Loading...
HomeMy WebLinkAbout3110 MACE AVE - Building Permits I • , CITY OF COSTA MESA - - - --- , "'FS,p BUILDING DIVISION .VI Iv % 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us �, FOR INSPECTIONS CALL: (714)754-5626 "%Papafi PERMIT NUMBER: B11-00407 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 13955102 DATE ISSUED: 11/16/2011 ISSUED BY: AP • JOB ADDRESS: 3110 MACE AV CM Suite/Unit: Vicinity: Squares: 1450 Valuation: $7,700.00 SCOPE OF WORK: TEAR OFF EXISTING TILES,RE-SHEET W/OSB 7/16"W/40 YEAR G&F COMP.SHINGLES(MANSARD ONLY). PITCH 24:12.NO ATTACHED GARAGE.TOTAL 1450 SF. NOTE:RESIDENTIAL RE-ROOF: Final approval of permit shall not be granted until access to dwelling unit(s)is provided for verification of the installation of smoke and carbon monoxide alarms by the City Inspector. See Attachment w/Inspection Card • - OWNER: LAMBE,BRIAN W TR Address: 2220 NEWPORT HILLS DR E Unit: PHONE: City/State/Zip: NEWPORT BEACH,CA APPLICANT: NOLTE ROOFING Address: 10812 LA BATISTA Unit: : PHONE: 714-964-0554 City/State/Zip: FOUNTAIN VALLEY CONTRACTOR: NOLTE ROOFING License No. 418550 Address: 10812 LA BATISTAUnit: PHONE: 714-964-0554 City/State/Zip: FOUNTAIN VALLEY 92708 CELL: ARCHITECT: License No. PHONE: • ENGINEER: License No. PHONE: FEE SUMMARY I Reroof Plan Check: $0.00 Reroof Permit Fee: $153.25 Reinspection Fee: $0.00 '" . Bldg Std Admin Fund $1.00 • TOTAL FEES $154.25 _ .. HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3118/2010 -PER CMMC Sec. 13-279 ,; .;; Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibitied all hours-Sundays and the following Federal holidays New Years Day, Memorial Day,Independence Day,Labor Day.Thanksgiving Day and Christmas Day 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. CODE S. INSPECTION TYPE DATE IN1111ALS CODES INSPECTION TYPE DATE INITIALS 16i6 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof / 11,30•II kie 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 250 Final Building/Occupancy " ' T''Or" n"-'T'i 204 Final Demolition rWORKE 'COMPENSATION DECLARATION: Owner ID verified by drive cense. ❑Yes ❑No , .4 I her affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document.i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. O I have and will maintain workers'compensation insurance, as required by DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: 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 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are:: l v /� person is required to descend,will be made in connection with work authorized S' by this permit,and that no building structure,scaffdding,falsework.or demolition Carrier: T or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2.Grp (This seaaoi need not be c�omtpetted��e pe 6.aiued at one hundred dollars(SIM dress.) 2.Ant Sec.341,Title 8,California Administrative Code). Policy Number: �w acile ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. - to the workers' ompensation laws of California, and agree that if I should become sus` to e workers'compensation provisions of Section 3700 of Applicant's Signature Date the La•= •./010:5a hwith comply with these provisions. A C -_,a, /L /6 // Division of Industrial Safety Permit Number: Applicant's Signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: •RNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code,and 2. Does or will the applicant or present or future building occupant need to file my license is in full forand effect. �j a registration form for acutely hazardous materials? 0 Yes 0 No .,Lic.# �/D✓ Class# G' 3/ (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 Contractor's Signature Date 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). O I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec. 3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications for non-residential building permits). • 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes". the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds Or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No thereon,and who does such work himself or herself or through his or her own 8. (If"yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she . CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and O I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that 0 I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of Business and Professions Code for this reason: the City of 'Ma Mesa to enter upon the above-described property for inspec . nose- a•,ree not to occupy or allow occupancy of any building authority O� until final inspection. //_// /1 Signawre of Legal Ownertsl Date Signature Dale 3057-26 13/07) And/or Authorized Applicant Date • Prescriptive Certificate of Complhce: Residential CF-1R-ALT Residential Alterations (Page 1 of 5) U;6ojecn•Nrunc ��� �� Clim_ite Zune#6 q of Stories General In tormatiun eatteXddress 3r/o /ak /c/. Enforcement Agency: c-Building Type 0 Single Family 'Bi Multi Family Circle the Front Orientation:N,E,S,W,or degrees ,Conditioned Floor Area(CFA): Project Type: 0 Alterations 0 Envelope 0 Fenestrations❑ HVAC Replacement or Change Out 0 Duct Replacement 0 Water Heater NOTE: This form is not to he used far Newly Constructed Buildings or Additions - Insulation Values For Opaque Surfaces(for Furring use the Mass and Furring Strips Construction table below) Assembly Alteration ❑Opening of framed cavity:done-Alterations that involve the opening of the fronted cavity of wall, ceiling, or floor must install the mandato.),minimae insulation value per§150/br the altered assembly. Fill in Columns A-C and enter mandatory insulation value in Column H. ❑ Replacement of entire assembly-Replacement mean entire wall, ceiling,or floor assembly requires the installation of Component Package-D insulation values in Table 15 I-C. Fill in Columns A-J. Opaque Surface Details For the furred portioned of Mass Walls see Furring Strips Construction Table below. •A I B C • • D 1 E - • R G H I J Proposed See otv Standard 1 Values From JA4 Table Framing Thickness, Framed Continuous JA4 Proposed Tag/ Assembly Name Material Spacing, U- JA4 Table Cavity Insulation Assembly Assembly ID' or Type' and Size' or Other3 factor4 Numbers R-valuer' R-Value' Cell Values U-factor9- Note:For furred assemblies,accounting for Continuous Insulation R-value,see Page JA4-3 and Equation 4-1. For calculatingfu red was use the Mass and Furring Construction table belmr. I.For Tag/ID indicate the identification name that matches the building plans. 2.Indicate the Assembly Name or type:Roof/Ceiling, Walls,Floors,Slabs, Crawl Space,Doors and etc..-Indicate the Frame type and Size:For {hood, Metal, Metal Buildings,Mass, enter 2x4, 2x6,or etc...see JA4 for other possible frame type assemblies. 3. Enter the thickness for mass in inches or Spacing between framing members enter; 16"or 24"0C;or Other,for all other assembly description such as Concrete Sandwich Panel,Spandrel Panel,Logs, Straw Bale Panel and etc.... 4.Based on the Climate Zone;enter the Standard U facto'from Table 15I-B, C or D for each different assembly Name or type. 5.Enter the Table number that closely resembles the proposed assembly. 6. Enter the R-value that is being installed in the wall cavity or between the framing; otherwise, enter "0". 7. Enter the Continuous Insulation R-value for the proposed assembly; otherwise, enter "0 8.Enter the row and column of the U factor value based on Calvin,,F Table Number and enter the Assembly U-factor in Column.1 9.The Proposed Assembly LI-factor, Coleman 1, must be equal to or less than the Standard U-factor in Column E to comply. Furring Strips Construction Table for Mass Walls Only A B l C D I E F I C H I I Proposed Properties of Masonry and Concrete r Added Interior or Exterior Insulation Walls From Reference in Furring Space from Reference ,joint Appendix Table 4.3.5;4.3.6.4.3.7 Joint Appendix Table 4.3.13 1(5 U O V_ L G ~ v. Assembly r ' c` ° H `c a'u z„a � Final Mass Name or JA41 Table O i v E F .e F c o o f Assembly Thickness' Type- Number` < " � 5 m , E. 2 c a c < F w U-factor6.7 Comment Ifegisnntion Number: Registration Date/Time: PIERS Provider': 2008 Residential Compliance Forms August 2009 Prescriptive Certificate of Compliance: Residential •CF-IR-ALT Residential Alterations (Page 3 of 5) Project Name: Climate Zone# #of Stories • ROOFING PRODUCTS(COOL ROOFS)§151(/)12 When the area of exterior roof surface to be replaced exceeds more than 50%of the existing roof area,or more than 1,000 ft', whichever is less,the new roofing area must meet the roofing product"Cool Roof'requirements of§152(b)IHi, 152(b)IHii,or 152(b)1Hiii. Check applicable alternative or exception below if the roof alteration is exempt from the roofing product "Cool Roof'requirements. Note:If any one of the alternatives or exception below is checked, the Aged Solar Reflectance and Thermal Emittance requirements for roofing products in §1180) re not applicable.Do not fill table below. ❑j of Roofs Not Required in Climate Zones 1-12, 14,and 16 with a Low Sloped. Less or 2:12 pitch. • ool Roofs Not Required in Climate Zones 1 through 9 and 16 with a Steep-Sloped Roofs(pitch greater than 2:12)and product unit weight less than 5th/ft2. Alternatives to§152(b)IHi and§152(b)Hii,Steep-slope roof(pitch>2:12) ❑ Insulation with a thermal resistance of at least 0.85 hr&°F/Btu or at-least a 3/4 inch air-space is added to the roof deck over an attic;or ❑ Existing ducts in the attic are insulated and sealed according to§I 51(010;or ❑ In climate zones 10, 12 and 13,with 1 ft''of free ventilation area of attic ventilation for every 150 ftof attic floor area,and where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge;or ❑ Building has at least R-30 ceiling insulation;or ❑ Building has radiant barrier in the attic meeting the requirements of§151(1)2;or ❑ Building has no ducts in the attic;or ❑ In climate zones 10, 11, 13 and 14,R-3 or greater roof deck insulation above vented attic. Exception to§152(b)1Hiii,Low-slope roof(pitch<2:12) ❑ Building has no ducts in the attic. Other Exceptions • . ❑Roofing area covered by building integrated;photovoltaic panels and solar thermal panels are exempt from the below Cool Roof criteria. ❑Roof constructions that have thermal mass over the roof membrane with at least 25 lb/ftis exempt from the below Cool Roof criteria. - Note:If no CRRC-I label is available,this compliance method cannot be used,use the Performance Approach to show compliance,otherwise, Check the applicable box below if Exempt from the Roofing Products"Cool Roof'Requirement: Roof Slope Product Weight Product Aged Solar Thermal CRRC Product ID Number] < 2:12 >2:12 < 51b/ft2 >_ 51b/ft2 Type Reflectancea 4 EmittanceSR15 ❑ ❑ ❑ ❑ ❑4 ❑ ❑ . ❑ ❑ ❑4 ❑ ❑ ❑ ❑ ❑4 ❑ ❑ 0 ❑ ❑4 ❑ ❑ 0 0 04 . I. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www.coolroofs.org/products/.search.pho 2.Indicate the ape of product is being used for the roof top,i.e.single-ply roof asphalt roof metal roof etc. 3. If the Aged Reflectance is not available in.the Cool Roof Rating Council's Rated Product Directory Oren use the Initial Reflectance value front the sante directory and use the equation(0.2+0.7(p;,,,,tat-0.2)to obtain a calculated aged value. Where p is the Initial Solar Reflectance. 4.Check box if the Aged Reflectance is a calculated value using the equation above. 5. Calculate the SRI value by using the SRI- Worksheet at http://www.energy.ca.gothille24/and enter the resulting value in the SRI Column above and attach ucopv of the SRI-Worksheet to the CR-IR. To apply Liquid Field Applied Coatings,the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage recommended by the coatings manufacturer and meet minimum performance requirements listed in§1180)4. Select the applicable coating: 0 Aluminum-Pigmented Asphalt Roof Coating 0 Cement-Based Roof Coating 0 Other it Registration Number: Registration Date/Time: HERS Provider: 2008 Residential Compliance Forms • August 2009 • Prescriptive Certificate of Compliance: Residential CF-3 R-ALT Residential Alterations (Pace. S of 5) Project Name: Climate Zone ti It of Stories HERS VERIFICATION SUMMARY The enforcement agency should pap special attention to the HERS Measures specified in this checklist belom. A completed and signed CF-4R Form for all the measures specified shall he submitted to the building inspector before final insnection. Duet Sealing & Testing HERS verification is required for this measure. ❑ YES ❑ NO YES:In Climate Zones 2 and 9-16,if more than 40 linear feet of new or replacement ducts are installed in unconditioned space,the ducts are to be sealed per§152(b)IDii and the newly installed ducts are to be insulated pet §I51(010. D EXCEPTION:Existing duct systems that are extended, which are constructed,insulated or sealed with asbestos. ❑ YES 0 NO YES: In Climate Zones 2 and 9-16, if the existing space-conditioning system(FIVAC equipment and ducting)is replaced,the ducts are to be sealed per§152(h)]Di. ❑ YES 0 NO YES:In Climate Zones 2 and 9-16;if the existing HVAC equipment is replaced(including the replacement of the air handler, outdoor condensing unit of a split system,cooling or heating coil,or the furnace heat exchanger)the ducts are to be sealed per§152(b)IE. • EXCEPT]ON: Duct systems that are documented to have been previously sealed confirmed through HERS verification in accordance with procedures in the Reference Residential Appendix RP3. ❑ EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space. - • EXCEPTION: Existing duct systems constructed, insulated nr sealed with asbestos. Refrigerant Charge - Split System HERS verification is required,for this measure, ❑ YES ❑ NO YES: In Climate Zones 2 and 8-15,when the existing HVAC equipment is replaced(including the replacement of the air handler,outdoor condensing unit of a split system A/C or heat pump,cooling or heating coil,or the furnace heat exchanger)a refrigerant charge measurement shall be verified per§152(b11F. Central Fan Integrated (CFI)Ventilation System and Fan Watt Draw The ventilation requirements of§150(o)do not apply to existing residential homes. Ducted Split Systems-Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure. - 0 YES 0 NO YES:In Climate Zones 10 through 15,when the existing space-conditioning system(HVAC equipment and ducting)is replaced.the airflow and fan watt draw shall be verified mer§152(811 Ci to meet the requirements of§151(fl7B. Documentation Author's Declaration Statement • I certify that this Certificate of Compliance documentation is accurate and comniet Name: I-Signature: 61-77 gin ny 7 Ag ' 27/ /‘• , Ad re, Z l/ If Applicable❑ CEA or❑ CEPS iaiv (Certification 1/): r yr: e 92'o? 7 7,7622,...05W Responsible Building Designer's Declaration Statement • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility ibr the building design identified on this Certificate of Compliance. • I certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform to the requirements of Title 24,fans I and 6 of the California Code of Regulations. • The building design features identified on this Certificate of Compliance are consistent with the information provided to document this building design on the other applicable compliance forms,worksheets,calculations,plans and specifications submitted to the enforcement agency for approval with this building permit application. Name: Signature: Company: Date: Address: I License: City/State/Zip: I Phone: Far assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300. Registration Number: Registration Dote/Ti roc•: HERS Provider: 2008 Residential Compliance Forms August 2009 taw � Mac 4. • CITY OF COSTA MESA 4 BUILDING DIVISION y r,,,, . DEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER o PERMIT B07-00040 Itb'eP000rcos# (714)754-5273 • Fax(714)754-4856 • www.ci.cosia-mesax....., DING PERMIT 77 FAIR DRIVE,COSTA MESA, CA 92626 Job Address: 311q_MACE AV A , Status: ISSUED Suite: -• • - . I Applied: 01/11/2007 Vicinity: LOWER LEVEL FLAT ROOF Issued: 01/11/2007 Primary Occ: R1 Type of Construction: Parcel Number 13955102 Zoning: R3 Applicant: ',ROOF,SAVERS INC .:, • Address: 2323 N-TUSTIN AV '`-\ -�`�;- �. '- =•t\ SUITE'C-146 . Phone: 714-835-7663 \ SANTA ANA,CA Zip: 92705 ISSUED BY: Owner LAMBE, BRIAN W TR Address 2220 NEWPORT HILLS DR E Phone: NEWPORT BEACH,CA Zip: 92660-6730 Contractor: ROOF SAVERS INC Address: 2323 N TUSTIN AV SUITE C-146 Phone: 714-835-7663 SANTA ANA,CA Zip: 92705 License: 752128 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT PARTIAL REROOF ON APARTMENT BUILDING FLAT ROOF,APPROX 16 SQUARES.WORK TO INCLUDE:TEAR OFF(E)ROOF MATERIALS, INSTALL LAYER OF COMBO BASE SHEET AND MODIFIED TORCH DOWN CAP SHEET ON LOWER LEVEL OF AN APARTMENT BUILDING, APPROX 16 SQUARES. FEE SUMMARY Plan Check: $0.00 Calc Valuation: 54,900.00 Permit: $111.25 Claim Valuation: 54,900.00 SMIP Res: $0.50 SMIP Com: $0.00 Other $0.00 Inspection: $0.00 Total: $111.75 PLANNING &ZONING SETBACKS MAIN STRUCTUR 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 • 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)7545626 2446-46(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. 1 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 workcomp pnsaloser gnce carrier and policy number are: •Cavi se-c 1177ib d'Y-/ Policy,Numbec17.�ryZ1,- -(T1i15 sectio no be plate i!16e perm/f is valuetl of one nuntlretl dollars(3100)or/essJ 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 Califom and agree that if I sh ome subject to the workers'compensation provisions of Se ion 300 of the Labor Code.I shall forthwith comply with these provisi Applicant Signature: Date:... - / 41 I- WARNING: LL URE TO SECU ORKERS' ENSA COVERAG S UNLAWFUL AND SHASUBJECT AN EMPLOJER-TO CRI P ALTIES AND CML FINES UP TO ONE HUNDRED 'THOUSAND DOLLARE($100,000). ADDITION TO THE COST OF COMPEN ATION,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 under provisionyf Chapter 9(commencing with Section 7000)of Division 3 ofrthe Business a Prof ssions Code,and y license is in full Irce and'attedt.9F: / .47/ v /, ,6 �GIBas-M� / c ConliaSignature: ifr�fl/Y��/�L�1 /f"/(�Q Datet. //f CONSTRUCTION LENDING A� // _ /l ! - a 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 nereby 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).): d 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.). I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business end 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 Drivers License N0. 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). O 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 materiel? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). _ 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons,or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 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 appermit 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 LJ 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 construcled 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 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 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. / < : f Date ./. ..� / "I.vLLT-.�.�]a And/•ru • z=• •l..cant .ate—'- COLL , • to, L' FOIL MINIM 5 Pout' INSPECTION TYPt PATE. IHIMALZ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final i/ 208 Final Plumbing 200 Final Re-Roof "4 i�� 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 _ 111 1PROJEC ADDRESS: 3110 MACE AV IT CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 061293 11‘. DW/ER'S NAME:LAMBE, BRIAN W l ADDRESS: 11A COLBECK MEWS � PERMIT NO: B 061293 PLAN CHECK NO: N GOVT: N SUPP; N LONDON SW74LX ENGLAND CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: ALT ARCH/ENGINEER: (714 ) 675-4630 REG.NO.: JOB DESCRIPTION : T/O EXIST ROCK APPLY NEW BUILT—UP SQ FT: 5, 000 ADDRESS: UNIT: CLAIM VALUE: 5, 000 . 00 CALC—VALUE: 5, 000. 00 GROUP OCC: R-1 / PERMITTEE: LEE ROOFING ( 714 )642-72.23 ADDRESS: 1653 SUPERIOR COMMENTS ; SMOK DETEC PER 1991 ED UBC COSTA MESA CA 92627 **x*****4x**;'E***** +F*x**xxxxx****x* EE-xx*x+c+r*xx*rF>f**x* xN**** *xx*x****>E****xx** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 DI the Business and Professions Code.and my license is in full force and ellect. SETBACKS CITr .:02 7`12 sTATEuc.:349686 cuss: —39 '— Date: * "3 Signature:_- _�� ��'� MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a cerlificat. sent to self-inure ora rtificate of Workers' FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensahon;nsumcj.,pr p grtifiep,gopy thereof(Section 3800,Lab.C) LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN POLICY NO.:1 `1J LL EXP.DATE: 0 6/3 0/9 3 COMPANY:STATE FUND PARKING RE • PROV: PARCEL: 13955102 ZNE: REF NO: ❑ Certified copy is hereby furnished. K1 Certified copy a with the ity Bui inti inion. PLANNING N TES> - Date: .5—Y-9 3 Applicantai� � > ***k*********** ****************************************3 *********************** DEVELOPMENT SERVICES REQUIREMENTS EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section n mpleted it the permit is for one hundred(S100)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 o the Workers'Compensation Laws of California. ZONING APPROVED BY DATE: Date: Signature: BUILDING APPROVED BY : / DATE: NOTICE:If,alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor Code.you must lorthwllh comply with such provisions or this permit shall be deemed revoked. - , CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• //.�J/ , DATE: -3!//�p ///(.,1' which this permit is issued(Section 3097.Civ.C). ***********************fe14— iEi-***. ** *** •it• .x' . .'x"** *'1e**************z`iFTy it xi- *if** LENDER: *************#******************************** k******************************* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SM IP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 72 , 00 , 50 repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed / pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN -� SM I P/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by , j 1 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE /7 / I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 72 . 50 0 . 00 0.:, 00 72 . 50 72 . 50 .-3 , 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through / A _ his or her own employees. provided that such improvements are not intended or offered for sale. If.however the building or REVENUE DIVISION TOTALS--> COLLECTED: 72, 50 OVER/SHORT; '- 00 improvement is sold within one year of completion,the owner will have the burden 01 proving he/she did not build or improve / for thepurposeolsale), BLDG PMT PLUMBING ELECTRIC MECHANIC. FIRE SMIP/TOT GRADING•'PLAN—CHECK •,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 72 . 00 ', 50 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon /I and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware '*'****'*************X-it******************LIE**************************************** that proof of their Worker's Compensation insurance should be provided to me. I N D I V I D U A L' ' FI '.E E BREAKDOWN ❑ I am exempt under Section: B. 8 P.C. for this reason: TYPE QTY D E S C R I P T I O, N,. ic UNIT COST "'TOTAL COST Date: Owner: SFR 5000 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 ') 5, 000 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END' OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a Q permit for construction or modification from the Air(laity Management District.Residential construction applications are exempt from '� % •'17 . ... these provisions. F' • Date: Applicant EXPIR E D I hereby certify that I have read this application and stale that the above intormation is correct.I agree 10 comply with all city and county Ineomplefre Inspections ordinances and state laws relating to building construction and hereby authorize representaf s this ty to enter upon the above-m ntionetl I properly lot inspection pun uses. �Lj /�C • Date �. . Sig Date: 3J (J Signature' ` / Driver's License or Social Security n: t . 1 64 5-46 While—Building:Green—Code Enforcement Canary—Applicant:Pink—Revenue:Goldenrod—Assessor I .jjr 1 r CONSTRUCTION AND PLANNING POOL ,PA APPROVALS Permit# • Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2; Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility•Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding • 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. • • 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap • 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final • 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. RoUgh Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68" APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL J, 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts,in Structure 70. Underground Hydro 22. Ducts,Ventilating 71. Product Piping El Gas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑Oil 25. Root Sheathing 3 /74 3 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& SidingI i 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing i HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat i I 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED • / / 33. Final Electric Notes:5dq_ 4/ ,3(pC. 34. Final Heating& Air Conditioning i fie-eateix 0�? (tet zoG�JJ• 35. Final Gas Pipe-Test 36. Hood or Canopy : .I 37. Final Factory Fireplace 38. Final Plumbing _ 39. Water Service-Final • 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 4` 45. Sound Attenuation EXPIRED 46. Handicap Regulations Incomplete r1Sp I 47. FINAL STRUCTURE & BUILDING • Pair sig 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date City of Costa Mesa Building Safety Department CERTIFICATE OF OCCUPANCY N? 2610 C p. Q. Box 317 Costo Mesa, California The Building located at 3110 N1BCO Avenue, A-® has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group _fL 85 rT Occupancy. Use of Building 4 Unit AptaRuildtng with atta.hed gnragns and laundry Legal Description Tract 6260>a Lot 1 (See reverse side for Metes and Bounds) e1��c Building Permit No. 29615 Electrical Permit No. 29606 Plumbing Permit No. 53465 Floor Load Signs have been installed as Room Capacity Signs have been instaled as required under Sec. 2308 U. B. C. required under Sec. 3301 (1) U. B. C. 17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied until the owner or operator has been issued a valid certificate of occupancy by.the enforcement agency. (b) A new certificate of occupancy shall be obtained whenever there is a change in: 1) Occupancy classification of a building or portion thereof 2) The number of apartments or guest rooms 3) Ownership If Group H Occupancy, number of apartments and/or guest rooms as required under Sec. 17050.1 (d), California Administrative Code, Title 8, Chapter 9, Article 8. Number of apartments_ 4 and/or guest rooms ISSUED TO: Building Official AMUR xwaasby �� ter` `�� Date aily 23, 1969 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Form BU34-1M-11.63-_6-B P 15 296 JAN -6-69FA��00 125* ***715.L.`. fii COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 - COSTA MESA, CALIFORNIA 92626 / 13------v For Applicant to Fill In CompletelyJ'� APPLICATION FOR PERMIT TYPE OR PRINT ht—/,/ BUILDING BUILDING 3110 P1/1f n For Office Use Only ADDRESS 3fiQv I '14 QQ _ 01A-pile RECEIPT NO. PERMIT NO. COSTA MESA. LI ORNIA -- ' OO I I�31 n / iQr. R[Dn Y Sen E D Ela OWN _ /�/1 (\� ....m,.//aL� - ...:4BUI //� (/y� /n/ . . T ADDRESS 1414 ti So• d 11 l r rl ADDRESS ING �//(f ///(n({/)'/Yn/{'(,((/T/ ��/J I IP,r�ii ` No�i'! 133 ZONE #3 TYPE Y GROUP " g CITY �"U 11-- + N John I"- In� NO. APPROVED TEL. us-7-003 BY DATE {{�� (/ 01 � ZONING ADDRESB70' �M [(a✓ ft c.�r�Q�Qlvy 4 lea u./ ZONE I NO.OP • I USE OFN[W p R-3 PLANE 2 BuILDING5 car att.oar CONTRACTOR(V,0,A Co�iI,llruc ois Inc • (� L LEGAL ADDR888 j1�44/12./ dID , DESCRIPTION Tit' 14. Tr. 6260 CITY rL/IIL�✓'F()✓I A.P.NO. none NOSTATE {{]] / THL �/ �(1\' SOTTO BOIDH B OVERHANG KAU EAR PSHALL BE LESS THAN LIC.NO. Il -/026 / NO. �+ �/-" 3� VES OF LOT 73 x I LU I No.Oj.✓•yDyt._ Q ALLOWED .(U.B.C.REQUIREMENT) NOW ON YARDS APPROVED YARDS APPROVED USE OF p MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. 'YL/"✓1�---- _ (FROM C/L STREET) SETBACK LINE FROM 7 �J Q\,�,, CENTER OF STREET J1 RGRYARD /0 FRONT / Fr 1/,ite-P- IA-e-irr• f/ SIDE YARD I LEFT U I RIGHT R.SIDE FT. FT. • DEPtSCRIPTION OF WORK L.a1DR e PFT. NV ESALTERATION_ ADDITION REAR /e2 PT. PT. DISTANCE BHT. BET.MAIN& REPAIR MOVING; DEMOLISH MAIN BLDG'S, ACCESS.BLD/323. [�p/ 0 NO.OF �(n VAR.* DATE SIZE _` J./. it, /"ROOMS . STORI A C.U.P.# APPROVED ' ExTERIOR ��J}��J}�B���//� /��/��(ff( APPROVEy/� COVERING WjeYYYiC� I COVERIT60e+ CO °' BY DATE L I'Z� �O USE OF BUILLDDINS AND WORK TO BE PERFORMED °, il 1 REBY ACK DOE THAT I NAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE j A D STATE T THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. F15 PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION //[[ wD BUILDING CONSTRUCTION. PERMIT FEE 0 A4-3, So F SIGNATURE OF ,�,/� G PERMITTEF �/ I ' •' '7/, �' Z o PLAN CHECK S / AUTHORIZED AGENT 1.7' :-) /21.0— TOTAL FEE I60715 °25