HomeMy WebLinkAbout894 18TH ST - Building Permits�
(714) 754-5273 • Fa�c (714) 754-4856 • vnvw.ci.costa-mesa.ca.us 77 FAIR DRIVE, COS7A MESA, CA 92626
BUILDING PERMIT
Job Address: 894 W 18TH ST
Suite:
Vicinity:
Parcal Number. 42418238
Applicant: HREHA, DAVIb
Address:
Owner: JAKOSKY, JOHN JR TR
Address P O BOX 7836
NEWPORT BEACH, CA
Contractor. 294 W 18TH ST
Address: COSTA MESA, Cq
Zip: 92627
Arch :
Address:
Zoning:
Phone: 949-646-5001
Zip:
Phone:
Zip: 92658
Phone: 949-64&5007
License: 273876
Eng:
Address:
ISSUED BY:
Sfatus: ISSUED
Applied: 04/O6/2004
Issued: 04/O6I2004
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
DEMOLISH EXISTING UNPERMITTED MEZZANINE AND TERMINATE UNPERMITTED ELECTRICAL. '
REF: C04-0588.
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total:
$0.00
$23.50
$0.00
$0.50
$0.00
$0.00
$24.00
SETBACKS
MAINSTRUCTURE Fronl 0-0
ACCESSORY Front 0-0
PARKING Existinq: o
Rear � 0- 0
Rear ' 0. 0
R uired: 0
FEE SUMMARY
PLANNING & ZONING
LeN � 0- 0
Left 0- 0
Pr000sed: 0
Calc Valuation:
Claim Valuation:
Right 0- 0
Righl 0- 0
Szso.00
s25o.o0
NO710E: The work authorized by this permit shall comply vnth all applicable handlcap access requiremenis under California statutes and related
regulations. (Ord. No.92•28, § 7, t241-92)
EXPIRA710N: Thls permit shall automatically expire and become void II work Is not commenced within 180 days, or it work Is suspended or abandoned
for a period of 780 days.
INSPECTIONS: In order for the work authorized under this permit lo be considered legal, such work musi comply with ail applicabie codes, antl elI
requlred Inspectiona 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
Zaaase leroo)
WORKERS'COMPENSAnON DECLARAnON:
I hereby eMirm under penalry of perjury one o1 iha tollowing tlaGarelions:
❑ I heve end will meinteln a cenificete ot consent to selbinsure tor workers' compensation, es proWdetl for by sectlon 3700 af the Lebor Code, tor ihe pertortnance W ihe
work for which Ihls pertnl� I5 issuetl.
❑ I �ave end will melntain workers' compensatlon InsyyyFFFeeence, es requiretl 6y section 3700 of I�e Lebor Cotle, tar Ihe peAormance of Ihe work for which this pertnit is Issued.
My workers' com ` n In r ce card r e �mber ere:
Cerrier. Policy Number: �
(inls secnon need no+Ee comWetetl ir the pemur vaNed et one nundred dollars (Sloa) or �ess.)
nity that in �he performance o1 ihe work lor which this peimit Is I55ueQ I ahell not employ any person In eny mennar so es lo bec me sub�ect to tha workers'
compensatlon laws otCalila entl agree Uat il I shoulC becwne sub�ect to t�e workers' campensetlon pmvlsions of Sectlan 37 of the Le r Code, shell forthwit�
DN with these proD lons.
Applltent Signeture: Dete:
W/ RNINO: FAIIURE TO SECURE WORKERS' COMPENSATION OOVEMOE IS UNUW FUL AND SHALL SU&IECf Ml EMPLOVER TO CRIMIN�L PENqLTIES AND CML FlNES UP TOONE MUNDRED
THOUSAND DOLLARE (5����I.IN ADDITIqJ TO THE CQST OF COMPENSATIpJ, DAA4I�ES AS FROVIDED FOR IN SECTION 3]OB OF THE IABOq ODDE. INTEREST, AND ATiORNEI"S FEES.
LICENSEDCONTRACTORSDECLARATON:
I hereby eNirm Ihat I 9m Iitensetl untler pro�risians ol ter 9(commendng wlih Sectlon 7000) ot DMsion 3 0l ihe Business antl Professions Code, anA my Iicense is in full
�OrCO 90d BRBLi. Ll0. d CI854 M '
Contracrofs SlgnaturB: Deta: .. /1 /1 ,
CONSTRUCTION LENDING AGENCV:
❑ I hereby eHirtn that thero is e construction lentling egency for ihe perlormence ol I�e work for which this permit Is issued. (Sec. 3097, Civll Code).
Lender's Neme: _ Lender's Addross:
SlpnaNre:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby ettirm t�al untler penafty ot perjury Nat I am E%EMPT FROM TNE CONTAACTONS LICENSE LAW tor the tollawing reeson i5ec. 7031.5, Business enE Professlons
Code: Any ciry or counry which requiraz e pertnit to construct, elter, improve, tlemollsh, or repair any slrucWre, D�ar lo its issuance, elso requfres the epplicent for such pertnit
to lile e signetl stetement thet �e or she is licensed pursuant ro the proWsions oi the Contractors License Lew (Chepter 9(commencing wlth Sectlan 7000) of Dlvisian 3 oi the
Business entl Professians Cotle) or t�et he or sha is exempt therefram and ihe basis lor Ihe elleged exemption. Any Nolation of Section 7031.5 by any epplicant for e pertnit
su6�ects Ihe epD�icant to e civll penalry of not more then five hundred dollars ($500).): �
❑ I, es owner af the property, or my emplqrees wlth wagas es Ihelr sole compensetion, WILL DO THE WORK, and the structure Is not Intendetl or oHered tor sale (Sec.
7044, Business and Professions Code: The Contractore License Law does no� epply to en owner ot property who builtls or imprwes thereon, and who does such work
himself or herselt or Ihrwgh his or her own employees, provided that such impmvemems are not Imendetl or oHared for sale. II, however, Ihe 6uilding or improvement is
soltl wit�in one year ai completion, the owner-builder will have Ihe burden of proving that he or she did not Duild or improve tor purpose ol sela.). -
❑ 1, as ov+ner of the properry, am EYCLUSIVELY CONTqACTiNG WI7}1 LICENSEO CONTRACTOHS to construct the prolecl (Sac. 7064, Business and Professions
Code: The contraMors License Lew does not appy lo en owner ol properry w�o builds or Improves Ihereon, and who contracts br such project with a contractor(s)
license pureueN �a tha Comractors License Lews.).
❑ I em exempl under sec.
Signature:
Owner ID vadfled by d��els Ilcense. ❑ Yes ❑ No
Business antl Prolassions Code for ihis reason;
Vedllcetion af Ownership by (type oi tlocumeN, i.e. - property tes bill or deetl):
DIVISION OF INOUSYRIAL SAFETV PERMR CERTIFICATION:
Driver's Ucense No.
Date:
Expires:
� I hereby certity t�et no axcevation frve (5) or more leet in depth into which e person is required to tlescend, will De made in connectlon with work eutho�ied Dy th(s
permit, antl t�at no building structure, scaflolding, telsework, or tlemolitbn or dismantling thereol, wlll Ge more Ihen ihirty-six (36) leet high. (Chep. 32, Grp 2, An 2, Sec.
341, Title 8, Calltomia Adminislraiive CoGe).
❑ As owner-bullder, I wlll not employ enyune to do wark whic� would require e permit Iram the Dlvlsion ol Intlustdel Safery, es notetl above, unleu such person has a
permit to do suct� work trant the division.
Signeture: Date:
Dlvision of Industrial Sefety PertNt Number:
ICER7IFlCATE OF COMPLIANCE AND AUTHOR¢ATION OF EMRY: I cenily under penelry of perjury that I have read this application an0 state Ihat the infortnation given is (
correct. 1 flgree to cahp�y with all state Wws flrnl dty ocdinances relaUng to 6ullding wnsUucUaq antl aulhodze representaUves ol Ne Ciry at Costa Mese to enter upon Ne
ebove-described propehy tor Inspection purposes. I egree not to oecupy or ellow occupancy ol any builtling authorized by this permit unpl final inspection.
LODE t. INSPECTIONTYPE
1816
1288
200
201
202
203
Si egelOwner(s)
AnNOr Authonzed AppliceN
Fi:etl System Flnal Flre PrevenGon
Pool Spe Fin91
Final Re-Roaf
FIna181ocWRa�alning Well
Flnal Fectory Fira Plece
Finel Sign
204 Final Demolition
QAg I[�ELS
COUE I INSPECTION TYPE
206 Final Mechenical
208 Finel Plumbing
210 Finel EIecl�Icel
212 Flnel Flre Praventlon
220 Flnel Planning Approval
222 Flnel Slte
250 FInalBullding�Occupency
PA� It�li
�...r�.�:
(714) 754-5273 • Fax (714) 754-4856 • www.ci,costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Address:
Suite No
Viciniry:
Parcel Nunmber:
Applicant:
Address:
894 W 18TH ST
42418238
HREHA, DAVID
Owner: ' JAKOSKY, JOHN JR TR
Address P O BOX 7836 �
NEWPORT BEACH, CA
Convacwr: 294 W 18TH ST
Address: COSTA MESA. CA
r
� ISSUE FEE
Temp service test
� Res. a/c package
� New Res (1-2 units)
New Res (3+units)
• Pool / Spa
Lighting Fixts
Recept Outlels
Switches
Non Res Appl
Res Appl
Service to 200a �
Service to 1000a
Service over t000a
Motors to 1 hp
Molors l0 10hp
Motors to SOhp
Motors to t00hp
Motors over 100hp
Communication drops
ISSUED BV:
Phone: 94&6465007
Zip:
Phone:
Zip: 92658
Phone: 94&6465001
Zip: 92627
License: 273876
Status: ISSUED
Applied: 04/O6I2004
Issued: 04I06/2004
SCOPE OF PERMIT
DEMOLISH EX�STING UNPERMITTED MEZZANINE AND TERMINATE'UNPERMITTED ELECTRICAL.
REF: B04-00678. REF: C04-00588
$23.50
$0.00
50.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
50.00
$0.00
$0.00
$0.00
$0.00
so.00
$0.00
$0.00
$0.00
50.00
Quantiry
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
FEE SUMMARY
Temp Dist System / Llghting
Busway 1100 fl
Standing Section
Misc Electrical Equipment
Transtormers up to 1 kva/kw
................up to 10 kva/kw
.................up to 50 kva/kw
.................up to 100 kva/kw
..................over 100 kva/kw
Low Volfage Equipment
Low Volt Wiring System I Ckt
Misc. Conduit
Misa Conductor �
Circus ( gen or ride)
Circus (mech ride or lights)
ChrisMas Tree Stand
Fireworks Stand
Other Electricai Fee
InvesUgation Fee
Quantity
$0.00 0
$0.00 0
$0.00 0
$18.20 1
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
NOTICE: The work authorized by this pertnit shall compty with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12•27-92)
EXPIRATION: This permit shall automatically expire and become void II work Is not commenced within 180 days, or it work Is suspended or abandoned
br a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspeclions and final approval must be obtained. Failure to obtain Inspections and final approval will result in the expiration oi ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
za+s-ae �emo�
i
�
WORKERS' COMPENSAYION DECLARATION:
I hereby eHirm untler penalty of per�ury one ol tha tWlowing deGarations:
❑ I have end will maintei� e ceNficete of consent to selt-Insure �or workers' compensation, es provided far by section 3700 of the LeDor Gode, for ihe peAortnence ot the
work for which ihis pa��� �S issueE.
O I �eve and w�11 meintefn workers' cwnpensatbn insu nce, es reQuiretl by section 3700 of Ne Lebor CoOe, lor Ne performence of Ne work for whkh NIs pertnit is iswed,
My workers' compe tlo s n e cerrier an�umEer ere:
Carder. Policy Number:
(Thls sect/on need not De c+�pleted U fhe permit Is luetl et one huntlred dollars ($f 00) or IessJ
'[] I.cerliy that in the pedorma�e ot t�e work for which this peimN ts issued, I shall not empfoy any peraon in any mannor so es lo ecome subject to ihe workers'
y%ompensetion lews of Celifo that if shoultl bewme subJect to t�e workers' compensatlon pmvlsions ol Sectlo 3 00 of t e Lebor Code, I s�ell lon�with
comply wlth these proWsions. ��
Applicent Signature: Date: ,
WARNINO: F�ILUPE TO SEWRE WORKE0.S' COMPENSATION COVEMOE IS UNLFWFUL AND SHNL SU6IECT AN EMPLOVER TO GRIMINAL PENALTIES A1 D CML FlI IES UP TOONE HUNDRED
TiK)USAND DOLLARE (5100,OWA IN MORION TO TME Cd6T OF COMPEN$ATION, �AMAGES AS PFOVIDED FOR IN SECfION 3]OBOF THE IABOR COOE.INfEREST. AND ATTORNEY u FEES.
LICENSED CONTAACTOPS DECLARATON:
I hereby altirm t�at I em licensecd- -u�nder proWsiads oi Chapter B(commendng wiih Section 7000) of DlWsion 3 0l ihe Busineu end
lorce entl eNect. Uc. M � \� Cless N
Contrectors Signamre: � — Date:
Code, anA my Iicense is In tull
CONSTRUC710N LENDING AGENCY:
❑ I hereby ettirtn thet there is e consiruction lending egency lor ihe peAormance ot the work for which Ihis pertnit Is issued. (Sec. 3097, Civll COde).
Lendels Name: Lendefs Address:
Sipnature: Date:
OWNER-BUILDER DECU�ATIONS:
I hereby eftirtn that unCer penelry of per�ury that I am EJ(EMPT FROM THE CONTRACTOHS LICENSE LAW tor Ihe following reeson (Sec. 7031.5, Buslness end Protessions
Coda: Any ciry or counry wnlch requires a permit to consiruct, elter, Improve, demdish, or repalr eny structure, prior to Its issuance, elso requires the applicant lor such pertnit
b flle e slgned stetement tl+et he or ahe Is Iicensetl pursuent to the provisions of ihe Contraciors Llcense Lew (Chapter 9(commencing with Section 7000) of Dlvislon 3 of Ihe
Buslness end Prafessions Cotle) or thet ha or she is e:empt tharefrom entl the besis lor Ihe elleged exemptian. Any violatlon a� Section �031.5 Dy eny applicant tor e pertnit
sub�ecis Ihe epplicant to a Gh�l� penelry ol not more ihan live huntlretl dollers (5500).):
❑ I, as owner of tha properry. or my employees with wages es t�elr sole compensation, WILL DO THE WORK, and ihe siructure is not Intended or oHered lar sale (Sec.
7044, Business and Professbns CoOe: The ConVaclors Ucense Law does not apQly to en ownar of property who huilds ar improves thareon. and wtw does such wak
himself w herselt or Ip�ough his or her own employees, proNded thai such improvements ere not Intended or oHered br sale. II, however, ihe building ar Improvement is
soltl wit�in one year o� �mpletion, the ownerbuiltler vrill �eve Ihe burden o� D�oving that he or she did not build w improva tor purpose of sale.). �
❑ I, as owner of the property, em EXCLUSIVELY CONTRACTING WfTH LICENSED CONTRACTORS ta construct Ihe project (Sec. 7044, Business ana Professions
Cotle: The contractor4 License law does nat appy to fln owner of pmperty who builds or impmves thereon, antl who comrects br such project with a comractor(s)
license pursuant to tha Contractors License Laws.).
❑ I em exempt under sec. Business end Protessions Code for Ihis reason:
Signe�ure: Da�e:
Owner ID verifietl by driver5 Iicense. ❑ Yaz ❑ No Driver's License No. Expires:
Vedticetion ol Ownership by (rype oi tlocument, i.e. - properry teu bill or deed):
DIVISION OF INDUSTAIAL SAFETV PERMR CERTFICATION:
❑ I �ereby certity ihet ntl excevetlon tive (5) or mora feet In deplh Into which e person Is requlred to tlescend, will be metle In connection wlth work euthorized by this
permit, anC t�at no Du��tling siructure, scaHoltling, falsework, or demolition or tlismantling Ihereol, wlll be more ihan thirty-six (38) leet hig�. (Chap. 3.2, Grp 2, Art 2, Sec.
341, 71t1e 8, Celltomia AdminislretNe Code).
❑ As awner-builder, I wlll not employ enyune to do work which woultl require e permit from the Divislon of Industrlal Sefery, es notetl ebwe, unless such person hes e
pertnit ro do such worN Irom tha tllvision.
Signeture: Date:
Division of Industrial Sefery Permli Number:
HAZARDOUS MATERIALS �1D EMISSIONS CERTIFICATION:
t WIII the eppOcent or present or tuture Duiltlinp xwpeN need to file enC certify a Business Plen br emergency response to releese or threatened releese of e heeertlous
meterlel7 ❑ Yes ❑ No �
(Sectlon 25505 �f th� Celitomie Heelth end Satery Code reQu�res, with some exce�tions, Ihet a Business Plan be IiIN with t�� Cost� Mesa Fir� Npartm�nt Yy �v�ry �
business which �as et eny ona tima during e reponed yeer e quen�liy ol hazerCous matenals equal to or greater then e weig�I o1500 pounds, or e volume of 55 gallons,
........._or 200.cuDic feet.of comDressetl ges et,stantlard temperature,end, pressure):......._ .:......................................................................................................._.............................___............"_.............___.
2 Does ar will tha applicant or present or future 6uiltling occupani neetl to hle e registretion lorm lor ecutely hazardous meterialsl ❑ Ves ❑ No
(Sectlan 25533 af the Callfamle Heelth antl Salery Cotle, wlth some exceptlons, requires registretlan wlih t�e Costa Mesa Flre Depariment by eech busineu which et eny •
one time has on hantl e quentiry of ecutaly hezerdous mete�lels equel to or greater Ihen e weighl ot 500 pounEs, or e volume ot 55 gallons, or 200 cublc teet of
comoressed ues et stentlartl temperature antl pressure).
or wlll ine applfca�� or presem or
need to prepare an
(Section 25534 of the Califomia Health and Safety Code provitles ihat the Costa MeSa Fire Depariment may requlra Ihe preparation, cehifiwtlon end tilinp with ihe Flre
Department of en RMPP by Duslnesses wNch are requlred to reg�ster acutety hazardous matedels wit� the Fire Department.
....................................._............_.--........_.._._._..'_."__...__._.._.........................._................__.................................................................................... ........................ .____..............._�........._._
4 If en RMPP is presenity �equireq �as SecUon 25534 ot the Celifomia Heelth and Salery Code been fulty complied with7 ❑ Yes ❑ No
.................._..................._................._—.._.._._......_..........'_'._..."_.._............_....._._....."'...............__..........................._..................................._._.........................................._................_.."__'............_
5 Does or will the applicant or presem or tuture bulltling occupant requlre tor the work wnleh Is ma sue�ea ol tnis e�PIicetlon a ertnit lor suc� consWcibn or modification
trom the South Coest Air Ouellry Menegemem DlsMci or from eny other elr pollWon control tlisidct or agenc�? �,J Ves � No
(SeCtlon fi5850.2 ot the Celifomia Govemment Coda requires Ihet t�e requestetl intormetlon be furnishetl on applications lor nomresidentiel bWltling permits).
................................................................................................._.....__.._....................................._.............................................................................................................................................................._._...................__.................."'
8 W ill eny part ot the faGOry 10 ba constructed under this permit be wiihin t0001aet trom the oNer bountlarles oi e school? ❑ Ves ❑ No
Qf'j�es", tha taciliry mus� meet the requirement ot Sectlon5 25534 and 42303 of the Celibmla Health end Safery Code).
......................................_._........................_..__.._ _._...............—._....._...._.......................__...._......................................._.__......"'_'.........................�.._......._..'_'....."'_
7 If e permi� irom 1he South Coest Air �uality Menegement DiStritt or olher eir polWlion control disirict or agenry is repulrad br Ihe work which I5 Ue subjeci of Ihis
epplicatlon, have ell of Iha dlsGosures prescribed 6y Celitomie Health and Safery Code Section 42303 been made7 � Ves ❑ No
..__........._.... � ' '_"._"._ .....................................'__'_'_'__
B (II yes', anach certifica�e ot compliance Irom the apOroP�ate air pollutian control oflicer).
CERTIFICATE OF COMPLIANCE: I cenity that under penalry ol perjury the infortnation given ebove is conect. I agree to compty wit� all state laws flnd dry ortlinances
regarding Hazardous Matedals end Emissions.
Slpneiure: Date:
CERTIFlCATE OF COMPLIANCE AND AUTHORVA710N OF ENTRY: I certity under penelry of perjury thet I hava reed Ihla epplication entl state t�at the inlormatlon given is
cortect. I egree m comply with ell stete lews enC ciry orAinances releting to builtling constructlon, end euthodze representatives ol Ihe Ciry ol Costa Mesa ro enter upon t�e
ebove-described property lor inspection purpases. I egree not to accupy or ellow occupancy ol eny building euthorized by Ihis pertnit until finel inspection.
natur ner(s)
And/OrAuthorized Appiiwm
LOOE �• INSFECTIONTYFE
1616 Fi:ed System Finel Fire Preventlon
1288 Pool Spe Finel
200 Finel RaRoof
201 FIneI 81ocWRelaininp �"1e��
202 Final Fectory Fire F�aca
203 Finel Slgn
204 Final Demolilion
Q�]E �¢ �j INSPECTIONTYPE
206 Final Mec�eniwl
200 Final Plumbing
210 Finel Electrical
212
220
222
250
Finel Fire Prevention
Final Planning Approval
Final Site
Finel Bullding/OccuOency
P6�
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It�