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HomeMy WebLinkAbout1755 ANAHEIM AVE - Building PermitsG (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.cB�LDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 1755 ANAHEIM AV Status: ISSUED Suite: Applied: 07/29/2002 Vicinity: Issued: 07/29/2002 Parcel Number: 42426326 Zoning: Applicant: PROSERVE ROOFING ISSUED BY: Address: P.O. BOX 25307- _ -_„Phone_ (714)772-7485 ANAHEIM, CAS Zip: 92825 Owner: WEST.BAY PROPERTIES NO.7 Address 436 ROCHESTER ST -- - - i Phone. - i ",COSTA MESA, CA” =- Zip: 92627-3009 ' PROSERVE ROOFING Contractor: Address: P.O. BOX 25307 Phone: (714) 772-7485 ' - ANAHEIM, CA i Zip:. 92825" ' License::; 489090 .. Arch.: Eng: - Address: i ��„� '' ' Address':,, , Phone: Phone: Zip: , License: 'License: ' SCOPE OF PERMIT TEAR OFF COMP, INSTALLBO YEAR 2 LAYERS OF.15LB FELT. FEE SUMMARY- Plan Check: $0.00 Calc Valuation: $5,500.00 Permit: $125.25 � �jj - Claim Valuation: _ $5,500.00 SMIP Res: $0.55 / `SMTP Com: $0.00 Other: $0.00 Inspection: $0.00 'Total: $125.80 %. PLANNING & ZONING' SETBACKS ' MAIN STRUCTURE ,Front„ 0-0 '� Rear` -0. 0 Left 0-0 - Right. 0- 0; / ACCESSORY 'Front 04 Rear 0-0 Left 0-0 Right "0-0; - Z� PARKING Existing:, -0 -„ Required: .0 Proposed: 0 , NOTES: '- 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 withlrr180 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) 7545626 acs-ae tWQl DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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. 1 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. ork s' compensation Insurer carrier and policy number re: Carrier: n v - Poli yNumber INC �17�iY3� ec need not be completed if the permit is valu at ane hundred dollars ($100) or less.) ❑ cert' 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' pens n ws of C lit is, and agre that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith .."Twith t se provr t pli tSign re: Dae: WA ALLURE 'OSE RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT P TO CRIMINAL PENALTIES AND GVIL FlNES UP TO ONE HUNDRED THOUSAND DOLLARE ($100.000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37Ca OF THE LABOR CODE, IMEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm Ih it I am licensed under ro cions of Chapter 9 (commencing with Section 7000) of Division 3 Business and Professions Code, and my license is in full for ' # t1ga IS g lure: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions o1 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).): ❑ 1, 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.). ❑ 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Lew does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractors) license pursuant to the Contractors License laws.). ❑ 1 am exempt under sec. Business and Professions Cade for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ 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 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 6, 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 WIII 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 ❑ 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 Dces or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Cade, 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 eque 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). ............................... ..... ................ ............................................................................................................................................ I.. _ ... ................................... .................. _.......... .............................. I.._............................................................................... 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. ........................................................................................................o-n-.....................................................................................................................full.............................................. ............................................................................................ 4 If an RMPP is presently, required, has Section 25534 of the California Health end Safety Code been Cully complietl with? ❑Ves ❑ No ...................................................p"pI............................................................IIdiiin,g,.......................................torr.........................................................................."i's'................'t,io........................................................................................................ 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication a,germil for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LI No (Section 65650.2 of the California Government Code requires that the requested information be furnished On applications for non-realdential building permits). ........._.__ ..................._.__..._... ...... __..................... _...... __.___—___........................................ _...................._..........................___............................................. ....................... 46 . _..........................__.................._._ e Will any pan 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? ❑ Yes ❑ No ...................__....... ............... _.................... _..._..........._...__..................................... _....___..................__.................__._..........................................._..—_........................_.—....._..._......._._........... __ 6 (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 1 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. Sigi Of Legal Owner(s) Date Ani Autho' plicant Date CODE E. INSPECTIONTYPE INTITALj CODES INSPECTION TYPE gaTE Its 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 206 Final Plumbing ". 200 Final Re -Roof �— �L' 210 Final Electrical 201 Final BlockJRetaming Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 2D3 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy U)OPE54 aF BUIIIaNG 17» ANAHEIM AV UNT: cymRrs NAYEIFNgWN RICHARD A SEWELL _ Gy2'-(qo� ADDPEss: 136 ROCHESTER ST COSTA MESA, CA 92627 APPL. YFUUNDI ADDRESS: ARCHITECT OR ENGDIEER: ARCK OR ENG.'S ADDRESS: CONTMCTORS NAYS: CONLRACTORSYAPNG AGGRESS CITY OF COSTA MESA — BUILDING PERMIT PERM NO: IB 08310 PERMIT NO: IB 083107 PLAN CHECK NO: N GOVT: N SUPP: Y CONSTRUCTION TYPE: V—N PERMIT TYPE: OTH SIR PURPOSE: OTH UC.li JOB DESCRIPTION INSP OF STRUCT ELEMENTS /DAMAGE REPAIRS SQ FT: UNIT. CLAIM VALUE: CALC—VALUE: GROUP OCC: R-1 / UC NO: UNT: LICENSED CONTRACTORS DECLARATION: I hereby aRFm under Way of perjury that I am liumed under proviaiow of Chapter B (wmmencn9 Mh Section ]Oo0) of Ohnon 3 of Ne Elmmnm and Pmleeeiom Cade, od my license is In full lace and effect. CRY LIC. NO.: UC. CLASS: LLC. NO.: EXP: Dine: Cormeda 'OWNER BUILDER DECLARATION: I hwOW affirm umler penly of mots, thio I am mmmpl from the Contmomm Lioenaa Lew la Ne IdoMp mmO m (Section 7031.5 Dwihm and Prohamme Code: Arty cay or oamty which nPdna a puma to oommum, suer, improve. 'emooh, a raped err, sm,, �P� to a lsawnoe, also tw uitm the apptiamt la such puma to Rb a mead vatemed NU M aha aha, licensed ptueuMl to the pwhw`^m of Ne Cadnctas License hew [Chapter 9 (caenmenmhp wish Swion ]000) of Dwbion 3 ON IM duainm amhd Prolmione Code) or thin M or she is vamp therehom and the hau la Un eaeyed memplcn. Arc/ vbluion of Section 7031.5 by any applicant for a puma subjects tM epptMem to a evil Nmoh, of rM mast then fate hurdmed dollen [55000. ❑ I,mawner dtim poWdya my employees Mh we9es m lhai aab oompemetbn, will do Ne worn, and thotanxmn b nal intended a OfOrw fa eels (Section 7044. Susinm and PldessMm Code: TM Cmtnchm, Limine Lewdwe M epl yman owner of property wM halals or roll thveon. eM Mm does such work hcnnE or hash or Wwph M or by oven wmPlaleea, pw,tded tIml xch Mp ,moOhm ere not kevdad Or dhrad ler stab. 9, however, the IW1i g or inpmwmad at acct Mho one year of tan platbn, Ne y .-I)ukor voT hew tM Whduh d pmvhp how she &I not bund m imaow b tM papme d ub). LpJ, I, m ownn of 1M Monty. do asch®My caNrmip with flommd contractors to ovavw the prNad (Section TOu. Swinw and! Prolmime Code: TM Co lmdom Limmom Lew don, mat appy N on own, d VOPWY M MIWO a impo m tMnsun sM who wntmots for wch project with a wntmdons) licensed Wn nam to the Commomm Lioeme Law). ❑ 1 em wempl under Section: B. 8 P.C., for th exon: Data: a Owner: 1 do homby o.* Vhel I On aware d erd uroMune Ne neon;Uaade Neelh end Bal y Code Sedions 25505.25533. Ord 25536, and thv I a en)' Mae wMav woomou will / will ne) not 1 need to eomply Mh said etre wdm end the hO,,Om nerds b Dole: AppGcald: WORKER'S COMPENSATION DECLARATION: I Mnby affirm undo penehy of perjury one of Ne IdbMhN dMermbn: ❑ I Mw send W meim:n a mNfs:ete d aaheMl to stsainsun b wokvi ownpemelon, m pmwided la by SacUw 3]00 d tM Leta Code, for tM pedwmencs of Ne wank for wldch thio perms b issued. ❑ IMweMWmebdeilwpken'mnPehwYMnimnamu,mreeuiwd by Section 3700dlhe labor Cods,biM pwlormwhcedlM wak la Much tlM potm's b bsuad. MY wvkere' Campwnmian uheunanca mrtiar ud po&y rOvnber ere: Cannot: pa" Numbw ycNs se don need no, be oompleled 9 I Mmhl le for on hematmd callus /5100/ or bin) u I coney ihU in the wd alwh d om work b w0. thb perms b Imuvl, I shall cath eI sivoy My pelma in eery maner x m to becan eubptl to IM wakes' n 3 Wen f tMn laws d California,vend how thio 0 I ehwd becaw mbject to the woryen' • whnpeneerion probiaa d Section 3]Oo d tM Leber Code. I to hMh oompy oven s path a. Dw: • Q- ' App6r. o Z. WarnhUr: FeOun M axon.&— wmpotaatlon row,apl le stM Ilrel1 anrb/eot an Mrplogvr to edmhvl PMOMm Omf civil fires Wm ore Itundnd fhouaeral4 .n. (51000001. n b Ilene cwt of Comp mOOdon, dellmglal m povWad fu, In Section 3106 of tit Labor Coda /dent aha attorney' I CONSTRUCTION LENDING AGENCY: I Mneby elfimh under penalty of puppy the Ihme is e owwhhwion bnduhp e9enry for the pedamaae of tM work for which tM pend b baued (SadMn 3091. CN. C). LENDER'S NAME: LENOER'S ADDRESS: I candy that I hew reed thla ell, i:l Md art 11,01 the above udarmetbn b coned.I epeelo campy Mh a city and o." adk sows ahastalehat mdetip to Wittig wmwaam.'m and hereby adhwbe repasannor. ed tba city to edwupon tM Obow9nMtilhed pmopMy fano-'owi JIM BEESON ' \ (5151 d6.W P) Wham-BNldiq 8 Seldy: G—On : CMmy-Appirenk pnk-P.; Gdd..d-Ammo o, COMMENTS: REPAIRS MADE WITHOUT PERMIT/ INSPECTOR EVALUATION REQUESTED ############################################################################### Z 0 N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING-------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 00000000 ZNE: REF NO: PLANNING N TES> F. > ✓i D E V E L O P M EN T S E R V I C E S R E Q U I R E M E N"T S ZONING APPROVED BY NLA DATE: APPLICATION ISSUED BY: DATE:—G7-� LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC' MECHANIC %FIRE SMIP/RES.7' `GRADING PERMIT 42.00 ' %h (• PLAN SMIP/NON7RES N ISSUE FEE A BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL [ PAID' DUE TOTALS 42.00 0.00 '' 0.00 ^ 42.00' 92.00'% ?_ ? •00 r. REVENUE DIVISION TOTALS--> COliLECTED i, 42. 00 "OVER/SHORT:'- 00 BLDG PMT PLUMBING ELECTRIC MECHANIC r ..FIRST SMIP/TOT GRADING PLAN -'CHECK 42.00 I N D I V I D U A'<L F E E 13 - R'E !A -K D 0,-,W N TYPETY D E S C R I P T I O N, Q � � �,. UNIT COST ,';: TOTAL,", COST INS 1 BUILDING RE-INSPECTION-''FEE'42..00 � �) 42.00 END OF FEES' �1 ' 'rh /�. .r• rt ., r i Pr7/542.08 r RCPi;Gl-Cfla6987 r• - - .3 CnH31fh/ CONSTRUCTION AND PLANNING APPROVALS Permit# Date - Inspector POO'_ SPA APPROVALS ' hv�mit# 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 - - S. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER 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, 0 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 1 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, POOUSPA SYSTEMS FINAL 19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22, Ducts, Ventilating 71. Product Piping OGas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank 0 Gas 13 Oil 25. Roof Sheathing 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 PREV. 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: �,�, q7- ri h GaT pii s'Ife 34. Final Heating & Air Conditioning r Itz r. 35. Final Gas Pipe -Test 36. Hood or Canopy Od f Ci✓G�©� / .s9� .0��� //,, d� ` T i'Y�w.i�LrO 'e'/ wt�//ccQ b� GrY1ii"�L YO�sli. ar ��1iY- wh-e-c- 9 ` f (f/C_GLv "% � %'`2.__G_9_!✓k +'h TCIJr 37. Final Factory Fireplace� 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic-Finalce 42. 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System l`.ea. //� O� al-Lead- ae I.`` O/c,/�-7Oi/1? T % jgR -i6 `e,v . //�� eS ' �7 / J pn (/� work by �gY� Gv mcvltt`l� B(i• �j,fs GOr/t -e G7-vw_- .4v tis p00/- �� r•-/ `,�5.y� 77 /G / T/y `//�'� `✓m�`G� r � L WOl S ",Zp 14- 0' 9 Cod r a_.,a 45. Sound Attenuation 46. Handicap Regulations 47. FINALSTRUCTURE & BUILDING q-/7--47 48. FINAL PLANNING s dL--#- 49. Electric Release to Edison 414.5 P Oe 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date