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HomeMy WebLinkAbout2588 NEWPORT BLVD - Building Permits BU.—DING AND SAFETY DIVISi`.N FIRE DAMAGE INSPECTION REPORT Q p (Required Prior � To Permit Issuance) Address: 2 c V O q ,V?c 'pv✓ f /✓�[/ Q Unit: a 4 Owner: 1 "elr Y evrine — M1? pev,4e (o *-f'71 . .dye. Owner's Address (if different from above): /2-/f Lir 't4. Co FL,N e ( Pei f errs //el ,51 . Cd. Street 3 /0 3 _ %I Q City State 017c, gi Structural permit required. 9 ® Repair or replace as necessary. — Plans required.— 1-rpt fs j /� Comments: 0A N-r a 5 P ry w i if - /` vcc a , tfi //v/L-c wa 1,tr cross//ilei l ✓'k/ cc L7G.r-• 4 �l� 't'a f/ / /Lr f,,c { ojS, A/t /L - , 4,5 _ C `c PeiA, o P✓µ , F t, 44- / i4yec . "vice- too ifft-e . 'RI Electrical permit required. 12 Repair or replace as necessary. le/ Comments: 1711- I f Cr l(t, t o kr u r' i/e . ( ,/'f �l - G /I (c 4 di e� / ire 4, , Ic cc,f ® Plumbing permit required. Repair or replace as necessary. �J / Comments: oOSSi `jl .e lGw�- l� et 'nli 'M GAC,.0 fkn cn l / t c f -e C �� ' 1 Z5 b3- ,• r ❑ Mechanical permit required. El Repair or replace as necessary. flat ar �0 Comments: �� ajoi ////: �• jz i w #,yok. 12-i- ( -7/g - 74 y_ 5-6 / 7 Inspector Date Phone 1872-46 Triplicate'Original-Owner;Yellow-Contrator; Pink-Building Division yip if CITY OF COSTA MESA 4 966@ BUILDING DIVISION H �I DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER v PERMIT dC M02-00212 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 2588 NEWPORT BL Status: ISSUED Suite No Applied: 05/28/2002 Issued: 05/28/2002 Vicinity: Parcel Number: 43917114 ISSUED BY: Applicant: MASCIALE, FRANK Address: - - - Phone: 714-612-3875 • Zip: Owner M R DEVINE CONSTRUCTION Address: %PELLEGRINI,A J COSTA MESA,CA Phone: 2584 NEWPORT BLVD Zip: 90274-1901 Contractor: •SOUTH COAST CONSTRUCTION Address: P 0 BOX 4238 Phone: 714-612-3875 • COSTA MESA,CA Zip: 92628 License:546532 SCOPE OF PERMIT REF:B02-00122. REPAIR HVAC DUCTING AND REGISTERS DUE TO FIRE DAMAGE.GAS PIPE TEST. .-. • FEE SUMMARY Quantity Quantity ISSUE FEE $23.50' Repair/Alt Absorbtion Unit $0.00 0 Inst FAU<100 k BTU $0.00 . 0 - - Repair/Alt Refrigeration Unit $0.00 0 Inst FAU>100 k BTU $0.00 0 Ventillation System $0.00 0 Repair/Alt Cooling/Heat $27.40 2 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 Domestic Incinerator $0.00 0 Refrig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems Gas Piping $6.15 1 Up to 3 hp/100 k BTU $0.00 0 Factory Fireplace $0.00 0 3 To 15 hp/500 k BTU $0.00 0 Hood w/Mach 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 $0.00 0 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 $0.00 0 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 $57.05 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 permit. FOR INSPECTIONS CALL: (714)754-5626 2446.46(6/00) DECLARATIONS - WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: . 4 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 ve 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. y 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.) 0 I certify that in the performa•-. .f 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 . or,a,and agree tha ' I should become subject to the workers'compensation provisions of Sectio00 of the abor Code,I shall forthwith comply with these• .visio... el �L/ j1 �()^ Applicant Signature: / / Date: - /)--1 WARNING:FAILURE TO SE .•E WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100p00),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: I hereby affirm that I am licensed under provisions of Chi-/:er 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full fo ce and is Lic.e / " / Class# 6/ ef�Contractor's Signature: //L _ Date: — te 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,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. ❑Yes ❑No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). • ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes ❑No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 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 a ppermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No (Section 65850.2 of the Califomia Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No 8 (If'yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. /'�� Signature Of O al Owner(s) D�r\ �l /` And/Or Authorized Applicant Dat,4 U O`— • CODE II INSPECTIONTYPE DATE• INTRIAL5 COOP 1NSPECTIONTYPg / /fig �� 1616 Fixed System Final Fire Prevention 206 Final Mechanical v(3'c.. � 1266 Pool Spa Final 208 Final Plumbing ... • 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition . 250 Final Building/Occupancy Y • 0011CITY OF COSTA MESA • BUILDING DIVISION Y •4, �� DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER 7S 7n- b. . IC 7� PERMIT !'O�m 1' 602-00381 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.usNG PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDIJob Address: 2588 NEWPORT BL Status: ISSUED Suite: Applied: 03/18/2002 Vicinity: UNITS C AND Issued: 03/18/2002 Parcel Number: 43917114 Zoning: C1 C1 Applicant: MASCIALE, FRANK ISSUED BY: Address: P 0 BOX 4238 Phone: 714-612-3875 COSTA MESA,CA • Zip: 92628 Owner M R DEVINE CONSTRUCTION Address %PELLEGRINI,A J COSTA MESA,CA Phone: 2584 NEWPORT BLVD Zip: 90274-1901 Contractor: SOUTH COAST CONSTRUCTION Address: P O BOX 4238 Phone: 714-612-3875 COSTA MESA,CA Zip: 92628 License: 546532 Arch : _ Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT - DEMOLITION OF FIRE DAMAGE AREA FOR UNITS C AND DIN AN EXISTING COMMERCIAL BUILDING.REF:B02-00122 FEE SUMMARY Plan Check: $0.00 Calc Valuation: $4,500.00 • Permit: $111.25 Claim Valuation: $4,500.00 SMIP Res: $0.00 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $111.25 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result In the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 . . 2448-46(6•m) 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. L. 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 Insur nce caller and policy number are: carrier: S7 A"re r-6 ALb /V &'6 1s9-0/ Policy Number: (This section need not be completed if the permit is valued at one hundred tl0liers($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 C 'Ionia...we that If I should be a subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these r ons. w //�/a2� Applicant Signature: "" ` = Date: (/ WARNING:FAILUR SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(5100.000),IN ADDmON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed uncle provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business end rofessi9ps Code,and my license is In full force and effect.Lk.k - .S_.- Class N — 6 L.'s-et 41.4- Contractor's Signature: _ark' ..ref Date: 3//r�d,----- 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 appy 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 properly,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(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 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. ❑Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document.i.e.-properly tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet In depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2.Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes [J No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 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 aggermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes L-I 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? ❑Yes 0 No (If yes".the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safely 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 whicic is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. • SIgetire Of Legal Owner(s) 3 Da And/CI Authorized Applicant Date CODE p, INSPECTION TYPE USE ItrIMALS CODE E INSPECTION TYPE PALE MAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical _ 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign g(A)/4 + ' I 222 Final Site 204 Final Demolition q-01-0 1 /rD W F} 250 Final Building/Occupancy I . B _DING AND SAFETY DIVI 3N FIRE DAMAGE INSPECTION REPORT t (Required Prior � To/ Unit: Permit Issuance) // Address: ----)- 5-41d /N-1G✓ vL Yco/ 1 Q /- Owner: ti "e i ,) a vi-,e - 11 R 0 nv,4 e (o h fl . r,-r e. Owner's Address (if different from above): / ( / / /_ / /2 /G VIt4, Co I-0N 'eI f4 / it-roe/ex /=:1 6/5/. Street 3/0 _ 1/ p ``// City c� // State 14 Structural permit required. 3 T / C'2 77 ® Repair or replace as necessary. - - }(4I I,yaq,f.C7 I" Plans required.— f rN fs er / Comments: 041.. 4 5 .6 Tv w i, i t- - /FV14 � —j/ An-76-- 4 (7 sc.. (G. i- s h. - �O c$,/l/ l Ie ! "kg C.5 Q a-ti- 45-e _- t-,...- <.. , 1`' li/n.H - d- k7 w-4 // /14 (LA, //1ofs , - /r /=4.�,- . Lr5 _ c 71 Lir.•, p tedem, ' / f- -4, 4/4- ( i l-r y t c . fr (0,- to /1.5-14,,e o v/hu GC i� /1-end. r TS 2 Electrical permit required. V '{2 Repair or replace as necessary. // / / / _ Comments: Ll n / CT - f!D to k r 44. r ,// I e T f= �Fr . cvc t l �11, 54 i , h} f, /,, y5 ff,, , "7/ I ,c< - -e. 4 (2 ., 'lT - G /1 /'c 4 'f .4 Io L f <i: . ,1� G TCG41rc _ .,Ia ® Plumbing permit required. ja Repair or replace as necessary. Comments: f ✓/f S • Ate r 4.........,_ /'�- il-n Yt ? c f - 'e 4. 77 -es 1i lits/b2- ❑ Mechanical permit required. ❑ Repair or replace as necessary. Comments: / • / V 6AnLy t York . /2-6 -te( 7/t/ - 7c y 5-6 / 7 Inspector Date Phone 1812-46 Triplicate:Original-Owner;YBIkaoContrator; Pink-Building Division h'" �S CITY OF COSTA MESA \ _i 4 BUILDING DIVISION °r!- ►. i �d� I DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 1"4 PERMIT 02-00122 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ccaUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 • Job Address: 2588 NEWPORT BL Status: ISSUED Suite: Applied: 01/25/2002 Vicinity: UNITS C AND Issued: 04/08/2002 Parcel Number: 43917114 Zoning: Cl C1 • - Applicant: MASCIALE, FRANK ISSUED BY: Address: PO BOX 4238 Phone: COSTA MESA,CA • Zip: 92628 . Owner M R DEVINE CONSTRUCTION Address %PELLEGRINI,A J - - - - COSTA MESA,CA Phone: 2584 NEWPORT BLVD Zip: 90274-1901 Contractor: SOUTH COAST CONSTRUCTION Address: P 0 BOX 4238 Phone: 714-612-3875 COSTA MESA,CA Zip: 92628 License: .;546532 • Arch : Eng: H C HANSEN Address: _ Address: 17371 IRVINE BL ' Phone: Phone: 714-573-0073 TUSTIN,CA Zip: License: 92780 License: SE3027 SCOPE OF PERMIT REPAIR FIRE DAMAGE TO ROOF RAFTERS, FRAMING AND DRYWALL DUE TO STRUCTURAL FIRE ON 12/06/01.WORK TO BE DONE TO UNITS C AND D. • FEE SUMMARY Plan Check: $320.29 Calc Valuation: $35,000.00 Permit: $492.75 Claim Valuation: $35,000.00 SMIP Res: $0.00 SMIP Corn: $7.35 Other: $0.00 Inspection: $0.00 • Total: $820.39 - • PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void it 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 244648(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I here y 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: C�rlerS%4Tr itl.c.w> o cY'Nubmr--' q-(.495 9_V I (This-section need not be completed it the permit is valued at one hundred dollars($100)or less.) - O I certify that in the perto ance of t �r 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 lifornia, '//at if should becom• e bject to the workers'compensation provisions of Section 700333 000}}}the Labor Code,I shall forthwith comply VSwitur Bions. 4 CC 0 Y A�pllcant'Signature: / • te:Y WARNING:FAILUR TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P NAL ES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE 1$100000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed nder pr visions of Chapter 9(commencing with Section 7000)of Division 3 of the Businessnd Professions Code,and my license Is in full fdjce end effect.Lic,#. � s3 Iasa' tractoris Signature: n� COS" V/Ø- -- 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).): O 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 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.). O I,as owner of the properly,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.). O I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑NO (Section 25534 of the Califomia 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 a ermit for such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency? Yes 0 No (Section 658501 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Duality Management District or other air pollution control district or agency Is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes-,attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given Is correct. I agree to comply with all state laws and city 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. gnatur, gal Ow r(s) / gt� R.,4nd/Or.Authodzed Applicant _ / 4�Dete CODE t, LNSPECTIONTYPE DAIS MALS LODEI INSPECTIONTYPE RAIL 2010ALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site !� 77 204 Final Demolition . 250 .Final Building/Occupancy av�I` ©Z' 6- 4`a51p 4I 9 I CITY OF COSTA MESA BUILDING DIVISION Y:j _ k� DEVELOPMENT SERVICES DEPARTMENT PER NUMBER F 1 ^�% PERMIT 02-00342 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 2588 NEWPORT BL Status: ISSUED Suite No Applied: 04/26/2002 Vicinity: UNITS C AND D Issued: 04/26/2002 Parcel Nunmber: 43917114 /�'l'��Y' � Applicant: ROBERTS, STEVE • ISSUED BY: �' 1�/�/�� Address: 12 SAND POINT 'Phone: 714-495-3541. LAGUNA.NIGUEL,CA Zip: 92677 Owner:, M R DEVINE'CONSTRUCTION . , Address %PELLEGRINI,.A'J , COSTA MESA,'CA Phone: 2584 NEWPORT BLVD Zip: 90274-1901 Contractor: ROBERTS ELECTRICAL Address: 12 SAND POINT. . P6ane: 714-495-3541 LAGUNA NIGUEL(CA' Zip: 92677 , ' - License: 380116 , SCOPE OF PERMIT , ELECTRICAL TO INCLUDE:18 LIGHTING FIXTURES, 12.RECEPT OUTLETS,6 SWITCHES, 1 COMMUNICATION DROP,2 SUB PANELS TO 200A,;AND 3 SIGN CIRCUITS. REF:1302-00122 UNITS , C AND D. , - - - -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 $0.00 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 Fixts. '$19.80 . 18 up to 50 kva/kw __ $0.00- 0 Recept Outlets $13:20' 1-'12 up to 100 kva/kw $0.00 0 Switches ., $6.60 --, 6 - 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 N $0.00 0 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 $1.00 1 Investigation Fee $0.00 Sub panel to 200a $61.00 2 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $73.80 3 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $198.90 Intermed Pole $0.00 0 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 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: ❑ 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 d i ars($100)or less.) '�I certify that in the performance of the ork for which that perm) 's' ued,I shall not employ any person in any manner so as to become subject to the workers' L.....-compensation laws of California .:agree th ' h uld bec subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with.these provisi.. SAPPIice to SlgnaJ t�:f . -- PI? `� —C)-7— WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAG IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE(TAT OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: rI-hereby.affirm thha_m licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full )force and effect.Lic.# Z�l�//e / Class q? r /l% Contractor's Signature: / /:- - C� / Date/ s /—7 l -- .Z 1 i /a> 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.). O 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.). O I am exempt under sec. _ Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑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: O 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,Gip 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Ll Yes L7 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF NTRY: 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 ci ordi -mees relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purpo -s.I al re: not to occupy or allow occupancy of any building authorized by this permit until final inspection. Si nature O e 6. er(s) / Date And/0 Authorized •pplicant) ( Date 1 coin INSPECTION TYPE OATS =AL=ALS CODEI INSPECTION TYPE PAIS =ALI 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 6-2'0Z201 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