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HomeMy WebLinkAbout1877 NEW JERSEY ST - Building Permits . . `05TH MF 4 'r9 CITY OF COSTA MESA •. '.. °,/. BUILDING DIVISION i PE IT NUMBER :' DEVELOPMENT SERVICES DEPARTMENT o a PERMIT 00-00878 bAPoRFM1°` ' (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1877 NEW JERSEY ST Status: ISSUED Suite: Applied: 06/16/2000 Vicinity: HOUSE&ATTACHED GARAGE Issued: 06/16/2000 Parcel Humber: 13910230 Zoning: Applicant: FERGUSON, LEW ISSUED BY: Address: 11237 SLATER AVE Phone: (714)775-1947 FOUNTAIN VALLEY,CA Zip: 92708 Owner: WALLINGTON, BILLY J Address 1877 NEW JERSEY ST Phone: (714)434-7295 • COSTA MESA,CA Zip: 92626 Contractor: A PLUS SERVICES INC./A PLUS ROOF Address: DBA: FOUNTAIN VALLEY ROOFING FOUNTAIN VALLEY,CA Phone: (714)775-1947 11237 SLATER AV Zip: 92708 License: 675241 • Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF EXISTING SINGLE FAMILY RESIDENCE&ATTACHED GARAGE(25 SQ).TEAR OFF EXISTING GRAVEL ROOFING,INSTALL 1 LAYER OF 15#FELT UNDERLAYMENT,&REROOF WITH"ELK PRESTIQUE"30 YEAR COMPOSITION SHINGLES. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $3,965.00 Permit: $97.25 Claim Valuation: $3,965.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $97.75 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 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 env — arcs 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. . ❑ My we and will maintain on Insurance workers' Carrie compensation Insurance,m r ed by section 3700 of the Labor Code,for the performance of the work for which this permit H Issued. '-�My workers'compensation carrier and policy number are: '/ �Certler: `)1 //i71JQLra Policy-Number-_ _7&1123 Jai /17 (1 -(Thls'section need not be completed ll 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 Califomi 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 these provisions. Appticant.Signalure:—• .Gc..�-� X U"��- Da a:_. 062//ec/err7 WARNINGaFAILURE.TO'SECURE WORKERS'COMPENSATION COVERA UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100.003),IN ADDMON TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST.AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm t afam.licensed undeCr provisions of Chapter 9(commencing with Section 7000)of Division 3 oLthe.Business and Professions Code,and my license Is In full force and effect Lic.e IGY 7 J 2.'1,4/ class N / 0 39 $/ -Contractor's Signature.: _e....,..-�o /C Date: J € ca/ /(< /c-O 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,CMI Code). Lenders Name: Lenders 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:My 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 tile 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 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 then 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 Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safely 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 of the Califomla 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? ❑Yes ❑No (Section 25533 of the Califomia Health end 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 Califomia 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 Califomia Health and Safety Code been fully complied with? 0 Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication akermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? IDI Yes Li No (Section 65850.2 of the Califomia 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 eyes',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 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 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 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. Sign re Off egal Owner(s) Date Ota //62/0-0' ind/OF AbthOdzed''•p Cent :--- �Da � • COOE# i6SPFCTION TYPE USE ILLS CODE INSPECTION TYPE gsg maga 1816 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final �1 �c7� 7 77 2013 Final Plumbing 200 Final Re-Roof (�J•a !'6D (�LVkJ� 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 2446-46 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • PE:p IT NO. TRACT NO. LOT NO. UNIT NO. CITY OF COSTA MESApCONSTRUCTION PERMIT 41002417 A.P.# I zone • Project Address 11'77 N W P,/S�i p//� S Main Building: Accessory Building: Applicant's Mailing Address ' ele o ii — TYPE OF CONSTRUCTION LI NEW U ADO U ALTERATION VJ aEPAIR E Front Z fr ,,, O /, ' • ❑ CONVERSION ❑ DEMOLISH ❑ OTHER i T _ O Owner's Name /T�/L�A/r�,,�s Phone DESCRIPTION OF WORK/USE OF BLDG. B Rear N Address ______„„5,0AWL.....____________. I - Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING Hyl-OUNDATION El STRUCTURAL KK Right - N Address ❑ TENANT ❑ ELECTRICAL PLUMBING C MECHANICAL $- Left -- R Contractor's Name 1a /4_ a I -11 iS Phone ❑ OTHER l Ping. Ref.# - Parking Req./Provided E PROJECT DESCRIPTION SQ. FT. OCCUPANCY 0 Address(mailing) 'jQ,���jv� �� • Planning Notes: M City'License No. ' ! •• J.t-1{tkir / ZONE CONSTRUCTION TYPE GRADING CU.VOSV ALUATIONASC RES RFCE,:ni SEP 1 9 1989 T LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: ' with section 7000) of Division 3 of the Business and Professions Code,and . my license Is in full re .yM effect. a ELECTRICAL FEES S. License Class C/ CO t1SAir A N� — `�' / e PLUMBING FEES Automatic Washer Transformer 0 15-50 KW Date �� .� Signature WORKERS' COMPENSATION DECLARATIONBar Sink Showers Construction Pole Sub. 0 50+ KW • I hereby affirm that I have a certificate of consent to self-insure or a certificate • ` of Workers' Compensation Insurance, or a certified copy thereof (Section Cooking Unit Meter [pup to 100 amps 3800, Lab. C.J� 2 �� / Backflow Prevenler Service Sink - 'J/7j/9(J�mai Companydp Dishwasher "� Meter Dover 100 amps '�. PolicyNo. / Backflow Irrigation Sewer(:a ertified copy is hereby furnished. —J —•Dryers ❑Gas :❑Electric Sub Panel Ce ciUyliaq//�cop filed with the city rySya ig, sio Bathtubs Sewer Connection Date /-- ApplicantFan Clarifiers Solar Collectors Motors 00-1 HP 01%-B EXEMPTION FROM WORKERS'COMPS TI DECLARATION ss(This section need not be completed If the permit is for one hundred ($100) or Dishwasher Solar Piping F.A.U. Inc.Solar 09-15 HP 016-15+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 te Drinking Fountains Solar Tank Fixtures Microwave . Workers' Compensation Laws of California. Device Boxes Pole Light Date Signature Floor Drains Swimming Pool w/Spa g NOTICE: If,after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal - • Outlets Range - comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Switches Sign Gas Service Outlets Water Closet 9 I hereby affirm that there is a construction lendingagency for the performance issued the work for which this permit is issued (Section 3097 Civ. C.) Garbage Disposal Standing Sections Lender's Name Interceptors 1 Water'Heater i Lender's Address - Kitchen Sink 1 Water Service Generator DO-5 KW 05-15 KW Trash Compactor OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or ' county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee $ 3 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 enalty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS: LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 Zoning Approved By Date compensation, will do the work,and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By Date License Law does not apply to an owner of a property who builds or improves _ thereon, and who does such work himself/herself.or through his or her own Application Issued By Date_$ employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 sale. If, however, the building or improvement is sold within one year of corn- Canopy Type II ❑ SUMMARY OF FEES pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground prove for the purpose of sale). - BUILDING PERMIT $ SMIP $ 0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ PERMIT tractors to construct the project (Section 7044,Business and Professions Code: /✓� The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU PLUMBING $ — 5,0ISSUANCE $ Al builds or improves thereon. and who contracts for such oroiects with a con- - ENERGY P.C. $ tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration I PLAN CHECK 25% $ proof of their Worker's Compensation insurance should be provided to me. ELECTRICAL $ GRADING $ ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers MICROFILM $ • PLAN CHECK 50% $ Date Owner Heating System& Ducting Registers 00 MECHANICAL I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BTU - $ TOTAL FEE $ information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $ and state laws relating to building construction, and hereby authorize repre- sentatives of tr- cit o enter �.n the above-mentioned property for Inspection pus,' //./ Date 9./6, n _ SignatureReinspection Fee $15 Issue Fee $ 3 01 00043206-00043206 TOT Drivers' License or SS ,;.����„� pe DATE: 09/25/89 TIME: 03:.10 0865.46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING POOL&SPA APPROVALS Permit Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement i' • 3,•Electrical Conduit.Utility-Undrgrnd. 54. Forms 4.-Eleciical Conduit-Undrgrnd. _ 55. Electrical Bonding 5. Steel Reinforcement. 56. Rough Plumbing & Pressure Test -( ' 6.-Electrical UFER Grhd:' 57. APPROVAL TO COVER-GUNITE 7. Footings ..... ' . f 58. Electrical Conduit-Undrgrnd. 8.:Foundation ,C7 .re 59. Gas Pipe, 0 Undrgrnd., Test 9t'Water Pipe-Undrgind l,^1 , �� f 60 . Backwash Lines, P-Trap, 0 Undrgrnd. I. 10: Structural Floor System -1 t 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection " / 62. Backwash & Receptor-Final 12. Sewer Cap ' • _ -_ "! 63. Heater & Vent-Final , , vo 13. Roof Drains , .- 'A 64. Plumbing System - Final • 14. Rough Plumbing t' 1 ' 65. Electrical-Final - 15. Rough Electrical-Conduit 66. Solar System-Final 1.6. Rough Electric Wiring 67. Fencing & Access Approval i 1:7-. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL iv 39'. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 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 PREY. 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: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing .3//6/40 \LtP 39. Water Service-Final i7 ;_r 40. Gas Service-Final 41. Solar Domestic-Final - 42. Backflow Preventer :,`: Ili, v 43. Backflow Irrigation 10 44. Landscape Irrigation System (5) r' 45. Sound Attenuation 3 co 46. Handicap Regulations- 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 1_ !d 50. Gas Release to Southern California Gas Co r- _..;y 51. CERTIFICATE OF OCCUPANCY >- L No. Date .. 12375 FEE RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT JUN 211$60 • P. O. BOR 917 COSTA MESA. CALIFORNIA FINANCE ��DEPT CITY . For Applicant to Fill In Completely APPLICATION FOR OF TYPE OR PRINT BUILDING • BUILDING Jersey 1877 New St. COSTA MESA. CALIFORNIA For Office Use Only 1 RECEIPT NO. I PERMIT NO. OWNER Vermont Avenue Land Co. 12375 MAIL E. 17th RECEIVED BY DATE RECEIVED Pp,^ATE ISSUED ADDRESS 419 E St. /)'E�� 6—j0 - Co ,'1I3211Q BUILDING CITY Costa Mesa NO.1-181159 ADDRESS ARCHITECT Carlson & TEL. COSTA MESA. CALIFORNIA OR ENGINEER !Ljdulctrocl: NO. ADDRESS Garden Grove FIRE �u� ZONE TYPE GROUP - CONTRACTOR Dike & Colegrove, Inc. APPROVED BY DATE ADDRESS 419 E. 17th St. ZONING Iia/ /� Z]]pp,p��JJ NO.OF ?,...,1 UBE OP NE V W CITY Costa, Mesa \ I y �/ PLANE BUILDING A /U( STATE NO. 167293 TNO. Li. 8-1159 DESCRIPTION Tint lW y SIZE NO. OP 11, Tr 3A ,B OF LOT 70 x 100 I NOW ON SLOGS.none A.P.NO. trr [A USE OF YARDS EVES EXISTING BLDG. nOne APPROVED ALLOWED SETBAi CENTERRK OP LINEFROM53' REAR YARD 241 FRONT LINE eT.l FT. IN. SIDE YARD LEFT 8'' I RIGHT 121 R.SIDE / FT. IN. DESCRIPTION OF WORK L.SIDE 7 FT. IN. NEW I X!p�ALTERATION I II ADDITION I REAR IA FT. IN.// REPAIR I 1 MOVING I II DEMOLISH I APPROVED 14/1 \ DATE -4 lQD SB=ILDINGE1450 sQ.ft.RNO. OF OOMS 6 STORIES 1 111 (J (� EXTERIOR WALL ROOF /— COVERING stur en COVERING rnnnT_ & rnek /ti O 47 USE OF BUILDING AND WORK TO BE PERFORMED Kb ° � 4 — �" Single family residenre with attached garage. Plan 40C 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 FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. VALUATION SIGNATURE 0 PERMIT FEE $ 35. PERMITTEE // S S 15,045. PLAN CHECK $ 17.50 R, AUTHORIZED AGENT Dike & C legrove3 Inc. e TOTAL FEE 52.50 0A OWNER Vermont Ave. Land Co. DATE 6/21/60 JOB ADDRESS 1877 New Jersey St. BUILDING PERMIT NO. 12375 GENERAL CONTRACTOR Dike & Colegrove, Inc. VALUE $ 15 045 AP. No. LOT 111 TRACT . 3648 FIRE ZONE DESCRIPTION OF WORK Res.w/att.Gar. INSPECTIONS -7.../0.6.0 DATE I GROUP I & J TYPE V ZONE R-1. Underground Soil 4 'j U.G. Water AAA,. PERMITS ISSUED Underground Gas J�/I FOW SUBCONTRACTOR DATE NUMBER Overhead Water and . Gas 1 Rough Heating Atm S6.e.-2.4--6,0 , h,, ^�. 9-60 „7%iJ -� J Rough Plumbing /VHS. 9-)9-!.t .� �D,(i -the 7-7-60 �S DP' 444 Miscellaneous r /� yd Prop. Swt:-Chine Hoon. St. Swr. W /h p ua -c--�L�S7� eft/0 o 7•W "-et 9 i { , Sprinkling System 4.-a, ,h� Heating, Final / - - p II Plumbing Fixtures / - ,i Final Gas Test ;,ice{_ -..4 A. - - Construction Pole Underground Power _ Rough Wiring e3/-2,-,14-.!-1-9-Cl�i�•t.n,, >-;v -60 7_7,p. .5-j Trenches (/Forms 4- Steel /1.41-c -2.1-00 Floor System Steel Reinforce Chimney Re-Rod Bond Beam Sheathing 7CJ w 56- . 6 6.0 — 60 Frame and Flashing LJ- µ Lathing, In Out _ , 7 ` ezi— /0 — 6 U Plaster, brown coat , �i ¢• . _ 3 Co Plumbing Fixtures, Final .(d Electric Fixtures, FinalEll 7�a Building, Final /_ / 2 (V/ L OCCUPANCY Y borm 210-5M-11-59 S-B P n l' CITY OF COSTA MESA O�rh ,p1 \ P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 S. _ Pb! DEVELOPMENT SERVICES DEPARTMENT • BUILDING DIVISION COURTESY NOTICE OF PERMIT EXPIRATION • • August 6, 2010 • Billy J. Walligton 1877 New Jersey Street Costa Mesa, CA 92626 PERMITNUMBERS: • E08-00168 1.877oNetiit Jersey StCosta'Mesa,'C%1 ' R: Mechanical & Electrical work for Air Conditioner and Furnace 'Our records indicate the above listed permit(s) were obtained for property improvements or alterations at the above address. Per the 1997 Uniform Building Code, Section 106.4.4 Expiration, permits are valid for 180 days from the date of such permit, or the date of the last inspection for the project. • Our records do not show an inspection for these permits within the last 180 days nor have they had an approved final-inspection. If you have a signed inspection card showing that an inspection was made within 180 days, or that the final inspection was approved, please contact this office so we may correct our records. If you do not have an approved final inspection, your permits will expire on August 18, 2010. Additional fees will be required to finalize expired permits. Requesting an inspection - If you need to request an inspection, please call our Inspection Request Line at 714-754-5626. Requesting an extension -If you wish to request an extension, requests must be made in writing addressed to Bill Nunes, Chief of Inspection at the above address, detailing circumstances and listing an estimated date of completion. If you have any questions, please contact the Building Division at 714-754-4871, between 8:00 a.m. and 4:30 p.m., and a staff member will assist you. The accuracy of records affecting your property is our goal and we appreciate your working with us to resolve this matter. Sincerely, yIq\lottilict Barbara J. wart Office Specialist II . cc: Add Air Inc. Building Division(714)754-5273 • Code Enforcement(714)754-5623 • Planning Division(714)754-5245 FAX(714)754-4856 • TDD(714)754-5244 • www.ci.costa-mesa.ca.us CITY OF COSTA MESA 4i� 1 BUILDING DIVISION �r ..A;, 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 4. FOR INSPECTIONS CALL:(714)754-5626 _ : `+ n PERMIT NUMBER' E08-00274., . PERMIT TYPE ELEC STATUS: ISSUED APN: 13910230 DATE ISSUED: 07/03/2008 ISSUED BY: RMD JOB ADDRESS: 1877 NEW JERSEY ST CM - Suite/Unit Vicinity: SIDE YARD .. - - , SCOPE OF WORK: ELECTRICALPERMIT TO INSTALL NEW NC UNIT FOR A SFD. REF#:-M08-00100 =:'• - OWNER: WALLIGTON BILLY„I: Address: 1877 NEW JERSEY ST`Unit:-< PHONE: 714-719-2512 ' - , City/State/Zip: COSTA MESA`CA • - APPLICANT: RASMUSSEN DAVID .r - "Address: . 13271:PINTO ROAD Unit PHONE: 714-537-1357 City/State/zZip: GARDEN.GROVE CA- CONTRACTOR: GARAS HEATING;AND AIR CONDITIONING .License NO. 599036_ :4 Address: 13271'PINTO ROADUnit ' . - - - PHONE: 714-5374367: City/State: GARDEN GROVE;CA :ZipCode: 92843 - CELL: • ELECTRICAL PERMIT'FEES. Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $78.00 Reinspection Fee $0.00 TOTAL FEES $78.00 • 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. , 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: CODES. INSPECTION TYPE DATE umn4i.S CODES INSPECTION TYPE D "INTMALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical • 1266 Pool Spa Final 208 Final Plumbing ' 200 Final Re-Roof 210 Final Electrical e-lipL.10G r 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 WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver....cense. 0 Yes ❑ No • I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: - ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): 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 .DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: 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 ' Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This section need not be completed the permit is valued al one hundred dollars($100)or less) 2,Art 2,Sec.341.Title S,California Administrative Code). Policy Number: ❑ As owner-builder, I will not employ anyone to do work which would 11:4 certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above, unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the rkers' compensation provisions of Section 3700 of the Labor Code,I shal ort with comply with these provisions. Applicant's Signature Date r _ 3 _G8- Division of Industrial Safety Permit Number Applicant Signature Dale <-- - - HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑ No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? ❑Yes ❑ No • i Lic#' C e)S-a ti 71S Class#� C'c CI (Section 25533 of the California Health and Safety Code, with some 1/ exceptions, requires registration with the Costa Mesa Fire Department by • (7j��_A/- y.„r.....,w� 7-.3_—U� each business which at any one time has on hand a quantity of acutely �� Contractor Signature Date 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec. 3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes ❑No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑ No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes",the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑No 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 8. (If yes", attach certificate of compliance from the appropriate air pollution sale. If, however, the building or improvement is sold within one year of control officer). - y . completion, the owner-builder will have the burden of:proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty'.of perjury.the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. '' ❑' 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 Signature ' Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION"OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to buildingconstruction, and authorize representatives of Business and Professions Code for this reason: 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 I Owner(s) Date Signature Date -2 _3 ,of 305746(3/07) - �� And/or Auth nzed Applicant " Date CITY OF COSTA MESA r sicif � '` - BUILDING DIVISION 0; ; :�. 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 4. 00141� FOR INSPECTIONS CALL:(714)754-5626 +Pm� PERMIT NUMBER1/M08-00100 PERMIT TYPE MECH STATUS: ISSUED APN: 13910230 DATE ISSUED: 07/03/2008 ISSUED BY: RMD ' JOB ADDRESS: 1877 NEW JERSEY ST CM' , Suite/Unit Vicinity: HALLWAY CLOSET - - SQ. FT: 0 SCOPE OF WORK: MECHANICAL PERMIT-TO-CHANGE OUT 1 FAU < 100 K BTU 1.REPAIR/ALTER COOLING/HEAT, 1 REFRIG SYST< 100 K BTU FOR A SED REF#: E08'00274 1'' OWNER: WALLIGTON,BILLY,J , Address: 1877 NEW JERSEY ST -Unit: PHONE: 714-719-2519 '-' ' ,. City/State/Zip:- ' COSTA MESA'CA ``,'t APPLICANT: RASMUSSEN- DAVID." Address:- -13271-PINTO ROAD ;Unit:- :', • PHONE: 714-537-1367 , City/State/zZip: GARDEN GROVE 'CA' . . t''- - ' • CONTRACTOR: GARAS HEATING AND AIR CONDITIONING • License No. 599036.:. Address: 13271..RINTO ROADUnit ,: - 4 `- :' -. .' - 'PHONE:- 714-537-1367, City/State: GARDEN GROVE, CA ZipCode: 92843 CELL: • MECHANICAL PERMIT FEESUMMARY MECH ITEM FEE: - - '$66.80 ' PLAN CHECK FEE: INVESTIGATION FEE: _$0.00 - REINSPECTION FEE: - $0.00 , TOTAL FEES: $66.80 • • • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. - . 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. CODE 1 INSPECTION TYPk Mg INIITALS CODE t INSPECTION TYPE - '', INTMAL 1618 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Rbtaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval d- 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy • WORKERS'COMPENSATION DECLARATIONS Owner ID verified by drive. -.oense. ❑Yes ❑No I hereby affirm under penalty of perjury one of the following declarations: •Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' ' Verification of Ownership by(type of document,i.e.-property tax bill or deed): 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: . permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffdding,falsework,or demolition C Carrie. or dismantlingthereof,will be more than thirty-six 36 feet high. (Chap.3.2,G nt section n, be completed it Chep at one hundred dollars(5/00)orless.) r ( ) 9 Grp 2,Art 2,Sec.341,Title 8,California Administrative Code). cy N mbe ..,/ El As owner-builder, I will not employ anyone to do work which would c- y that in the performance of the worth this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. 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 f with comply with these provisions. Applicants Signature Dale fc.l7 �� 7= 3-0g Division of Industrial Safety Permit Number: Applicant's Signature Dale HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes El No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be fled with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? ❑Yes ❑ No Lic.# C O 4-r2y 7 y Class# L' 2 e (Section 25533 of the California Health and Safety Code, with some `` exceptions, requires registration with the Costa Mesa Fire Department by 7 — 11(...W each business which at any one time has on hand a quantity of acutely v .contra tor's Signature ,Dale 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work fa which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes ElNo (Section 25534 of the California Health and Safety Code provides that the Lender's Address: _._ 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish. or repair any structure, prior to its any other air pollution control district or agency? ❑Yes El No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Govemment Code requires that the requested 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 information be furnished on applications for non-residential building permits). Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044,Business and Professions Code:The,Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No thereon,and who does such work himself or herself or through his or-her own . 8. (If'yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion. the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty.of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and city ordinances regarding.Hazardous Materials and Emissions. ❑ 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 Signature 'Dale property who builds or.improves thereon,and who contracts for such project with a contractor(s)license pursuant to the Contractors License Laws.), CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described properly for inspection purposes. I agree not to occupy or allow occupancy of any building • authorized by this permit until final inspection. , Signature orkegatpwner(s) Dale Signature Dale 3057-66(31071 „) �G � - `And/or Authorized Applicant Dale APPROVED CITY OF COSTA MESA PLANNING DIVISION SUBJECT TO BLDG. DEPT. REG. i NOTE: ADDITIONS, DELETI S , ., OR CORRECTIONS . L BEfl. APPROVED BY TH 'LANNING DIV, is S BY: l` a ATE1 1% VT fk lc': r\NY- 6 r. (e \L-1------------HP ' •-•? • m--R N.euo - - ' H .