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HomeMy WebLinkAbout256 19TH ST - Building Permits ill ' Ms _ CITY OF COSTA MESA 44 BUILDING DIVISION °,!'� �. F I r,;,w � I DEVELOPMENT SERVICES DEPARTMENT PE MIT NUMBER PERMIT -`�•c0. D ,'�1B03-01203 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca..uUI LDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 256 E 19TH ST Status: ISSUED Suite: Applied: 07/16/2003 Vicinity: ROOF Issued: 07/16/2003 Parcel Number: 42628118 Zoning: Applicant: KAISER, MIKE ISSUED BY: Address: 928 CHEYENNE ST - ' - ���i Phone: (714)979-5314 • COSTA MESA;CA/-/- -"" - Zip: 92626 Owner: GRACEY,-PAUL M - •. Address 256-B E19TH ST . Phone: COSTA MESA,CA. - Zip: 92627 Contractor: vKAISER'ROOFING Address: 928 CHEYENNE ST ' Phone:, (714)979-5314 COSTA-MESA,CA Zip: , 92626 • License: 682897 • Arch : - - Eng: . Address: . Address:- - Phone: - Phone: -Zip: License: License: _ SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 30 YEAR G.A.F.SHINGLES,REPLACE SHEATHING AS NEEDED AND 30#FELT.2,000 S.F.FOR RESIDENCES ONLY(UNITS AAND B)`"'" - - • FEE SUMMARY Plan Check: $0.00 Calc Valuation: $3,400.00 Permit: $97.25 Claim Valuation: $3,400.00 ' SMIP Res: $0.50 SMIP Corn: $0.00 Other:' $0.00 Inspection: $0.00 Total: $97.75 - PLANNING &ZONING SETBACKS . . MAIN STRUCTURE Front ' 0-0 Rear 0-0 ' Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-9 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)754-5626 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. ❑ `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 workerj'compensation Insurance carrier and policy number are: Carrier" 5m M. P(AnitPolicy Number: 06 0/6-zr— -2 043 (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provision Applicant Signature: //l.b /� Date: 7-, 4- o3 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 DOLIARE($100,000),IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licenseid under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and�dProfessions Code,and my license Is In full force end effect.Lic.# V 7 Class it C- 3 1 Contractor's Signature: h7/ //G"T Date: 7-/6- 62 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 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 fora permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): El 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 havethe burden of proving that he or she did not build or improve for purpose of sale.). • ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes ❑No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need t0 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? ❑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 a2ermit 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 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? ❑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? ❑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. I i-, i natu a Of Legal Owner(s) 77S-0 Date And/Or Authorized Applicant Date CODE IL INSPECTION TYPE ' ' PATE QIJTRIALS CODER INSPECTION TYPE QATE 1NTRIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 7'/n) �y.��a_ 208 Final Plumbing 200 Final Re-Roof 1"� 419 l�'W`"' 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 ADDRESS OF MM. 2256 E 191H ST ger: CITY OF COSTA MESA - BUILDING PERMIT OWNER'S NAME IFI ant GRACEY_ PAUL N PERM NO: B 085769 enst256-B E 15TH S1 - COSTA MESA,CA 92627 PERMIT NO: B 085769 PLAN CHECK NO: N GOVT : N SUPP: N _"' APPL.MMWCADORES& CONSTRUCTION TYPE: V-N PERMIT TYPE: SIR PURPOSE: 0 H ARCHITECT OR FNCINffk UC.MD. JOB DESL.Ri. si.ON : 1/OFF & REROOF W/TORH DOWN SQ FT: 1 , 200 _ ARCH.OR ENGla ADDRESS: OMT: CLAIM VALUE: 1 , 200 . 00 CALC-VALUE: 1 , 200 . 00 GROUP OIC: U-1 /R-1 canRAcraR'SNAw: KAISER ROOFING ( 714 ) 979-5614 cmAiRMMa 9e8 CHEYENNE ST COMMENTS : GARAGE ONLYADDRESS: C .M. CA TICN . bBL^ __ zzzxzxxxxzzxzzzzxxxtx xxxzxxxxx xae t it t t t ara r t tit txxxrzxxrrexiaiext iar tit itii.zi ' ccx ie itxi 7 2 b.eb WIT: Z ONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby slim under penally of perjury that I am licensed under provisions of Chapter 9 SETBACKS (commencing with Section 7000)of Divbun 3 of the Business end Professions Code,and my license i in IUD force and Sled. CrrYuc.N0.:064056 LIC.CLASS: C-39 4C/.NO.: 682897 EXP: 01 /98 MAIN BUILDING ACCESSORY BUILDING 11'1]-/997 cmttedeJlk/fed +0(�0` FENT: FT IN REAR: FT IN FRNT: FT IN REAR: FT • IN 4101 / LEFT ; F1IN RGHT: F1 IN LEFT : F1IN RGH1: 2' 1 114BUILDER DECLARATION:I hereby affirm under gassy d pe'FKY that 1 w nand from the Cwradon License law la PM .reason Medial 70315 Business end PNeaaam Code:Any ray o minty which earls a Perna Pi construct ober.endow., PARKING REQ: PROV: PARCEL: 42628116 'ENE: REF NO: omoteh,or repai any mutters.prior toes issuance,deo requires Us appGcan for each pane to file a signed stelemam that he a she —. ,licensed pursuant to the proveicen a the Contractors License Law(Chaplet 9(commencing with Sedan TOW)of Duan 3 a the PLANNING NOIES>.., user's and Profession Code]or that he or she is exempt therefrom and the basis for the alleged exemp'at.Any violation a Semon > 14 7W.5 by any applicant aapermit cute=the epPeaa toe dg penalty of rd more then fire hundred donors MOOD. z..z..+z..z..z....z..x..+3x..x..x..x..x..x..43z..4*3z..3.z3z..z..34z....z..3z..x.. iit i xiit t txxtrxxiexat aat e>ciixt t it e e tzic iiyx e>rx;* ❑ I.as owed the property or my ermMe•erind wages as the*ate compermtion,y do the work and to Scene's m intended D E V ESL V P M E N 1 SERVICES R E f U 1 R E M E N 1/ S or offered foredo(Section 7044.Business and Professions Code:The Contractors License Law does not appy to an Owner d progery who bolds or implore thoraces.and who does such worn Kissel or hared or through or pl throughgh hher own employees,Provided that such n improvements ars no Mended o altered Ice sab.t,however.the bulging or improvement is sol within one year of annotation,the ZONING APPROVED BY • owner-builder ell have the burden a MOM he a she did rod bad or improve la purpose of ere). L.,"-7 • DATE: _ ❑ Le a oawr a the Contractors License doecel kcalyt wnomamneem Ne (Sadat DATE. i Professions code:The Cs eat,as Law does not sutaY r an owrw a properly who builds a improves thereon and who B U 1 LD 1 V Y Y KU V hD B I coned,tor such meads with a mnredo(s)[named pursuant to the Contractors License Law). ❑ Tamexempt under Section: B.BP.C..Wthe reason: APPLICATION ISSUED BY: DATE: arse sew srs'ivs-learn w-sir erne eyestores-sr w x x x x xx x x xxxx xwn-sr x xx x x'Rx xxx xxxx*'*'*alltathxatxxxse xx frit* Dale: OnLEGALIZATION:N F E E SUMMARY STRUCTURAL ' GMEI 1:Y I do hereby certify that I am aware of and Understand the regdnmana of Caliente Heal and Safety Code Sedans 25505,?syn.end 25534,and that I or any haus building occupant will/wil not(drab one)need N comely with said pate Dods and the requirements for a permit loeorstructionce modification from the Airt •oepenw OiandResid dSmnandioneppiwas ens eradtromhse BLDG PHI PLUMBING ELECTRIC MECHANIC FIRE SMIF/RES GRAiDINl, ProNabne. PERMIT 40 . 25 . 50 Dae: Apptaent:_ S M I P/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby am way penalty a o perjury w d the Sawing declarations:t N ISSUE FEE ❑ Ihave end whnsbaenacertificate of canon tosdinwvefor woken'coag•subs.s provided101W&ceon3700olin Leber BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE coot lot the performance a the wank for Mich this permit a betted. Li and TOTALS woke&compasuan insurance.as mound try Sudan 3700 a the Labor the athe TOTALS - > 40 . %5 0 . 00 V . VV 4U . 7J IV . 75 l/0 work lot with Ne pent is issued.My woken'canpasa ce insurance wrier and policy number are: Cada: REVENUE DIVISION TOTALS--> COLLECTED: 40 . 75 OVER/SHORT : . 00 Po0cy Number BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK rails Toro need rot be completed I the erne is tor one handed dole MOM°,Wert 4V . 25 50 I caddy Uel in the performance d the wait for which the pane b Issued, any nI shall nd employ penman in any manN mariner so as escorts Babied to the weds*'comPensabon laws d CsMomia.and Kass OM i 1 skald bsuOme to the wen• ii ii .. .. W ..... ... . ... ......... bpd .. ««Teat xxxat it it xat at at itxat iteitxxxxir itxitxaf itx xis at it it itz atexatzit itxit it it at ie-it St iizx zicxzzSex x7t x>t itxat it ii aux 7txxxz7t it partake pro/labels d Section 37W d the Lobo Code,I dud Io4hrAth OPmpy with those povmcrs. (1-ii-1947 APeliunl: M,I/C $*tel I N D I 'V I D U A L F E E B R E A K D O W N Warning:Falun to aeon workers'corrparsatlon coverage is anlarfu(and she subject an employer to criminal penalties and TYPE Q TY D E S L It 1 Y 1 1 V N UNI 1 l V S 1 TOTAL COS 1 civil fines up to ons hundred thousand dollars(yfag00lA in addition to the cost of compensation,damages as provided roe In Section 3706 OI the Labor Code,!Molest and attorneys fees SFR 1200 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 1 , 200 . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm oder bendy of perjury Thee there is a msuudbon Wiling agency for the performance d the work b ch th which permit is issued(Seaton 3087,Civ.C). END V tFEES LENDER'S NAME • LENDERS this ADDRESS:catio \ I and staNaIhewig to oreingvcn and tlaethatthe e400edar eeantmmolf Ipre•t campyoven egayve-msryeddewiss and state Laws purposes robuibaq Pgnabuabon end hereby arlvvKnkpreerlaineadthe city to enter span the above-mentioned property fa inspection purpose. MIKE KAISER 11-17-1997/09:47 AH/f40,75 Pig Nana RCPTR:191-0315501 /kyr f/`/7-/f 9? PERMIT:085769 Signature d OwtadAgent/ nm (5151-4/.WP) Nntae-&ntog a Safety Great-Fee:Gamy-Appiwu:Ilk-Revenue:OoMauod-Assessor f CONSTRUCTION AND PLANNING , POOL - LPA APPROVALS Peynit# 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 UFER 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, ❑.ZJndrgrnd. 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 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory FireplaceAPPROVALS Permit # 21. Ducts, in Structure . 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test - • 72. Underground Flush 24. Roof Framing - • 73. Undergrnd.Stdrag_a Tank 0 Gas 0 Oil 25. Roof Sheathing ` -01-41 r 74. Overhead HydrO 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing • 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation - - 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat • 79. FINAL INSPECTION , 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED • 33. Final Electric - Notes: 34. Final Heating& Air Conditioning 35. Final Gas Pipe-Test . 36. Hood or Canopy - - - 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 - 45. Sound Attenuation 46. Handicap Regulations - 47. FINAL STRUCTURE & BUILDING l , _` 47 48. FINAL PLANNING 49. Electric Release to Edison - - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date Costa Mesa Building Department APPLICATION FOR PERMIT`— P. O. Box 317 BUILDING 1 COSTA MESA, CALIFORNIA 3588 FOR OFFICE USE ONLY FOR APPLICANT �FILLL IN Receipt No. Permit No. AddrBuildess� �(� /. j/7 i I I3G b 40 Received by Date Reed. Date Issued Costa Mesa, California 80l� d -6 7,S�I Nearest �� �, 61 Cross St. D /v 9. E Building Owner f(SQA-17 i/ TO//4, Address / Mall X 6 Costa Mesa, California Addressss� O Sy C Nearest Arty i . S // /V�J/� No. Cross St Zone Q i • I Plans No.of I Type Group / Architect or No. Approve "/SIL,//l— Group .ti Engineer No. Approve by Date 30 Address / C0 arirru is tractor 0f"'C/kaL f ai Noy Lic. Address APPROVED LegalLot ICITY OF COSTA MESA Description I No. I Ir**--Block(/ I ac . '�°LAWNIidt, UtPI. (Attach Metes and Brnds)' )/ O o{1 gJ ) V SUBJECT TO LL::C. DEPT. REC. IN No. Size of Lot (B x /35" I Nowf n Lot No R By (i-). la UATE -a. �xi . .Existing Bldg. '� I Famlllep I Rooms PI AN T � �� O Setback Line from / Rear Yard c�Q -S% L• Center of Street �� Side Yard /1/f' Z DESCRIPTION OF WORK14,•2,0 k : uwu-� New JI X I Alteration I I Addition I C5- p W_ ♦! '1 Moving I I Demolish I Building /� .L7' No.of Size 16-gin Rooms 8 Stories Fvterior WailcTUGG� Roof p — ering ..JJ! CoveringCOf/. APPROVALS Building of New `�� B ulloing �� Foundation Location Inspector Date 4 .1t0 �� et —tart Under. Materials,in �(/ Under, n Frame: Fire Stops, cc Bracing,Bolts I hereby acknowledge that I have read this Application �'. ' and state that the above is correct and agree to comply Lath.Int o with all City Ordinances and State Laws regulating F: o building construction Lath. Ext. •"I•^ Signature of Permittee Plaster, Int 4 J Authorized AgtExt.Plaster, PR Valuation Permit Fee $ 3 .Z/ Masonry Reinforced / y' (—�_ Plan Check $ ' p —/C — Bond Beam � $ J `J Totai co . Fee $ FINAL y o " y d J C G - J D p a L t a. •_, .r- . • . _ _ . . ' Street •-- — ' PLOT PLAN Show location and distances from property line and between buildings. `• . , , • S.;d\\ •\\O :\1 S I . •