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HomeMy WebLinkAbout1951 HARBOR BLVD - Building Permits -new City of Costa Mesa 2387 Building Safety Department CERTIFICATE OF OCCUPANCY N° C P. 0. Box 317 Costa Mesa, California !":!.\ p The Building located at Witt 2difionikra has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group P4 Occupancy. Use of Building TO Out +Restmount Legal Description i 115-302002 (See reverse side for Metes and Bounds) Building Permit No. 25Electrical Permit No. P;�8 4 Plumbing Permit No.-4'i'• 352 6 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— and/or guest rooms ISSUED TO: Building Official COMP MDGR by %1 �X- ✓ /�r C� Date ‘//r/ ‘(`. 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, 81734—tM-11.S3 S-B P • ` 'i . 25389 I' -COSTA MESA BUILDING-SAFETY DEPARTMENT CITY OF CJS rti iclESA i P.O. BOX 1200 COSTA MESA,CALIFORNIA 92620 MAR 15 1966 • For Applicant to Fill In Completely APPLICATION FOR PERM TYPE OR PRINT �� LIZ*BUILDING/yam/ %c ..e /�j, `o _�LiYr 1 RECEIPT NO. COSTA MESA. CALIFORNIA R[C[IV • DAT 7Cu IS OWNER //4LG/.OA4 e,CA77 3/7 ,5V* /`_Q,,///g MAIL p ADDRESS I S S f/ ,4/n Me'e ship FIRE ADDRESS �ldO ,ClITL�DFc//J .T/^ TEL ZONE GROUP CITY •V`fje' �C�ii/ NO. _ `�//�/'�//^/� ARCHITECT .BL APPROVED ARCHITECT �� DATE 3h yam= OR ENGINEER NQ, ONING JRBet .T.-M- NO.OP U•[0►N[W .}'''' 2 ,� /U- �l mANS {�--I BUILDING CONTRACTOR J Sitz i. C1"XJG L �n/dCLE"` O� .�{/ /�` ADDRESS ��GDC�- //,C �7/•0 .V4/ ' oDESClLamoN 1.4-17� ! — ���t�� )J CITY C_QS%.O //,/lr�/0 A.P.NO. // f ) � Z - �_ ATEJ' 9 �7 NOTE: NO SAVE OVERHANG SHALL BE LESS THAN LIC..NO. NO,///J /Z5 (� 90.TO SIDE BREAR P.L. EAVES SIZE NO.OF SLOGS. ALLOWED (U.B.C.REQUIREMENT) OF LOT NOW ON LOT /+ (��1�., YARDS APPROVED YARDS APPR VSD USE OP EXISTING BLDG. C42 .�'J/F/V 710, MAIN BUILDING ACCESSORY IS ILDING (FROM C/L STRIA ) O[TOACR LINE PROM FRONT FT PT CENTER OP STREET REAR YARD - - - - "-- SIDE YARD' LEFT I RIGHT R.SIDE DESCRIPTION OF WORK I L.SIDE PT. PT, ALTERATION ADDITION RSA PT, rr' DISTANCE BET. BET.MAIN& Im�AIR MOVING DEMOLISH MAIN BLDOS. ACCESS.BLDGS. BUILDING NO.OF VAR. DATE SIZE ROOMS STORIES C.U.P.# APPROVED EXTERIOR WALL ROOF APPROVE ] \Of(t'Fi COVERING I COVERING SY (I/ �A�' MAre .�//r/6,G USE OF BUILDING AND WORK TO BE PERFORMED / 0, . oeY/Gr .cren.ne,/ m 1 SO.PT. Ol I HEREBY ACKNOWLEDGE THAT.I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEZ ONLY. PLY WITH ALL CITY 0E0INANCES AND STATE LAWS SEGULATINS BUILDING CONSTIIVCTIDN /� ` /] / VALUATION CG �/ CO SIGNATURE OF UU -G�1/J //W�•'T'(yN�.///� . (JlJ PERMIT FEE s PERMITTE•- yT�� j / /0 PLAN CHECK S b W AUTHORIZED AGENT VVV (� • , .. _ _ TOTAL PEE S : , 25302 -- I COSTA MESA BUILDING-SAFETY DEPARTMENT CITY COSEA A MES P.O.BOX 917 COSTA MESA.CALIFORNIA CITY 1 OF 1r J fi !il A For Applicant to Fill In Completely Ap IBAIIQN1995 PE R TYPE OR PRINT BUILDING BUILDING 4 Of IFIL@ OS@ On ADDRESS / / S j N tq 2 30R. ��� PERMIT NO. COSTA MESA. CALIFORNIA - — S3OZ a� * n RQCQIV Y �DMTH RE IVVEDG DAT818�s/per L OWNER C O }. F/ 1Y G 211 ! 4 +�T ' `I/ ((/ V MAILt 1 `� BUILDING r AD RESS �1cco Q ,EN > ADDRESS i '� {���� " N� rTEL FIRE '� CITY N @tV 'pear -so} NO. STfi �� ZONE '/ TYP GROUP /✓ ARCHITECT 00It1RR f1. TEL. . t APPROVED �� DATE /o K'� OR ENGINEER "MC 1< NO. 14}-1412 /r sss /37/c R(/2 Q13 l k ` t u' /�t Id ZONING (\ , I / VV ZONe NO.OF USE OF NEW. �y �'� CONTRACTOR W V. �1. ,\f� ` I Ear PLANS 4-�/nneulLDl/n O(� ADDRESS 1'06 ltt1 L-liMr/Ij 6. DESCRIPTIOtl ) i7�-�`�.IIJ re. IJ�+.I CITY I4 a,U1/4) (7e CT I�c? �(�' 'J-. A.P.NO. II �_ �_ ATEJ ,} TEL. rF NOTE: NO EAVE OVERHANG SHALL BE LESS THAN LIC..NO. I76:44-3 7 NO.S. r qg J 90*TO SIDE 0 REAR Q,L. SIZE EAVES ^ '/ / NO.OF BLOCS. OF LOT`� � X / NOW ON LOT ALLOWED (U. B.C.REQUIREMENT) YARDS APPROVED YARDS APPROVED USE OF __ D MAINBUILDING ACCESSORY BUILDING EXISTING BLDG. .."1--- — (FROM C/ ,STREET) SETBACK LINE FROM / ('�L FRONT {/q-p Fr. FT. CENTER OF STREET {/J O REAR YARD //� �/ SIDE YARD I LEFT I O I RIGHT )L. i R.SID .�gg/� FT. DESCRIPTION OF WORK L.SIDG GPT. LSO FT. •NEW ALTERATION , ADDITION REAR SFT FT. r DISTANCE BET. BET.MAIN 9 R. .R MOVING DEMOLISH MAIN BLD48, ACCESS.BLOCS. BUILDING y 3 C NO.OF VAR•# DATE -Ic SIZE .al{!r ROOMS STORIES C.U.P.# APPROVED EXTERIOR WALLaA -�. I ROOF APPROVe�// Z —/dy—Ce COVERING (LC(d(O,f' COVERING By /1'40 DATE USE��OF BUILDING AND WORK TO BE PERFORMED „OLD FOR SPECIAL REOUIREMFNTC (1[`Its f o--�-d ca� 1PrA%+, �' Mhz�c cello-ice"' �'�I ' /�/ N V SQ.FT. e' I HEREBY ACKNOWLEDGE THAT 1 HAVER D THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE T T THE ABOVE IS C ECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. G PLY WITH ALL ITT ORDINANCES ND TB LAWS REGULATING VALUATION p BUILDING CONS RUCTION. on �'1 /— N SIGNATURE ` ♦ /,/ -7 �1 PERMIT FEE $ K O PERMITTER J / /VIA C/ 77i 7, /4-5-6 O D $ I A PLAN CHECK $ ✓ o AUTHORIZED AGENT 2 u I\ TOTAL FEE 1 ../ / S ORANGE COUNTY BUILDING DEPARTMENT APPLICATION FOR PERMIT 636NoABroaFOay • _ BUILDING SANTAA ANA,, CALIFORNIALI FOR APPLICANT TO FILL IN • FOR OFFICE USE ONLY )�� �,y rA RECEIPT NO, �JfP�ERMI/xTyN NO. BUILDING ADDRESS ,9J' }(itvt y C A It • 53. i • �V f! SCHOOL DIST. —V Sh �d 41 �. OR TOWN /y/� `, ` 1 RECEIVED/BY 1" L/�/DATECOF APPL. DATE ISSUED NEAREST CROSS ST. RI win awe - #.4 YkrY kI // (( `.E , f _g V ��[I�� _ O4'�j ^�O• OWNER •Il. I, AC III 1 C M�ty r ADLDRRRESS _y)V'GL"u i I:__ C&C.•� MAIL ///��� I Ls SCHOOL DIST. ADDRESS 40 6 � I. OR TOWN n�({„ fJ TEL. • ) NEAREST CITY A P.....4.-ei,` NO. � _�//� CROSS ST. ARCHITE OR TEL. ZONE I NO. OF I TYPE GROUP ENGINEE NO. �' Li PLANS I T^ ADDRESS SETBACK LINE FROM CENTER OF ST. L/'-I O I_ TEL. REAR YARD '- .(SIDE YARD 9/t2.4_NJ TRACTOR NO. APPROVED �� - •.,DATE4 V` ADDRESS LEGAL I' - t CORRECT„{QFiS t DESCRIPTION I LOT NO. 4/• I BLOCK e I , (ATTACH METES 8 BOUNDS) rya . TRACT �/ ■ F - -'- -- SIZE OF LOT t� /I II 6I NOW ON BLOT J. Er USE OF I /// NO. OF NO. OF O • EXISTING BLDG. /) I FAMILIES AI ROOMS ' DESCRIPTION OF WORK . .-c#=7" NEW I I ALTERATION I XI ADDITION I ] " I REPAIR I I MOVING I I DEMOLISH _ BUILDING NO. OF f SIZE ROOMS STORIES WALLROOF • COVERING . COVERING USE DI NEW •NG -' Z ! ,) /� 1 air / / 4 S3 a ilt fi APPROVALS FOUNDATION: Q@CATION INSPECTOR DATE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS FORMS, MATERIALS, APPLICATION AND STATE THAT THE ABOVE IS CORRECT UNDERPINNING AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FRAME: FIRE STOPS. BRACING, BOLTS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. f slaw LATH. INT. • ��Il Acie �i•/ f '1'v(/w/rL^• Q SIGNATURE F LATH. EXT. PERMITTEE PLASTER. INT. r' 3 AUTHORIZED ACT. i O PLASTER, EXT. . $ ��� P. C. $ AST. MASONRY REINFORCED i ,------------ff-f FEE i© � V BOND BEAM „ VALUATION S 0 SR FEE = , FINAL • IND �I'Z 3�5 I . . :'t '.lf:)i ,. iii_.\r. "2.f...r.n: 7',.:![•.•;;;. 2... L L:L' :.i) Y' : . . [ i..:' Z, PLOT PLAN i - d _ _ ., ¢ .. ii , . r _ . i-•l ( t... . - . . . „ , .... : ,, ,. .. !\- - _ .yam _ _. ./) .. . _� .t- . /. . • 3 t - _ Y U 0 lSTREET. _ t Y.L.. :-. 3° .:I '.r2 :-. 3° . .._ . V. .1 • V I • r i . - I . ,1 • 45 }58 54092/06/76 5,50 TL COSTA MESA BUILDING-SAFETY DEPARTMENT £0— P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 Applicant to Fill in Completely ION FOR STRUCTURAL PERMIT For P Y —Use Ink Only R Y DATE RECEIVED DATE ISSUED 41 BUILDING i3-1 /_ ADDRESS_ `• /`\ �{Q /syr OWNER I W 0 1/Aix S/�� /-� A.P.NO.• ''/�/s — ��` PERMIT NO. MAIL ) (_� . „r ebit a ADDRESS/7 Ste/ / tfrt) ADDRESS I ) r T(}'((�S BUILDING ,��s�s� CITY S .O--PJL. NO.TE '^"`-T Jsr•'� LOT y BLOCK CONSTRUCTION NEW ADD ALTER REPAIR MOVING f1FMOLISH LENDER 1V /BRANCH OWNER rTa /iG/ QIsty//jUN ADDRESS , V- 7�rr ARCHITECT TEL. USE ! OR ENGINEER NO FIRE ir ADDRESS A ZONE JYPE GROUP t� M� `�s� ' APPROVEDAe. )(CONTRACTOR nU& 'a - \RQ s d veiY DATE r / ADDRESS It 13 VV Ts-U..) pita-- , p 1� � � � ( TEL. ZONE NO.OF USE OF NEW CITY (OS Vl/-s--rC._« NO. 'J PLANS BUILDING F-i STATE CITY (oS-h>- kgs- YARDS APPROVED YARDS APPROVED LIC. NO. 3 9g 2si -7 LIC.NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO.OF BLDGS. (FROM C/L STREET) L OF LOT NOW ON LOT RONT FT. FT. _ Q USE OF (� p�`` Co � r� 92 EXISTING BLDG. �N JT Rip B 1 E FT. FT. CA F Separate permits are required for L.SIDE FT. FT. electric,plumbing and heating work. REAR__. . FT. - F...4 USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN& 1 MAIN SLOGS. ACCESS. BLDGS. (�\\\ ( „ VAR.# DATE r V Y'7 (�� • C.U.P.Sy+ APPROVED I tt AILS (� T f}. APPROVED ›- AIL V 71 BY_ DATE a $6 w 0 I hereby acknowledge that I have read this application and state N c4 that the above information is correct and agree to comply with _ m G •all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of m bl the State of California. m I hereby certl that am properly licensed as a contractor under 50. FT. a the State of alifornia :usiness and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ta Chapter 9, a d that sue• li -• ere In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLZ': _ w am exempt f • the pr•, sions o he State of California Business �.(i d and Professlo Code, Di Ision 3,C •pter 9. VALUATION PERMIT FEE $ 3 m m Signature of Nult-; % —PLAN CHECK $ ^ \ o Perm lttee L_J\7 / - $� TAX $ ,e('}0 p_ V�j IliU Authorized Agent TOTAL PAID $ LJ / 5v i CITY OF COSTA MESA �; 0;;' AL BUILDING DIVISION w ' DEVELOPMENT SERVICES DEPARTMENT J' grclif P PERMIT PERMIT NUMBER y, *al P99-00123 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT A Job Address: 1951 HARBOR BL Status: ISSUED 7 J1)' Suite No Applied: 02/25/1999 Issued: 02/25/1999 Vicinity: Parcel Nunmber: 42210301 Applicant REGENNITTER, ROBERT Address: Phone: Zip: Owner: SAUNDERSON, ELEANOR JANE Address TR . COSTA MESA,CA. Phone: ' 2769 BLUEBIRD CIR Zip: 92626 • Contractor: CAPITAL PLUMBING, HEATING &AIR Address: 358 S MAIN ST STE 43 Phone: 714 525-5858 ORANGE,CA - - Zip: 92868 License: 670418 Arch/Eng: Address: Phone: • Zip: License: SCOPE OF PERMIT PLUMBING REPAIRS TO WEINERSCHNICHEL:NEW SEWER LINE(REPLACEMENT),2 FLOOR SINKS, 1 TRAP PRIMER, 1 FLOOR DRAIN AND 1 TOILET. FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $22.00 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $8.75 1 Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 • Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain,Floor $8.75 1 Sewer Connect $22.00 1 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $8.75 1 Drain,Roof $0.00 0 Shower $0.00 0 Water Heater/vent $0.00 0 Drinking Fountain $0.00 0 Sink,bar $0.00 0 - Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink,Floor $17.50 2 Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $87.75 COMMENTS/SPECIAL CONDITIONS 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 thi ermit. FOR INSPECTIONS CALL: (714)754-5626 -. IF 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: Cartier: Policy Number. (This section need not be completed If the permit is valued at one hundred dollars($100)or less.) ❑ I certify that In the performance of the work for which this permit is issued, I shall not employ any person In any manner so as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with theseyrovisl•.-s. Applicant Signature: ✓✓ /__ __ _ Date:V WARNING:FAILURE TO SECURE WORKERS'r.* PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(5100,000),IN ADDmON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Uc.# Class# Contractor's Signature: ,��1 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: r 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 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 pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver'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 PERMR 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,faisework,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 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 Quality Management District or from any other air pollution control district or agency? Li Yes ❑No (Section 65850.2 of the California Government Code requires that the requested information be fumished 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 (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health end 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 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 OF COMPUANCE 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 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. _ Signature Of Legal Owner(s) Date ✓/ . i _� ✓ �? — •nd/Or Aut orized Applicant Date • cODEE INSPFCTION?YPF DATE BMW COLE) INSPFCTx1N TYPF OATS B U S 1816 Fixed System Final Fire Prevention 206 Final Mechanical 1268 Pool Spa Final 208• Final Plumbing - 3....('Y-91 q 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 2448-48