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Home My WebLink About276 19TH ST - Building Permits CITY OF COSTA MESA 4f < BUILDING DIVISION >•t ,. ,,,�,,,, .' , PERMIT NUMBER I DEVELOPMENT SERVICES DEPARTMENT 4 .; PERMIT StIbtstmso (714)754-5273 • Fax(714)754.4856 • www.ci.costa-mesa.cBUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 276 E 19TH ST Status: ISSUED Suite: Applied: 12/19/2005 Vicinity: Issued: 12/19/2005 • Primary Occ: R-3 Dwellings/Gong Res<10 Type of Construction: V-N Parcel Number: 42628114 Zoning: Applicant: PHILLIP RICHARDSON Address: c� Phone: 9 49-631-4320 ISSUED BY: Zip: Owner: RICHARDSON;PHILL'IP L Address 276E 19TH ST - , ,• _ • " Phone COSTA MESA,CA Zip R •I P Contractor: • Address:- - 10 - Phone: • • Yt• Zip: License: y� ��A . L ao 0- - Arch : . Eng: q� Address: - Address: DK • _ • Phone: . 1 Phone:, • Zip; License: '-- - 'License: SCOPE OF PERMIT • • .•T/OFF AND REROOF 1200SF.RESIDENCE W/COMP SHINGLES. , ' • - • FEE SUMMARY Plan Check: $0.00,--; _ , ,, , Calc Valuation: $2,500.00 Permit: $83.25 -- r • - Claim Valuation: $2,500.00 i SMIP Res:,'' °""$0.50 ; SMIP Com: - $0.00 Other: $0.00 , Inspection: $0.00 Total: : $83.75 - PLANNING & ZONING SETBACKS MAIN STRUCTURE-Front 0-0' • Rear.," 0-0 Left 0.0 Right 0-0 - - . ACCESSORY Front . 0-0- w . Rear 0-0 - - Left 0-0 Right. 0-0 ,- PARKING. ' Existing: ' 0Required: 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 end final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)7545626 2446413 WOO) • DECLARATIONS ' ° F• • ,, 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 carrier and policy number are: Cartier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) . ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($l00,000),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 DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full force and effect.Lic.# Class# Contractor's Signature: Date: 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 DE a-. A,TIONS: 'J D 1 hereby affirm that und�t Ity of perjliry.that I am'EXEMPT FROM, CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county a tY quires&permit to cortainl t:eiter,im ik(0molish,or repair any structure,prior to Its Issuance,also requires the applicant for such permit to file a signed statement the or she is.'gcensod pkiysuantto the p o cit the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the • Business and Professions a or that Se-or she lb exempt therefr nd tub 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,end who does such work himself or herself or through his• 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 corn! - o ,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 pr• '.e, : EXCLUSIVELY CONTRA G WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The conte" •.. can • Law does not apply to a•owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursue•C. ractors •nse.Laws. ❑ I am e.- t,'• ,, . �• •../ B ness and�Pr0fes50 f r this reason: Signature. ��4i� z ED ' Expires: ?C7-35 ' - 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,taisework,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: - 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 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). ._ ._ can ._tui_ ._.._ _ ....._..__ 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 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 apermit for such construction or modification from the South Coast Air Duality 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 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: --•ify 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:-• Em'. ions- Signature: // Date: — i •F ENTRY: certi penalty perjury CERTIFICATE C. ' -' AND • 0- fy under anal ofthat have read this application and state that the information given is correc -• "to .•yy.ly �I st' - laws-�-• , • dinances r ting to building construction,and authorize representatives of the City of Costa Mesa to enter upon the ab• 8-dos i••' �j/.•: •e ... . ...0 --.I-tree not to upy or allow occupancy of any building authorized by this permit until final ins ction. i Z r 7� SI• ature Of Legal Owner(s) Date And/Or Authorized Applicant Date CODE t INSPECTION TYPE PATE • MALI • ,ODE• INSPECTION TYPE - PAff. PIMA • 1616 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 Sign _ 222 Final Site . 204 Final Demolition - ' 250 •Final Building/Occupancy ' - '' • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONST UCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. [A.P.# Zone Project Address Z7S E, l yS�r�a-r 3 8'6 g4� ` ICl+". TYPE OF CONSTRUCTO U NEW U ADD U ALTERATIOry Main Building: Accessory Building: Applicant's gAddf¢is r - -C�4�� U REPAIR E Z ��"j CI CONVERSION DEMOLISH LI OTHER T Front O Owner's Namel})l-LLP ^tL PkS•''�Phone�c�I'� �� DESCRIPTION OF WORK/USE OF BLDG. C �a-t.& _ f B Rear N Address z-7 C. fir+' .. I -`� St. ,2 I� Arch/Eng. }-�'f"� /" +icense No. I' TYPE OF PERMIT U GRADING LI FOUNDATION tie STRUCTURAL C Right N ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL $ Left R Address ❑ OTHER Ping. Ref.dp Parking Req./Provided E Contractor's Name 5f1`N.-4_40e+'a•`•.YYL Phone _ - O !{. PROJECT DESCRIPTION SQ. FT. OCCUPANCY M- , Planning Notes: M Address mailing) 7 CONSTRUCTION TYPE �r R/ VALUATION$J.e_t2j !llC. T City License No. . ZONE GRADING CU.YDS. _ - ACRES S. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: (/y��y/s/ ///� If with section 7000) of Division 3 of the Business and Professions Code,and 11 asps "'^`//J(a �• ,�a'v� my license is in full force and effect. ELECTRICAL FEES Ucense Class License No. - Date Signature PLUMBING FEES Automatic Washer Transformer 0 15-50 KW WORKERS'COMPENSATION DECLARATIONBar Sink Showers Construction Pole Sub. • ❑ 50+KW I hereby affirm that I have a certificate of consent to self-insure or a certificate r' workers' Compensation Insurance, or a certified copy thereof (SectionBackflow Preventer Service Sink Cooking Unit Meter ❑up to 100 amps ', Lab. C.) _y No. Company Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps ❑ Certified copy is hereby furnished. Dryers ❑Gas DElectric- `— Sub Panel ❑ Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Date Applicant Fan EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors MOLOrS 1 HP ❑1 h-8 (This section need not be completed if the permit Is for one hundred($100)or F.A.U. less). Dishwasher Solar Piping .Solar 9-15 HP ❑16-15+ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any man as,[ mysub'ect� to the Drinking Fountains Solar Tank Fixtures Microwave Workeel�s�' Compensa�(IOn Laws of C -I/yC/. {/5/ Dater 1) MAt Y7 Signature Floor Drains wimming Pool w/Spa Device Boxesg Pole Light NOTICE: If,after making this declaration, you sho Id become subject to the e Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks / Urinal Outlets Range comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets / Water Closet Switches Sign I hereby affirm that there is a construction lending agency for the performance l/ of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Garbage Disposal Standing Sections Lender's NameGenerator ❑0-5 KW ❑5-15 KW Trash Compactor Lender's Address Kitchen Sink Water Service OWNER BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or . county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays any structure, prior to Its issuance, also requires the applicant for such permit to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains ' • the Contractor's License Law(Chapter 9(commencing with Section 7000) of - Division 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee $ 3 th^•^from and the basis for the alleged exemption. Any violation of Section 5 by any applicant for a permit subjects the applicant to a civil y of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS: - L _ as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work,and the structure is not intended or offered Zoning Approved By -nate for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL I FEES Building Approved By Date License Law does not apply to an owner of a property who builds or improves — ��....w••}}} thereon, and who does such work himself/herself or through his or her own Hood or Type I 0 Application Issued By Date •�/ employees, provided that such improvements are not intended or offered for Boiler sale. If, however, the building or improvement is sold within one year of com- - Canopy Type II 0 SUMMARY F FEES pletion, the owner will have the burden Of proving he/she did not build or im- Duct-Under Ground prove for the purpose of sale). - BUILDING PERMIT $ "2-5- - 00 SMTP $ _. 0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refri ration System PLAN CHECK tractors to construct the project (Section 7044,Business and Professions Code: $ PERMIT The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 100,000 BTU 0100,000 BTU PLUMBING $ ISSUANCE $ builds or Improves thereon. and who contracts for s .h orolects with a con- tractor(s) license pursuant to the Contractor's . Law). I . - are that Exhaust System 0 Multiple El System Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $ proof of their Worker's Compen .. is is�;l#jho It be • • de• to me. - ELECTRICAL $ GRADING - $ 1"�I am exempt under Section = for is reason Firepl/Fact.B1t. ICBG dk Fire Dampers / MICROFILM $ r�Bf PLAN CHECK 50% $ Date �go owner ThrtrAtTa lrf Heating System& Ducting Registers '- MM I hereby certify tha ev- re.• this ap(y'cation and state that the above 00-100,000 BTU 0100,000 BT MECHANICAL $ TOTAL FEE $ lJ� Information is com• ' . e'e to come y th all city and county ordinances PLAN CHECK 25% $ and state laws r ..rr•ul g uctlo and hereby authorize repre- sentatives , .' o jli .t'•'% the ••Ove-mentioned property for Inspect l•• p 4..:„/s Signature //_` Sze Date3Q. ' Drivers' (cense o 9f Reinspection Fee $15 Issue Fee $ 3 RC:QLN7 ^'7 :1 81174020__ + 0865-46,rev.5/88 White - Building: Canary - Applicant; Pink -Accounting; Goldenrod - Assessor 02 r�b3 007 0003rail1 u.'U.SSi'. t75/:i0/39 01 Le: rf-an 7C _, CONSTRUCTION AND PLANNING POOL 12-^PA APPROVALS Permit# Date Inspector APPROVALS Pe, # Date Inspector • 1. Tempotary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3_l�Electrical Conduit Utility-Undrgrnd. 54. Forms .4t Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5.,Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. }_ 8. Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final r 14. Rough Plug 65. Electrical-Final .15. Rough Ele al-Conduit 66. Solar System-Final '18. Rough Electric Wiring 67. Fencing & Access Approval pi 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 60. Rough Factory Fireplace - APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating t.) 71' Product Piping 0 Gas ❑Oil / 23. Gas Pipe-Rough & Test 14\ •72. Underground Flush • / 24. Roof Framing .-J 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 1/4..1 74. Overhead Hydro 26. T-Bar Ceiling (Structural) &CMonocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing &'Siding y 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing ,.) G' HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 2 79. FINAL INSPECTION 32. Electrical Power Mefer-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 / er,‘,1 41. Solar Domestic-Final / j_ 42. Backflow Preventer ;7,1M1 43. Backflow Irrigation iii%• 44. Landscape Irrigation System • y 45. Sound Attenuation ri,A0 ,46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING05 / 9 \p VflC 04-- 48. Special Requirements Completed 49. Electric Release to Edison i �r 50. Gas Release to Southern California Gas Co tG 51. CERTIFICATE OF OCCUPANCY r • I No Date • ' Costa Mesa Building Department •7 APPLICATION FOR PERMIT 111 EAST 20th STREET 11 COSTA MESA, CALIFORNIA 007 BUILDING FOR OFFICE USE ONLY FOR APPLICANT TO IN Receipt No: er`Permitf�N/ o. AddresBuildins / / y-/C I I /7 Costa Mesa, California Releyd by I Date Reed. Date issued Nearest fr.- ki6' /7 S.i /E t ] •iS Cross St S 7 f} n/i�J Addres Owner `` .'f-L�}S' Address '� �/ Costa Mesa, California Mail 27/ :/,t pro %,—. Address //pp ,///r, .�jf/ Nearest /� n /-�/' / Cross St. City l f:„(.."V4- / ,ssiiryo/rI fl?/K Zone /7 I No.of I Type V Group Architectgof 9?1/'/!_i-� m �J t Plans i Engineer ( 7 I�' �y Approved by Date Address CORRECTIONS City tic. Tactor No. Address Legal I Lot/o A--; I /j/��j Description No./7 C� Block Tract""S V GG (Attach Metes and Bounds)��/e�3/— / ` t has Xa 7a. I Ale.of Bldgs 6I r��f `�S Size of Lot N Now on Lot 6c, Use of No.of No.of _ 7O� Existing Bldg.gi amilies I Rooms — \ Setback Line from !!/////•� Rear Yard 9f.>" ' / OCT 1 i '�9b5 Center of Street 51* .c&7' Side Yard.Z%'.'o � >D' `. DESCRIPTIONRIOF WORK C+� �. COSTA MESA New I k' I Alteration I I Addition I l Repair I I Moving I I Demolish I ` ) Building aO y o o Roof Size i! Rpoms Stories F blor WallRo f t •ing /fgdlSToS I 9witevFcsCoMP APPROVALS Use of New �� p Foundation Location Inspector Date Building Forms,Materials, Under-Pinning Frame: Fire Stops, Bracing,Bolts I hereby acknowledge that)'have read this Application and state that the above is correct and agree to comply Lath.Int. with all City Ordinances and State Laws r lacing building construction. ////// Lath. Ext. Signature oft.......6 Permittee r/.L .�/A/f? Plaster,Int. Authorized Agt. Plaster, Ext. Valuation fermIt Fee $ .6.-0 0 Masonry Reinforced $ ei20, lan Check$ —l7e a Bond Beam yi A p� amt �, eeal $ / G FINAL C�'b't ungwed '5 x nPM 204 S-BP 2M 6-55 - . . ‘7.-.--30D . . . _- . . • a -r7 ao 'GET i1-551)01 :-a 7 :: *7Co.. • • _ - >- • I • t»:.? 1 y.-a- r, . j 1 Street . - .. •...;: ;�, ' • PLO'TPLAIIT �r�_____ Show location and distances from - - 1, property line and between buildings. • _ • .. — - - . – -1_-. _. ,_,7 r. t. - _ - - �. .. • r . '. • - _ _ ___ _ _ .. . _ .. _- • • . - _ - - - - r. . - - -- . ._ _ . . .._'__ - " t . . .. -- -- .`. -. --. . - _ _ • • .- I: . .. " ' 1 .. II M^ q1)_: v..+