HomeMy WebLinkAbout3555 HARBOR BLVD - Building PermitsCITY OF�COSTA MESA
F, BI/ILDING DIYIS/ON
i` � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-0856 • wvnv.ci.costa-mesa.ca.us
r
�. ` FOR INSPECTIONS CALL: (714) 754-5626
*�'"°'�� PERMIT NUMBER: E10-00092
PERMIT TYPE ELEC
APN: 41508134
JOB A
Vicinity:
A THRU G
STATUS: ISSUED
DATE ISSUED: 05/25I2010
ISSUED BY: RMD
it:
SCOPE OF WORK: ELECTRICAL PERMIT FOR 13 DISCONNECTS IN CONJUNCTION WITH THE CHANGE OUT OF 13 ROOFTOP UNITS
(UNITS A-G). REF#: M10-00047
OWNER: C J SEGERSTROM & SONS
PHONE:
APPLICANT: PEREYRA, MICHAEL
PHONE: 714 241-1769
CONTRACTOR: AMP MECHANICAL
Address: 3554 BUSINESS PARK DRIVEUnit: SUITE E
Ci[y/State: COSTA MESA, CA ZipCode: 92626
ELECTRICAL PERMIT FEES
Electrical Plan Check Fee: 50.00
Electrical Permit Fee: $37.80
Reinspection Fee 50.00
TOTAL FEES $37.80
Address: 3315 FAIRVIEW RD Unit:
City/State/Zip: COSTA MESA, CA
Addiess: Unit:
Cily/State/zZip:
License No. 799431
PHONE: 714-241-'1769
CELL:
NOTICE: The work aulhorized by this permit shall comply with all applicable handicap access requirements under Califomia sfatutes and related
regulations. (Ord. No. 92-28. § 1. 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPEC710NS: In order for the vrork authorized under this permit to be considered legal, such work must comply vrith all applicable codes, and all
required inspections and final approval must be obWined. Failure to obtain inspections and f nal approval will result in the expiration of this permit.
COOE �. INSVECTION TYPE QA,]_ �M�jIR�.$ �QOga INSPEC710N TVPE DFTE INTRIRlS
1818 Fixetl System Final Fire Prevention 206 Finat Mechanical
1266 Pool Spa Final 208 Finai Plumbing �/
200 Final Re-Roo/ 210 Final Electrical � ��_23 � i 0�� h�0
201 Final BIocWRetaining Wall 212 final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Appmval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
WORKERS' COMPENSATION DECLARATION:
I hereby aNirm under penalry ot perjury one of the following declarations:
❑ I have and will maintain a certifcate of consent to self-lnsure for workers'
compensation, as provitled for by section 3700 of the Labor Code, for Ihe
peAormance o( the work for which this permit is issued.
❑ I have and will maintain v.orkers' compensation insurance, as required by
5ection 3700 of Ihe Labor Cotle, for the perfortnance of lhe work (or which this
pertnit is issued. My vrorkers' compensation Insurence carrier antl policy
number are:
CGetriC[:.. �/y�///�Q!% . f/41' �'o .
(ilut sepqn neetl nd Oe mmpele0 d Ihe pe:rm9 is ✓alued al one hun/d�/etlnOdla�s (St00) a leu.)
Policy,Number. ���a Z 2 07 l
❑ I certify [hat in Ihe peAormance o( the vrork for which this permit is
issuetl, I shall not employ any person in any manner so as to become su6ject
to the vrorkers' wmpensation lavrs of Califomia, and agree thal if I shoultl
bewme subject to he vrorkef¢ ' compens lion provisions of Section 3700 0l
the Labor e all 1 1 Ih co +pl Ih lhese provisio`ns.
/ ���^�
LAao' ' ' naWre ale
�
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
(5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. IMEREST, AND
ATfORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensetl untler provisions of Chapter 9(commencing
vrith Section 7000) of Division 3 of the Business antl Professions Code. antl
my license is in full force and effect.
���- 3 r. �c�s. ±l.. �''� �
f 2S /�
�C§utnd8fi`Signalure � .��
CONSTRUCTION LENDING AGENCY:
❑ I hereby affum that there is a construction lending agency fa the
peAortnance of the work fa v.fiich this permit is issuetl. (Sec. 3097. Civil Code).
Lender s Name:
Lentlers Address:
Da�e
OWNER-BUILDER DECLARATIONS:
I hereby affirm Ihat unaer penalty o( perjury thal I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the lollowing reason (Sec. 7031.5.
Business antl Professions Code: Any cily or county which requires a permit to
consWct, alter, improve, tlemolish, or repair any slrucWre, prior to ils
issuance, also requires the applicant for such permit to file a signetl statemenl
that he or sha is licensed pursuaN to Ihe provisions ot the Contraclors
License Law (Chapter 9(commencing vrilh Section 7000) of Division 3 ot the
Business and Pro(essions Coae) or that ho or she is exemp[ lherefrom antl
the basis for Ne alleged exemption. Any violation ol Seclion 7031.5 Dy any
applicaN for a permit subjecis the applicant to a civil penalry of not more than
five hundretl tlollars ($500).):
❑ I, as owner ol the properly, or my employees vnth vrages as their sole
compensation, WILL DO THE WORK, and the structure is not intentletl or
oHered tor sale (Sec. 7044, Business and Professions Cotle: The Contractors
License Law tloes not apply to an owner ol propeny who builds or improves
thereon, and v+ho tloes suc� work himsell or herself or ihrouqh his or her own
employees, provided that such improvements are nol inlended or offeretl !or
sale. If, hovrever, the 6uiltlinq or improvement is sold within one year of
completion, the ovmer-builder will have the burden ol proving that he or she
did no[ build or imprOve (or purpose of sale.).
� I, as ovmer of the property, am EXCLUSIVELY CONTRAC7ING WITM
IJCENSED CON7RACTORS to consWct the projecl (Sec. 7044, Business and
Professions Code: The contractors License Law dces not appty to an owner ol
property wfio builds or improves thereon, antl who contracts for such pmject with
a conlracta(s) license pursuant lo the Contractors License Laws.).
❑ I am exempt under sec.
Business and Professions Cotle for this reason:
]OS�.d6(YO"!)
Owner ID verifed by driver's license. ❑ Yes ❑ No
Onver's License No. Ezpires:
Venfication o( Ownership Dy (type of aocument, i.e. - property taz bill or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereDy certAy that rro ezcavation frve (5) or mwe leet in tlepth into wfiich a
person is requiretl to descend, will be made in connection with work authorizetl
by Ihis permil, antl that no building structure, scaHdding, (alsewnrk, or demolition
or dismantling Ihereof, will be more than thirty-six (36) leet high. (Chap. 3.2, Grp
2, M 2, Sec. 34t. Ttle 8. Califomia Adminisl2tive CoCe�.
❑ As ovmer-builder, I will not employ anyone to tlo vrork which vrould
require a permit from the Division of Industrial Safety, as notetl above, unless
such person has a permil to tlo such work from Ihe division.
Applicml's Signature
Division of Intlustnal Salety Permit Number: _
HAZARDOUS MA7ERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or IuWre Ouilding occupant need to file and
certity a Business Plan for emergency response lo release or I�reatened
release of a hazardous matenall ❑ Yes ❑ No
(Section 25505 0l the Califomia Health and Safery Code requires, with some
exceptions, thal a Business Plan be filed with the Costa Mesa Fire
Depanment by every business which has at any one time dunng a reported
year a quantily of hazartlous materials equal to or greater than a weiqht of
500 pounds, or a volume of 55 gallons. or 200 cubic (eet o( compressed gas
at stantlartl lemperature and pressure�.
2. Does or will Iha applicant or preseN or tuture building occupaN neetl to file
a registration tortn for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the Cali(omia Health and Safety Cotle, with some
exceptions, requires regisUation with the Cosla Mesa Fire Department by
each business whic� at any one time has on hanA a quantity of aculely
hazardous materials equal to or greater Ihan a weight ot 500 pountls, or a
volume ol 55 gallons, or 200 cubic feet of compressetl gas at standard
remperaNre and pressure�. �
3. Does or vrill Ihe applicaM or preseM or fuNre building ocwpant neetl to
prepare an RMPP (Risk Management and Prevention Program for acu[ely
hazardous matenals)? ❑ Yes ❑ No
(Section 25534 of the Califomia Health and Safety Cotle proviGes Ihat the
Costa Mesa Fire Depanment may require the preparation, certifcation ana
(iling wilh lhe Fire Department of an RMPP by businesses which are required
to register acutely hazardous materials vrilh the Fire Department.
4. If an RMPP is presently requiretl, has Section 25534 of the California
Health and Safety Code been fully complied vrith7 ❑ Yes ❑ No
5. Does or will the applicant or present or fulure building occupant require (or
Ihe vrork which is the subjecl of this application a pertnit (or such consWction
or modification Imm Ihe South Coast Air Quality Management District or from
any other air pollution control district or agency? ❑ Yes ❑ No
(Section 65850.2 of the Calitomia Govemment Code requires that the requested
information De fumished on applications fv rron-residential DuilCing pertnils).
6. Will any part of the facility lo be constructed under this permit be within
1000 (eet (rom Ihe outer bountlaries ol a school? ❑ Ye5 ❑ No
(II yes", ihe facility musl meet the requirement of Sections 25534 and 42303
of the Califomia Health and Sa(ery Cotle�.
7. It a pertnit Bom the Soulh Coast Air Ouality Management District or other
air pollulion Gontrol di5lritt or agenty is requiretl for Ihe work which is the
subject of this application, have all of the disclosures prescnbetl by Cali(ornia
Health and Safety Code Section 4230J been made7 ❑ Yes ❑ No
8. pf'yes", atWch certifiwte of wmpliance from the appropdate air pollution
comrol oKcer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
intormation given above is cortect. t agree to comply with all state laws and
city ordinances regartling Hazardous Materials antl Emissions.
SignaWre Da1e
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
cerlify under penalty of perjury lhat I have read this application and state that
t�e inlormation given is wrrecL I agree to wmply with all state laws and city
ordinances relatinq to builtling construction, and authorize representatives o(
the Ciry o( CosW Mesa to enter upon the above-descnbetl property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection.
e otye ner(s) Date
j�� 2f�/9
�or�i o�AVPli�nt �Oate�
' CITY OF COSTA MESA "
o F BUILDING DIYIS/ON
i � 77 FAIR DRIVE. COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • wNnv.ci.costa-mesa.ca.us
°.�`w� FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER: 610-00156
PERMIT TYPE B ROOF2 STATUS: ISSUED
APN: 41508134 DATE ISSUED: 06/03/2010
ISSUED BY: RMD
JOB ADDRESS: �3555yHARBOR'GATEWdY S,;CM
Vicinity: COMMERCIAL ROOF
Squares: 16000
SuitelUnit:
Valuation: $80,000.00
SCOPE OF WORK: TEAR EXISTING ROOF MEMBRANE AND REPLACE WITH A FOUR PLY BUILT•UP ROOF SYSTEMS. TWO COATS OF
ACRYLIC WITE COATING (CRRS 0646-0005) OVER NEW ROOF SYSTEM FOR A COMMERCIAL BUILDING, APPROX
16,000 SF. COMPLIANCE FORMS ATTACHED TO JOB CARD AND CITY PERMIT.
OWNER: C J SEGERSTROM 8 SONS
PHONE:
APPLICANT: WEILS, WAYNE
PHONE: 714-632-6929
CONTRACTOR: MESA ROOFING CORPORATION
Address: 2550 E MIRALOMA VJYUnit:
City/State/Zip: ANAHEIM, CA 92806
ARCHITECT:
ENGINEER:
FEE SUMMARY
Reroof Plan Check: $0.00
Reroaf Permit Fee: $853.75
Reinspection Fee: $0.00
Bldg Std Admin Fund $4.00
Address: 3315 FAIRVIEW RD
City/State/Zip: COSTA MESA, CA
Address: 2550 E MIRALOMA WAY
City/State/Zip: ANAHEIM, CA
STE 100
License No.
License No.
License No. 564151
PHONE: 714-632-6929
CELL:
PHONE:
PHONE:
Unit:
Unit: :STE 700
AL FEES $857.75
HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3I18/2010 - PER CMMC Sec. 13-279
Monday thru Fritlay - 7:00 am thru 7:00 pm. Saturdays - 9:00 am thru 6:00 pm. Prohibitied all hours - Sundays and the following Federal
New Years Dav. Memorial Dav. Indeoendence Dav. Labor Dav. Thanksoivina Dav and Christmas Dav
NOTICE: The vrork authonzed by this permit shall comply with all applicable handicap access requirements under Calitomia statutes and related
regulations. (Ortl. 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 ezpiration of this permit.
CODE /. INSPECTONTYPE OR INTRIALS COUEt INSPECOONTYPE DRTE IN RL
1676 Fized System Final Fire Prevention 208 Final Mechaniwl
t2fi6 Pool Spa Final p (��(� ���/��/ 208 Final Plumbing
Z00 Final Re-Roof �°� 1� l ��y�" 210 Final Electriwl
U
201 Final Block/ReWining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Si9n 222 Final Site
204 Final Demolition . 250 Final BuildincyOccupancy
0
' WORKEi2S' COMPENSATION DECLARATION:
I hereby aKrtn under penalty of perjury one of the following declaralions:
❑ I have and will maintain a cetlificate o( consen[ to self-Insure lor vrorkers'
wmpensation, as provitletl for by section 3700 of the Labor Code, lor the
peAormance of the wvrk for which this permit is issued.
❑ I have antl will maintain workers' compensation insu2nce, as required by
seclion 3700 0( lhe Labor Cotle, (or the peAortnanca of the work for whkh Ihis
permit is issuetl. My worker5' compensalion Insurance carrier and policy
number are: �
(Ca+r"�r: �7�71-T'i ��'�+II�
(Thif s�iu� neetl nd De mmpletM d Ine pemN is vaNeO el one nuntlred tlollars (S100) a less.)
P�,Number: UUJOIO2— ZU �l'�
❑ I cerli(y that in the performance ol Ihe work for which Ihis permit is
issued, I shall not employ any person in any manner so as to become subjecl
to the vrorkers' compensatio laws ol Califomia, and agree that i( I should
ecome subject to�the worke ' compensation provisions of Section 3700 of
the a�or Code, I h II fp 11 i comply with ihese provisions.
/ —�j� ZU ( CJ
pp.- tSipnaWre �W�o
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNL4WFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLIARS
($100,000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATfORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencinq
with Section 7000) of Division 3 of lhe Business and Professions Cotle. and
my license is in full force and ftect.
{',c�- �.S �4 S a�'� C-3�
/ ��uco
�/ 'n' 110F4Signalum ba�1e�
CONSTRUCTION LENDING AGENCV:
❑ I hereby affirtn that there is a consWction lending agency (or the
perfortnance of the v.ork for which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
Dale
OW NER•BUILDER DECLARATIONS:
I hereby aftirtn that under penalry ol perjury that I am E%EMP7 FROM THE
CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5,
Business and Professions Code: Any city or counly which raquires a permit to
wnstruct, alter, improve, demolish, or repair any struclure, prior lo its
issuance, also requires the applicant for such permit to fle a signetl statemenl
that he or she is licensed pursuant to Ihe provisions of Ihe Contractors
License Law (Chapter 9(commencing with Section 7000) ol Division 3 of the
Business anC Prolessions Codo) or that he or she is exempl theretrom and
the basis lor the alleged exemption. Any violation of Section 7031.5 by any
appliwnt for a permit subjecls the applicanl to a civil penalry of not more than
five huntlred dollars ($500).�:
❑ I, as owner ol lhe property, or my employees with vrages as their sole
compensalion, WILL DO TME WORK, antl the siructure is nol intendetl or
offered lor 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 lhrough his or her ovm
employees, provided thal such improvemenls are not intended or otleretl for
sale. If, hovrever, Ihe building or improvement is sold within one year of
completion, the ovmer-builder will have Ihe burden o� proving Ihat he or she
ditl nol build or improve for purpose ot sale.).
❑ I, as ovmer of ihe property, am EXCLUSIVELY CONTRACTING WI7H
LICENSED CONTRAC70RS to construct the project (Sec. 7044, Business and
Protessbns Code: Tha contractas License Law dces not appty to an owner of
propeAy v.ho builds or improves thereon, and who contracts for such projecl vnth
a conl2ctof(s) license pursuant to the CoN2clors License Laws.).
❑ I am exempt untler sec.
Business and Professions Code tor this reason:
309-a6 (3I0])
,
Ovmer ID verifetl by driver s license. ❑ Yes ❑ No '
Driver's License No. Ezpires:
Veri(ication ol Ownership by (type of tlocument, i.e. - property taz bill or deed):
DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION:
❑ I hereby certdy thal no excavation frve (5) or more feel in depth into which a
person is required to descend, vrill be made in connection vnth work authonzetl
Gy Ihis pertnit, and that no building sWcWre. 5c�fdding, falsexork, or tlemolition
or dismaniling ihereo(, will be more lhan Ihirty-six (36) leet high. (Chap. 32. Grp
2, M 2, Sec. 341, TiUe 8, Califomia Atlminislrative Cotle).
❑ As ovmerbuilder, I will not employ anyone lo do work which wou10
require a permit from the Division of Intlustrial Safery, as noted above, unless
such person has a permit to do such work from the division.
Appiranl's SipnaWre
Division of Industrial Safety Permit Number: _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will lhe applicant or present or fuWre DuilGing occupant neod �o file and
certi(y a Business Plan (or emergency response to release or threatened
release of a hazar0ous material? ❑ Yes ❑ No
(Section 25505 of lhe Calibmia Health and Safery Cotle requires, with some
exceptions, that a Business Plan be fled with the Costa Mesa Fire
Department by every business which has at any one time during a reportetl
year a quantity ol hazardous materials equal to or greater than a weight o(
500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at standard lemperature and pressure�.
2. Dces or will the applicant or present or tuWre building occupant need to (le
a registration tortn tor awtely hazardous matenals? ❑ Yes ❑ No
(Section 25533 ot the Calitomia Health antl Safery Code, with some
eaceplions, requires registration with t�e Costa Mesa Fire Departmem by
each business vAiic� 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 o! 55 gallons, or 200 cuDic feet of compressed gas at standartl
temperature and pressure�.
3. Does or will the applicant or present or future builtling occupant need [o
prepare an RMPP (Risk Management antl Prevention Program for acutely
hazardous matenals)? ❑ Yes ❑ No
(Section 25534 of the Cali(omia Health anC Safery Code provides that the
Costa Mesa Fire Depanment may require ihe preparalion, certificalion antl
filing vrith the Fire Department of an RMPP by businesses which are requiretl
to register acutery hazardous materials wit� lhe Fire Department.
4. If an RMPP is presently required, has Section 25534 of the Calitornia
Health and Safely Code been (ully wmplied with? ❑ Yes ❑ No
5. Dces or will Ihe appliWnt or present or (uture builtling occupant require for
the work which is the subjecl of this appliwtion a pertnit for such conslruclion
or modification from Ihe South Coasl Air Quality Management Distnct or from
any other air polWtion contml disMct or agency? ❑ Yes ❑ No
(Sectbn 65850.2 0l the Calitomia Govemment Cotle requires that the requestetl
infortnation be fumisheC on applications fa rmn-residential building pertnits�.
6. Will any part of Ihe facility lo be constructed under ihis permit be within
1000 leel from Ihe outer boundanes of a school? ❑ Yes ❑ No
(II yes", lhe laciliry must meet the requiremenl of Sections 25534 and 42303
of Ihe Califomia Health and Safery Code).
7. If a permit fmm the South Coasl Air Quality Management District or other
air polWtion control district or agency is required �or tha work which is Ihe
subjecl of t�is appliwtion, have all o/ the disclosures prescnbed by Califomia
Health and Safety Code Section 42303 been made7 ❑ Yes ❑ No
8. Qf yes", attach cenifcale of compliance from the appropriate air pollution
control offcer).
CER7IFICATE OF COMPLIANCE: I certify that under penalty of perjury the
information qiven above is wrrecL I agree to comply with all state laws antl
ciry ordinances regarding Hazartlous Materials and Emissions.
Sie^alure
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certity under penalty of perjury thal I have read this application and state that
the information given is correct I a9ree to comply with all state laws and city
ortlinances relating to building consWction, and authonze representatives of
the Ciry of Costa Mesa to enter upon the above-tlescribetl property for
inspection purposes. I agree not ro occupy or allow occupancy of any builtling
authorized by lhis pertnil until final inspection.
sie^aWre L g I 1) /,, oate
� � lY_� �ZO��
a,a ..a�i. �....