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Home My WebLink About3333 BEAR ST - Building Permits (36)CITY OF COSTA MESA O�pMFQp BUILDING DIVISION F�� 77 FAIR bRIVE. COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us � FOR INSPECTIONS CALL: (714) 754-5626 . '�°•^«�°"° PERMIT NUMBER: E11-00204 PERMIT TYPE ELEC APN: 41249207 ,-,�`��u.�n'a��a; �=�` t JOB ADDRESS: �3333Y1�10�BEAR ST'CM Vicinity: ELEC METER ROOM STATUS: ISSUED DATE ISSUED: 09I0812011 ISSUED BY: MDM Suite/Unit: 110 SCOPE OF WORK: REMOVE REPLACE 1200 AMP BREAKER IN THE ELEC ROOM SPACE t'10 SOUTH COAST PLAZA � OWNER: SOUTH COAST PLAZA Address: %C J SEGERSTROM & SONS Unit:COSTA MESA, CA PHONE: City/State/Zip: 3315 FAIRVIEW RD APPLICANT: JOHN KUBACKI PHONE: 714-751-6133 CONTRACTOR: J A K ELECTRIC Address: 1340 LOGAN AVEUnit: STE C City/Siate: COSTA MESA, CA ZipCode: 92626 ELECTRICAL PERMIT FEES Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $147.80 Reinspection Fee $0.00 TOTAL FEES $1,47.80 Address: Unit: City/Stale/zZip: License No. 405289 PHONE: 714-751-6133 CELL: , ..Fµf�'�I.�^;w ��r.�>.��„v ;�. ..'''� .`.,; NOTICE: The work authorized by this permit shall wmply with all applicable handicap access requirements under Calitomia 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. INSPEC710NS: In order for the work authorized under this permit to be coosidered legal, such work must comply with all applicable wdes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will resWt in the expiration of this permit. CODE/. INSPEL110NTYPE DRTE INi111AL5 GOOEp INSPECiIONTYOE �RTE INTITIpLS 1616 Fixed System Final Fira prevention 206 Final Mechanical ^ 1266 PoolSpafinal 208 FinalPlumbing ��' �� ' � 200 Final Re-Rool 270 Final Electncal SG /—/ �� 20� Final BIocWRetaining Wall � 272 Final Fire Prevenlion 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site � 204 Final Demolition 250 Final Builtling/Occupancy WORKERS' GOMPENSATION DECLARqTION: I hereDy aNirm under penalty of perjury one ol the following tleclarations: � �� I have and will maintain a certificate o( consent to sel4lnsure tor workers' Compensation, as provideA for by section 7700 of the Labor Code, for the performance o( the work lor which �his permit is issued. ❑ I have antl vrill maintain vrorkers' compensation insurance, as required by secCqn 3700 of ihe Labor Code, for the pfAortnance of the wnrk fw which this pertnil is issued. My woMerS' compensalion Insurance carder and policy number are: Carrier: (ilut seq.on neetl rc4 �e mndcleE d Mo pe�mR i� valucvf at one hunOred doNars (EI00) a leu ) Policy Number: ❑ I certity Ihat in Ihe peAortnante oi Ihe vrork (or whiCh IhiS permil i5 issued, 7 shall not empby any person in any manrter so as !o become subject to ihe workers' compensation laws of California, and agree Ihal it I shoultl become subject to lhe workers' compensation provisions oF Seclion 3700 of t Labor C e. I shall forthwith comply �(h these provisions. �� Apqimm's SigmWm Da1e WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF TF{E LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrtn that 1 am licensetl under provisions of Chapter 9(commenting with Section 7000) ol Division 3 0l the Business and Professions Cotle. and my license is in full lorte and eflect. Lic. # `� � a g'� Class # �� v n .-�_ L -- �/ y� �� Conuatlor's Signawre Date CONSTRUC710N LENDING AGENCV: � ❑ I hereby affum Ihat there is a constructbn lending agency tor Iha peRwmance of the xork la which this permit is issued. (Sec. 3097, Civil Cotle). Lender's Name: Lender's Adtlress: $ignaiure Dile OWNER-BUILDER DECLARATIONS: I hereDy affirm [hai untler penalty of peryury that I am EXEMPT FROM THE CONTRAC70RS LICENSE LAW lor lhe following reason (Sec. 7031.5. Business and Professions Code: Any city or county which requires a permit to consWct, alter, improve, demolish, or repair any sWcNre, prior lo it5 issuance, also requires Ihe aDPlicant for such pertnit to file a signetl statement thal he or she is licensed pursuani to the provisions of Ihe Contracbrs License Law (Chapter 9(commencinq wilh Section 7000) of Division 3 of �he BuSiness and Pmfessions Code) or Ihat he or she is exempt Iherelrom antl the basis for the allegetl exemplion. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than (ve hundred dollars (5500).): � I, as ovmer of the property, or my employees wilh vrdges as their sole compensation, WILL DO THE WORK, and Ihe sWCWre is not intended or ollered for sale (Sec. 7044, Business and Pmfessions Code: The Contractore License Law tloes not apply to an owner o( property who builtls or improves I�ereon, and who dces such vrork himself or herself or through his or her ovm employees, providea that suc� improvemems are not intended or ottered lor sale. If, however. the builtling or improvement is sold within one year ol completion, the owner-builder will have Ihe burden of proving that he or she did not build or improve tor purposa ol sale.). ❑ I, as ovmer o( the property, am EXCLUSIVELY CONTRAC7ING WITM LICENSED CONTRACTORS to conslruct the project (Sec. 7044. Business antl Professions Code: The contractors License Law dces not apply to an o.vner of property who builds or improves lhereon, and who cont2cts for such project wilh a cmfractor(s) ficense pursuant to the Contractors License laws.). ❑ I am exempt under sec. Business antl Prolessions Code for this reason: Owner ID verified by drive� a licen5e. 0 Ye5 ❑ No Dnver's License No. Expires: Verification of Ownership by (type ot document, i.e. - property lax bill or deed): DIVISION OF INDUS7RIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cetlify Ihat no ezcavation frve (5) or mwe leet in tlepth into vfiicb a person is requiretl to descend. will be made in connection with work authorized by this pertnit, and lhat no building simcNre, scaHdGing, false�wrk, or tlemolition or tlismantling thereol, vrill be more than thirty-sia (36) feet high. (Chap. 32. Gry 2, M 2, Sec. 341, TNe 8, Calilomia Administ2tive Cotle). ❑ As ovmer-builder, I will not employ anyone to do vrork vfiich vrould require a Oermit from Ihe Division of Industrial Safery, as noted above, unless such person has a pertnit to do such work (rom the tlivision. Appl¢anfs Sg�aWre Division of Industnal Sa(ery Permit Number. _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or fWure building occupant need to file antl certify a Business Plan lor emergency response to release or throatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 0( lhe Califomia Health and Safety Code requires, wiih some exceptions. that a Business Plan be fled with the Costa Mesa Fire Depanment by every business which has at any one lime tlunng a reponed year a qUantity Of haz2fdou5 material5 equal to or grealer than a weight Of SOD pountls, or a volume of 55 gallons, or 200 cubic leet ol comprossed gas at standard temperaNre and pressure�. 2. Does or vnll the applican� or present or (uture building occupant neetl to fle a registration form for acutely hazardous materials? ❑ Yes ❑ No (Seclion 25533 of Ihe Calilomia Heallh and Sa(ety Cotle, with some exceptions, requires regist2tion with the Costa Mesa Frre Departmenf �y each business which ai any one lime has on hand a quantity of acutely hazaraous materials equal to or greater than a vreight o/ 500 pounds, or a volume of 55 gallons, or 200 cubic (eet of compressed gas at slandartl temperaWre and pressure). 3. Does or will (he applicant or present or fuwre building occupant neetl lo prepare an RMPP (Risk Management antl Prevention Program lor acu�ely hazardous malenals)? ❑ Ves ❑ No (Section 25534 of the Califomia Health antl Safery Code provitles Iha1 the Costa Mesa Fire Department may require the preparation, certifcalion and filing wilh the Fire Department ol an RMPP by businesses which are required ro register acutely hazardous materials with Ihe Fire Department. 4. II an RMPP is presently requiretl, has Section 25534 of the Calilornia Health and Sa(ety Code been lully wmplietl vrithl ❑ Yes ❑ No 5. Dces or will the applicant or present or tuWre Duilding occupaN require for the work which is ihe subjetl ol lhis appliCation a pertnit for Such conStNction of modifiGalion Imm Ihe Soulh Coast Air Oualiry Management DiSMGt or (mm any olher air pollution control district or agency? ❑ Yes ❑ No (Sectbn 658502 of lhe Califomia Govemment Code requires ihat Ihe requested infortnation be fumished on applications far non-residential builtling pertnils�. 6. Will any pari of the facility to be conslructed under Ihis permit be within 1000 (eet from the outer bountlanes ol a school? ❑ Yes ❑ No Qf yes", the Facility must meet the requirement of Sections 25534 and 42303 of (he Califomia Heal[h and S8f0ly Cotle). Z If a permit from the South Coast Air Quality Management District or other air pollution control tlislrict or agency is requireC for the work which is Ihe subject o( this applicatioq have all of I�e disclosures prescnbed by Califomia Health and Safely Code Section 42303 been matle? ❑ Yes ❑ No 8. (If'yes", attach certificate of wmpliance from the appropriate air pollution control officer). CERTIFICATE OF COMPl1ANCE: I cenify that under penalry of perjury the information given above is correct. I agree ro comply with all slate laws antl cit rtlinances regartling Hazartlous Materials and Emissions. . � Signamm Daii� ej CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalry of perjury that I have read lhis application antl state that the infortnation given is correcl I agree to compty with all state laws and ciry ortlinances relating to building wnstruction, and authorize representalives of the Ciry of Costa Mesa to enter upon lhe above-descrihed property for inspection purposes. I agree not lo occupY or allow occupancy of any building aulhorized by ihis pertnit until final inspection. oi Legal Owner�s) ](IS]d61y0]) AntllOr AutM1Mz¢E ApdiWnl � CITY OF COSTA MESA ��'TaMfq BIIILDING DIVISION t F� �pe' 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.wsta-mesa.ca.us �. ` • FOR INSPECTIONS CALL: (714) 754•5626 "°�"° PERMIT NUMBER: BC11-00252 PERMIT TYPE: B COMBO STATUS: ISSUED Sub Type: COM_ALT DATE ISSUED: 06/03/2011 ISSUED BY: RMD �oe aooaess: �3,333110=BEAR $T'CM. ' APM: 41249207 ZORf77g: , , Vicinity: SPACE 110 Const Type: I-A SQ. FT: 150 Suite/Unit: 110 Primary Occ: Valuation: 88,000.00 SCOPE OF WORK: INTERIOR NON-STRUCTURAL DEMOLITION OF (2) EXISTING RESTROOMS IN PREPERATION OF A 150SF FUTURE STORAGE ROOM AND RUN GAS LINE FOR FUTURE TI WORK FOR "SUR LA TABLE", SPACE 110. NO OTHER WORK (KITCHEN WORK) AUTHORIZED UNbER THIS PERMIT. SEPERATE PLANS TO BE SUBMITTED FOR TI WHICH WILL INCLUDE HOOD. OWNER: SOUTH COAST PLAZA CA Phone: APPLICANT: BOWERS, JOHN Phone: 714-883-5172 CONTRACTOR: BOWERS CONSTRUCTION Phone: 714-883-5172 Cen: ARCHITECT: LANCE BROWN ENGINEER: COMBINATION PERMIT FEE SUMMqRY Building Plan Check: Building Fees: Electrical Fees: Mechanical Fees: Plumbing Fees: SMIP Residential: SMIP Commercial: Bldg Sld Admin Fund TOTAL FEES: Add�¢SS: °/aC J SEGERSTROM & SONS City/State2ip: 3315 FAIRVIEW RD Address: Ciry/State/zZip: License No. 930403 Address: 3231 CUTTING HORSE RDUnit: City/State: NORCO, CA License No.C19698 License No. $99.61 5153.25 $0.00 $0.00 $52.90 50.00 $1.68 $1.00 8308.44 Unit COSTA MESA, Unih : Z'rpCode 92860 PHONE:714-427-0370 PHONE: HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3N8/2010 - PER CMMC Sec. 13-279 Monday thru Frltlay-7:00 am ihru 7:00 pm. SaturEays-9:00 am thru 6:00 pm. Prohibited all houf5 - Sundays and the following Federal h0lidays: New Years Day, Memorial Dav. Indeoendence Dav. Labor Dav. Thankspivinq Dav and Christmas Dav NOTICE: The work authorizetl by this permit shall wmply with all applicable handicap access requirements under California statutes and relaled regulations. (Ord. No. 92-28. § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 780 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPEC710NS: In order for the work authonzed under this permit to be considered legal, such work musl comply with all applicable codes, and all required inspections and tinal approval must be oblained. Failure to obtain inspections and final approval vnll result in the expiretion of this permit. OC pE;l. INSPEC110NME 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 FinalSign 204 Final Dertwlition DATE IN7Ii1RL5 CO�E� INSPEL710NTYPE � 206 Final Mechanical 208 Final Plumbing 210 Final Elecirical 212 0 �_ l � � 'i Y�� _� 22 �= 1 S` �1 �l—YJ zso Final Fire Prevention Final Planning Approval F'rnal Site Final Building/Occupancy o� mnn�is WORKERS' COMPENSA710N DECLARA710N: I hereby affirm untler penalty ol perjury one o( Ihe lollowing tleclarations: ' ❑ I have and will maintain a certificate of wnsent to se161nsure tor workers' compensation, as provided for by seclion 3700 of the Labor Cotle, for the peRoimance of the wnrk for which this permit is issuetl. ' ❑ I have and vnll maint8in workers' compensation insurance, as requiretl by section 3700 of the Labor Code, for the pedwmance of the v.ork lor which this permit is issued. My workers' compensation Insurance carrier and policy number are: Carrier.- lS� % �T t �r� h � (TNs seaw need ndOe pmnp¢feE I me per..0 u reA.eCal orre niuW�e00ohars (5�00) a kss 1 Poliay.Number. l / �� ❑ I certify that in Ihe peAortnance o! the work for which this permit is issue0. I shall not employ any person in any manner so as lo Decome subject to Ihe workers' compensation laws of Calilomia, and agree Ihat i! I shoulA become subject �o Ihe wqrkers' compensation provisions ol Seclion 3700 0l the Labor Co � I hall (orth ' comply with these provisi s� �_ DG Awhv�n's S�Biuwre LDa! `e W NING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE I UNLAWFUL AND SNALL SU&IECT AN EMPLOYER 70 CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000�, IN ADDITION 70 THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF 7HE LABOR CADE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrtn that I am licensed under provisions of Chapler 9(commencing wilh Seclion 7000) ol Division 3 0! the Business and Professions Code, antl my license is in (ull force and effect. �j r--- /-� ��c.u- �30 5�o_z c�aestt; L�— ��L�—ZD // �Camacto sSg�ture Daie STRUCTION LENDING AGENCY: I hereby a(fmn that there is a crostNction lending agency fa the perfortnance o( Ihe �+ork fR Hfiich ltti5 permit's ssued. (Sec. 3097. Civil Code). Lender's Name: Lender's Address: D31C OW NER-BUILDER DECLARATIONS: I hereby aKrtn that under penalty of perjury Ihat I am E%EMPT FROM 7HE GONTRACTORS LICEN$E LAW for the (ollovnng reason (Sec. 7031.5, Business antl Pmlessions Code: Any ci�y or tounty which requires a permit to conslrucl, aller, 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 lhe provisions of the Contractors License Law (Chapler 9(commencing vnth Section 7000) of Division 3 0! Iho Business and ProfessionS Cotle) or that he or she is e:empt therelrom antl the basis for the alleged exemption. Any violalion of Section 7031.5 by any applicant lor a permit sub�ects the applicant to a civil penalry of not more than �ve hundred dollars (5500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, antl the structure is not intentletl or oBered for sale (Sec. 704q, 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 wnrk himsel( or hersel! or through Ris or her own employees, provided that such improvements are not intended or ofleretl lor sale. I!, however, the building or improvement is sold within one year of completion, Ihe ovmer-builder will have the burden of proving that he or she tlitl not build or improve for purpose of sale.). ❑ I, as ovmer of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS ro consWct Ihe project (Sec. 7044, Business antl Professbns Code: The contractors License Law dces not apply to an ovmer of property who builds or improves t�ereon, and who contracts tor such project v,ith a contrac�a(s) license purguaN to the Cont2ctors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: SignaWre ]09�a6(3/0]� Owoer ID verifed by drivei a ncense. ❑ Ves ❑ No Driver's License No. Ezpires: -Verification of Ovmership by (type o( document, i.e. - propeny taa bill or deed�: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:� ❑ I hereby certify that no excavation frve (5) or mwe feet in depth into which a pereon is requiretl to descend, will be made in wnnection with �wrk aulhorfzed bylhis permil, antl that no b+iilding sWCNre, scaffddirrg, falsexork, a demolitbn or dismantling thereof, will be more than thirty-six (36) (eet high. (Chap. 3.2, Gry 2, M 2, Sec. 341, Tille 8, Califomia Atlminis[rative Code). ❑ As Ovmer-buil0er, I will nol employ anyone lo do work which vroultl require a permit from the Division of Intlustnal Safety, as noted above. unless such person has a permit to do such work from the tlivision. AOW��'s SiB^��re Date Division of Industrial Safery Permit Number. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or presenl or IuWre buiidinq pccupant need to file and certily a Busine55 PIaR fof emergency re5ponse to release or threalened rr,lease of a hazardous material? ❑ Yes ❑ No (Section 25505 of the Calilomia Health and Safery Cotle requires, wit� some erceptions, that a Business Plan De filed with the Costa Mesa Fire DeDartment by every business v+hich has at any one time tluring a reportetl year a quantiry of hazartlous materials equal lo or greater than a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic (eet of compressed gas at standard IemperaNre and pressure). � 2. DoeS or will iha applicant or present or fuWre building occupant need to file a regislralion form lor acutely hazartlous materials? ❑ Yes � No (Section 25533 0l the Califomia Heallh and Safery Code, with some eaceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hantl a quanlity of acutely hazardous ma�enals equal to or greaier than a weighi of S00 pounds, or a volume o( 55 gallons, or 200 cubic feet o( compressed ga5 at standard tempereture and pressure). 3. Does or will the applicant or present or fuNre building occupant nee0 to prepare an RMPP (Risk Management and PreveMion Program (or acutety hazardous materials)? ❑ Yes ❑ No (Sec�ion 25534 of the Cali(omia Health antl Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification an0 liling with the Fire Department of an RMPP by businesses which are required to register aculely hazartlous materials wilh Ihe Fire Department. 4. II an RMPP is presently required. has Section 25534 of the Calitomia Health and Safety Cotle been fully complied with? ❑ Yes ❑ No 5. Does or will Ihe applicant or present or future building occupant require for the work which is the subject of t�is appliwtion a permit lor such construction or mo0ification from the South Coast Air Oualiry Management District or Irom any other air pollution control tlistrict or a9ency? ❑ Yes ❑ No (Seclion 65850.2 of the Calilwnia GovemmeN Cotle requires tl�at the requested informalion be lumished on applications for roo-resitlential builtling pertnits). 6. Will any part of lhe lacility to be constructed untler lhis De�mi� be vrithin 10001eet fmm Iho outer bountlaries o! a school9 ❑ Yes ❑ No (If "yes", the facility musl meel Ihe requiremenl o( Sections 25534 antl 42303 of the California Health and Safety Cotle). 7. I! a permit (rom the South Coast Air Ouality Management District or other air polWlion control disVict or agency is required for the vrork which is the subject of this application, have all of the tlisclosures prescribed hy Calilomia Health antl Salety Code Seclion 42303 6een matle? ❑ Yes ❑ No B. pf "yes", auach certificate of compliance from the appropriate air pollution control of(icer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the inlormation given above is correcL I agree to comply with all state laws and city ordinances regartling Hazardous Materials and Emissions. Slgnalurc Dale CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I cenify under penalty ot perjury that I have read Ihis application anE state that lhe information given is correct. I agree lo comply with all 5tate laws antl ciry ordinance5 relating lo building consWction, and authorize representatives o! the Ciry o! Cos1a Mesa to enter upon the above-0escnbed property for inspection purposes. I agree not to occupy or allow occupancy of any builtling authonzetl by this permit unlil final inspection. � I�wn r¢(h) � pale �ry"�� ..3 ZO// ME/�_AUIM1OnxM pplipnl �Dale