Number: _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or fuNre building occupant need to file antl ceAify a Business Plan tor emergency response lo release orthreatenetl release of a hazardous matenal? ❑ Yes ❑ No (Seclion 25505 of the Calitornia Health antl Sa(ety Code requires, wilh some exceptions, that a Business Plan be filed with the Costa Mesa Fire Departmenl by every business which has at any one time dunng a reported year a quantiry ot hazardous matedals equal ro or greater than a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic fee� o( wmpressed gas at standard temperalure and pressure). 2. Does or will ihe applicant or presenl or fulure builtling occupant need lo fle a registration form tor acutely hazartlous materials? ❑ Yes ❑ No (Section 25533 0( the Cali(omia Health and Safety Code, with some exceptions, requires regislretion with �he Costa Mesa Pire Department by each business which at any one time has on hand a quantiry o( acutely hazardous materials equal to or grea[er than a v.Qight o( 500 pounds, or a volume o( 55 gallons, or 200 cubic fee� of compressetl gas a� standartl temperature antl pressure). 3. Does or will Ihe applicant or presenl or (uture building occupant neetl to preDare an RMPP (Risk Management antl Prevention Program for acutely hazardous materials�? ❑ Yes ❑ No (Seclion 25534 0( the Califomia Health and Sa(ely Code provides Ihat the Costa Mesa Fire Depariment may require lhe preparation, certifica[ion antl �fling with the Fire Depatlment of an RMPP Dy businesses which are required �to register acutely hazardous materials wiN the Fire �epartment. 4. I( an RMPP is presently required, has Section 25534 of Ihe California Health antl Safely Cotle been fully complied vrilh? ❑ Yes ❑ No 5. Does or will the applicant or present or fulure building occupanl require for the work which is Ihe subjecl of lhis application a permit for such wnstruction or modi(cation from the South Coasl Air Qualiry Management District or from any other air pollution conirol distnct or agency? ❑ Yes ❑ No (Seclion 658502 ot ihe Califomia Govemment Code requires �hat the requested information 6e fumist�ed on appliwtbns fa ron-residential building permits). 6. Will any part of the facili�y to be constmcted under this pertnit be within 1000 leel from the outer boundades ot a school? ❑ Ves ❑ No Qf yes", the faciliry must meet the requirement of Sections 25534 and 42303 of the Califomia Health antl Safety Cotle). 7. If a permit fmm the South Coast Air Qualiry Management District or other air pollution control tlistrict or agency is required for the work which is the subject of this application, have all of the disclosures prescnbed by Cali(omia Health and Safety Code Seclion 42303 been made? ❑ Yes ❑ No B. pf "yes", attach certificate of compliance from ihe appropriate air polWtion control oKcer). � � � . CERTIFICATE �OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct I agree to comply with all state lavrs and city ortlinances regar0ing Hazardous Malerials and Emissions. � CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:� I certify untler penaliy of perjury tha� I have read this application and state Ihal the information given is correct. I agree to comply with all stale laws and ciry ordinances relating to building constmction, and authorize representatives of the Ciry of Costa Mesa to enter upon the above-described property for inspection pur oses. I agree not to occupy or allow occupancy of any building author is pe�4up�llWa�l i ecl — , ,� ��S/'f. � FJa��U Signalu egal eqs) � DAt � AnElor Aul�onzed AOPliwni Dale ` �! +. • CITY OF COSTA MESA BlIILDING DIVISION 77 FAIR DRIVE, COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • wv+w.ci.costa-m�'sa.ca.� FOR INSPECTIONS CALL: (714� 754•5626 PERMIT TYPE B_ROOF2 APN: 42519107 JOB ADDRESS: 377 16TH PL CM Viciniry: Squares: 0 PERMIT NUMBER: 608-00299 STATUS: DATE ISSUED: ISSUED BY: Suite/Unit: Valuation ISSUED 10/20/2008 KJB $7,000.00 SCOP� OF WORK: TEAR OFF EXISTING ROOF. REPAIR/REPLACE SHEATING AS NECESSARY. INSTALL FELT AND TWO LAYERS OF 30 YEqR COMP SHINGLES. ROOF PITCH IS 4:12. - OWNER: HOLESTINE, JOSEPH . , PHONE; APPLICANT: KIM MCCLAIN PHONE: 7'14-897•1780 -� -- CONTRACTOR: MCCLAIN ROOFING INC Address: 12812 VALLEY VIEW STUnit: Ciry/State/Zip: GARDEN GROVE CA 92845 ARCHI7ECT: - ENGINEER: � - FEE SUMMARY Address: 377 16TH PL City/State2ip: COSTA MESA�, CA Address: 12812 VALLEY VIEW ST City/State/Zip: GARDEN GROVE, CA STE 33 License No. License No. Reroof Plan Check: $0.00 .. RerooF permit Fee: � $139.25 - � ' . � , � . Reinspeclion Fee: '$0.00 � > TOTAL FEES $139.25 " � � � Unit Unit: :STE 33 ^'1 _ :> .. License No. 625013 PHONE: 714-897-1780 CELL: PHONE: PHONE: � .,'.k,_RS�P J�li: , S7E 3 ; NOTICE: The work authorized by this pertnit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) - EXPIRqTION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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 lo obtain fnspectlons and final approval will resull in the expirah'on of ihis permit. sooe�, ixsvEcnoNrne onre �_§ f�� INSPECTIONTYPE o1Lg INIIMlS 7878 Fixed System Final Fire Prevention 206 - Final Mechanical '" ' 1288 Pool Spa Final �� 208 Final Plumbing - � 200 Final Re-Root rJ � 210 Final Electrical 201 Final BIocWRetaining Wall 272 Final Fire Prevention 202 Final Faclory Fire Place 220 Final Planning ApP��al 203 Final Sign 222 Final Site 204 Final Demolilion 250 Final Builtling/Octupancy WORKERS'COMPENSATION DECLARA770� I hereby a�rm und enalty of perjury one of the follaxing declarations: ❑ I have and wi naintain a ceAificate o! consent to self-Insure for workers' compensation, as rovldeCW(or by sec0on 3700 ot the Labor Code, tor the ec orma�nce o1 [he work for whlch this permit Is Issued. ve and will mainlain workers' compensation insurence, as requiretl tiy n 3700 of the Labor Code, for the peAortnance of Ihe work' for which this pertnit is issuetl. My workers' compensalion Insurance carrier and policy numberare: r, 7� �) carrier: i'i��%`- �l/�%� (inis seCun nee0 rwt be mmple�teI0 AMe perma k val✓eC v1 one nun .eotl"tlollarsi(St00) o� less.) Policy Numbe[ I� I �/ 1L v' Z OD �L�� g/ /✓U ❑ I certify that in the peAormance oF the work for which this permit is issued, I shall not employ any person in any manner so as to bewme subject to the workers' compensation laws of Califomia, and agree that if I should become subject to the vrorkers' compensation provisions of Section 3700 of [he Labor qC/o�e, I shall forihwith wmply with ihese provi �ons. L J'��,. `Applicanl's Signaw�e � -_Oa � .m.i�--' WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IM'EREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm [hat I am IicenseC under pmvisions of Chapler 9(commencing with Section 7000) of Division 3 o( Ihe Business and Professions Cotle, antl my license is in full force and ef(ect. Lic..#� . .2 � � . ..��ass.# n . �}!] � � .�. . �Conv�nor'sSignawm (_ ate_. CONSTRUCTION LENDING AGENCY: ❑ I �ereby affirtn that there is a constructbn lending agency for the peAortnance of the work for v,hich this pertnit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Signalure Oale OWNER-BUILDER DECLARATIONS: I hereby aKrm that under penalty of Derlury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe follovnng reason (Sec. 7031.5, Business and Pro(essions Code: Any city or counry which requires a permit to construct, aller, improve, tlemolish, or repair any slructure, prior to its issuance, also requires lhe applicant (or such permit to fle a signed statement that he or she is licensetl pursuant to the provisions of the Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Pmfessions Code) or lhat he or she is exempt there(rom and the basis for the alleged ezemption. Any violation of Section 7037.5 by any applicant for a pertnit subjects the applicant to a civil penalry of nol more than five hundred dollars ($500).): ❑ I, as ovmer of the properry, or my employees with v2ges as their sole compensation, WILL DO THE WORK, and Ihe strucWre is nol intentled or oRered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law dces not apply to an ovmer of properry who builds or improves thereon, and who dces such work himsel( or herself or lhrough his or her ovm employees, provitled ihal such improvements are nol intended or oRered for sale. If, however, Ihe builtling or improvement is sold wilhin one year of completion, the owner-builder vrill have the burden of proving that he or she did not build or improve for purpose of sale.). ❑" I, as �ovmer of t�e propeAy, am EXCCUSIVELY CON7RACTING WITH LICENSED CONTRACTORS to constmcl lhe project (Sec. 7044, Business and Professions Code: The contractas License Law dces nol apply to an owner of properry who builds or improves thereon, and who contracls fa such pmject vrith a contracta(s) ticense pursuant lo the Contractars License Laws.). ❑ I am exempt under sec. Business antl Professions Cotle lor this reason: Signalore 3051�n6(3/0]) Owner ID veri�ed by drive�ense. ❑ Yes [, No � Driver s License No. Expires: � Verification of Ovmership by (type of document, i.e. - property taic bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: . ❑ I he2by certNy that no excavation frve (5) or more feet in depth into wfiich a person is required lo tlescend, will be made in connectbn with work auttqrizetl by this permit, antl thal no building struclure, sca((dding, (alsevrork, a demoli�ion or dismantling ihereof, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2. M 2. Sec. 341, T�le 8, Califwnia Atlminist2tive Code�. ❑ As owner-builder, I will not employ anyone to do work which would require a permit trom the Division ot Industrial Sa(ety, as noted above, unless such person has a permit to do such work (rom Ihe division. Ap0licanl'S SignaWre Date Division o( Intlustrial Safely Pertnit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: ' 1. Will the applicant or presen[ or future building occupant need to file and cerlify a Business Plan for emergency response [o release or threalenetl release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the Califomia Health and Safely Code requires, with some exceptions, that a Business Plan be fled with the Costa Mesa Fire Department by every business which has at any one time during a reportetl year a quantily of hazardous materials equal lo or greater than a v+eight of 500 pountls, or a volume ot 55 gallons, or 200 cubic feet of wmpressed gas at slandard temperature and pressure). 2. Does or will the applicant or presenl or (Wure building occupanl neetl to file a registration (orm for acutely hazartlous ma�erials? ❑ Yes ❑ No (Section 25533 0� the Califomia 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 pounes, or a volume of 55 gallons, or 200 cubic (eet o! compressed gas al standartl temperature antl pressure). 3. Does or will [he applicant or present or fuWre builtling occupant neetl to prepare an RMPP (Risk Management and Prevention Program (or acutely hazardous ma[erials)? ❑ Yes ❑ No (Section 25534 of the Califomia Health and Safety Code provides that Ihe Cosla Mesa Fire Depatlment may require the preparatioq certification and filing wi[h the Fire Department of an RMPP by businesses which are required b reqister acutely hazardous matenals with Ihe Fire Department. 4. If an RMPP is presenUy required, has Section 25534 of the California Health and Safe[y Cotle been fully complied with7 ❑ Yes ❑ No 5. Does or will the applicant or present or (uWre building occupanl require for the vrork which is the subject of ihis application a permit for such consimction or modification from the South Coast Air �ualiry Management Dislrict or from any other air�pollution control disMct or agency? ❑ Yes ❑ No (Section 658502 ot the Califomia Govemment Cotle requires lhat the requested information be fumishetl on applications fa rron-residential Duiltling permits). 6. Will any part of the faciliry lo be consWctetl untler this permit be within 1000 Feet from the ouler boun0aries of a school? ❑ Yes ❑ No Q!'yes", the facility must meet the requiremen� of Sections 25534 and 42303 of the Calitomia Health and Safely Code). 7. If a pertnit from the South Coast Air �uality Management Dislnct or other air pollution control tlistrict or agency is required for the work which is the subject o( this application, have all of the tlisclosures prescribed by Calilornia Health and Safery Code Section 42303 been matle? ❑ Yes ❑ No � 8. Qf'yes", attach certificate o! compliance from the appropriate air pollution control officer). . , . ' - . . " ' CERTIFICATE OF COMPLIANCE: I certify that untler penalry.o( perjury lhe infortnation given above is correct. I agree to comply, with all slate laws and city ordinances regarding Hazardous Materials and Emissions. �� CERTIFICA7E OF COMPLIANCE AND AUTHORIZATION OF ENTRV: 1 certify under penalty of perjury that I have reatl this application and sWte that the information given is wrtect. I agree to comply with all state lavrs and city ordinances relating to building construction, and authorize representatives ot the City of Costa Mesa to enter upon Ihe aDovedescribed propeAy for inspection purposes. I agree nol to occupy or allow occupancy of any building/ authorized by this permi[ until final inspection. SignaWreolLeqalOwner(s� Date —� /l�i��— — la 2c�- , AnOlwAul�onzetl AOOliwnl , � Dale _ �,�.�_� —..__ _ GENERAL CONTAACTOR Owner/Sldr. AP.No.117-271-ib LOT THACT IN�PECTIONS y,�7�(ja I DATE DATE PERMIT SUBCONTRACTOR I PERMITSISSUED _ -ii-c•o —V-dr�A"�. I J -/o-bo F- ne and Flashing e S— 1 ng,In d7l,i' Out S'^�9-6' Plaster. brown coat /J . �n'J @— > -- � n OCCUPANCY Form 210-SM-11-59 5•B P 1159� �� COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 COSTA MESA. CALIFORNIA For Applieant fo Fill In Complefely TYPE OR PRINT ,,/ ADDRESS � / / / �/�! ��.._. •- ---�" T � COSTA MESA. CALIFORNIA i OWNER c Ao REs� l990�- �,.. .h.�, 0 STATE TEL. LIC. NO. NO. SIZE �3 X I I 1 7� I NO. OF BLDGe� OF LOT NOW ON LOT USE OF �y��_ - EXISTING BLDG. BETBACK LINe FROM � CeNTER oF 6TREET �O REAR YAR� �� Y� � 51DE YARD LEFT e� RIGHT � DESCRIPTIOId OF WORK ISZFDING f�� '�� .�� i7/�^`' u��- FiNANCE DEPT. APPLICATIONCF��R rP�R�vIIT BUILDING � For Offiee Use Only RECEIPT NO. I P¢RM'. I_ RECEIVED BY DATE HECENED T i !�'" ' - �7-�D � �� , BUILDING � �% �f _ // //� ADDRESS / � �' •(. COSTA MESA. CALIFORNIA APPROVED LEGAL rvo.oF use oF rueis � eminm LINE 9T.) APPROVE��, � � �� f V Y .�- (/ (� ' O ✓,-IG;N ' � %h�li '�7 1 HEREBY ACKNOWLEOGE THAT 1 HAVE REAO THI6 APPLIGTION THE AMOONT 6XOWN ONDER VALII l AND 9TqTE THAT THE ABOVE IS CONRECT AND AGREE TO COM- pUPPO6E OF ESTABLIBHING A PER PLY WITH All. CITY ORDINANCE6 AND BYATE LAWB fiE(iULATiNG BUILDING CONBTROCTION. VALUATION 61GNATURE OF j "' � PERMIT FEE PERMI7TE �; $ � � ��„� PLAN CHECK AIJTHORIZED AGENT iOTAL FEE , � d I6 POR THE � � _��'�� PEE ONLY. �/ H �20 5� p