HomeMy WebLinkAbout3099 GINGER AVE - Building Permits City of Costa Mesa •
Building Safety Department CERTIFICATE OF OCCUPANCY N° 2595 C
P. 0. Box 317
Costa Mesa, California
The Building located at 3099 dinar Amp A•D
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group U a J Occupancy.
Use of Building 4 Unit Apartment Dundi n with attach9de0 and laundry
Legal Description - Vrect.6260. LOt13
(See reverse side for Metes and Bounds)
Building Permit No. 29606 Electrical Permit No. 29741 Plumbing Permit No. 53528
Floor Load Signs have been installed as Room Capacity Signs have been instaled as
required under Sec. 2308 U. B. C. required under Sec. 3301 (1) U. B. C.
17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied
until the owner or operator has been issued a valid certificate of occupancy by the enforcement agency.
(b) A new certificate of occupancy shall be obtained whenever there is a change in:
1) Occupancy classification of a building or portion thereof
2) The number of apartments or guest rooms
3) Ownership
If Group H Occupancy, number of apartments and/or guest rooms as required under Sec. 17050.1 (d), California
Administrative Code, Title 8, Chapter 9, Article 8.
Number of apartments 4 and/or guest rooms
ISSUED TO: Buildin fficial
ARMIN !COMMby ne � /� 442.,
Date aline 19. 1969
This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed
except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Fora, Bu3+-1M-11-e3–.S 0 P
29606
ID
COSTA MESA BUILDING-SAFETY DEPARTMENT JAN -6-6v " OO *
PNI- 115* ** 715.'L'
P.O. BOX 1200 COSTA MESA,CALIFORNIA 92626
/ For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT A.� BUILDING
BUILDING Si ` For Office Use Only
ADDRESS 3099 Ch�Pr ,1✓c�nue S��]I(]-�,T
MRECEIPT NO. • f` fnF�
COSTA E3;. CALIFORNIA � _ 7.
O / I RECEI i DATE- CEIVED DA ISSUED
/ ] ' RF` /j3/-6 I��3/—,
OWNER AA ..IL:,_ '\n- [.,.,'/°=:.. ..m.
MAIL. S{L I T 1Z +D`—..( •�l/,l /� iL j ADDRESS BUILDING 'JO 0��/ - .a. L.
FIRE
erre 1 I.(IIQ YI . LEO". 6/("O L33 ZONE
TYPE GROUP T • '
. APPROVED
1 R ,{7 1(l� --I no S 3J 7aC3 BY DATE
1 ZONING
ADDRESS 0 Ilir ' L, 4111 , el • - , e
ZONE PNO.LA S YS[O.NEW
/� 1Cali
{ y/,, _ PLAN, BUILDING S ar att.
CONTRACTOR I.0/I IG. Cali/ILI L1Yr3 I(7( ' ;
gar
ADDRESS 14 4 7 S. rte[I 1 1?d. DESCRIPTION .. . .I
CITY TIC
I•
I O/h ] ,/y� A.P.NO. nnne
LNOTE: NO NAVE IC.NO. I O Z 6 Y TEL.NO. 11/y/ I �33 •TO SIDE a REAR PH LNG SHALL BE LESS THAN
VES
SIZE .--7-3
/ NO.OFBLOWN_ ALLOWED (U.B.C.REQUIREMENT)
OF LOT / >. // (0 I NOW ON LOT Ike.
YARDS APPROVED YARDS APPROVED
USE OFy� MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. f'D«
(FROM C//L STREET)
SETBACK LINE FROM !^� FRONT- -5 FT. "•�"�PT.
CENTER OP STREET n/�� REAR YARDQ 1 V
SIDE YARD I LEFT f I RIGHT / R.SIDE 7 IT. FT.
DESCRIPTION OF WORK ( 4.HIDE )0 FT. PT.
tyLoW ALTERATION _ ADDITION R�GR-+/�1 IT. FT.
Dr ISTANCE BET. BET.MAIN&
MAIN BLDG$, ACCESS.SLOGS.
REPAIR MOVING DEMOLISH
BUILDING �� C1 NO OF 1/]/J (q� VAR.# __� _. DATE
HEXTERIOR ALIZE LA LF y, I OOF( kj ,/ l�//JIYplQ' e PROVED /y/� 1 f -.. DAT APPROVEDa /
COVERING UAG IH M O G� /. E/�--X-4f-
COVERING
USE OF BUILDING AND WORK TO BE PERFORMED (L
pt 3rd a -kr ;
!��)/eit ' T .FT. !&V
I HEREBY KNOWLEDO AT I NAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE j
AND STATE THAT THE AB E IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. Ry
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION .`(
BUILDING CONSTRUCTION. / 5a
PERMIT FEE S p
SIGNATURE OF
PERMITTEF102 I?,93/� s7a5
AUTHORIZED AGENT.. . .. . .. .. . ;_�.. TOTAL FEE
" y --it CITY OF COSTA MESA
„ ‘, BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
°• _ PERMIT , r PERMIT NUMBER . „
"°tiaoa+m B98-01932
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
• BUILDING PERMIT
Job Address: 3099 GINGER AV Status: ISSUED
Suite: Applied: 10/26/1998
Vicinity: Issued: 10/26/1998
Parcel Nunmber: 13956306 • Zoning: R3 R3
Applicant: BURKE, MIKE
Address:
Phone:
. Zip:
Owner: BRANNAN;'CLYDE TR
Address 214 VIA SAN REMO
Phone:
NEWPORT BEACH,CA Zip: 92663
Contractor: LEE ROOFING OF COSTA MESA
Address: 01653 SUPERIOR AV
Phone: 949-642-7222
COSTA MESA CA Zip:, 92627
License: 349686
Arch l Eng:
Address: ,
Phone:
Zip:
•
License:
SCOPE OF PERMIT •
EAROFF ROCK ROOF&INSTALL NEW HOT TAR BUILTUP,TO THE 2ND STORY ONLY.
•
FEE SUMMARY
Plan Check: $0.00 - Calc Valuation: $6,419.00
Permit: $124.75 Claim Valuation: $6,419.00
SMIP Res: $0.64 •
SMIP Corn: $0.00
Other: $0.00 -- ,
Inspection: $0.00
Total: $125.39 •
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
NOTES:
•
1✓ 1 /7 or
1i� d 4 yi
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
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 sell-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:
Carder: Policy Number.
(This section need not be completed if the permit is valued et 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,an. g that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
.plicant Signature:- I / Date: <U z c•/
WARNING:F. - • CURE ORK -S'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPL• - a - n PENAL S AND IL RNES UP TO ONE HUNDRED
`•• • D DOLLARE 0100,r• ,IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
- - • . • • DECLARATION:
I here 1 am licensed u •er provisions of Ch= er 9(commencing with Section 7000)of Division 3 of the Bus - and Professions Code,and my license Is in full
force and effect.Lic.a �' ass 8
Contractors Signature: T4.1; irDate:
CONSTRUCTION LENDING -GENCY:
❑ 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: t• 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 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,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.).
❑ 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 Rursuant to the Contractors License Laws.).
❑ I am exemptiunder c. Business and Professions Code for this reason:
Signature: ' t Date:
Owner IDivverified by fiver'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 0 No
(Section 25505 of the California Health end 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 Flre 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 end 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 end 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 Califomia 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 a_p2emit for such construction or modification
from the South Coast Air Duality Management District or from any other air pollution control district or agency? Yes f]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 Nes',the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code).
7 If aermit 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 Califomia Health and Safety Code Section 42303 been made? 0 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 SF CObIPLUWCE AND'AUTAORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree ti�pp cgmply with%lhstate laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described'prop�erty forspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
•/ ` / e•al Owner(s) ja=ete
l•r•r Authorized Applica Date
COOL L , ' Al.. r' If, REIMS QQSE• twat-mile TYPF DATE MALE
1616 F. ed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Fin 200 Final PEllum0bingl
C200 Final Re-Roof )
`'lift Final Bloc VRetaining Wall Final Fire Prevention
202 Final Factory Fire Place (SC( It/,C 0 Final Planning Approval
203 Final Sign 222 Final Site _
204 Final Demolition 250 Final Building/Occupancy
2446-46
CITY OF COSTA MESA •
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT PERMI 'NUMBER
F 1 pcj • PERMIT
J "°a'romo9Al�
,d? ' /602-01271
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 3099 GINGER AV Status: ISSUED
Suite: Applied: 08/14/2002
Vicinity: SINGLE-STORY ROOF ONLY Issued: 08/14/2002
Parcel Number: 13956306 Zoning: R3 R3
Applicant: ALEXSON, TROY ISSUED BY:
Address: 1653 SUPERIOR AVE
Phone: (949)642-7222
COSTA MESA,CA Zip: 92627
Owner: BRANNAN, CLYDE TR
Address 214 VIA SAN REMO
Phone:
NEWPORT BEACH,CA Zip: 92663
Contractor: LEE ROOFING OF COSTA MESA
Address: 1653 SUPERIOR AVE
Phone: (949)642-7222
COSTA MESA,CA
Zip: 92627 License: 349686
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
REROOF SINGLE-STORY ROOF AREA ONLY:T/O EXISTING 2 LAYERS OF ROCK ROOF,REPAIR SHTG AS NEEDED,
INSTALL 4-PLY BUILT-UP CAP SHEET ROOF WITH HOT ASPHALT. 1700 SO FT
FEE SUMMARY
Plan Check: $0.00 . Calc Valuation: $5,000.00
Permit: $111.25 Claim Valuation: $5,000.00
SMIP Res: $0.50
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00
Total: $111.75
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
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 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 ell
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
244846(WOO)
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
O 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
w rk for which this permit is issued.
It/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.
My workgrs'compensation I ce mer and policy number are:
Carrier: t Policy Number:
(This section need not be completed if the permit Is valued at one hundred dollars($100)or less.)
' ❑ I certify that in the perfo anco of the work for which this permit is issued,I shall not employ any person In any manner so as to become subject to the workers'
compensatl • ' , agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these pro s.
Applicant Signature: _ L �� Date:
WARNING:FAILURE TO SECURE W ERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED
THOUSAND DOLIARE($lC .CC0),IN AOOrr1ON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR LODE,INTEREST,AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am linen un a,provisions of Chapter 9(commenting with Section 7000)of Division 3 of the BusingS9an ,P essions Code,and my license Is In full
force and effect.Uc.A • O Class N C- S
Contractors Signature: y _ Date:
CONSTRUCTION LENDING AGENCY: (S�
❑ 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:
S
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(commenting 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 morra�han five hundred dollars($500).):
O., 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.).
❑ 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 drivers license. 0 Yes 0 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 stricture,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,Califomia Administrative Code).
❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safely,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).
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
_.._ _._ _.._...__...._.__.._
4 IIfan 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 Ls the subject of this pli
a cation apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? T3 Yes U 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
(II'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 prescnbed 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 under penalty of perjury the information given above is correct.I agree to comply with all state laws and dty 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 dty 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.
flurfLe9alrs)
nt Date
NNOE I, INSPECTION TYPE PAM IIImALS GOOF( INSPECTION TYPE DATE IWEAL$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final /�1� �,/p,,..,�� 206 Final Plumbing
fr
200 Final Re-Roof o Cl • - 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 Slle _
204 Final Demolition 250 Final Building/Occupancy
PROJECT ADDRESS: 3099 GINGER AV UNIT: CITY OF COSTA MESA — BUILDING PERMIT PhJM NU: E USZUU_'
. OWNER'S NAME: WEISENBERG JOHN W
ADDRESS: BRANNAN, CLYDE TR ET AL PERMIT NO: B 052009 PLAN CHECK NO: '01625-91 S ()UV1 : N SUPP: N
214 VIA SAN REMO
NEWPORT BEACH, CA 92663 CONSTRUCTION TYPE: ^V—N PERMIT TYPE: SIR PURPOSE: OTB'
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : CITY STD BLOCK WALL 52 LN FT SQ FT: 52
ADDRESS: UNIT:
CLAIM VALUE: 1 , 040 . 00 CALC—VALUE: 1 , 040 . 00 GROUP OCC: R-3 /
PERMITTEE: MORALICE MASONRY ( 714 ) 548-4752 .
DDSs: UNIVERSITY DR * **E***• ***** DETE**** R*p *R*DIN THE
CA 92660 * c ** * F+ + * ** FF+ FFr6* F + i + ******* rF
tF****************+ ***
LICENSED CONTRACTOR DECLARATION: I hereby album that I am licensed under provisions of Chapter 9(commencing with Section Z O N I N G REQUIREMENTS
7000)of Division 3 of the Business and Professions Code and my license is in lull force and effect. SETBACKS
CITY LIC.: 048257 sTATELIc.:538369 a CLASS' C-29 MAIN BUILDING ACCESSORY BUILDING
Aale:5 ' 9 ' 9( signature: �1 ��^ FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
WORKERS'COMPENSATION DECLARATION: thereby affirm that l have a certificate of consent to self-insure or a certificate of Workers'i LEFT; • FTIN RGHT: FT IN LEFT: FT IN RGHT: FT IN
Compensation t1s272 70(311A)Goy thereof(Section 3800,lab.1)0/01 /91 '
POLICY NO.: V J EXP.DATE:
7DMPANY STATE FUND PARKING PARKING REop PROV: PARCEL'FT.
ZNE: R3 REF NO:
• Cerihetl copy i5 hereby furnished. Li Certified copy plea tnm city Building Division. PLANNING NOT
PROPOSED 42 LINAER FT. , 6FT. HIGH BLK. WALL ALONG THE SIDE
���..CC _ /� > PROPERTY LINE.
ate:xj' 7—qt DEVELOPMENTApplicant: PA M E N T SERVICES REQUIREMENT S
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5700)or less). •
Icertily 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 ZONING APPROVED BY . • DATE:
subject to the Workers'Compensation Laws of Calitornla. --
Date. Signature: BUILDING APPROVED BY : DATE:
NOTICE:II,after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor / /y4____- /
Code.you mustEfoDINGwAG comply Iwith esuch provisions r this pa construction
shru iii be ending deemed revoked:y APPLICATION ISSUED B Y: (-+F # \� TF(F DATE: —# tf
CONSTRUCTION LENDING AGENCY: Ihereoy affirm therelhaLHaconstrtotion lending agency for the performance of the work for *************************** ** ** ** *************************** ** ****
which this permit is issued(Section 3097.Civ.C).LENDER: ***********************************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 27. 00 ,50 '
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed PLAN 17. S S SMIP/NON= RES
pursuant to the provisions of the Contractors'State license Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ISSUE FEE
any applicant or a permit subjects the applicant to civil penalty of not more than live hundred eogam($500). BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
I, as owner of the property or my employees with wages as their sole compensation. will do the work, and the TOTALS----> 27. 50 0 . 00 17. 55 45 . 05 45 . 05 . 00
❑ structure is not intended or offered for sate(Section 7044.Business and Professional Code: The Contractors'Slate License Law
does not apply to en owner 01 a property who builds or improves thereon,and who does such work himself/herself or Through '
his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED• 45 . 05 OVER/SHORT• 00
improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC „ FIRE SMIP/TOT GRADING PLAN—CHECK
for the purpose of sale).
27. 00 . 50 17. 55
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business '.
❑ and Professions Code: The Contractors State License Law does not apply to anowner of propertywlto butes or improves thereon ****************************************************,***************,***"*********
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'state License Law).I am aware
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E , BREAKDOWN '
❑ I am exempt under Section: B.8 P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST _TOTAL COST
Date: Owner: SFR 52 RES—CONCRETE BLOCK WALL / FT. 20 .00 1 , 040. 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES ,
25534 and that I or any future building occupant willtwill not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air uakty Management District.Residential construction applications are exempt Irom
these provisions.
•
I her: n Applicant' ti
heretic sany mat I wsr Latin mis uildinglion sotl tonamat ere y auth Irde repr s nt ti es of isagree to enter lyu with ell city antl countyOrdinances anti stale laws relalinp to building Con5lruClion and hereby aulhor¢e representatives of this clry to enter upon one above mentioned ?Aii ,", lproperty for inspection purposes. RiC _ V
fr. 01 UZW87oo3-tJOo3?o1c 7-:i:r
ate: 6'G - 9 ( Signature: DATE; 05/10/91 TATE: 15:•,0
•
.. Driver's License or Social Security a:
1641-46 White—Building:Green—Code Enforcement:Canary—AOolicanC Pink—Revenue:Goldenrod—Assessor
t ,
• CONSTRUCTION AND PLANNING _ Pot WA
' APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole. 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. ' r. 53. Steel Reinforcement
:: '3. Electrical Conduit Utility-Undrgrnd. 54. Forms
.4. Electrical Conduit-Undrgrnd. : '' 55. Electrical Bonding
,5. Steel Reinforcement r-/c4, ‘d4-is 56. Rough Plumbing & Pressure Test _.
6. Electrical UFER Grnd. . 57. APPROVAL TO COVER.GUNITE
7. Footings ' $/O-(/ 4�, �1� 58. Electrical Conduit-Undrgrnd. ;
8. Foundation . - "�/" 59. Gas Pipe, El Undrgrnd., Test
f9r 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 c_, 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 Fireplace .- ' . - • ;r 1' 1 APPROVC. ALSO.. - Permit# _-
21!.;Ducts,in Structure , . _ }. �_ - ' 70. ,Underground HYdro
22: Ducts, Ventilating . . . - '<"' - ' 71. Produc�,Piping Dtas O Oil
•
23.,Gas Pipe-Rough & Test ' = •• . 72. Underground FliusLL
24. Roof Framing * • " 73' Undergrrid.StorageTank ❑Gas OOil
25. Roof Sheathing , - s• r ,.: c• •• ' 74F Overhead Hydro'*.' c. - .
26. T-Bar Ceiling (Structural) & Monocoat t- n . ', 75. Dry Chemical • ; =
27. Frame and Flashing F _ " , , 76. 'Dr Stan i e .' , '
28'. Lathing& Siding . _ _ - .i_;:3 • > • •• • • 77, FIXED SYSTEM FINAL'
29. Insulation • "•#'; - I ' ; 7& FIRE PREV. FINAL 7 ,
30. Drywall:Nailing ' r I I HEALTHIDEPT.,REQUIREMENT
.- 31. Plaster Brown Coat i ' 4 : . 79. FINAL INSPECTION ,: `' .,
32. Electrical Power,Meter-Final I . • 80,- FOOD CERTIFICATE ISSUED /^
.33:Final Electric '_ ` I ✓i. - Notes: ?7 ^ r ..
t!L . `i
34: Final Heating &'Air Conditioning - .. J' ( - r ;,- c= - _ ,
35! Final Gat Pipe-Test " I =
. _ . .
.36. Hood or Canopy, .r - -. •. , , Iy S ; :
37: Final Factory Fireplace ?T °. ' ' •r. . 5;17-4C1( 0 ,� A P.l9
38-,Final Plumbing , "'_,, „ , • .tr " 7, _ �J
39: Water Service-Final - r , r, .•
40..•Gas Service-Final t' , , . • •
i 41- Solar Domestic-Final- •• • _ '
'42: Backflow Preventei - .4„:4i i I - ; - - ....
43. Backflow Irrigation
. s ♦ b
r44. Landscape•IrrigationSystem y,,� 1.71
45. Sound Attenuation E Q•`•, ••
46; Handicap Regulations - •' , '•
.,47. FINAL STRUCTURE & BUILDING• 25.25:-7), 6.4-•. j>6vec J & l�a /,
48. FINAL PLANNING l ' �
49.' Electric Release to:Edison ' I I •, ; mu.
y50. Gas Release to Southern California Gas Co ( He. • _ - -
51. CERTIFICATE OF OCCUPANCY 4 i i ._ H I•!,' , :r ;,
No. Date