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HomeMy WebLinkAbout1076 WESTWARD LN - Building Permits ADDRESS OF BUILDING 1070 WESTWARD LN WIT: CITY OF (COSTA MESA - BUILDING PERMIT - GNhaRSNAMEIEIOgWN: WESTBLUFF HOMEOWNERS ASSO PERM NO: B 076827 : 111 PACIFIC #250 IRVINE CA 92714 PERMIT NO: :B 076827 PLAN CHECK NO: . N GOVT: N SUPP: N 727-26A0 AFPL.AUJLDIG ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: STR ' PURPOSE: 0TH „ Al1CNrECTORENGINEER: UC..NO.: JOB DESCRIPTION : T/OFF & 'REROOF W/BUILT-UP SQ :FT: 6,t00 " ' ARWL OR ENG'S ADDRESS: WIT: 1 t CLAIM VALUE: 6, 800 .00 CALC-'VALUE: 6, 800 . 00 GROUP OCC: R-1 / cOtrRACTowsNAME: R. P. HIRSCHMAN ( 714 ) 960-8329 - CONTRACTOR'SMuuNo 8855 ATLANTA *O******4****OOFit*U*****0*DO4*ADD***iSE ****QD** ;0***11_'00,7* 0*.�i-4o*8'�WES**ARD**** ADDRESS: HUNTINGTON BEACH CA uc.mm 475948 92646 SMT: 285 Z ONING REQUIREMENTS . LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of penury that I em licensed under provisions of Chapter 9 SETBACKS (commencing with Section 7000)of Division 3 of the Business and Profession Code,end my license is in full force and effect, CITY sac.No.: 038468 sac.CLASS: C3 948 EXP: 04 /96 MAIN BUILDING ACCESSORY BUILDING , mat -,1—Shp con. LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT . IN OWNER BUILDER DECLARATION:I hereby affirm wider penally d ware that I am exempt from the Contractors License Law for the NAlowiq reason(Sedion7031.5 Business end Profession Code:Any cityor county which requires Poona der.irpove, PARKING REQ: PROV: PARCEL: 93523015 ZNE: REF NO: lemolsh,or reps any structure.prior b As issuance also requires the applicant In such peri to file a signed statement that he or she a tensed pursuant I0 the provisions of the Contractors License Lew(Chapter 9(commencing with Section 7000)d Division 3 of the PLANNING NOTES).., Business and Prdeor exns Code) that pt he or she s exemtherefrom and the baso for the Ar Ihe alleged nptoy violation of Sewn L ' r"j 1031.5 by any ewlicant for a permit subjects the applicant toe eW penalty of red more then Me hundred dollen j$5031). **************IE******************************************************e9f********* d Inn ownerd thepnpeny or my employees with wages a their sole compensation,'Al do the work and the letuwcun's nor Wended D E V E L O P M E N T SERVICES R E U I R E M E N 3' S • or offered for sale(Section 7044,Business and ProfessionCode;The Caniradors License Law does rot appy to en owner of property Q who beide or improves thereon,end who does such work himself or hared or through he or her own empbees,resided that such ?" improvements are not intended or offered for sale.I.however,thebueling a inpnwernerd's sold within one yen of completion,the ZONING APPROVED BYDATE: I own rbuilr wD have the burden of posing r sh na he e did not buildor improve for the purpose el sale). .-- El Prooffessi�ons al the TheeCCntMraaeors LicenseLeclusively wd does,apply to breneed�S�who l the or Immo.thereon044,onw."rod BUILDING APPROVED BY : DATE: J ''• I contracts for such projects with a contractor(s)licensed prsuad 10 the Contractor License Law). 1, 1 I,l^ lot El I am exempt under Section: B.AP.C.,fr9Snspn: APPLICATION ISSUED BY: DATE:, ( 1` l E . • *********-*********************************** ***********-******* ,**********'E Date: Owner LEGALIZATION:'61 F E E S U M •M A R Y STRUCTURAL% SEGMENT:Y ' " m I Ido hereby certify that I aaware of and undersWd the requirements of Caccia Health end Safety Code Sections?5505,25533,and ,.'. \•. 25534,end that I or any future building oodryers will/wR not(Sole one)need to wooly with said state codes and the rsauiements for \ pe antor nw oobaor n noddxxtonhom the Ai' mG�w Maarrgsmem District.Resioemsl oorstrlpionappfmation !twee exempt from wee BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP'/RES GRADING r PERMIT • 90 . 00 . 68 Dale: AMorcad: yJ., SMIP/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under gently of parry ore of the blowing dedrdons: PLAN ../. ISSUEUIFEE r El Iheveand ell mafmen ce utedwrv.tkh self-insure wehri mlpmWbn,npraidsd far by Section 310gdthe labor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE Code frthe pedarmance of the rock for which this permit is Sued. TOTALS----> 90 . 68 0 . 00 d lhave and wjmaintain workers'comlpensationuuuance,nrquiredbySection 3700dthe Labor Code.tor the pedrmancedOr � 0 . 00 90.68 90 . 68 .00 ., work Ir which this permit's Sued.My wren'compensation insurance crier ad poky number are: Carrier STATE FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 90.68 OVER/SHORT: . 00 ' . Policy Number: 1292R90-94 10/01 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK (Ras sectionneed not he permit s for m ornpleted i the permit hundred dollen Isletr/ An.) 90 . 00 '/r . 68 I cedly that in the pedormence d the work for which this permit is issued,I shall nor employ any person in any manner n n to iI become subject to the workers'cornpereathun Wet d Cardoms,end knee this E I acerb Scorns'Meet to the/cams' *********************************lE********************************************* compensation provisions of Section 3700 of the labor o h comply wren nose provision* I N D I V I D U A''f a' FEE BREAKDOWN l DOG: 3_I S—s4 A9� A r� tlWll�in Fp to cabm sure an Cor 51coverage 04OOo saddldonb costshall ofa aemployer n.i asProvided tor A, TYPE QTY D E S C R I P T I O• N UNIT COST TOTAL COST Section 9205 of the Labor clefs,lnrerwer,and amomen Aln. SFR 6800 REROOF BY VALUE RESIDENTIAL NOZONE 1 .00 6, 800 .00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that them s a construction lending agency for die END OF FEES pedrmann of the work for which this Fermi is issued(Sedco 3091,Cs.C). ,q. LENDER'S NAME: t . • LENDER'S ADDRESS: I Nulty that I have read this appfra5cr end dole that the show sdrmdon stand.l agree to oomph,with d Sy and county rd'vwces Y . old spec lees Mmrpobildxq cerdprmnend hereby eWorse nrnentatnn of this city loWOW uponthe cionwlMntiprmed papery T" / for inspection purposes. BOB HIRSCHMAN I. .- . , .. Prig Nemo (4-:'r Signature d Owror/ApnUApWosmmr DeSa ' 1S—g(e nbCr (5t5145.WP) While-Boling A Safety;GreenrFde:Canary-Appind:Rak-Mwer:GOMrne uod-As _ -__._ _. • FS- • CITY OF COSTA MESA inn: BUILDING DIVISION ; PERMIT NUMBER DEVELOPMENT SERVICES DEPARTMENT 'J PERMIT P00-00067 (714)754-5273 • Fax(714)754-4656 77 FAIR DRIVE,COSTA MESA,CA 92626 . PLUMBING PERMIT Job Address: 1076 WESTWARD LN Status: ISSUED Suite No Applied: 02/01/2000 • Issued: 02/01/2000 Vicinity: GAS LINE FROM METER TO HOUSE Parcel Nunmber: 93523012 - A. ISSUED BY: A.777 / Applicant: JEFF GORES ' Address: 4075 E LA PALMA AVE#H - • : Phone: (714)632-0170 - ANAHEIM,CA ; . Zip: 92807 . - Owner: ' WALKER;DAVID SCOTT TR Address 1660 N MAPLEWOOD ST - Phone: ORANGE,-CA Zip: 92867 Contractor: CALIFORNIA COSAT PLUMBERS INC - Address: 4075 E LA PALMA AVE#H i - - Phone: (714)632-0170 • ANAHEIM,CA / .. Zip: 92807 • License: 736992 Arch/Eng: , - . ' Address: . - • Phone: . , Zip: . . i r License: . ,• -- ` . - . _ SCOPE OF PERMIT ` ' REPLACE EXISTING GAS LINE FROM METER TO HOUSE..SUBJECT TO FIELD INSPECTION. .,FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub I Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation ' $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System . $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain, Rainwater $0:00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 Drain, Roof $0.00 0 Shower $0.00 0 Water Heater/vent $0.00 0 Drinking Fountain $0.00 0 Sink, bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial ' $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 - Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00. 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 • 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 DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: O I ve 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 ark 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 comple • (the permit is valued at one hundred dollars($100)or less) O I certify that in the p: o :rice of the w•' for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation law •f C: omia,and a•-:e that' I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with rhes pray'.a• 7 1— 7J Applicant Signature' Date: �ljj I/ G WARNING:FAILURE 0 SECURE WORKERS'COMPENSATION COVERA UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($108000),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 DEC TION• I hereby affirm that I am limen under pro cions hapter (commencing/ with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.# l.-/ Class# Contractors Signature: Dater CONSTRUCTION LENDING AGENCY: O 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 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 en 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. 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). 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 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? ❑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 end 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 Califomia 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 a plication agermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes LI No (Section 65850.2 of the California 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 in No (It'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ___._.._.p _.South..C._.__.Ai-_ ___ ._. _-- .work _ h_.... 7 application,a permit than the South Coast Air Quality prescribed Management CaliforniaHealthat or otherd Safetyt pollution ction 42303 district been agency is r Yes ed for the work which is the subject of this have all of the disclosures by Callfoia and Code Section made? ❑Vs 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 COMPLIfjNC- 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 corn•y'w all state . and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described pro•.rty .r ins-e • purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. /�ll©f�1rga jer- Z 7- — An. '"r"e• •pplicant Date NIDE• INSPECTION TYPE DAM INTRIAL$ CODE4 INSPECTION TYPE gam INTIUAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing o2Agielti /Yw{y — 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 2446-46 _. tt: ` 4 ' COSTA MESA BUIL i ING-SAFET DEPARTMENT p.0.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink Only p RECEIVED BY DATE RECEIVED DATE ISSUED BUILDING Q V,IY/l ADDRESS 7 ,P i (�,c i,: "At /o 7& - PERMIT NO. OWNER A.P.NO `)„e�'g/ MAIL BUILD' OI,Gy ADDRES�S/� ��a Z... " /J S77— ADDR //5/n`0 /J�,yG//y� CITY //D�/ JY2/C jCJ i( N /At • TRACT.IXb.3 �,iy'icLS•O J�O?6L3CK CONSTRUCTION # /2.2"1 ±_. . NEW ADD ALTER REPAIR MOVIN�(�III DP$UUSH LENDER J`�� BRANCH �1� </�j,6—, � a OWNER to Pl✓ ' V44CD Y 1 , ADDRESS ,r,., ^_ �� VALUE ARCHITECT �•,s. TEL US�iVI� $ OR ENGINEER Y/,G� 1 NO ��S 6w .t/ FIRE C J ADDRESS � f��: �_D� ZONE TVP GROU // " APPROVED CONTRACTOR 6.Ll�Si✓.¢ BY DATE ADDRESS TEL. ZO E,r','� NO.OF l USE OF NEW CITY NO, gz(/� PIANS BUILDINGenej 1,076041C. F STATECITY ' YARDS APPROVED YARDS APPROVED ... LIC.NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING W SIZE r NO.OF BLDG& (FROM C L STR T) 0. 1/4._OF LOT J NOW ON LOT FRONT FT. Q USE OF �. EXISTING BLDG. _R.SID40E f Cr�,,-} FT. rn F Separate permits are required for L.SIDE 27 FtF/e FT. electric,plumbing and heating work. W �'7J 4 (� REAR r 4 JZ-al. 0 FT. [--i USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& .2 +/� /) MAIN BLDGS. 7/_ r� ACCESS.BLDGGS. 7-76) .i (/_�� /VI1- (,1 e.....„ DATE C U.P.# 26-764.9./ ���ppp /(y(j'3APPPROVED J-/ >. RYPPRoVED)g1 s+DATE- 1.-----,24-77 �. ,'-TOLD FOR SPECIAL REQUIREMENTS 40 I hereby acknowledge that I have read this application and state Nn- EX N p: that the above information is correct and agree to comply with M. all laws regulating building.construction, and I shall not employ m Z any person in violation of the workman's compensation laws of /�'' -c�s�t �/]J� W the State of California. 12. /0 SQ. FT, /�jV(/ �'/�dO�••T• a I hereby certify that I am properly lice -=d as a contractor under !llbbb"'///WWW___ the State of Callfor a . siness and Pr/esslons Code, Division 3, THE AMOUNT SH N UNDER VALUATION IS FOR m Chapter 9, a.- hi'sy% licen .s a e= full f• ce and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am axe • fro - 4 e 'rovislo so tate o California Business VALUATION o PERMIT FEE $ and Pro =ssion `e.d D%isi• 3,/// r9, in / �,� � $ fl PLAN CHECK $ el U.Signature of o Permittee r TAX $ E U Authorized Agent TOTAL PAID $