HomeMy WebLinkAbout616 BAY ST - Building Permits1'-• �:ta Mesa Building Department ���PP�IpCATION FOR PERD?IT
� \ 111 EAST 20th STREET _p U.,.I,L_D ��i N_G. __ _. _�
� COSTA MESA, CALIFORNIA f -• " '-- -f �
FOR APPLICANT TO FII.L IN � g'OR OFFICE USE ONLY i
Receipt No. Permit;No. �
Builtling � r" i n/� ` �`�
Address 616 Bay Street • , '- � %-� 6, �-I : '
CiOSt� �CS&� California Receivedlb� Date Rec'd. Date I'ssued �
rvearest � �
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CrossSt. t n treet Building , 7 �
Addre55
_o'""" ggK-B�H�Tn�_, � ` bosta Mesa, California '
Mail
nddress 419 E. 17th St. � rvearest '
Cross St. � - '
City Costfl Me9a N��• 8-1159Yi Zone pjans I 7ype ± Group •!. '
Arohitect Lic. �
Engineer�aTlson-MiddlbTkao. C1673 i� Approved � -
b . � Date • � '
nddressg593 GardeIl_Gt�v� A�vd.,c;.r,�;', ± � CORY��CTIONS
City Lic.
Contractor Dlk2&COlegTOVe No. , ---. s�
T� � �
nddress419 F._17th �t_ Cnsta 1�?Fsa �` � � . `� r = ; �-
Legal Lot � 1_...1.,;.� -""�--.s..�........=. t d. :� .
DescNption I No. 'z ( Block npI Traet . j� ' �
� h•
(Attach Metes and Bounds) - - - � ' �'v : . r 1, , -
I No. of Bldgs. � .
s�ze or �ot 62, 84x106. 46l Now oo �oc None ���� ----- -----• o
Useof No.oi No.of (�T �-M� �A
Existing Bldg. -- I F,a.m�iliea I Roo,m�s,� � Ob17r �
Setback Line from Rear Vard GD' " - --"� �- -" " -
Center of Street �JD �'�' Side Vard rJ t�/" Z
DESCRIP7`ION OF WORK -`• '- "• .�, , .` �
New ! X I qlteration I I Addition I "' '� �� �"` � V���T—
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Repair I I Moving I I Demolish I
. Buildi�g No. of
Size riOl1S8 Area Rooms 5 Stories 1
Extcrior Wall I Root
Cevering $'tUCCO Covering (�i0fIlp0. APPROVALS
Use of New Fountlation �ocation Inspector Date
Building Sinale �'emi�y Res . — Forms, Materlals, I
Under-Pinning
Frame: Fire Stops,
Bracing, Bolts
I hereby acknowledge that I have read this Application
and state that the above is corrert and agree to comply Lath. Ext.
with all City Ordinances and State Laws regulating
building consVuction. �
Signature of Plaster, Int.
Permittee
Plaster, Ext.
Authorized Agt. 'y�
- asonry ReinToreed
Valuation Permit Fee $
Plan Check $ Bond Beam
$8����•�0 Total
Fee $ FINAL
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Show Iocation and distances trom �
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Chsta Mesa Bnilding Department . APPLICATION FOR PERMIT
�- P. O. Box 3�� :�'��'7 B U I L D I N G^� �^
r` COSTA MESA, CALIFORNIA
FOR APPLICANT TO.FII.L IN ' FOIt OFFICE USE ONLY
Receipt No. Permit No.
Building . . } /_ ��
Addrcsa � " J r0
Costa Mes California e eiv by f�D Re fi/ /GDate Issued
Nearest � 2 I/ � "' I�7 ' 7� 6
Cross St. . � ' Builtlin9 : . / % , . / .
Address E7
Owner Z
ma;i �j ' Costa Mesa, Calif rnia
Address �/� L l� r/ Noa�nM
Contractor
I Lot
tion No.
Metes and
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City
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cK I Tract
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No. of Bldgs /
Now'on Lot �
Nu.of / No.of
Familles I� Roomsf
Rear Vard
e�de v�.a i_ — Q 7
Roof
Demolfsh
Stories
APPROVALS
, Frame: Fire Stope,
Bracing; Bolte �
I hereby acknowledge that I have read this Applicatfon �
and state that the abwe Is correct and agree to comply Lath. Int. '� ."
with all GYty Ordlnances and State Iaws regulating .
building ConstruCtion. • • . � Lath. ExA � �
Signature of /� //����
PermiNee l7`GLr� d� Plaster, Int �
AuthoNzed Agt Plaster, ExL
Vaivatlon Permit Fee $ �� Masonry ReinToroe
�^( � PIart�Ch°°k $ �
$ d " � Totai
Fee � FINAL
XM 204 10�55 O. P. h 9. •
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(714) 754-5273 • Fax (714) 754-4856 • www.ci.casta-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address: 616 W BAY ST
Suite:
Vicinity:
Parcel Number: 42213216 Zoning:
Applicane ORELLANA, LEO
Address: 676 W BAY ST � -'
� Phone:� 949-722-8337 .
COSTA MESA, CA "��- Zip: 92627
�
/, ' �
Owner. ORELLANA, CEO � �
Address 676 W BAY ST� � ' - �- -
", - �, , - . - Phone: � .
� �.COSTA MESA, CA Zip: 92627 -
Contractor: '
Addressr �. /-" �
,. .
- - - Phone:.
i
Zip: � � License: �
Arch :. ' � .. � Eng:
Address: . . � , `, , " � _ � Addre'ss:'
' � . � � ' - � Phone:
Zip: � - � License:
Status: ISSUED
Applied: 11/07/2007
Issued: 11/07/2001
ISSUED BY:
, . . �
. � � ' , , Phone: �
. - ' �License:
SGUPt Oh PtNMIT �
� ' TEAR OFF EXISTING ROOF. INSTALI NEW SHEATHING AS REQUIRED. COVER WITH 25 YEAR COMP SHINGLES. DOES .
NOT INCLUDE ATTACHED GARAGE. � � � � � � � f � � � - � � � �
� � - . FEE SUMMARY . � � .
Plan Check: $0.00 - _ � � ' ��� j - Calc Valuation: Ss,000.00
Permit: $8325 � � � ., � . Claim Valuation: Sa,000.00
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: ,. $0.00 '
�. Total: , $83.75 . . � � _ ,
SETBACKS.
MAIN STRUCTURE Front � 0- 0
ACCESSORY Front - 0-0
PARKING Existina: o
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
PLANNING & ZONING
teft 0- 0
Left 0- 0
Proposed: 0
Right 0- 0
Right 0-0
NOTICE: The work authorized by lhis permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expira and become void if work is not commenced wlthin 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
requlred Inapectlona and final approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
240&48 (0/00)
WORKERS' COMPENSATION DECLARATION:
I hereby eXirm under penelry of perjury one o1 Ue Idlowing dedarations:
� I heve entl wlll maintaln e cstllflcate of consent to selt-Insure tor workers' compensatlon, es D�ovidetl tor by sectian 3700 oi the Lebor Cotle, for the pertormence ot the
work for which t�is permit Is is5ued.
❑ I heve end will mainte f workers' compensetlon in urence, es raquired by sectim 3700 al the Lebor Code, lor the perfortnar�ce ot ihe work for whlch Nis pertnit is issued.
My warkers' com er�AYat n surence cerri e number ere:
Certler. �L . ., Pollty Number:
Is sectlon need nol be co �pleted I/ the p !f Is ve/ued et one hundred ddlars ($100) or less.)
certlly �het In Ihe peAormence o1 Ne ork for which thLs pertnit is luue0,1 shell not employ eny pereori In eny menner so as to become suD�ect to the workers'
campensetlon laws of Califo le, end eprea t et if I s�oulA 6ecome auDlec� �o the workers' crompensetion proNslons ot Sectlon��33700 of the Lebor Code, I shall torthwit�
compy w%h these Provisio .� ( 1 / /� I
Appllcent Slgnature: � L�a . Dete: ��`%
WARNINO: FAILURE TO SECURE W ERS' � NSATION COVEMQE IS UMAW R1L AND SHALL SUBIECf AN EMPLOYER TO CRIMINAL ENrLLTIES AND dVIL FlNES UP TOONE HUNDRED
THOUSAND DOILAHE (510QOOO�.IN ADIXTION TO TNE ODST OF OpAPENS�TION, ONM�GES AS PROVIDED WR IN SECfIpJ 3�OB OF THE IABOR CODE. IMEREST, AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I heroEy aHirtn that I em licensetl under provislons ot Chapter 8(commenchg wllh Sectlon 7000) of Dlvlsion 3 of Ihe Buslness and Pmfessians Cade, antl my license is In tull
lorte entl eMect. LiC. M Class M
Contrector's SipneWre: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby eHirtn �het there is a construMlOn IenCinp egency for Ihe peAortnance ot t�e work tor which this pertnit is IuueC. (Sec. 3097, Civll Cotle).
LenOefs Neme: Lentler's Atltlress:
Signeture: Dete:
OWNER-BUILDER DECLARATONS:
I �ereby ettirtn that untler penalry at per�ury that I em EXEMPT FROM TME CONTRACTORS LICENSE LAW lor Ihe tollowing reason (Sec. 7031.5, Buslness antl ProfesSions
Code: Any Gry or counry which requlres e permit Io construct, eller, ImDrove, tlemolish, or reDalr any structure, pdor to Its issuance, elso requires Ihe flppliceM for such pertnit
to file e si8netl stetement thet he or she Is Ilce�y� pursuent lo Ihe provislons oi Ihe Coniractors Llcense Lew (Chepter B(cammencing with SecUon 7000) of DMsion 3 of Ne
Business end Pmfeubns Code) or Ihet he or she is eaempt therelrom flnd the Desis for the elleged exemptlon. Any vidatlon of Sectlm 7031.5 by any applicent for e pem+1
sub�ects Ihe epplicant lo e clvil penalry of not rrwre than frve hundred dollars (E500).):
❑ 1, es owner of Ne property, or my emplqyees with wages fls Nelr sole compensallon, WILL DO THE WORK, end tha strucmre Is not intended or ottered (or safa (Sec.
7044, 8usiness and Professions CaCe: The Contrattors lJcense Lew does no� appy to en owner at pmperry who builds or improves Ihereon, antl who tloes such work
II or herseN or through hls or her Own employees, provided Nat such imprwements are not intended or aHered lor sale. If, howevar, the builtling w imprrnement is
sold wit�in one year at completion, the Owner-Duiltler will have the burden ol proving t�at he or s�e ditl not build or improve tor purpose of sale.).
I, as owner ot the property, em E%CLU$IVELV CONTRACTING WITH LICENSED CONTiiACTORS to construct Ihe projed (Sec. 7044, Business and Profassions
COCe: The canirectora Lkensa Lew doBs not eppy to en owner at pmperry who build5 or improves thereon, end who contrects tor such project wlth a coniredor(s)
license pursuent to t�e Contractors License Laws.).
❑ I am exem �u�n�de/r l�c. Business fln0 Protessions Code lor this reason:
Signeture: � �•f�AN4.� Data:
Owner ID verltied by drivete Iicense. ❑ Yes ❑ No Drivefs Ucense No. E� pires:
Vedficatlon of Ownership by (type of document, i.e. - properry tax DIII or tleaa):
DIVISION OF INDUSTRIAL SAFETY PERMfT CEpTFICATION:
❑ I hereby certlty thet no excavetbn Iive (5) w more feet In depth Into which e person Is requiretl to descen4 wlll be made in wnnection wiN work euNorizetl by thls
pertnit, end t�et no building structure, staHddinp, falsework, or demolition or tlismantling Ihereof, will be mare than thirty-six (38) tee� hig�. (Chap. 32, Grp 2, Art 2, Sec.
341, Titla B, Celtlomla AdminlslreUve COde).
❑ As owner-builder, 1 will not employ flnyone to Ao work whlch would reQuire e pertnit trom the Dlvision ot Industrial Sefery, as noted ebove, unless such person has e
partnit to tlo such work irom the tlivision.
Signeture: Date:
DlWsion of Intlustriel Satery Permlt Number:
CERTIFlCATE OF COMPLIANCE AND AUfMOROATION OF EMRY: I certily under penelry oi perjury thet I heve reatl ihis ep0liwtion and stata thet the Inlortnation given Is
conect. I egree to compry wlth ell stete lews end dry ortlinences relating to bulltling constructlon, an0 euthoriza representatives ol the Ciry of Costa Mesa to enter upon the
ebove-descnbed property 1 insp ion pptp0.qes. I agree not to occupy or ellow occupancy ol eny building eulhorized yy�this der�un I finel inspection.
(L% I � lJ /I
Ignamre Legal owneqs) -�� Date "
COUE �. INSPECTIONTYPE
1818
1288
AnNOr Authadied Applicant Dale
Fixetl System Finel Fire Preventlon
Paol Spe Finel
200 Flnal Ra-Root
201 FIneI BIocWRetelning Well
202 Final Fectory Flre Place
203 Finel Sign
204 Finel Demolitlon
Deff, II�{S
li•aa.o� i��
COOE� �xsvecr�oNnre
20B Finel Machanicel
20B Finel Plumbing
210 Flnel Electdcal
212 Flnel Fire Prevemlon
220 Flnal Plenning Apprwel
222 Final Site
250 Final Bullding/Occupency
P� It�eLS
OWNER GRAY HAROLD F � JAN 11 ty5� onre �
MpR 1 1 195
JOBADDRES3 C)].6 B8y � BUILDINGPERMITNO. #36%S
GENERALCONTRACTOR OWI1eI' BZCII', VALUE $ 5GO.00
A� l 5-312-16 �
LOT BLOCK TRACT Pn+.in Rnnf
GROUP I TYPE V
INSPECTIONS DATE
Footing Trench
Foundation Forms and Grade to Garage
Rough Framing
Plumbing, Rough to Slab
Plumhing, Rough Complete
Temporary Pole
Wiring, Rough
Heating, Rough
Heating, Final
Sewer, House Sewer, St.
Septic Tank or Cesspool
Lathing, In Out
Plastering
Plumbing, Final, Fixtures Complete
Plumbing, Final Gas Test
Wiring, Final �
Occupancy (� _�
iORM 210 3M 10�59 '
SUBCONTRACTOR
PERMITSISSUED
I NUMBER
u
3675
OWNER RRKR�H TNC_ DATE 10—li—rill
JOBADORE83 616 B&jr Street BUILDINGPERMITNO.' 623
,-GENERALCONTRACTOR Dike & Coleerove � vn�ue�s 8.���.��
�oT 2 e�ocK TRACT 2315 Single Famil,y Res.
GROUP I TVPE V ZONE �� FIRE DISTRICT 64�
PERMITSISSUED
INSPECTIONS DATE SUBCONTRACTOR
. DATE I NUMBER
Foundation Forms and Grade
Rough Framing
Plumbing, Rough to Sla �
Plumbing, Rough Complete
Temporary Pole
Wiring, Rough
Heating, Rough
Heating, Final
Sewer �Ji7Ji
. Septie Tank or Cesspool
LatM1ing �y,�y
Plastering
�Plumbing, Final, Fixtures Cor
Plumbing, Final GasTes
Wiring, Final
Occupancy
Form 110 GA 1h1 I'469
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