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Home My WebLink About1182 BRISTOL ST - Building Permits Cr• Y OF COSTA MF"A Development Services, Division of Building and Safety CERTIFICATE OF OCCUPANCY This certificate is issued pursuant to the requirements of the Uniform Building Code,Section 308 adopted by the City iof Costa Mesa certifies that at the time of its issuance the building structure herein below described was inspected and approved for occupancy as follows: Building Address Bristol S'E . Bldg. Permit Number B06-00848 Use Chiropractic -11 , 238 s . f . ) Group 8 Type of Construction v-N R>dt2SdfiX Use Zone C-1 Owner of Building Slusher Second Family LTD Tenant FAMILY CHIROPRACTIC CENTER Partnership Address 8 Morning Dove , Laguna Niguel , CA 92677 • By /�a.. BUILDING OFFICIAL-Khanh Q. Nguyen, C.B.O. Date 1 2/2 8/0 f/ ;7 REQUIRED TO BE POSTED IN A CONSPICOUS PLACE C°7 • `d -cu 4- d Y O1 COSTA MESA BUILDING DIVISION >:ir DEVELOPMENT SERVICES DEPARTMENT PER T NUMBER f 1 ..._.r.. I �• PERMIT 06-00848 14° (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.c SJILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1182 BRISTOL ST Status: ISSUED Suite: Applied: 06/01/2006 Vicinity: FAMILY CHIROPRACTIC ' Issued: 08/23/2006 Primary Occ: B Eat<50/Office/Bar<50 Type of Construction: V-N �. Parcel Numher: 43932104 Zoning: L.) Applicant: BONTE, CHRISTIAN Address: 13208 MYFORD RD 310 .Phone: 909-578-8066 CELL ISSUED BY: TUSTIN,CA Zip: 92782 Owner: SLUSHER SECOND FAMILY LTD PARTNERSHIP Address %SLUSHER,JAMES R LAGUNA NIGUEL,CA Phone: 714-546-5433 8 MORNING DOVE Zip: 92677-5307 Contractor: OWNER-BUILDER - Address: Phone: Zip: License: 000000 Arch : Eng: Address: Address: Phone: - Phone: Zip: License: License: SCOPE OF PERMIT 1,238 S.F.INTERIOR TENANT IMPROVEMENT FOR"FAMILY CHIROPRACTIC CENTER".WORK TO INCLUDE:RELOCATE ENTRY DOOR, REMODEL RECEPTION AREA,RELOCATE DOOR TO MASSAGE ROOM IN THE FRONT AND INSTALL 36"DOORS IN THE RESTROOM AND OFFICE AREAS. FEE SUMMARY Plan Check: $80.07 Calc Valuation: $35,000.00 Permit: $492.75 • Claim Valuation: $35,000.00 SMIP Res: $0.00 SMIP Corn: $7.35 • Other: $0.00 Inspection: $0.00 Total: $580.17 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 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.asuspended 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(WOO) DECLARATIONS rj ( 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 provkled 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 w rkers'compensation Insurance carrier and policy number are: Carder: Policy Number: (Th/ action need not be complef:•11 the panni/Jr; of one hundred dollars(S100)or less.) —I certify that in the parte : of thehich this permit Is Issued,I shall not employ any person In any manner so as to become subject to the workers' compensation laws of 0: la,and ":sari. at If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith __compensation pro �/7 T I -Applitent Signature: ��' _die \ Date: 1 2 �! -WARNING:FAILURE TO SE rr- W-' ' ., :F` TION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMI PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS($1. ),IN ...• TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37W OF THE LABOR CODE,INTEREST,AND ATTORNEYS 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.tic.it Class 4 Contractors Signature: Date: 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: 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 end Professions Code:Any city r 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 sign 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 Bushes d 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 /sub the applicant to a civil penalty of not more than '• - hundred dollars($500).): --__ as owner of the property,or my employe:- • ages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code: rectors 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• ployees,provided that such Improvements are not intended or offered for sale.If,however,the building or improvement is sold within one`-r of completion,the •. •:r-builder will have the burden of proving that he or she did not build or Improve for purpose of sale.). - CI I.as owner ofAT: property,am •- LY C.NTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The-.tractors Licen not ap• to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pur /tint to the Con ,p nse : -.). ❑ I am exam•under sec. Ar Business and Professions Code for this reason: 06 9 �_�'� f Oatei 'SI nature:/%I a ( —/ 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 has of the Califonri timene Safety fe Cede year requires,with hazardousme exceptions, pttiion , that a Business Plan be filed with the Costa Mesa Fire Department by every any during reportedquantity 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). _._ o....._.o ... 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 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 an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully compiled with? ❑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 a kenTill for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? IJ Yes I_I 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 Califomia Health and Safety Code). 7 if a permit from the South Coast Alr 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 Safely 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 Emissio • Signature: Date: CERTIFICCOMP • E . • - ORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the Information given is correct. o comply . tat- aws :nd city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the abov:, p u.: • •: '.n pu t.,: agree not to occupy or allow occupancy of any building authorized by t rmi 2 i firmBLJaspectJprt,(5--- / Pf`ture O,.Legal Owner(s)_f Date And/Or Authorized Applicant Date ;ODE I, INSPECTION TYPE 2dgg IEWALB Mit 11121.02 112E 2dIE 20106L$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1268 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 Sign222 Final Be a 204 Final Demolition • 250 Final Building/Occupancy 107 ,41111 F- CITY OF COSTA MESA ' BUILDING DIVISION >,=.12.91.:1a, ( ,,;,- � DEVELOPMENT SERVICES DEPARTMENT PE NUMBER Ft p _ J illithe PERMIT itctePokrnsott E06-00944 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ctuCTRICAL PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1182 BRISTOL ST Status: ISSUED Suite No Applied: 08/25/2006 Vicinity: Issued: 08/25/2006 • Parcel Nunmber: 43932104 Applicant: SLUSHER, JAMES ___4_± Address: %SLUSHER,JAMES R ISSUED BY: LAGUNA NIGUEL,CA Phone: 714-546-5433 8 MORNING DOVE Zip 92677-5307 Owner: SLUSHER SECOND FAMILY LTD PARTNERSHIP ' - Address %SLUSHER,JAMES R • LAGUNA NIGUEL,CA - . Phone: 714-546-5433 8 MORNING DOVE • - .Zip: 92677-5307, . - , Contractor: OWNER-BUILDER ' • Address: - ' Phone: Zip: , , , License:000000 • - ` SCOPE OF PERMIT • ELECTRICAL PERMIT FOR A 1,238 S.F.INTERIOR TENANT IMPROVEMENT FORtFAMILY CHIROPRACTIC CENTER". . REF#:606-00848- - , - , WORK TO INCLUDE:46 LIGHT FIXTS, 18 OUTLETS, 11 SWITCHES,5 COMMUNICATION DROPS AND 1 SUP ANEL TO 225A-. "P. " " :- " - ' ' 7 - ' . FEE SUMMARY ' ' Quantity . Quantity ISSUE FEE S23.50 , Temp Dist System/Lighting $0.00 0 , • Temp service test $0.00 " - I Busway/100 ft - - ' _ $0.00 0 Res.a/c package $0.00 Standing'Section $0.00 0 New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 , " New Res(34-units) $0.00 0 Transformers up to 1 kva/kw $0.00 Q. Pool/Spa $0.00 0 up to 10 kva/kw $0.00 oG, ' Lighting Fixts $40.98 46 up to 50 kva/kw $0.00 ,'0 / , Recept Outlets $19.80 18 - up to 100 kva/kw $0.00 .'. 0 Switches $12.10 11 ' over 100 kva/kw :$0.00 ' 0 , ' Non Res Appl $0.00 0 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 - Misc.Conductor -$0.00.' '. 0 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0 Motors to 1 hp $0.00 0 - Circus(mech ride or lights) $0.00 0 ' Motors to 10hp $0.00 0 - Christmas Tree Stand $0.00 D Motors to 50hp $0.00 0 - Fireworks Stand $0.00 ' 0 Motors to 100hp • $0.00• 0 _- - Other Electrical Fee $0.00,/'-C/ Motors over 100hp $0.00 - - 0 " / - , Communication drops $5.50 5 , - .Investigation Fee $0.00 Sub panel to 200a $30.50 1 . Plan Check Fee $0.00 Pole Light Pkg $0.00 0 .- . .Reinspection Fee . $0.00 Sign Circuits 50.00 0 - _ Temp Pwr Pole S0.00 0 - - . TOTAL CALCULATED FEES $132.38 Intermed Pole $0.00 0 it 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) al 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 2446.48(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 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 poll ' umber are: Carder: 1 Policy Number: C (This tion need not be comple-•If the permit is v.I/CI at one hundred dollars($100)or less.) ` lY" _ .- 1 certify.that Iri.the perfor an e of the workhich t.'s permit Is Issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of C.lif• la,and agri. it if I. ould b: ome subject to the workers'compensation provisions of Section 37 of the Labor ode sh forthwith comply with these pray'-io /`� L Tgne plicant'Siture:� o1Dat T WARNING:FAILURE TO SECUR ORKERS'••- PENSATION COVERAGE IS UNLAWFUL ANO SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND OOLLARE($100,•••, ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRAC 0- DECLARATION: I hereby affirm that I ' ' ensed 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.Lk. Class# Contractors Signature: Date: 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). 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 state 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 P Ions 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 pplicant to a civil penalty of not more than five hundred dollars($500).): as owner of the property,or my employee ,Ith 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: •:-ontractors 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 he employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within on: car of completion, + • ner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner . th-property,am - • U0 LY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:Th,con actors Lice. w•••-not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license• mu: t to thT •orz nse Laws.). ❑ I am,e^ ••/und.' se• ' Business end Professions Code for this reason: r i& Signature: �lI �fl ' ,^ p 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: I Wit the applicant or present or future building occupant need to file and certify a Business Plan for emergency response t0 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). 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 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 Ouality 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 feat 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 Duality 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 •.er penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazards'als and Emissions. Signature: Date: CERTIFICATE 0- • - .ANCE AND .f :TION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree •• •m. with al :- - I- 0,!'a • city o .nen :s relatin• • •uilding construction,and authorize representatives of the City of Costa Mesa to enter upon the above-describ.•prop/ 0 ^•� /coo >5.II irne .+it. •- ••y or alio, occupancy of any building authorized by this it until fin specFO� fid/ DJr •re Oftoga!Owner(s)J ",,;_.Date til) And/Or Authorized Applicant Date CODE I INSPECTION TYPE PAIS • ItilmAL& S.gpfl INSPECTION TYPE RALE wimAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 206 Final Plumbing ' 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention /zfrY/6 et 202 Final Factory Fire Place - 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy