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1062 MISSION DR - Building Permits
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.cMILDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 1062 MISSION DR Suite: Vicinity: Parcel Number: 14157109 Zoning: R3 R3 Applicant: TEMORES,LOURDES Applied: 10/03/2003 Address: 2702 W POMONA ST SMIP Com: $0.00 Other: $0.00 Phone: (714) 754-4107 SANTA ANA, CA Zip: 92704 Owner: HO, YU SOO Address 17 STARLIGHT ST Phone: IRVINE, CA Zip: 92612 Contractor: R B ROOFING Address: 2702 W POMONA ST Phone: (714) 754-4107 SANTA ANA, CA Zip: 92704 License: 772680 Arch : Address: Phone: Eng: Address: ISSUED BY: Status: ISSUED Applied: 10/03/2003 Issued: 10/03/2003 Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF COMP. SHINGLES INSTALL 1-30 LB FELT UNDER 30 COMP. SHINGLES. Plan Check: $0.00 Permit: $125.25 SMIP Res: $0.60 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $125.85 SETBACKS MAIN STRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Existing: 0 NOTES: FEE SUMMARY PLANNING & ZONING Rear 0-0 Left 0-0 Rear 0-0 Left 0-0 Required: 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0-0 Right 0-0 $6,000.00 $6,000.00 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: 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 2446.46(6100) DECLARATIONS kORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to salt-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. ve and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. orkers' enKs 2Insur a tante/—d policy number are: 10 Cards � �M'! e ��n%L icy mbar: DTI ssection need not be completed if the permit is valued at one hundred dollars ($100) or less.) 9�!URE t 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' aws alifomia, and agree that' hould become subject to the workers' compensation provisions of Section 3700 ofthe I aapor Cotle, I shall forthwith iwamdAn s 1]ale� \ Q TOS URE WORKERS' CAMPENS ION CAVERAGE IS UNLAWFUL AND SHALL SUBJECT ANE OYER TO INAL PENAL ES AND IVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37O60F THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. ®RUCTION TORS DECLARATION: m II ensed u der rovis�QO Chapter 9 (commencing with Section 7000 Business P f ions Code, and my license is in full # � i s # e: Date: NDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil 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: Any 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 file 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).): ❑ 1, 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.). ❑ 1 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 than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art2, Sec. 341, Title 8, California Administrative Cotle). ❑ 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 Safety 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? ❑ Yes ❑ No (Section 25505 of the California 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 California Health and 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 California Health and Safety Cade 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 California Health and Safety Code been fully complied with? ❑ Yes El No ..... .......................................................................................................................................................................................................................................................................................................................................... 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this Mplication apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ........................................................ ..................................................................................... .................................... ........................................................................................................................... I....................I........... ....................................... 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (If "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ...................................................................................................................................................istr..................................pol-1.6-t-i- ...............rol-..............................e-n-.......................................................................................................................... 7 a a permit from the South Coast Air Quality Management District or other air- pollution control district n 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 .................................................ertiific................................................................................................11ut............................................................................................................... .......................................................................................................... 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 AUTHORIZAT10N 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. Si f egalOwner(s) Da 3 IQ r Authorized Applica CODE I. INSPECTION TYPE DATE INTITIALS CODEX INSPECTION TYPE pAT€ INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final * 208 Final Plumbing 200 Final Re-Root ` �/ 210 Final Electrical 201 Final Blmk/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 City of Costa Mesae . Building Safety Department CERTIFICATE OF OCCUPANCY NO 1808 08 P. O. Be. 317 Costa Mesa, California The Building located at low mosi ; Drive, At, Be C L~b D has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group g J Occupancy.. Use of Building bIA am!�Ar -- Legal Description iL1Z 110, Tewt (See reverse side for Metes and Bounds) Building Permit No. Electrical Permit No. MOM Plumbing Permit No. �'ii 0 Floor Load Signs have been installed as Room Capacity Signs have been instaled as required under Sec. 2308 U. B. C. required under Sec. 3301 (1) U. B. C. 17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied until the owner or operator has been issued a valid certificate of occupancy by the enforcement agency. (b) A new certificate of occupancy shall be obtained whenever there is a change in: 1) Occupancy classification of a building or portion thereof 2) The number of apartments or guest rooms 3) Ownership If Group H Occupancy, number of apartments and/or guest rooms as required under Sec. 17050.1 (d), California Administrative Code, Title 8, Chapter 9, Article 8: Number of apartments_ b and/or guest rooms ISSUED TO: Official tIr t:.1F a�•l:.::.t:i si.;:i'Cl'uin:ts. This Certificate of Occupancy SHALL BE posted in a conspicuous place an the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Fona Bu34-1ar-11-0—S-B P OWNER DILLMALB-BRIMMELL ENTERPRISES DATE MAR I = 1963 PERMIT NO. GENERAL CONTRACTOR Dillman-Brwmitell Enterprises VALUES 40� AP ^To. LOT 11 TRACT 3922 FIRE ZONE DESCRIPTION OF IN. .:CTIONS Signaturel DATE I GROUP Jj&j TYPE V ZONE R-4 Soil - -/S SUBCONTRACTOR PF'R -TITS ISSUED Gas DATE NUMBER Water Rough Com.',frig. ❑ Air Cond. ❑ Rough Heating Rough Plumbing 0--7/—a J� _ _ -�,�/ _.r_�l� U� —3-1 to- 3S�y Miscellaneous Prop. Prop. Swr. Line House Con. St. Swr. ❑_ Sprinkling System l - _ ' Construction Pole _ 11✓ Underground Power ❑ Rough Wiring _ % ,5-19-(, Trenches ❑ Forms ❑ Steel Reinf. ❑ =L - Floor System o. _ Bond Beam ❑ Steel Reinforce ❑ Sheathing e Frame and Flashing (7 bath; -g — In Out K1 v, _t� 58 Plc brown coat Ilefng. ❑ Airond. ❑ Final. Heating, Final Plumbing Fixtures, Final Final Gas Test Electric Fixtures, Final !-z9c3 Building, Final OCCUPANCY 2-51W mold Gun . 4d — zet 1 n l CCISTA-MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 917 COSTA MESA, CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT BUILDING 10 2 issi Ott D 7.VG' ADDRESS A� COSTA MESA, CALIFORNIA ADO ADDRE68 12081 $uaro -11 Garden Grove L5�30-1160 TEL. OOh.RACTOR Selt' ADDRESS �— CITY �- STATE .TEL. LIC. NO. NO. of for lis'c9"il NOW ON LOTSO USE OF EXISTING BLDG. 61DEYARDI LEFT 101 1 RIGHT 201 DESCRIPTION OF WORK FE RECEIVED BEAR 8 1963 FINANCE DEPT . OR�nMITE SA APPLICA% BUILDING For Office Use Only BUILDING ADDRESS FIRE ZONING ZO�� NO. OF USEOFNEW , PLANS (/ BWLDIN fI LEGAL / . I • i t i. , I E: NO EAVE OVERHANG SHALL BE LESS THAN TO SIDE @ REAR P. L. ES OWED (U. B. C. REQUIREMENTYARDS APPROVED YARDS APPROVED MAIN BUILDING ACCESSORY BUILDING OMC L TRE `�1NT FT. 1A IS: SSV 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO DOW PLY WITH ALL CITY ORDINA CES AND TS LAWS REGULATING BUILDING CONSTRUCTIOU SIGNATRE OF PERMITTEE AUTHORIZED AGENT THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. G VALUATION $ 4Z1w— PERMITFEE PLAN CHECK 69 — o TOTAL FEE $ aai— NCE S CE B DISTANET. BET. MAIN @ II I II I MAIN ACCESS. BLD S, RE' MOVING DEMOLISH VAR.* DATE ..INC No OF ... 34' 78' ROOMS 24 STORIES 2 C. U. P.# APPROVED EXTERIOR WALE ROOF I APPROV /� 1!. COVERING JLUCCO COVERING shake BY DATE U USE OF BUILDING AND WORK TO BE PERFORMED i Q. I 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO DOW PLY WITH ALL CITY ORDINA CES AND TS LAWS REGULATING BUILDING CONSTRUCTIOU SIGNATRE OF PERMITTEE AUTHORIZED AGENT THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. G VALUATION $ 4Z1w— PERMITFEE PLAN CHECK 69 — o TOTAL FEE $ aai— OWNER JOSEPH ODDO DATE 8-15-79 JOB ADDRESS 1062 Mission Dr. BUILDING PERMIT NO. 48643 Gr"rRALCONTRACTOR Oar/ Builder DESCRIPTIONofWORK B1 A - LOT 11 TRACT iQqq FIRE ZONE VALUE $ INSPECTIONS Si nature I Dere ITYPE GROUP SOIL SUBCONTRACTOR GAS WnTEa I Plumbing ROUGH PLUMBING PROP. SWR. LINE j j HOUSE CON. E] SPRINKLING SYSTEM ROUGH HEATING AND AIR CONDITIONING I 1 II 1 1 1 UNDERGROUND �J POWER U ROUGH WIRING TRENCHES IJ FORMS ❑ STEEL; FLOOR SYSTEM BOND BEAM STEEL REINFORCE SHEATHING FRAME AND FLASHING LATHING — IN OUT PI SR. BROWN COAT PLUMBING. FINAL AND GAS T ELECTRIC. FINAL RIIII IIIYF. Cluel C7 E 1065 8/15/79 17.00 TL COSTA MESA BUILDING -SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only RECEIV PERMIT ' N2 48643 ADILDINGDRESS 1�� `� �( 1 A.P. NO. '¢` ` Oct OWNER OR �L / TENANT �e�F1 Q C{ti BUILDING n ADDRESS 1. UNIT OR SSPACEPACE NO. MAILING.I��tt� ADDRESS �7 ncj �Nt'y� — LOT `/ 11 ELK. TEL CITY SAS ;:_% NO. NEW ADD ALTER REPAIR MOVING DEMOLISH CONSTRUCTION LENDER OW��/i./ X 02,j BRANCH OWNER a JVA)_U E USE �L� $ ZONE TYP - ROUP ADDRESS ARCHITECT - . a TEL.����// -1 OR ENGINEER N 5�1°0 ADDRESS 17,755Pau- A& nrC CONTRACTOR OWAILZ' / APPRO BY DATE ADDRESS TEL. CITY NO. STATE CITY LIC. NO. LIC. NO. APPROVED SETBACKS SIZENO. OF LOT OF BLDG G. NOW ON LOT ,�� (FROM C/L STREET) FROM FT. USE OF n ,n�� r EXISTING BLDG. 1TY V R. SIDE FT. Separate permits are required for electric, plumbing and heating work. L. SIDE FT. REAR FT. USE OF BUII-L_DING AND WORK TO BE PERFORMED PLANNING ACTION II C` ON C.- 1✓^ C(,(, lfti V/ APPDA ROVED APPROVED DATE I hereby acknowledge that 1 have read this application and state that the above information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under the State of California Business and Professions Code, Division 3, Chapter 9, and that Su h licenses are in full force and effect, or I ame th rovisions of the to of Celi Drnia Business Professions Co e, ivision , C - ter }. Signature of ,� Permittee SQ. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: VALUATION S/O�� QO PERMIT FEE $ ©Q PLAN CHECK $ S 0 TAX $ rt1 or / - Auth ant Dae TOTAL PAID $ 7.0Q COSTA MESA BUILDING -SAFETY DEPARTMENT Q�JB P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 48. 50TL A PL ION FOR'`Rli i AtuVRRM11 For Applicant to Fill in Completely — Use Ink Only Fl"V DATE RECEIVED DATE ISSUED BUILDING , ISSU ADDRESS / PERMIT NO. OWNER A.P. NO. BUILDING MAIL _ ADDRESS e, cz/yj. TEL CITY No I I LOT BLOCK CONSTRUCTION NEW ADD ALTER PA LENDER BRANCH OWNER ADDRESS ARCHITECT TEL. S i/w 64 $ 1, OR ENGINEER N FIRE ADDRESS ZONE TYPE GROUP APPROVED CONTRACTOR BY DATE ADDRESS TEL. ZON NO. OF USE OF NEW/7A \\\ CITY NO. PLANS BUILDING F STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LC. NO. MAIN BUILDING ACCESSPRY BUILDING W SIZE NO. OF BLDGS. %FROM C/L STREET C, OF LOT NOW ON LOT FRONT _ FT. \\ Q USE OF /� {1 I V1\ice EXISTING BLDG. SIDE PT. FT. 11 FSeparate permAS are required for L. SIDE I< FT. FT. ry� electric, plumbing and heating work. REAR rFT A FT. ) �� [Wj. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & �.. MAIN SLOGS. ACCESS. SLOGS. VAR.# DATE "C C.U.P, 7 0 APPROVED K 7 APPROVE r ' f I] I hereby a that I have read this application and state n Cd that the aboveova information is correct and agree to comply with O. all laws regulating building construction, and I shall not employ H LD FOR SPE Z any person in violation of the workman's compensation laws of W the State of California. 3 I hereby certify that 1 am properly licensed as a contractor under SO. FT. �v the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UN 1F3j,VALUATION IS FOR I �j nr Chapter 9, and th su licenses are in full force and effect, or 1 THE PURPOSE OF ESTABLISF}tNG A PERMIT FEE ONLY: �l IL am exempt from he ons of he St of Cali rnia Business VALUATION PERMIT FEE $ and exempt fapt Sign � PLAN CHECK $ Per ittee $ �}-/ ��•� TAX 1 $ Dch L U Authorized Agent 40TAL Pl� D $ qV a c n t 4583'7 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 ADPL AT N FOR STRUCTURAL PE"IT For Applicant to Fill in Completely —Use Ink Only R CE ED V DATE RECEIVED DATE ISS ED `,, • _13U DIG 1 ADDRESS OL2— S If�1J OWNER �TOSG—pFF QC��iO , A.P. NO. s� MAIL ' 8S MM N rJ ti ADDRESS ADID RI EBULONSS /lo ` -s CITY Co E NOLq /q_jt(O TRACT LOT BLOCK CONSTRUCTION _ NEW ADD ALTER P LENDER BRANCH ��pS OWNER ADDRESS UOQ -1.`R £ �' fd LU$ ARCHITECT (( /I TEL ,ws // C$ ]5"f'LP 0 S OR ENGINEER N d da N . - FIRE C ADDRESS 5 S fAIM-01706 JaUL ZONE TYPE GROUP APPROVED CONTRACTOR CDWAIt:lLi c5I By DATE ADDRESS ' I I/ TEL. ZONE O.OF USE OF NEW CITY NO. PLANS BUILDING STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO.OF BLDGS. (FROM C/L STREET) OF LOT Z�j x 3 NOW ON LOT I FRONT FT. FT. USE OF EXISTING BLDG. F Separate permits are required for L SIDE FT. FT. electric, plumbing and heating work. REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCESS BLOCS. VAR. db DATE Q U C.U.P. 0 APPROVED APPROVED I hereby acknowledge that 1 have read this application and state that the above information Is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. 1 hereby certify that I am properly licensed as a contractor under _ SO. FT. THE OUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are In full force and effect, or 1 THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the pr visions of the State of California Business VALUATION PERMIT FEE E antl Professions Code, I ision 3, Ch pwr 9 PLAN CHECK E Sig tura of a 11 TAX S Per Ittae $ LLLGGG "`CCC (/(� 0 17 TOTAL PAID E Authoriz