HomeMy WebLinkAbout301 MESA DR - Building Permits�
CITY OF COSTA MESA
(.��'jpMF'r9 BlIILDING DIVISION
>` . � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • H^.wv.costamesaca.qov
°. � � FOR INSPECTIONS CALL: (714) 754-5626
�"°�^^`°'� PERMIT NUMBER: B12-00090
PERMIT TYPE B ROOF2 : STATUS: ISSUED �
APN: 43910110 DATE ISSUED: 0510112012 •
ISSUED BY: KJB
JOB ADDRESS:
Vicinity:
Squares: 900
301 MESA DR CM
Suite/Unit:
�• �
Valuation: $2,300.00
SCOPE OF WORK: GARAGE ONLY. TEAR OFF EXISTING ROOF. RE-SHEATH AND COVER W ITH 30 YEAR COMP SHINGLES. ROOF
PITCH IS 4:12. R�ROOF FLAT PORTION OF WITH BUR. NON-HABITABLE SPACE
NOTE:RESIDENTIAL RE-ROOF: Final approval of permit shall not be granted until access to dwelling unit(s) is provided for
verification of the installation of smoke and carbon monoxide alarms by the City Inspector. See Attachment w/lnspectiom Card
OWNEft: SCHUSTER, JEFF J
PHONE:
APPLICANT: DEKEL, ISRAEL
PHONE: 8y8-593-8161
Address: 301 MESA DR
Ciry/Stale/Zip: COSTA MESA, CA
Address: 18643 COLLINS ST
City/State2ip: TARZANA
GONTRACTOR; LA CONSTRUCTION AND ROOFING _
Address: 18643 COLLINS STUnit: PHONE:
City/State/Zip: TqRZANA 91356
ARCHITECT: License No.
JC
ENGINEER: License No.
--�-
So.
FEE SUMMARY
J�
I')!'
aeroof Plan Check:
Reroof Permit Fee:
�Reinspection Fee:
Bldg Std Admin Fund
ps
�fOTAL FEES
$0.00
$83.25
$0.00
$1.00
License No. 965125
818•593•8161
CELL:
PHONE:
PHONE:
Unit:
Unit: :
,,p hIVURS FOR WNSTRUGTION ACTIVITY; EFFEC7IVE 3178/2010 - PER CMMC Sec. 13-279
,y Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays - 9:00 am thru 6:00 pm. Prohibitied all hours - Sundays and the following Federal
New Years Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day and Christmas Day
G:; .
ad� :.'..
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t%IbTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
,iegulations. (Ord. No. 92-28, § 1, 12-21-92)
��XPIRATION: 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
fe�quired inspecHons and final approval must be obtained. Failure to obiain inspections and final approval will resWt in the expiration of this permit.
1"
o�oE.p, INSPEGTIONTYDF � ix ni C�DE� INSPECiIONiYPE qng INTfM�S
"}bi6 Fixed System Final Fire Prevention 206 Final Mechanical
��
;(.4�r66 Pool Spa Final � � 208 Finai Plumbing
2e0 Final Re-Roo� w �l •v �� 210 Final Electrical
7!i �—T--
'2D1 Final Block/Retaining Wall 212 Final Fire PreveNion
'P��'1 � Final Factory Fire Place 220 Final Planning Approval
r-
�Pp3 Final Sign 222 Final Site
�20d �' •Final Demolition 250 Final Building/Occupancy
�.
c. • `
WORKERS' COMPENSATION DECLARA710N;
I hereby aKrm under penalry of perjury one of lhe follovring declarations:
❑ I have and will maintain a certificate of consent to seli-Insure (or vrorkers'
compensation as provided (or by section 3700 of Ihe Labor Code, (or the
Aorma of the vrork for which �his pertnit is issued.
have and vnll maintain vrorkers' wmDensation insurance, as required by
ction 3700 of the Labor Code, (or the peAortnance of Ne vrork (or which this
permit is issued. My workeC�a � Insurance� and Policy
number are:
Carrier.
(missecfronneetliat�W¢r���mmkvaluetlar^ nur�etlCofdrs(s1001a1essJ
/i1 r7� �l T! t
Policy Number: ' f L ��� l�
Owner ID verified by tlriver's I� .❑ Yes ❑ No
Driver's License No. Expires:
Verifcation of Ownership by (type of tlocument, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certiy that no excavation fve (5) or more feet in depth into which a
person is requiretl to descend, will be matle in wnnection vrith vrork authonzed
by this pertnit, and that no building sWcture, scallolding, falsework, or demolition
or dismantling thereof, will be more ihan thirty-s� (36) feet high. (Chap. 32, Grp
2, Art 2, Sec. 341, Title 8, Califomia Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would
rial Safety, as noted above, unless
rom the division.
❑ I certi(y that in t�e peAortnance of ihe vrork (or which �his permit is �equire a permit from Ihe Division of Indus�
issued, I shall not employ any person in any manner so as to bewme subject such person has a permit to tlo sucn work t
to the workers' compensation laws of California, and agree that i( I should � �
become subject to the vrorkers' compensation provisions of Section 3700 of ApPi;can��s siqnarore
the Labor Code. I shall forthwith ply with these provisior�,
C� �(� /�Bivision of Industrial Safety Permit Number.
AppliranCs SiB�alure Da�e l HAZARDOUS MATERIALS AND EMISSIO
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
IS UNIANIFUL AND SHAII SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUN�RED THOUSAND DOLLARS
($100,000). IN ADDITION 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 affrm that I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of ihe Business and Professions Code, and
my license is in full force and eHect.
�ic. # C�ass # c-3
ConUactoYs SignaWre �ata
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirtn that lhere is a consWction lending agen�y for the
peAormance of the vrork (or which this pertnit is issued. (Sec. 3097. Civil Code).
Lenders Name:
Lender's Address:
OW NER-BUILDER DECLARATIONS:
I hereby aKrm Ihat under penalty of perjury Ihat I am EXEMPT FROM THE
CONTRALTORS LICENSE LAW (or lhe following feason (Sec. 7031.5,
Business and Pro(essions Code: Any ciry or counry which requires a permit to
conslruct, alter, improve, demolish, or repair any strucWre, pdor to its
issuance, also requires the applicant for such permit to file a signed s[atement
that he or she is licensed pursuant to the provisions of the Coniractors
License Law (Chapter 9(wmmencing vrith Section 7000) of Division 3 of the
Business and Professions Cotle) or that he or she is exempt therefrom and
�he basis for �he alleged exemp�ion. Any violation of Section 7037.5 by any
applicant tor a permit subjecls lhe applicant to a civil penalry ol not more ihan
fve hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the sWCWre is not intended or
oHered for sale (Sec. 7044, Business and Professions Code: The Contracrors
License Law does not apply to an owner of property who builtls or improves
ihereon, and who does such vrork himself or herself or through his or her ovm
employees, provided thal such impmvements are not intended or offeretl for
sale. If, however, the building or improvement is sold vrithin one year ot
completion, the owner-builder vnll have the burden of proving that he or she
did nol build or imDrove for purpose of sale.).
❑ I, as owner of the pmperty, am EXCLUSIVELY CONTRACTING WITH
IICENSED CONTRACTORS to consWct the pmject (Sec. 7044, Business antl
Pmfessions Code: The coniractors License Law does not apDN lo an owner of
propeM �o builds or improves thereon, and who wntracls (or such project with
a wntractor(s) license pursuant to the Contractors License LavrsJ.
❑ I am exempt under sec.
Business antl Professions Cotle for ihis reason:
305]-06 (3I0�)
NS CERTIFICATION:
1. Will the applicant or present or future building occupant need to fle and
certiry a Business Plan (or emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the Califomia Health anA Safety Coee requires, vrith some
exceptions, that a Business Plan be filed vrith the Costa Mesa Fire
Department by every business which has at any one time during a reponed
year a quantity of hazardous materials equal lo or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressetl gas
at slandard temperature and pressure).
2. Does or will Ihe applicant or present or future building occupant need to fle
a registration form tor acutely hazardous matenals? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, wilh some
exceptions, requires registration with the Costa Mesa Fire Department by
each business which at any one time has on hand a quantiry of acutety
hazardous marerials equal to or greater than a weigM of 500 pounds, or a
volume o( 55 gallons, or 200 cubic feet of compressed gas at standard
temperature and pressure).
3. Does or will the apDlicant or presenl or (uture building occupant need to
prepare an RMPP (Risk Management and Prevention Pmgram for awtety
hazardous materials)? ❑ Ves ❑ No
(Seclion 25534 of [he Califomia Health and Safery Code provides that lhe
Costa Mesa Fire Department may require the preparation, certification and
filing with Ihe Fire Department of an RMPP by businesses which are reQuired
to register acutely hazardous materials vrith lhe Fire Department.
4. If an RMPP is presently required, has Section 25534 of ihe Califomia
Health and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or fuWre building occupant require (or
the work which is ihe subject of this application a Dertnit for such construction
or modification fmm the South Coast Air Qualiry Management Dislrict or from
any other air pollution con�rol district or agency? ❑ Yes ❑ No
(Section 658502 of the Califomia Govemment Code requires that the requested
infortnation be fumished on applications for non-residential Duiltling pertnits).
6. Will any part of [he (aciiity to be consiructetl under this permi� be wilhin
1000 feet from the outer pountlanes of a school? ❑ Yes ❑ No
Qf "yes', the faciliiy must meet the requirement of Sections 25534 and 42303
of Ihe Califomia Health and Sa(ety Code).
7. If a permit from [he South Coast Air Qualiry Management Dis�ric� or o�her
air pollution control disirict or agency is required for ihe vrork which is ihe
subject o/ this application, have all of the disclosures prescribed by Califomia
Health and Safety Code Seclion 42303 been made? ❑ Yes � No
8. pf'yes', attach certiFlcate ot compliance from the appropriate air pollution
conirol oKcer).
CERTIFICATE OF COMPLIANCE: I certiry that under penalry o( perjury the
infortnation given above is correct. I agree to comply vrith all state laws and
city ordinances regarding Hazardous Materials antl Emissions.
Uate
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty ot perjury that I have read lhis application and state lhat
ihe information given is correct. I agree ro comply with all state laws and city
ordinances relating to building conswction, and authorize representatives of
ihe City of Costa Mesa ro enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any building
aulhonzed by this permit until final inspection.
SignaWreofLeg er(s) [.� J� �
-.l ✓ � �
AnC/or utM1onzetlApPLcan� Date
Aoo���ant ta fill in all so��es except tnose witnin heavy eorCar Ilnes antl sign all aoProvriate aeclaratlons.
CITY,OFCOSTAMESA ,C NSTRUCTIONPERMIT
Project Address /� � �
Applicant's Mailing Addr ss �
Owner'sName n Phon a � ��Q
Addreu �+., -
Arch/Eng. License No.
Address ' � �nOo�
Convactor's Nam � Phone H
, Address�m�'�'n�l � C P YVLyI�
Ciry Licencr Nn �J
LICENSED CONTRACTOR DECLARNTION
I he�eby affirm thdt 1 am licensetl untlet pravizions o1 Cha�ter 9(commencing
with seclion 'l000) Ot DlviSiOn 3 ot the Bu5ine55 antl PrOtlssions Cotle, antl
my Iicense is In full for �ntl etfect. 1 I�,
�License a �� ' ms �...yttt'���/ Yyy'')
Date • $I9nature v "^ A ,{
'"'ORK RS' OMPENSATION DECLARATION
� ;reby atiirm that I have a carti0cate of consent to self-insura or a certifi<ato
Workers' Comp¢nSatiOn Insurance, or a certifietl copy thereof (Section
� 3800, Lab.Tl' ��� �� � J
�� Policy No.'�+1 �g�� Company A P � R'��,�
�mtifietl ca�PY lz fl�le wi[hr(hehary�,@/� i� p//�y i�f" n.
EXE�ON�� ftOF M WORKERSaCOMPEN5AT10N DECLAR�� AT ON�
(Tni55eGtion n¢eE not De completetl i( tne permit is tor ona nuntlretl (5100) or
' less)..
I cerlify that in the perlormance of tne work for whicn tnis perm�t is issuetl, I
shall not employ any Oerson in any manner so as to betome subject to the
Workers' Compensalion LawS of CdlifOmia.
Date 9gnature
NOTICE: 1t, atte� makln9 thi5 tl¢<Ia�dtiOn, YOu zhOultl beGOme subjec[ ta Ina
Workers' Compensalion provisions oi tne Labor Cotle, you must fortnwlth
comply wilh such provisions or IhiS Oermit Shall be tleemetl rOVOkCtl.
CONSTRUCTION LENDING AGENCV
I heroby af(irm that tnero is a cons(ruction lentlin9 a9en<y for the performance
OI lh0 work � for wnith �hi5 perml[ is (izuetl (SectiOn 3097 Civ. C.)
l.entler's Name
Lentler'z Adtlress
OWNER BUILpEH UECLARATION
1 hereby d�llrm that I am exampl irOm �he Conlractor'S Lltensc Law tor tbo
following reason (Saclion 7031.5 Buslne5s antl Professional CoCe:�Any city or
county which requiras a permit lo construct, alter, Improve, tlemolish or reoalr
any st�uctura, pdo� lo it5 issuant¢, alm reqWres tha appliCant f0� sucb parTil
to file a Signatl slatam¢nl that M1n/She ISlicensetl purivant to lhe proviSiOns ol
the Contractar's LI<onse Law (Cnao�er 9,(tommencing witn Sectlon 7000) oi
`iviSlon 3 of.tho BUSiOo55 antl Proles5ion5 Cotle)�or [bat Ile/sha i5 exomD�
' �rOfrOm antl thC basis 10r lhe allegetl Cxemptlon. Any violatiOn ol Sactlon
31.5 by any applicant 1or d pOrmll subjects lha appli<ant [o a civll
�enalty ol not more than livo huntlretl tlollars (E500).
�J I, as ownor ol tna Droporty or my employees witb wages as their sole
compensation, wlll tlo the work, antl Ihe structure is not IntenOetl or olferetl
for salo ($act(on 7044, Business antl Professional Code: The Conlractor'S
License l.aw tloes nol apply to an owner of a property who builGs or Improvas
theraon, ana wno tloas such work himseli/herzelt or throu9h his or ner own
employocs, provitletl t�al such improvements are not intentlotl or oneretl tor
sale.�lf, however, tbe builtling or ImOrovement Is sottl within ono yoar ot com-
pletion, tho ownor will havo the bur0en Of provin9 h0/Sh0 tlitl not builtl o� iM-
prov0 to� lho purposo oi Talu). o
❑ I, az owmr ol Na property, am exclusively contracting with Iicensetl con-
[rattOrs lo con5[ruct lho project ($ection ]044, Bu5ine55 antl PrOfesslon5 CotlO:
The ConVactor's License Law does not dPPly [O an owner of proporly who
builtls or imDrovns theroon, ana who coneracts for such orojetts wlth a con-
tractOr(s) I�cense pu/suant to tba Contrattor'S LiCen58 Lnw�. I am dware Ihat
proof o( thoir Worker'S COmpinSation insurance should be provitlotl to me.
❑ I am axempt untler SCction 8. 3 P. C. for tnls reason
�ate Owner
I hereby ttrti(y that I hava reae this application antl state tnat the abova
informatlon is correct. I agree [o tomply with all city antl county ortlinances
antl state laws relating to builtlin9 construction, antl hereby authorize repre-
sentatives of t�is tlty to e ter u o t�e above-mentionetl prf�perty for
inSPeCtIOn�Po �/� //S �
Signature � Date
. Drivers' License or 55 qp _ + �� —j�r
__.. . � 87a y _ _- -- - �,.,. ,..,. ,
TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR
� O CONVERSION ❑ DEMOLISH ❑ OTHER A p �6
DESCRIPTION OF WORK/USE OF BLDG. . S Main Building:
E
TVPE OF PERMIT GRADING�p/ yp UNDATION STRVCTURAL T FrOnt
❑ TENANT ❑ ELECTRICAL LJ PLVMBING ❑ MECHANICAL B Rear
❑ OTHER C Rlght
PROJECT DESCRIPTION $Q.FT. OCCUPANCV
CONSTRUCTION TVPE VA�VATION S g LCft
ZONE GRAOING CU. VpS. ACRES Ping. Ref. dh
Remarks:' � Planning Notes:
Sink
Preventer
Irrigation
Clarifiers
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
I nterceprors
Kitchen $ink .
�pVdLOfICi
P—Trap
Roof Orains
fleinspaction Fee
$15
Duct- Under Grountl
Duct - Strucmrel
Duct � Ventilating
Exhaust System ❑ Multiple
FirepVFect. BIL ICBO #
Heating System & Ducting
❑0�100,000 BTU 0100,000
Reinspection Fee I $75
CMF 0865-46, rev. 10/84 Whit¢ - Builtlin9: Canary - Appllcant; Pink - ACCOUntlrl9; Goltlenrotl - Asse55or
Showers
Service Sink
Sewer Cap '
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool wlSpa
Urinal
Water Closet
Water Heater
Water Servica
Auto�Wash
Issue Foe
Hood or Typel ❑
Canopy Type I I ❑
Re(rigeration System
04100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Registers
laue Fee
FEES
5 3
FEES
$•3
Automatic Washer
Constructi0n Pole $ub.
Cooking Unit
Dishwasher
Dryers ❑Gas �Eleci
Fan
F.A.U.
Fixtures
Device Bozes
OuUets
Switches
Garba9e Disposal
Generator �0�5 KW C
Foe
`
,
91�'a G/fC/•.. Zone r�. TI
Accezsory Building:
Parking Req./Provided
ELECTRICAL
Transformer ❑ 15�50 KW
o eo+Kw
Meter LJup to 100 amps '
Meter ❑over 100 amps
Sub Panel
Momrs D O-7 H P � 7'h - 8
Inc.Solar �9-15 HP �16-15+
Microwave '
Pole Light
Range
Sign
Standing Sections
Trash Compactor
515 � � Issue Fea
FEES
S 3
Z
O
N
I
N
G
R
E
Q
M
T
S
DEVELOPMENTSERVICESREQUIREMENTS:
2oning Approved By Date
6uilding Approved By Date
Appliption Issued By � - Data���
� SUMMARY OF FEES
BUILDING PERMIT $ SMIP • § '
PLAN CHECK $ —�l PERMIT � �
PLUMBING $ �'F-�'� �+iVV ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING S -
PLANCHECK 50% $ MICROFILM 5
MECHANICAL 3 TOTAL FEE $ 5�0
PLAN CHECK 25% $ �
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit # Date Inspector p�ppROVALS Permit # Date Inspector
i. Temporary Electrical Service or Pole 52. Pool & Equipment Location,
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement �� �
3. Electrical Conduit Utili[yUndrgrnd. 54. Forms �
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test �
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUN�TE
7. Footings 58. Electrical Conduit-Undrgrnd.=
8. Foundation 59. Gas Pipe, O Undrgrnd., TestC-�
i �
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, C7 Uhdrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Fina�
72. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing � 65. Electrical-Final
15. Rough Electrical-Conduit ' 66. Solar SYstem-Final '
16. Rough Electric Wiring 67. Fencing & Access Approval
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. 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 O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ 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 PREV. 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 EleMric Notes:(.,2G'p% Gl�I�GVQ� L.E.D
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy �
37. Final Factory Fireplace
38. Final Plumbing 7r��d77 LG�
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation �
44. Landscape Irrigation Syst¢m
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING
48. Special Requirements ComPleted '
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY �
No. Date .