HomeMy WebLinkAbout3072 JOHNSON AVE - Building Permits.� . —
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(714)754-5273 • Fax(714)754-4856
CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
JabAddress: 3072 JOHNSONAV
Suite:
Vitinity:
Parcel Nunmber: 14159245
BUILDING PERMIT
Zoning: R1 R1
Applicant: ROBER7S, WALT
Address: CIO LEE ROOFING OF COSTA MESA
Phone: 949�42-7222
COSTA MESA,CA Zip: 92626
Owner: TEMPLE, JAMES W TR
Address 3072 JOHNSON AVE
Phone:
COSTA MESA,CA Zip: 92626
Contrador. LEE ROOFING OF COSTA MESA
Address: 01653 SUPERIOR AV
COSTA MESA CA
Zip: 92627
Arch :
Address:
Zip:
Phone: 949b12-7222
License: 349686
Eng:
Address:
Phone:
License:
PER��BER
898-02213 `!
77 FAIR DRIVE, COSTA MESA, CA 92626
SCOPE OF PERMIT
T/OFF EXIST.; NEW BURS BUILT-UP ROOFING - 1l25# BASE; 2111# PLY + 1l72# CAP HOT APPLICATION.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation:
Permit: $74.75 Claim Valuation:
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $75.25
SETBACKS
MAIN STRUCTURE Front 0. 0
ACCESSORY Front 0. 0
PARKING Existina: p
NOTES:
Rear 0. 0
Rear 0. 0
Reauired: 0
PLANNING & ZONING
Left 0. 0
Left 0- 0
Proposed: 0
Right 0- 0
Right 0• 0
Status: ISSUED
Applied: 72111/1998
Issued: 12/17/1998
Phone:
License:
52,450.00
sz,aso.ao
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO 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, end all
requlred Inapeetione and 11ne1 approvel must be obtained. FaiWre ro obtain inspections and final approval will resull in ihe expiration of this permit.
I FOR INSPECTIONS CALL: (714) 7545626
WORKERS' COMPENSATION DECLARATION:
I hereby ettirm untler penalty of perjury one ot the fdlowing tleclaretions:
❑ I have and wlll maintain e certificate of conseni to selt-Insure tor workers' crompensetion, as provitled lor by section 3700 of ihe Lebor CoOe, for Ihe peAormance ot the
work for whiCh thi5 permit is issuetl.
❑ I have end will meinWin workers' compensatbn insurariw, as requlretl by sec�ion 3700 of the Lebor Cotle, tor the peAormance ol the work tor which ihis pertnit is issued.
My workers' compensatlon Insurence cartler antl policy number ere:
Carrier: Policy Number:
(Thls secBon nee0 not be comp/ete0 i/ fhe permit !s va/ued af one hundred tlollers (S f 00) oi /ess.J
❑ I certily that In tha pertormance ol l�e work lor which this perml� I5 Issued, I shall not employ eny persan in any manner so es to become subject to the workers'
tompenSetlOn laws ol Celifomia, end epree �a Ia hetome subject to the workere' compense�lon provlslons of Sectlon 3700 of lhe Lflbor Cotle, I shall forthwlih
comply with these provisions.'� q
ApplicanlSlgneWre: GC�• ,U Deto: ��'��— j S/
WARNING: FAILUPE TO SECURE WORKERS' OOMPENSATION COVEMGE IS UNUWFUL AND SNALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CML FlNES UP TOONE MUNDRED
T/IOUSANO OOILARE (5100,000), IN AD�rt10N TO THE COST OF COMPENSATION, OAMAGES AS PRWIDE� FOR IN SECTION 3'!OB OF THE LABOfi CODE, INIEREST, AND ATiORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby ettirtn Ihet I em licensed under proNslons ol Chapter 9(cammendng with Sectlon 7000) of DlWsion 3 0l t�e Busineu and Professluns Cotle, entl my Ilcense is In full
force end eRect. Lia x Cless a
ConVectafsSigneWre: i( ,�/ Date: /�'—��— �
CONSTRUCTION LENDING AGENCV: �
❑ I here�y eNirm Ihet thare Is a canstructlan lentling egency for the pedortnence ol the work lor which this permit Is issuetl. (Sec. 3097, GINI Cotla). �
Lende/s Name: Lentler's Atldress:
SlgnaNre: Date:
OWNEH-BUILDER DECLARATIONS:
I hereby eHirm Ihei under penalry of perjury thet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the tollowing reason (Sec. 7037.5, Business end Proles5ion5
Cotle: Any ciry or counry which requires a permit to wnsiruct, alter, improve, tlemolis�, or repeir eny strucwre, pdor to its issuance, elso requires the appliwnt for such pertnit
ta lile e signad statement that he or sha is IicenseC pursuam to tha provisions ol tha Gontracbrs License Lew (Chaptar 9(commencing with Section 7000) of Division 3 0l Ihe
Busineu entl Profeuions Code) or t�at he or she k exempt �herefrom and the basis lor the elleged e:emptlon. Any violation ot Section 7031.5 by eny eppliwnt for e pertnit
sub�ect9 ihe applicent to e civA penalty ot not more Nan five huntlred Oollars ($500).):
❑ I, as owner ot the property. or my employees with wages as t�eir sde compensation, WILL DO TME WORK, anC Ihe SVucture is not Intendad or ofteretl for ule (Sec.
7044, Business and Profession5 Code: 7he Conlrectors License Lew tloe5 not aOPN �o an owner of property who builds or improves Ihereon, end who does such work
himself or hersell or Ihrough his or her own employees, provitled that suc� Improvements are not Intentletl or oBeretl tor sale. It, hov.ever, the builtling or impmvement is
sold wilhin one year oi completlon, the owner-builtler will have ihe burtlen of proving i�at he or she did not build or improve for purpose of sele.).
❑ I, as owner ot ihe property, am EXCWSIVELY CONTRACTING WITH LICENSED CONTRACTORS Io construcl Ihe prqect (Sec. 7044, Business antl Professions
Cade: The contractors License Lew tloes not apply to an owner of property who builtls or improves t�ereon, entl who contrects tor such pmject wRh a coNrector(s)
license pursuant to the Contrectoro Llcense Lews.).
❑ I am ezempi under sec. Business entl Professions Cotle for this reeson;
Signeture: Date:
Owner ID verified by driver's license. ❑ Yes ❑ No Drivers License No.
Vediicatlon oi Ownarship by (rype ol document, i.e. - property taa bill or deed):
DIVISION OF INDUSTflIAL SAFETY PERMR CERTIFICATION:
Expires:
❑ I here6y certtly that no excavetlon ilve (5) or more teei In depth Into w�ich e person Is requiretl to tlescand, will be made in connectlon with work authorizetl by t�is
permit, an0 that no buildinq siructure, sceMolding, felsework, or tlomolitlon or dismentling thereot, wlll be more then thirty-six (36) leet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Tltle B, Calilarnle Adminisiretiva Code).
� As owner-builder, I wlll not employ enyone m tlo work which would require a permlt imm the DWlslon ol Indusiriel Setety, es noted ebove, unless such person has e
permil to tlo such work Imm the tllvlsion.
Signawre: �ate:
Division ol Induslrial Safery Pertnit Number.
CER7IFlCATE OF COMPLIANCE AND AllTHORIZATON OF ENTFiY: I certily under penalry ot perjury �hai I heve read this applicetion end state thet the infortnation given is
correct. I egree to comply wlth all stete lews and ciry ordinances relating 10 building consiruction, entl eu�horize represantatives of the Ciry of Coste Mesa to anter upon the
above-described proDerty for inspecUon purposes. I agree not to occupy or allow occupanty of any building authorized by ihis parmlt un�il finel inspection.
Legel Owner(s) !/Dete
.'� .( / aZ —/�— 7b
AnNOr Authodzed Appliwnt Date
COOE l INCPECiIONTYPE
1616 Fixed System Finel Fire Prevention
1288 Pool Spe Finel
200 Final Re-Rool
201 Final BIocWRateining Well
202 Final Fectary Flre Plece
203 Final Sign
204 Finel DemoliGon
2a4&d8
� I��
/2 �� - Rd ��
GOOE� INSPELTIONTYGE
206 Final Mechenical
20B Finel Plumbing
210 Finel Elacidcal
212 Finel Flro Prevention
220 Flnel Plenninp Approvel
222 Flnel Sile
250 Final Building/Octupancy
CAII III�EIS
APplieant lo fill irt�ll spaco wilhin
GTY OF COSTA MESA -
CONSTRUCTION PERMIT
Addrew
Address
ConVactor
Address
bortler lines antl sign a11 aoVroprialo aeUantlon
TRACT NO. LOT NO. BLDG. NO.
V 8. TVPE OF CONSTRUCTION � -
Pha��j —Q � ❑ NEW C�ADD ❑ HLTERATION
- - ❑ REPAIR ❑ CONVERSION ❑�EMOLISN
LicenSe No. ❑ OTHER . , ,
r_�
I h¢r¢by dltirT t�tt I am IlcansaE untler provislons'�ot�Charter 9(com-
mencing �with �sectlon '1000) ot Divis n 3 of tha usiness antl
PfOf¢SSIOOS COtlB� dfltl ffly ❑C¢OS< i O/4I � OftO d00 o(fect.
Llcenze Class Cr LJcBn �C �' �
I �O.
Date i9n �ire �L
W00.KER5'COMPENSATION DECLARATION
I hereby affirm that 1 have a certificate of <onsen[ to self ins e or a
certlti�at¢ of Work¢rz' CompensatiOn InSurance, a� a cer fIa copy
tne-YN(�5ecc�on98�l.�vgtc})���a1„rl� _.390C.
.� C ���
;ertifietl copy is her¢by furNih<tl. .
u Certifiltl COpy iz tiletl wi[h th¢ [ity Builtl{ng DiviSiOn.
EXEMPTION FROM WORKERS'COMPENSATION DECLARHTION
(This sectian neetl not be complete0 it the permit is for one �untlretl
(5100) or less).
I ceriify that in th¢ p¢rtOrrtlance 01 ih¢ work fOr w�ich this permit I5
I55uetl, I shall not employ any person in any manner so as to become
subject to the Workers' Compensation Ldws of Cdlitornia.
Date Sl9nature
NOTICE: If after makin9 �hls tleclaration, you shoultl become subjett
to the Worker5' Compensation provision5 of tne LaOor Coee, you must
fort�with comply wi[h such provislons or t�is perTi[ Thall be Ge<mttl
�evOketl. . . _ _
CONSTRVCTION LENDING AGENCV
I hereby atfirm that tnere iz a construction lentling agenty lor the per-
tormance ot Ihe work for which �this permib Is issuetl (Section 3097
Civ. C.). "
Lentler's Name
Lentler's Atltlress
OWNERBUILDER DECLARATION ' '
I her¢by aifirm lhat I am ezempt trom thG COntrd<tor'S LitenSe Lnw br
the following reason (Sec[lon �031.5 Business antl PioieSsionS Cotle:
Any Cily Or county whiGh rGpWres a pCrmit to COnSlruct, allt/,
Imp�ovo, tlemollsh o� �epal� any Sl�ucture, prior to il5 ISSuantE, alto re-
quire5 lhe ap� licanl (or Suth p¢rmi[ to til¢ a signttl 5tatemOnt lhat no
is Iitensetl Durzuant to [he proWslons'ot t�e Gontractor's License l.aw
(Chapter 9(commencing wit� Sectlon 7000) oi Divlsion 3 01 tbe
Buslness antl Prolessions Cotle) or tnat he is exampt tnercfrom antl the
�: for lhe alle9etl ¢xempiion. Any viOlal{On oi SnGtlon ]031.5 by
applit'ant Po� a pe�mlt subjecls the appliCant t0 a civil penalty
,ol more than tive hwtlr¢tl tlollars (E500).
LI I, as owncr o/ thC property, or my employees wtth wagei as l�elr
501¢ COmpCnsatiOn, will tlo the work, antl lho struclur¢ Is mt intentletl
or offeretl tor sale. (Settion 1044, Business antl Rofesslons Cotle: The
Contractor's License Law tlo¢s not aooW to an owner of a orooertv
nmea �or saie. n, noweveq [ne owiaing or improvemen[
one yea� of completion, the owner will havo lho burtlm
: tlitl not Ouiltl or Improve for Ih¢ -purpose ol sale).
ie� ol �pe p�operty, am BxCluSivaly contraGting with
an owner ot O�operty wno DWIOS Or ImprOv¢5 [n�reon, ana wno Con-
IldCLS ((OT SUCh'plOj[CIS WIIh d^COOIldCLO!(S) I�CBf08d-pUlSUdOI [O
the Contractor's license Law).
❑ I am ex¢mpt untler $e<tion � B. 8 P. C. f0/ thi5'
reason
Date Owner
�1 hereby c¢rtify%�1 al I have reatl lh z application antl state lhai tM1e above
iOfOlRldtioll -i5/CIjIICct. I agI¢e �[OTpIY Wilh dll Ci[Y dOtl COOOtV
TYPE OF PERMIT • � '
� GFADING ❑ FOVN�ATION ❑ STRUCTURNL
❑ TENANT ❑ EI.ECTRICAL �PLUMBING ❑MECHAI
❑ OTHER
PROJECT DESCRIPTION
SQ.FT.
OCCUPANCV_CONSTRUCTION TYPE
VALVATION ZONE
GRADING CU. VDS. ACRES
REMARKS:
PLUMBING
BATHTUB$
TOILETS
LAVATORIES
KIT. SINKS
SERVICE SINKS
FLOOR SINKS
DRINKING FOVNTAIN$
PLAN CHECK
SHOWERS
URINALS
DOUBLE LAVS
DISHWASHERS
SUMPS
FLOOR DRAINS
INTERCEPTORS CLARIFIERS
SWIMMINGPOOL PTRAP
WATER SERVICE - ALTERATION
GASSERVICE ' -OU'fLETS
EWER CONNECTIONS •
SOLAR TANK COLLECTOR!
SOLAR PIPING SVS. � -' '
ISSUE FEE
MECHANICAL PLAN CHECK
HEATING SVSTEM 0-300,000 BTU_
'AND DUCTING � 100,000 + BTU _
REFRIGERATION 0-]00,000 BTU_
�SVSTEM 100,000 + BTU _
BOILERS BTV
SVSTEM REPAIR, ALTERATION
EXHAVSTSVSTEM MULTIPLE
represenlatewij�Of 1��-t,y to�P er"upon the aDove ne etl
OroPertY for lysqu�o�.�ocao:�� �' �
Signa[ure at
Drivers' Licenze or SS gF _ — - �SSUE FEE
CMF 0965�J6 Wqite-Builtling; Gnary-Applicanh Vink�Accounting: Goltlenrotl-Assessor
I
D5oU II/16/H2
A.P. �
ZONE
REAR VARD (TO �/L)
PKG. SPACE R[Q.
STREET WIDTH
SPECIqI CONDITIO
ELECTRICAL
REGULATIOI
PLNG.REF.
PROVIDED
PARK FEE E
PLAN CHECK
TRANSFORMER 0-1KW_1-lOKW
APPLIANCE 10-50 KW_50 + KW
MOTORS 0-1 HP 1•30 HP
pNC. SOLAR� 10-50 HP 50 a HP
FIXTURES - OUTlETS SWITCH
GAS TUBE SIGNS �
POIE LIGHTS -
��-�
,_-�
�0�-
���—
��/111�� �
MAIN $UB
� qMP
APPLICATION APPROVE� BY
pl,(Il� TI
/
0
n
� SUMMARV OF FEES � � "
BUIIDING � �Q.
PERMIT i�� SMIP E
'PLAN CNECK b PERMIT �
ISSUANCE E
PLVMBING E
� 'C�RADING S
. PLAN CHECK S � �
ELECTRICAL E ' E
PLANCHEGK § _ � MICROFILM $
MECMANICAL E TOTAL FEE S
PLAN�CHECK E � ' LE55 AD- '
VANCEPC S_
1
, FINAL FEE E _
CONSTRUCTION AND PLANNING POOL & SPA -
APPROVALS Permit # �-`S`S'3 Date Inspector APPR�VALS . . Permit # � Date _Inspector
1. Temporary Electrical Service or Pole � 43. Pool & Equipment Location � - � --
.. Soil ipe-Undrgrn - 44. Steei Reinforcement - - -
3. Electrical.Conduit Utility-Undrgm 45. forms � -- �
4. Electrical Conduit,Undrgrn _ 46. Electrical Bonding , -�- -
_ tee ein orce . 47. Rough Plumbin` & Pressure Test
6. .Electrical UFER Grn � - � 48, ' APPROVALTO CO.VER-GUNITE �
7. ootings 49. Electrical Conduit-Undr m -� ��
- 8. Foundation� � . - - 50. Gas-�Pipe, ❑ Undr m, Test • " � �
-9. Water Pipe-Undrgrn ' � 57. Backwash Lines P-Tra ndr rn - "
70. Structural Floor SYstem - 52. APPROVAL TO DECK �
11. Property.Sewer_Line & House.Connection 53. Backwash & Rece rorFinal ' �
12. Street Sewer_�nnpction ` ' '' - 54: Heater & Vent-Final
13. Rough Plum6ing - ' - - �
14. Rough Electric-Conduit � '� 56. Electrical-Final -• �
15. Rough Electric-Wring - � - • 57. Solar SYstem-Final - " ' -
76. Rough Heating�& Air Cdnditioning ' � � - -- - • encing & Access Approval �
- 17. Ducts irt Strucwre'� -- '� - - APPROVED FOR PLASTERING �
76. Ducts,-Ventilating -- � - . _ _ . _ .
19. Gas Pipe-Rough & Test ' - 60. POOUSPA SYS7EMS FINAC , - , •
20. Roof Framing - ' - '
21. Roof'Sheathin � � � -
22. Frame and Flashin NOTES: a �d�..- � 1- � 3j� Z
' 23.- Insulation - ' �
1 24. Lathin &�Siding- - - � ' � - - �
I 25. Drywall Nailing . . ' e•„',
, � 26. Plaster-Brown Coat - ' � � � - - - ' - - - � � � '
'- 27. Elect�ical Power MeterFinal - - - �� � � � � -
' 28-. Final�Electric -- - - - - � �� � �
29. Final Heating & Air Conditioning - - - - � - - - - - � � �
30. Final Gas Pipe-Test - - - , - � � � �
� 31. Final Plumbing
32. Water Service-Final � � '
33. Gas Service-Final - - - �
' 34. Solar pomesticfinal .. ., �-� ' ' '
. 35. Landsca e S rinklin S stem � '
I 36. Sound Attenuation - ' - ' '
37. Handicap Regulations - - � � ' � ' ' �
38. FINAL STRUCTURE & BUtLDING
39. Special Requirements Completed � �
, 40. Electric Release to Edison � ' � "
. 41. Gas Release to Southern California Gas Co.
42. CERTIFICATEOFOCCUPANCY -
No.- Date "
%S"�Di�=l2
� . �P�v� �l..P
3t�'1 �- � oh r� Scx��z'2
��5� Vh.e- s a .
�
_�
'(,d'�-d�e���
�cr wv�-s �c� �
I 31��b �Q-�' ��
v��•
� � � � � �����
� C�TY Q� ���T�� E arSA
Mo;
c .eni�o! pivisicn
Euilding C���a;;;;�ziit
AAP�oved_.�� �l—r� �
'- ---•-�-------.D
Permit .# BP� S�� q
THIS NUMBEr� MUST ACCOMPANY
ALl INSPECTION REQUESTS
.d
SUNWORKS 3'x8' Coilectors
IAPMO H 5=2222
, OLIN II 3'x8' Collectors
� IAPMO # 5-2131
INDEPENDENT ENERGY
C-30 CONTROL
U.L. # MH-11153 (M)
GRUNDFOS PUMP
U.L. � Z-58326
RHEEM SOLAR
STORA6E
TANK
IAPMO N
BRADFORD- �
WHITE SOLAR
5i0RAGE
TANK
U.L. #
MH-11701
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; I 7034 � PAAY 17 i.�s 9
COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPi.
P. o. aoX ,�� COBTA MEBA. CALIFORNIA CI �'r OF COSTA MESA
For Applitanf fo Fill In Compleiely APPLICATION FOR PERMIT
TYPE OR PRINT
BUILDING
nooaes"s 3� �� T %7nson A"��•�"-
C05TA MESA. CALIFORNIA � FOf Office Use Only
REClIPT NO. Pf j��A
OWNER L i IJ�J�}
uen � " AECE�V D!Y OA HEL IVEO OATE 18SUE0
�
�
/�p [ I I'��AY s 1 1962
yy��—p� BUIL�ING 3072 ohnson Avenue
p ADDRE55
� No. / C05TA MESA, CALIFORNIA
� ..
uc.No. 1•hl No. �n -c7-o �
81ZE NO. OP BLDGB.
OF LOT ��ion NOW ON LOT
USE OF ��
EXISTING BL�G
BETBAGK LINE FROM
ceniew OP 9Tieei I REAR YARD
SIDE YARD I LEFT � I RIGHT �
DESCRIPTION OF WORK
EXTERIOR WA ROOF
GOVERING TiUCCO COVERiI
USE OF BUILDING AND WORK TO BE
� � Ti9Tt� iiPC T.l�9ii'.
1 HEREBV AGKNOW4EOG8 THAT I HAV6 READ THIB APPLIGTION
ANp BTATE THAT THB ABOVE IB CORREGT AND �GpEE TO COM-
PLY WITH ALL CI OR➢INANCEB AND 9TATE pHOULATNO
BUILDINO CANB GTION. /��� / ,
/ !
61GNATURE ��
PERMITTE z-' '�
AUTHORIZED A NT
FIRE
ZONING
20NE NO. OP U9E OP N6W
R—� I PV�N9 � eU1LOIN0 �
LEOAL _ _ .. _ � �.
(C¢NTER LIN¢ 6T.
27
APPROVED
i_
' /7 � h �-<'�%lzCn
THe AMOUNT BHOWN UNDER VI
PURP08E OF EBTABLIBNING A
$ zo,991.
IN.
�- IN.
IN.
3 IN.
]ATF_ 3 /7 /6 L
e? ' � �/ G'
5�
/
I �6 IOR TH[
MIT PE@ ONLY.
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