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HomeMy WebLinkAbout145 23RD ST - Building Permits CITY OF COSTA MESA 74i ►- BUILDING DIVISION :�. .A DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT �• � /05-01421 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.JLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 145 23RD ST Status: ISSUED Suite: Applied: 08/24/2005 Vicinity: Issued: 01/03/2006 Primary Occ: R3 Type of Construction: V-N Parcel Number: 42605410 Zoning: Applicant: JIM CEFALIA Address: 930 W OCEANFRONT Phone: 949-933-7986 ISSUED BY: - K NEWPORT BEACH Zip: 92661 Owner: JIM CEFALIA Address 930 W OCEANFRONT Phone: 949-933-7986 NEWPORT BEACH Zip: 92661 Contractor: OWNER-BUILDER Address: Phone: Zip: License: 000000 Arch : PETE VOLBEDA Eng: Address: 615 N BENSON AV Address: UNIT C Phone: 909-373-1150 Phone: UPLAND,CA Zip: 91786 License: C13077 License: SCOPE OF PERMIT NEW 2953 2 STORY SFD WITH 490SF ATTACHED GARAGE AND 98 SF FRONT PORCH.3 BEROOMS AND 1 OFFICE. REF:PA-05-07 AND G05-00025 BUILDING HEIGHT:26 FT OPEN SPACE:48% REAR YARD LOT COVERAGE:25% #PARKING SPACES:4(2 COVERED,2 OPEN) FEE SUMMARY Plan Check: $331.66 Calc Valuation: 5286,441.96 Permit: $2,040.95 Claim Valuation: 50.00 SMIP Res: $28.64 SMIP Corn: $0.00 Other $0.00 Inspection: $0.00 Total: $2,401.25 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 20-0 Rear 12-0 Left 5-0 Right 5-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 4 Proposed: 4 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calif/ia statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void If work is not commenced within 180 days,or it wo is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply�th all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result"In the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 /- 2448-46(6/00) • I WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: r • ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carder and policy number are: Cartier: Policy Number: (This section need not be completed it the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML RUES UP TO ONE HUNDRED THOUSAND DOI.LARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE.INTEREST.AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencng with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.q Class 0 Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5.Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): El I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). Rl I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions TCode:The Co. . tors License Law does not ap.k. •an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pur ant o the Contras• Licen ...roe . ■ ex, pt der se .__ Business and Professions Code for this reason: • ` .. ire): 6 C Owner ID led by driver;„,. - :. .7....-‘ ❑No • a- ' : se No. Sas: y O1Y V: ' on of Ownership by(type of document, ...-property tax bill or dee. : ....- DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made In connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2.Sec. 341,TItle 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file end certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be tiled with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). _ 2 Does or will the applicant or present or future building occupant need to tile a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health end Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application agermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes LU No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (It Nee,the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). ___...._..i.__ __._._ _._ _ which is the subof..—. 7 application,If a permit from the South Coast res QualitycedManagement is Healtheal or and Sr airpollution coon 4l 303 been or agencye? Le-required for the work which is the subject of this have all of the disclosures prescribed by California Safety Code Section 42303 made? ❑Ves ❑No 8 (If yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Sigr(atur eget Owner ) ( Date And/Or Authorized Applicant Date CODE I gISPEC11eN TYPE DM IN1flIbS LODE I INSPECIION TYPE Oa IHIIIIMS 1616 Fixed System Final Fire Prevention 206 Final Mechanical _ 1266 Pool Spa Final 208 Final Plumbing - 200 Final Re-Root 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval - 203 Final Sign � 222 Final Site - 204 Final Demolition -�! 250 Final Building/Occupancy 01 -04-2.3Co, 11 .54 << • 001 :�Ls:..54^1,=. _ . NEWPORT-MESA UNIFIED SCHOOL DISTRICT No 5693 CERTIFICATE OF COMPLIANCE OF DEVELOPMENT FEES PURSUANT TO AB 1600 AND AB 181 To: (City of Costa Mesa District Receipt No 12382 ( ) ity of Newport Beach p,, ( ) County of Orange Plan Check Nobz--iwz/ Applicant (II N C != A l 'A Address: l/_ _ r .7'3 13E4 CEJ eA4 T O 6 Z 1 Telephone Number: /J Tract/Parcel and Lot Number(s): —1 —' 0 3T -/LD Location of Project: C 3 23 4-11 Number of Square Feet of Residential Space 62 x $1.84 Total ?' S7 f 33. Commercial and Industrial Space x $ .30 Total Commercial/Industrial Project is: (Check One) Warehouse _ Motel _ Preschool R & D _ Bank _ Auto Repair Movie Theater _ Neighborhood Shops _ Hospital Mini-storage _ Racquet/Health _ Large Office Heavy Industrial _ Hotel _ Office Bldg. Regional Shops _ Medical Office _ Restaurant Light Industrial _ Office Park _ Fast Food This project is exempt because This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code sections 53080 and 65995. The Building Permits for this square footage in this proposed development may now be issued by your jurisdiction. Checks are to be made payable to Newport-Mesa Unified School District. By: ///7:) /C214& Authorized Represents The above representation as to square footage is true. Applicant agrees that if it is later determined that such representations are not true,then this certificate shall automatically terminate and the appropriateCity/Cobe.. . . . fled. Date: //�o6 j.. L Qti ROBIN B. HAL_LRS & ASSOC., INC. ...,4 E. 17TH ST., SUITE 205 R6/ CIVIL ENGINEERS • PLANNERS ' SURVEYORS COSTA MESA, CA 92627 949/548-1192 FAX 949/548-6516 SOS tzj December 27, 2005 City of Costa Mesa Building Dept. 77 Fair Drive Costa Mesa, CA 92628 nit 1 Attention: Grading Inspector, /01;r) r Subject: Rough Grade Certification ,��P// I `{ ' Reference Project: �+ 'y_ Address: --le, 147 23"t Street, Costa Mesa Rough grade for the building pads has been completed substantially in conformance with the approved Grading Plan for the two new residences as determined on December 27, 2005. Sincerely, QAOFESS/0.: b1 /, R bin B. Hamers ROE31 20 Registered Civil Engineer sEXPlo /L 2006 RCE 31720 it s} ` ,x4). leOF CALIFOP�\ O41U MFS CITY OF COSTA MESA y ,�° BUILDING DIVISION • *4__ 4 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER f: w�,r_ a PERMIT . #' /E06-00412 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesate.fTRICAL PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 145 23RD ST tL Status: ISSUED Suite No Applied: 05/03/2006 Vicinity: NEW HOUSE Issued: 05/032006 Parcel Nunmber: 42605410 Applicant: CRAIG SHEA Address: 25642 SALERNO WAY Phone: 714-692-8690 ISSUED BY: YORBA LINDA,CA Zip 92687 Owner: JIM CEFALIA Address 930 W OCEANFRONT • Phone: 949-933-7986 NEWPORT BEACH Zip: 92661 Contractor SHEA ELECTRIC Address: 25642 SALERNO WAY Phone: 714-692-8690 YORBA LINDA,CA Zip: 92687 License:404697 SCOPE OF PERMIT ELECTRICAL PERMIT FOR NEW 2953 2 STORY SFD WITH 490SF ATTACHED GARAGE AND 98 SF FRONT PORCH.3 BEROOMS AND 1 OFFICE. , REF#:B05-001421 WORK TO INCLUDE: 1 RES NC PACKAGE,65 LIGHT FIXTS,60 OUTLETS,70 SWITCHES, 1 SERVICE TO 200A. FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 • Temp Dist System/Lighting $0.00 0 • Temp service test $0.00 Busway/100 ft $0.00 0 Res.a/c package $54.50 Standing Section $0.00 0 New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 New Res(3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0 Lighting Fitts $54.85 65 up to 50 kva/kw $0.00 0 Recept Outlets $51.20 60 up to 100 kva/kw $0.00 0 Switches $58.50 70 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00'- 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $30.50 • . 1 Misc.Conduit $0.00 0 Service to 1000a $0.00 0 . Misc.Conductor $0.00 0 .Service over 1000a $0.00 0 - Circus(gen or ride) $0.00 0 Motors to 1hp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $273.05 Intermed Pole $0.00 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1,12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 - 244&48(8N0) WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: - • - • • ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. ❑ I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is Issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ "I certify that in the perform cool the work for which this permit Is issued,I'shall not employ any person in any manner so as to become subject to the workers' " compensation laws of f rnia,and,ggr hould become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pro si /�— r - Applicant Signature: f _ Date: C. WARNING:FAILURE TO SECU WORKERS'O MPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOI I ARE($100,000).IN ADDITION THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed and pr visions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lii'#-. /l `jb 4 Klass N ( —/0 'Connector's Signature: / \ Date:. - ^3 -0(. CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she Is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500).): ❑ I,as owner of the properly,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to en owner of properly who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement Is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). El As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Flre Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Us Yes ❑No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ..._ �..-...._ _ _. 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of Ws application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penally of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given Is correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Ape ^ .gn31u =Of Legal Owner(s) Date - C��rr u adz,:Applicant )Date - CODES , tIN t' PATE • IKTITIALS ' CODES INSPECTION TYPE MTF ICBM 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1268 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy • A MF CITY OF COSTA MESA _ -..' BUILDING DIVISION Y •1 �„' r -- DEVELOPMENT SERVICES DEPARTMENT , P MIT NUMBER '1 w.ws.• I - PERMIT 06-00254 %).4., o. cu (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 145 23RD ST Status: ISSUED Suite No Applied: 05/08/2006 Issued: 05/08/2006 Vicinity: „...i Parcel Number 42605410 ISSUED BY: / r A • Applicant: MAYER, RICHARD Address: 26752 VIA LINARES Phone: 949-768-4675 • MISSION VEIJO,CA Zip: 92691 Owner JIM CEFALIA Address: 930 W OCEANFRONT Phone: 949-933-7986 NEWPORT BEACH' Zip: 92661 • ' Contractor PLAYA HEATING AND AIR CONDITIONING • Address: 26752.VIA LINARES ' Phone: 949-768-4675 MISSION VEIJO,CA Zip: 92691 License:735483 SCOPE OF PERMIT INSTALL 1 FAU>100K BTU, 1 FACTORY FIREPLACE, 1 HOOD W/MECH EXHAUST, 1 3 TO 15 HP COMPRESSOR/ABSORPTION SYSTEM,AND 2 VENT FANS. REF.:B05-01421 FEE SUMMARY Quantity ' - - Quantity ISSUE FEE $23.50 - -- . Repair/Alt Absorbtion Unit $0.00 0 Inst FAU<100 k BTU $14.80 1 Repair/Alt Refrigeration Unit $0.00 0 Inst FAU>100 k BTU $0.00 0 Ventillation System $0.00 0 Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0 Inst/Rep.Recess Wall Htr $0.00 0 - Commercial Incinerator $0.00 0 Refrig Sys<100 k BTU $0.00 0' - - ' `--" 'Dbmestic Incinerator $0.00 0 Refrig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems Gas Piping $0.00 0 Up to 3 hp/100 k BTU $0.00 0 Factory Fireplace $10.65 1 3 To 15 hp/500 k BTU $0.00 0 Hood w/Mech Exhaust - $0.00 0 15 To 30 hp/1,000 k BTU $0.00 0 VAV Box $0.00 0 30 To 50 hp/1,750 k BTU $0.00 0 Vent Fan/Single Duct $14.50 2 . Over 50 hp/Over 1,750 BTU $0.00 0 Appliance $0.00 0 Boilers Fire Dampers $0.00 0 - . Up to 3 hp. $0.00 0 Smoke Dampers -$0.00 0 - - 3 To 15 hp $27.15 1 Inst or Relocate Appl Vent :$0.00-' 0 - • 15 to 30 hp $0.00 0 Air Handlers< `10000cfm $0.00 . 0 ., 30 to 50 hp $0.00 0 Air Handlers> 10000cfm , $0.00 .. 0 . Over 50 hp, $0.00 0 Floor Furnace $0.00' `0 - Other Mechanical Fee Floor or Suspend Heater, $0.00 .0 - Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES. $90.60 COMMENTS/SPECIAL CONDITIONS / NOTICE: The-work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. - / INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all` required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permiL, FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) DECLARATIONS I WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: - • ❑ ,1 have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. (.4 I pave and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. I My worker '. ^�enation Insurance carrier and policy number are: _ ...aria: r-7TZ VPI► ,,;Policy Number: — c2.(( i fl I� —69 I section need not be c plated i/the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the p rmance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws f alifornia,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these, inions. -c-- � �� cc 9� � pplt anC:Signature:` Y✓-- 'Spate' . RNINUP tH fj SAND D URE TO SECURE WORKERS'ITIOTo T COMPENSATION CO MPENS IS UN,DAMAG AND SHALL SUBJECT I AN SECTION TO F HECRIMINAL PENALTIES AND FINES TO N ONE HUNDRED USAND DOLLARE($100,OW),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060E THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACT S DECLARATION: 1 her y effvm that I em Ir tit r,prpyisions of Chapter 9(commencing with Section 7000)of Division htBusine anQ Professions Code,and my license is in full orde Otl eflect'L'ibp!` yU( Clain- `<e,[ Iseettclot sTsgnalure - let(e )1-6 C, CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any Violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work - himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ' ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions - Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. El Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or prevent or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or prevent or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? El Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes LI No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑No ....... .,. 8 (If'yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials end Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-describ property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature 01 Legal Owner(s) O ea Snt./sE rfApthprizdd Applicant kL_ La.,4 ,:. ;e7ri----- _m^— CODEX, IfISPECT10NTYPE DATE INTITIAL$ - CODE I INSPECTION TYPE DATA ditS 1616 Fixed System Final Fire Prevention 206 Final Mechanical / � r • 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall212 Final Fire Prevention 202 Final Factory Fire Place - - 220 Final Planning Approval ,. 203 Final Sign 222 Final Site 204 Final Demolition ,.. 250 Final Building/Occupancy CITY OF COSTA MESA 4fl BUILDING DIVISION };j r ;,,, ..t DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER ea anPERMIT i"� P06-00023 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 145 23RD ST Status: ISSUED Suite No Applied: 01/12/2006 Issued: 01/12/2006 Vicinity: Parcel Nunmber: 42605410 Applicant: MIKE GROGAN ISSUED BY: PP Address: 307 16TH ST APT 5 Phone: 714-206-4135 HUNTINGTON BEACH,CA Zip: 92648 Owner: JIM CEFALIA Address 930 W OCEANFRONT Phone: 949-933-7986 NEWPORT BEACH Zip: 92661 Contractor: MIKE GROGAN PLUMBING Address: 307 16TH ST APT 5 Phone: 714-206-4135 HUNTINGTON BEACH,CA Zip: 92648 License: 853540 SCOPE OF PERMIT PLUMBING PERMIT FOR NEW 2953 2 STORY SFD WITH 490SF ATTACHED GARAGE AND 98 SF FRONT PORCH. REF#:B05-01421 . WORK TO INCLUDE:2 BATHTUBS, 1 DISHWASHER,1 GAS(OVER 4 OUTLETS), 1 GAS SERVICE, 1 LANDSCAPE IRRIGATION, 1 SEWER CONNECT, 1 SHOWER, 1 KITCHEN SINK,5 WASH BASINS, 1 WASTE AND VENT SYSTEM,3 WATER CLOSETS, 1 WATER HEATERNENT AND 1 WATER SERVICE. FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $14.80 1 Swimming Pool $0.00 , 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $19.60 2 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $49.00 5 Dishwasher $9.80 1 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain,Floor $0.00 0 Sewer Connect $24.65 1 Waste and Vent System $9.80 1 Drain,Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $29.40 3 Drain,Roof $0.00 0 Shower $9.80 1 Water Heater/vent $12.30 1 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink,Floor $0.00 0 Water Service $9.80 1 Gas(1-4 outlets) $0.00 0 Sink,kitchen $9.80 1 Water Softener $0.00 0 Gas(Over 4 outlets) $1.10 1 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $9.80 1 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $233.15 rAMMCMTQ /eDGrIAI rf1NIlITIflMQ NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is ended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must co with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval wig suit in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 244646(6/00) WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: 0 I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed it the permit is valued at one hundred dollars($100)or less.) ----ar C -❑ I certify t{iabin the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisi ns. Apr ntslg : i� /� pt6 e: 0 6 1 _LNARNINO! AF ILURE TO SECURE WORKERS'COM/PBNSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(S1o0,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: 1 he :b affirm that I am liceo, ed oder pro sions• Chapter 9(commencing with Section 7000)of Division 3 of the Business d Professions Code,and my license is in full force and dffect..L c.Nd• a. c ass p Conirgctbr's SI eture: /I/ ka T").2 tr CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: _ Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • ❑ I,as owner of the property,em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,ialsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. • Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25506 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP Is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes U No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Cafe). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPUANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. SinatureOf Legal Owner(s) Date \ AnG/ r`u odzed Ica t Date— OWE A INSPECTIOtatil DDTE INTITIAL5 SODE0 INSPECTION TYPE gAg � 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing (// ZtI t 200 Final Re-Roof _ 210 Final Electrical 201 Final Block/Retaining Wall _ 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval _ 203 Final Sign _ 222 Final Site 204 Final Demolition 250 Final Building/Occupancy