HomeMy WebLinkAbout2457 IRVINE AVE - Building Permits bio•Lag,, i CITY OF COSTA MESA •-
BUILDING DIVISION
>1. I.',0,,,,,. ;�1 DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER
tab.
PERMIT B04-01389
41'
(714)754-5273 • Fax(714)754-4856 • www.cl.costa-mesa) fLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 2457 IRVINE AV Status: ISSUED
Suite: Applied: 08/04/2004
Vicinity: TR 16526 -LOT 2 Issued: 07/19/2005
Primary Occ: R-3 Dwellings/Cong Res<10 Type of Construction: V-N
Parcel Number: TPN00409 Zoning:
Applicant: PATTERSON, ANDREW -
Address: ISSUED BY: _iO4)7---
-
Phone: 949-294-9057 CELL
.,„-- Zip:
'. . ) -.
Owner: H G C V!
IRVINE LLC,...- ' - ' . ' ; • -
Address /2455 IRVINE AV = - -
/COSTA MESA,CA//�,�w
----. Zip: 92627 - ,
Contractor: ,, j '-� ,
. Address: /J„
��;7 �.Phone:
/d ./
Zip: o/,, License: '
-Arch-i DAVID L.ARNESON =%'" Eng: SHUCRI YAGHI
.I Address: 5530 SAN JUAN DR ' '` 7 - - _ .Address:. 112 E CHAPMAN AV
' --Phone: '714-547-9146 SUITE#D Phone: 714-997-9120
ORANGE,CA; ' - - ORANGE,
Zip: 92869 ' N �.- License: C13354 92866 License: 43205
/, , .., . , SCOPE OF PERMIT .,
CONSTRUCT NEW 2,408 S.F.SFR. 1186 SQ.FT. 1ST FLOOR,1222 SQ.,FT.2ND FLOOR,439�SQ.FT GARAGE,85 SQ.FT PORCH,DECK 1 -35
SQ.FT,DECK 2-37 SQ.FT. -
'4 BEDROOMS,2.5 BATHS.TR 16526,LOT 2.
PA-03-49M-16526 - - -
FEE SUMMARY
Plan Check:, ', $285.25 Calc Valuation: $235,769.74
',',Permit: ` $1,755.35 Claim Valuation:�% ,_ Woo
�SMIP Res: $23.58
SMIRCom: $0.00 , :'� - %./
N Other: $0.00 ,
Inspection: $0.00` cf,
/ -. 1 . ,
Total�`$2;064 18' „� ��' '
`., -A - %r , \i�o,�y _ - _ : ✓/ - Vii :
\��` ' ' ;/ �� PLANNING &ZONING - ' /! ,
SETBACKS � ` -
MAIN STRUCTURE Front 0 ,
0. = - Rear 0-0.0 - Left 0-0 - / Right-; ",0--0
ACCESSORY Front 0-0 Rear 0-0 - -- - - Left - --0-0.0; '2` ' Right 0-0
- ,
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord.No.92-28,§1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or If work Is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result In the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626 ,✓-r
2446-46(WOO) K/
•
DECLARATIONS
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 pemJt is issued.
My workers compensation Insurance carrier and policy number are:
Carrier: Policy Number:
(This section need not be completed if the permit is valued at one hundred dollars($100)or less.)
" I certify that in the performance• I e work •r whi • is permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
V _ _compensation laws of Calif or =,and agree : ' sh• Id become subject to the workers'compensation provisions of Section 3700 o the Labor Code,I shall forthwith
comply with these provisi•--. /
A�Neerrt Sipnstuie'-=4- Daje:�, 7 7 C ,
WARNING:FAILURE TO SEA ' •• - ON COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARS($1ro,000L IN•,:- • TO THE teL OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37re OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under pr f Chapter 9(cornmagcing with Section 7000)of Division 3 of the Business and Professions Code,and my license is In full
force end effect:117 O Z 35 7 Cla. s 27
4ongactats•Signature;,^-*- -/ cDere� '7//e/".;r--
AT
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,CMI 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 enact 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 Drivers License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth Into which a person Ls 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(38)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 o1 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 0 N
(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.
hasSecn 25 _ _... .__
4 If an RMPP is presently required,has Section 25534 of the Celifomla Health end Safety Code been fully complied with? 0 Yes ❑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 apermit 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 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 California Health and Safety Code Section 42303 been made? 0 Yes 0 No
_
8 (11'yes",attach certificate of compliance from the appropriate air pollution control officer),
CERTIFICATE OF COMPUANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPUANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
correct.I agree to comply with all state la, • :•• city ordi •. . :ling to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for Ins...'• purposes I :, :: not to occur y or allow occupancy of any building authorized by this permit until final inspection.
Si.•- . : •• ••:•: •• ••:r(s) ....)46D
y �,�
...er:Aut odzed App ,.tom ,
Ari
VOCE I INSPECTION TYPE DATE MALS DODEt INSPECTION TYPE DAM HTNELE
1618 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 Sign250 Final Be
Dem
204 Final Oemalltion 250 Final Building/Occupancy 44k
CITY OF COSTA MESA
4 , �% BUILDING DIVISION
>'ft •ir,,' DEVELOPMENT SERVICES DEPARTMENT PER NUMBER
PERMIT 05-00582
` x
(714)754-5227733 • Fax(714)754-4856 • www.ci.costa-mesa.Pti sUMBING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 2457 IRVINE AV Status: ISSUED
Suite No Applied: 07/28/2005
Issued: 07/28/2005
Vicinity: NSFD
Parcel Nunmber: TPN00409
Applicant: PATTERSON, ANDREW
Address: 421 31ST ST ISSUED BY: t&
//
Phone: -949-294-9057 CELL /
NEWPORT BEACH,CA - - :Zip: 92663'
-
Owner: HGC IRVINE LLC",: - ' ;
Address 190 NEWPORTCENTER DR e ` - ` , - - .
SUITE 220 -
;NEWPORT BEACH CA ' `Zip: 92660 -�' - ,
.
Contractor' PATTERSON"CONSTRUCTION CORPORATION
Address: 421 31ST ST
Phone: •"949-294-9057 CELL `'
NEWPORT BEACH,CA Zip: : 92663
•
License 802367. ; -
' SCOPE OF PERMIT '
CONSTRUCT NEW.2,408 S.F.SFR. 1186 SQ.FT. 1ST FLOOR, 1222 SQ.FT?2ND-FLOOR,439- 1.:;,H; .k
SQ.FT GARAGE,85 SQ.FT PORCH,DECK 1 -35 SQ.FT,DECK 2-37 SQ.FT.
), .,4 BEDROOMS,2.5 BATHS.TR 16526,LOT 2. - . .(
REF:604-01389 - - _ - t
`h3 BATHTUBS 1,DISHWASHER,3:ROOF'DRAINS,-1 GAS OUTLET�(1.4),1 SEWER CONNECT 1 SEWER
PRIVATE LINE,.4 SHOWERS,1 KITCHEN SINK,6 WASH BASINS,'I WASH BASIN SET, 1 WASTE, ,•
AND VENT SYSTEM,4 WATER CLOSETS, 1 WATER HEATERNENT, 1 WATER SERVICE,1'GAS SERVICE
11 FEE SUMMARY - '
-AMT QTY , AMT QTY •- AMT QTY
ISSUE FEE - $23.50 --- Laundry Tub/Washer -$0.00 0 Sump Pump - $0.00 0
Backflow irrigation ' , $0.00 0 . Landscape Irrigation • $0.00 • 0 Swimming Pool $0.00 0
Backflow Preventer $0.00 0_ , P-Trap $0.00 0 Trap Primer ..: $0.00 0
Bathtub - $29.40 3 . 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(1A) ` $0.00 0
Connect(Ice,Soda,etc) .? $000 "r0 Receptors°?'"', ", .' '$0.00'.,, 0 Vacuum"Brkr Bkflow(5+) . $0.00 0
Dental Units . $0.00 ; "0Septic Tank, $0D0 " ,'1'0 ;-_Wash Basin , 7, ,.$58.80 6
Dishwasher $9.80 ":1 a`r ,,XSewer Cap,for Demo $D00 :0 .."'=Wash Basin Set $9.80 1
Drain,Floor $0.00' 0 ,-, -' Sewer Connell .„r,$24.65 1 - - Waste and Vent System'J $9.80 1
Drain,Rainwater `. $0.00 , 0 ' `,.Sewer Private Line $24.65 -u1 Water Closet(Toilet) , $39.20 4
`
Drain,Roof , .$29.40 - '3-„;; '- 'Shower, - ,;x`$39.20 ,.:4 -Water Heater/vent $12.30 1
Drinking Fountain - $0.00- .-0 / -Sink;bar ._$0.00 .;':0 - Water.Piping(Inst or Rep.) $0.00 0
Expansion Tank $0.00,_ -0 -Sink,commercial _ ,_,-$0.00' 0 '-- 'Water Re-pipe- $0.00 0
Gas Earthquake Valve $0.00-- 0 ' ,, .-Sink,Floor -_. $0.00 0 - • 'Water Service $9.80 1
Gas(1-4 outlets) $6.15 .,1 Sink,kitchen $9.80-"01 E Water Softener $0.00 0
Gas(Over 4 outlets) $0.00 ,.:0 4... 'Sink,service/mop ` , .1 $0.00";,,0 - ---,.OTHER $0.00
Gas Repipe $0.00 0 Spa(private)./ - ,, .-, $0.00 -0 ";--VIOLATION $0.00
Gas Service $9.80 1 Spa Fr -
p (public) $000 � ;0 " PLAN CHECK $0.00
Interceptors(Grease,Oil) $0.00 0 `^ a �,.,, - ,;?, REINSPECTION $0.00 0
Interceptors(Sand Auto) $0.00 0 _---... ---- -^
TOTAL CALCULATED FEES: $346.05
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
fora 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 /'�;
244e-46(eroo) �
DECLARATIONS
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 cancer end policy number are:
Carder: Policy Number:
(This section need not be completed if the permit is valued et one hundred dollars($100)or fess.)
ify that in the pertornanc: • he work for hich this permit is Issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Ca • la, - d agree :t if I s • •become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these pro Ions. 7X 7 7:J-6--
WARNING:
Signature: �_�a Date: a-
WARNING:FAILUR ORNERS'COMP j1�'ION COVERAGE IS UNLAWFUL MD SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED
THOUSAND.• TTT���"'��� 00).IN ADDITION TOM COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,MD ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions f Chapter 9(commen th :don 7000)of DMsion 3 of the Business and Professions Code, nd my license Is in full
force and effect.Lie.a u Z SZ Class a 999
Contractors Signature: UUU Date: ,/ , c'C
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lenders 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 Ucense 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 Ucense 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- 0 Yes 0 No Drivers Ucense 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 MD EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑Yes 0 No
(Section 25505 of the California Health end 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 greeter 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 en RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No
5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application akermlt for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 15 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 Celifomia Health and Safety Code).
7 II a permit from the South Coast Air Quality Management District or other air pollution control district or agency Is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No
8 (If yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHO: • ON 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 - '- and ci ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspec': :Irposes. ,gree not to•• • .r allow occupancy of any building authorized by this permit until final/ inspection.
'Oat :Of :
CITY OF COSTA MESA '
4 i+ BUILDING DIVISION
1.•ri i -t DEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER
f 1 I
i� • PERMIT
�• I'1N O5-00433
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
MECHANICAL PERMIT
Job Address: 2457 IRVINE AV Status: ISSUED
Suite No Applied: 07/28/2005
Issued: 07/29/2005
Vicinity:
Parcel Number: TPN00409 9
ISSUED BY:
Applicant: PATTERSON, ANDREW /,00"
Address: 421 31ST ST -
Phone: 949-294-9057 CELL
NEWPORT BEACH,CA Zip: 92663 --
Owner HGC IRVINE, LLC '
Address: 190 NEWPORT CENTER DR ..
SUITE 220 Phone: 949-644-8900 - , -
NEWPORT BEACH,CA ' Zip: 92660
Contractor: PATTERSON CONSTRUCTION CORPORATION
Address: 421 31ST ST ;
._ Phone: ,949-294-9057 CELL
NEWPORT BEACH,CA Zip: - 92663
• ' .License:802367 ' '
, SCOPE OF PERMIT
• CONSTRUCT NEW 2,408 S.F.SFR.1186 SQ.FT.1ST FLOOR,1222 SQ.FT.2ND FLOOR,
.439 SQ.FT GARAGE,-85 SQ.FT PORCH,DECK 1 -35 SQ.FT,DECK 2-37 SQ.FT.
4 BEDROOMS,2.5 BATHS.TR 16526,LOT 2. . .
REF:B04-01389 i
1dNST FAU<100K BTU,.1-FACTORY FIREPLACE;1 HOOD W/MECH EXHAUST,4 VENT '
'FANS/SINGLE DUCT,1 COMPRESSOR 3-15HP/500KBTU ...
•• ' FEE SUMMARY
Quantity _ - -Quantity
ISSUE FEE $23.50 - Repair/Alt Absorbtion Unit • $0.00 ' 0
Inst FAU<100 k BTU $14.80 1 Repair/Alt Refrigeration Unit $0.00 0
Inst FAU>100 k BTU $0.00 0 Ventillation System $0.00 0
Repair/All Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0
Inst/Rep.Recess Wall Htr $0.00 0 CommercialIncinerator $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 $0.00 0 . . - Up to 3 hp./100 k BTU $0.00 0
Factory Fireplace • $10.65 1 3 To 15 hp'/500 k BTU - - . $27.15 1
Hood w/Mech Exhaust $10.65 '1 - ' •. .- - 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 , $29.00 . 4 - Over 50-hp/Over 1,750 BTU $0.00 0
Appliance $0.00 0 - , Boilers
Fire Dampers - $0.00 0' -,iii_ ; Up to 3 hp:;,; :i:; ' $0.00 0
Smoke Dampers $0.00 0 '.3,To 15hp:. • - $0.00 0
Inst or Relocate Appl Vent • - $0.00 0' - �-' 15 to 30 hp - $0.00 0
Air Handlers< 10000cfm i $0.00 0.` : .,.30 to 50 hp :' $0.00 0
Air Handlers> 10000dm $0.00 0 . _ ,Over 50 hp`. $0.00 0
Floor Furnace 50.00-- 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 $115.75
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
fora 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 codas, 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)754-5826 /
2446-46(6/00) - CV
DECLARATIONS
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have end 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 carver and policy number are:
Carder Policy Number:
(This section need not be completed it the permit Is valued at one hundred dollars($100)or less)
I certify that In the performance• ' e work for wh h this perms • .. :•,I shall not employ any person In any manner so as to become subject to the workers'
mpensatlon laws of Calif. a,and agree that I shou• •-•come subj: t to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provi s.
Applicant Signature: .rj Date: 7 �7�C-��
WARNING:FAILURE TO- CUR 'OFWERS' - •C:)•• RAGE IS UNLAWFUL D SHALL SUBJECT MI EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED
THOUSAND DOLLARE(S •Y), • TO THE•s" ' COMPENSATION,DAMAGES '• IDED 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 Chapter 9(co•- enc••wl• ectlon 7000)of Division 3 of the Business a rofesslons!Code,end my license Is In full
force and effect.Lk.ft _ O Class If //,
Contractor's Signature: !S'_� Date: r` — �6
CONSTRUCTION LENDING AGENCY: V
❑ 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 1 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 DMslon 3 of the
Business and Professions Code)or that he or she Ls 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
Cade: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 IlcenSe. 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 DMslon 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 filo 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 end pressure).
3 Does or will the applicant or present or future building occupant need to prepare en RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health end Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No —
5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 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 ❑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 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 law- :nd city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for tap." ' pu ••.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
�gong •• 7 =t /7G//
An• cr Author cent DatD ate e / G�
;ODE I, INSPECTION TYPE PAH MALS CODE( IVSPECRON TYPE �•� I
1618 Fixed System Final Fire Prevention 206 Final Mechanical a � a •"�,0.(/,(=yl
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Flre Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Anal Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
1 CITY OF COSTA MESA
4 BUILDING DIVISION
> :J ..,1 DEVELOPMENT SERVICES DEPARTMENT P IT NUMBER
tb. OP411se PERMIT
E05-00800
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesam_ TRICAL PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 2457 IRVINE AV Status: ISSUED
Suite No Applied: 07/29/2005
Vicinity: Issued: 07/29/2005
Parcel Nunmber: TPNO0409
Applicant: PATTERSON, ANDREW IP
Address: 421 31ST ST
Phone: 949-294-9057 CELL ISSUED BY: /�_
NEWPORT BEACH,CA Zip 92663- . Cr
Owner HGC IRVINE, LLC
Address 190 NEWPORT CENTER DR
SUITE 220 Phone: 949-644-8900 '
NEWPORT BEACH,CA ' - Zip:- 92660- ' - • ' - - -
Contractor PATTERSON CONSTRUCTION CORPORATION
Address: 421 31ST ST -
Phone: 949-294-9057 CELL
NEWPORT BEACH,CA Zip: 92663
License:802367 ,
SCOPE OF PERMIT , .,
• CONSTRUCT NEW 2,408 S.F.SFR. 1186 SQ.FT. 1ST FLOOR:1222 SQ:FT.2ND FLOOR;439
SQ:FT GARAGE;85 SQ.FT PORCH,DECK 1 -35 SQ.FT,DECK 2-37 SQ.FT.',
4 BEDROOMS,2.5 BATHS.TR 16526,LOT 2. -
REF:B04-01389 .
•
• 1 NEW RES ELEC - ' - --
GARAGE:4LIGHT FIXTURES,4OUTLETS, 1 SWITCH, 1 MOTOR TO1 HP. .
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) $134.85 2408 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 Fixls $4.40 4 up to 50 kva/kw $0.00 " 0
Recept Outlets $4.40 4 up to;100 kva/kw $0.00 ' 0
Switches $1.10 - 1 •- over:100.kva/kw _z ' $0.00 0 -
Non Res Appl $0.00 .. A - Low Voltage Equipment $0.00 0
Res Appl $0.00 .0 ' ' Low Volt Wiring System/Ckt $0.00 0
Service to 200a $0.00 ' "0' ' Misc.Conduit , " $0.00 . 0
Service to 1000a " $0.00 - 0: - ' Mise.Conductor. ,.- $0.00• '- 0
Service over 1000a . $0.00 0 Circus -
(geri ocride) '' , $0.00� 0
Motors to 1hp ' $475 - - ,' 1 - .. Circus(Sett.ride or lights) '.=,‘,`"$0.00 % ' 0'
Motors to 10hp -$0.00 - .0.ti t Christmas Tree Stand ',.,,,,- $0.00" 0
Motors to 50hp -$0.00 _0i ' Fireworks Stands+' .10.00 • 0
Motors to 100hp $0.00 " . 0 ' • . - Other Electrical Fee,: , -:',‘ -$0.00
Motors over 100hp
Communication drops $0.00 0 ;. ' 7, - Investigation Fee'',• - $0.00
Sub panel to 200a $0.00 0 - Plan Check.Fee:'t, -" ' $0.00
Pole Light Pkg $0.00 0 Reinspection_Fee $0.00
Sign Circuits $0.00 0
Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $173.00
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 /
i
244646(6/00)
DECLARATIONS
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 w0 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 carter and policy number are:
Carder. Policy Number
(This section need not be completed if the permit is valued at one hundred dollars($100)or less.)
I certify that In the perfo I- v: of the wo 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 o -:Mamie,and ag :: that if I should become subject to the workers'compensation provisions of Section 3700 f the Lebo Code,I shall forthwith
comply with these• ovislos.
Applicant Signature: Date:
WARNING:FAILUR 0 SEctJA. • ',tor - TION COVERA• .i ::a• • 0 SHALL SUBJECT AN EMPLOYER TO CRIMINA P TIES ANO CML FINES UP TO ONE HUNDRED
TH(YJCAND•• I. •INION TO COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR WOE,INTEREST,AND ATTORNEYS FEES,
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under prod los of Chapter 9(co•- encln• th , tion 7000)of sion 3 of the Businessand Professions Code,and my license Is In full
force and effect.Uc.# e0? 6 7 Class# A
Contractor's Signature: Air "' Date: - ID,
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,CMI Code).
Lenders Name: Lender's Address:
•
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business end 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 em 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 d' on.
Signature: Date:
Division of Indust 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 Calllomie Health and Safely 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
the California
Health
exceptions,with some requires reth th
Costa Mesa Fire Department Dg businesswhich at anyoSne time has on hand a quantity ofacutely hazardous materials equal to ogrraterthanawei weight pounds, or avolume 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 en RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes 0 N
(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? LI Yes Li No
(Section 65850.2 of the California Government Code requires that the requested information be fumished 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 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 end Emissions.
Signature: Date:
CERTIFICATE OF COMPLUWC AUTHOR r 1 i!N 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 all stet: : and ci e?tn•;noes relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described props or ins!,,:.... •on purposes. fano to•• py or allow occupancy of any building authorized by this permit untifinal In �
ctlon.
7/77o•�
Si.n: • •T/l Ow.- s) ate
And/Or Authorized Applicant Date
CODE I, INSPECTION TYPE IMIE IfflinALE ;DDE• INSPECTIONTYPE DEE Magi
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing ,' I
200 Final Re-Roof 210 Final Electrical ' loo
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