HomeMy WebLinkAbout1648 NEWPORT BLVD - Building Permits -.
LOQ tt, CITY OF COSTA MESA
BUILDING DIVISION
).y' ;" ] DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
F 1 ..._•...'.1 t - PERMIT
,• E04-00549
�fi
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
ELECTRICAL PERMIT
Job Address: 1648 NEWPORT BL Status: ISSUED
Suite No Applied: 05/11/2004
Vicinity: UNIT B Issued: 05/11/2004
Parcel Nunmber: 42542317 /
Applicant: MONTGOMERY, JEFF ISSUED BY: /�/
Address: 1652 NEWPORT BL
STE B Phone: 949-280-1681
COSTA MESA,CA Zip: 92627
Owner: BAY STORAGE LLC
Address 1652 NEWPORT BL ^w
STE TB Phone: f Y.\)/] �., "
COSTA MESA,CA Zip: 92627 t1 YYY lit
L b.
Contractor: OWNER-BUILDER
Address:
Phone:
Zip:
License: 000000
SCOPE OF PERMIT
REINSTALLATION OF A 200A SERVICE IN AN EXISTING COMMERCIAL BLDG.
1 SERVICE TO 200A
NO OTHER WORK AUTHORIZED WITH THIS PERMIT.
FEE SUMMARY
Quantity Quantity
ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0
Temp service test $0.00 Busway/100 ft $0.00 0
Res.a/c package $0.00 Standing Section $0.00 0
New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0
New Res(3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0
Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0
Lighting Fixts $0.00 0 up to 50 kva/kw $0.00 0
Recept Outlets $0.00 0 up to 100 kva/kw $0.00 0
Switches $0.00 0 over 100 kva/kw $0.00 0
Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0
Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0
Service to 200a $30.50 1 Misc.Conduit $0.00 0
Service to 1000a $0.00 0 Misc.Conductor $0.00 0
Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0
Motors to 1hp $0.00 0 Circus(mech ride or lights) $0.00 0
Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0
Motors to 50hp $0.00 0 Fireworks Stand $0.00 0
Motors to 100hp $0.00 0 Other Electrical Fee $0.00
Motors over 100hp $0.00 0 /
Communication drops $0.00 0 Investigation Fee $0.00
Sub panel to 200a $0.00 0 Plan Check Fee $0.00
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(6/00)
. / •
DECLARATIONS` --
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penally 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.
O 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 permit is Issued.
My workers'compensation Insurance carrier and policy number are:
Carrier: Policy Number:
(7hlVsection need not be completed if 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 Calif is nd agr that if I sh..d becou• ubject to the workers'compensation provisions of Section 3700 of the Labor Code.I shall forthwith
comply with these pr i/ Date: Ali I /0L/
Applicant Signature:
WARNING:FAILURE TO SECU ERS'COMPEN 'TI• s. ERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND OOLLARE($100, ),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 affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full
force end effect.Lic.a Class a
Contractor's Signature: Date:
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,Civil Code).
Lender's Name: Lender's 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).):
O 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'emplbyees,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.).
aNi 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 riot 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 icense Laws.).
❑ I am exempt un Business and Professions Code for this reason:
Signature: Date: 1 //f /ot-/ L
Owner ID verified by v s li ansa. es 0 No Driver's License No.
Expires: 125-
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
O 1 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,Art 2,Sec.
341,Title B,California 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 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? 0 Yes 0 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? 0 Yes 0 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 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 California Health and Safety Code been fully complied with? 0 Yes 0 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 appermit for such Construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? DI Yes ❑No
(Section 65850.2 of the California 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 yes',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 0 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 stale 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.
'�, ' : .J... .i. - _. Dat
Cn LI
A ctn Or uthorizbd Applicant / !Date
;ODE I INSPECTION TYPE PATI piTITIAL$ CODE JNSPECTIONTYPF Ea INTIM&
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing ���
��/
200 Final Re-Roof 210 Final Electrical r
it
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
CITY OF COSTA MESA
� BUILDING DIVISION
F j m.' www.ci.costa-mesa.ca.us
,
I 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 •
FOR INSPECTIONS CALL:(714)754-5626
PERMIT NUMBER! BC08-00063
PERMIT TYPE: B_COMBO STATUS: ISSUED
Sub Type: COM ALT DATE ISSUED: 02/2512008
ISSUED BY: RMD
•
JOB ADDRESS: 1648 NEWPORT BL CM Suite/Unit:
APN: 42542317 Zoning:
Vicinity: UNITS 24 THROUGH 28 Primary Occ: U
Const Type: SQ. FT: 0 Valuation: $13,000.00
SCOPE OF WORK: FIRE DAMAGE REPAIR TO ROOF FRAMING (LIKE FOR LIKE)AND CHANGE OUT 2 LIGHT FIXTS, 1 OUTLET,
1 SWITCH DUE TO FIRE DEAMAGE TO STORAGE UNITS 24 THROUGH 28 FOR "BAY STORAGE". REF#: BX08-00041.
OWNER: BAY STORAGE LLC Address: AGT:JEFF MONTGOMERY Unit: COSTA MESA,
CA
Phone: City/State/Zip: 1652 NEWPORT BL STE B
•
APPLICANT: CASH,SCOTT Address: 5700 STRATUM DR Unit: :
Phone: 817-366-0582 City/State/zZip: FORT WORTH,TX
CONTRACTOR: INTERSTATE RESTORATION GROUP INC . License No. 820510
Phone: 817-293-0035 Address: 5700 STRATUM DRUnit:
Cell: City/State: FORT WORTH,TX ZipCode 76137
ARCHITECT: License No. PHONE:
ENGINEER: License No. PHONE:
COMBINTATION PERMIT FEE SUMMARY
Building Plan Check: $0.00
Building Fees: $223.25
Electrical Fees: $27.90
Mechanical Fees: $0.00
Plumbing Fees: $0.00
SMIP Residential: $0.00
SMIP Commercial: $2.73
TOTAL FEES: $253.88
**Refer to fee receipts for all fees paid for project
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.
CODE S. INSPECTION TYPE DATE INTITALS CODES INSPECTION TYPE DATE INTITIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing J
200 Final Re-Roof 210 Final Electrical 3(/2./C 23t
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/Occupann v[o o -F� V
WORKERS'COMPENSA7.ON DECLARATION Owner ID verified by drio._ .lice.__. ❑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,scaffolding,falsework,or demolition
CCanier Z(�Q•dC H /V/1'1 hgf EA. Co- or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
(This section need not be aam eted/Me permit is valued at one hundred dollars(El 00)o(less.)
2,Art 2,Sec.341,Title 8,California Administrative Code).
Policy Number: (-0 C.3.) L IL/ 01
✓
D As owner-builder, I will not employ anyone to do work which would
0 I 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 Califomia, and agree that if I should
become subject to the wo ers'compensation provisions of Section 3700 of
Applicant's Signature Date
the Labor Code,I shall(ger' with comply with these provisions.
- ale_ _ Division of Industrial Safety Permit Number:
Appli .nt's azure ;Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: F• URE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAW- L 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? 0 Yes ❑No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. Department by every business which has at any one time during a reported
year a quantity of hazardous materials equal to or greater than a weight of
LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
Amy license is in full force and effect. a registration form for acutely hazardous materials? ❑Yes ❑ No
# • • Class# / --) 142—,11$a-G35 (Section 25533 of the California Health and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Department by
r 2 257-01 each business which at any one time has on hand a quantity of acutely
Contra • s g(alute 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
CONSTRUCTIO LENDING AGENCY: temperature and pressure).
❑ I hereby a ran 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 Dale
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 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 ❑No
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 (Section 65850.2 of the California Government Code requires that the requested
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be furnished on applications fp 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 ❑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 8 (I("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
❑ I, as owner of the property,am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
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:
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
0 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 property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection.
Signatureof gal Owner(s) Date 2 c
Signature Date _23- z
3057-46(3/07) ( AnC '/o Ihorize cram ;Date__
BU" )ING AND SAFETY DIVISI 1 r 1Og�Ba0�✓
FIRE DAMAGE INSPECTION REPORT '
(Required Prior To Permit Issuance) S7/ SF tie
`t,(
( �j
Address:
_
/6 sz Al ec✓pti•1 U ' ' c�� �j Unit: 29 2 9
Owner "I F -1--C �'rGs-/�Sc s,�<'l/ r 9 vet_5- - r 7 !U
Owner's Addressif differ nt from move):
/ F/7 Tt'tS{i.( ♦,`{—
Street .. , . City State
❑ Structural permit required.
.® Repair or replace as necessary.
❑ Plans required.
Comments: Y �� E rf4 /f(27— �QC4/ s
�A//S - ®Gd<
roc-
Y Deet4efiftiQ ( py��v' 1 illy ( c
K h.1 ,'/cfl PLc ,d f9
fn Electrical permit required.
•
`B Repair or replace as necessary. //
Comments: (-1-/(1, f(1 S / ` //�j7 )'S —
•
❑ Plumbing permit required.
❑ Repair or replace as necessary.
Comments:
////4
❑ Mechanical permit required.
❑ Repair or replace as necessary.
Comments:
Y/9—
•
6,4 U . ,-/cC6 /-21/41 7/1/- it S 5-67
Inspector ' Date Phone
18724E Tnplkm:Original-Owner:`Mbw-ContrWr; Wnk.Buildng Divi4on
CITY bF COSTA MESA a
BUILDING DIVISION
FAy ,) 77 FAIR DRIVE,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: BX08-00041
PERMIT TYPE B_MISC STATUS: ISSUED
APN: 42542317 DATE ISSUED: 02/08/2008
Zoning: , ISSUED BY: SOK
JOB ADDRESS: 1648 NEWPORT BL CM Suite/Unit:
Vicinity: UNITS 24 THROUGH 28 Primary 0cc: Const Type :7?
SQ. FT: 0 Valuation: $2,000.00
•
SCOPE OF WORK:
DEMOLISH DAMAGE CAUSED BY FIRE TO STORAGE UNITS 24 THROUGH 28 FOR "BAY STORAGE".
OWNER: BAY STORAGE LLC Address:: AGT: JEFF MONTGOMERY Unit COSTA
MESA, CA
City/State: 1652 NEWPORT BL STE B Zip Code: 92627
Phone:
APPLICANT: SCOTT CASH Address: Unit:
City/State: Zip Code:
Phone: 817-366-0582
CONTRACTOR: INTERSTATE RESTORATION GROUP INC License No. 820510
Address: 5700 STRATUM DR Unit:
City/State: FORT WORTH, TX
Zip Code: 76137 Phone 817-293-0035 Cell:
ARCHITECT: License No.
Phone
ENGINEER: License No.
Phone •
FEE SUMMARY
Building Plan Check: $0.00
Building Permit: $69.25
Electrical Permit: $0.00
SMIP Residential $0.00
SMIP Commercial $0.00
$0.00TOTAL FEES $69.25
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.
CODE O. INSPECTION TYPc DATE INfTIALS ;ODE IT INSPECTION TYPE OLIN INTITIALS
1616 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/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval _
203 Final Sign 222 Final Site _
204 Final Demolition 2 r. 1 ' CC r� 250 Final Building/Occupancy
WORKERS'COMPENSATION DECLARATION:a Owner"ID.verified by drivi ,ce,._-. ❑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):
comp sation, as provided for by section 3700 of the Labor Code, for the
pert ance of the work for which this permit is issued.
C 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
� '� l)Q..?Cµ by this permit,and that no building structure,scaffdding,falsework,or demolition
earner: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
(This section need not be competed Athe permit a valued al one hundred Uvulars(3100)or less)
.,�� 2.Art 2,Sec.341,Title 8,Califomia Administrative Code).
Pohcy-Numbe%= -(�yyi --���,��r--aZO WC3-1L Lio1
0 As owner-builder, I will not employ anyone to do work which would
O I 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 shall rthwith comply with these provisions. Appimanrs Signature Date
2_-%..cs.2> Division of Industrial Safety Permit Number:
Apple " t' 'gnature CDate HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILU 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? 0 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 al 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 e ct. (� a registration form for acutely hazardous materials? ❑Yes 0 No
ruc..g_,13ew0570 / CIS V (Section 25533 of the California Health and Safety Code, with some
o exceptions, requires registration with the Costa Mesa Fire Department by
( � 2-g-03 each business which at any one time has on hand a quantity of acutely
f - — - Contract. gnature (_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 ENDING AGENCY: temperature and pressure).
❑ I hereby --trm 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? 0 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? 0 Yes ❑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 information be fumished 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 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? ❑Yes ❑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
❑ I, as owner of the property,am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
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 building construction, 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 ft - inspection.
Signature of Le• 0# Date
Signature Date , 44P"
i 2 -13-08
3057-4613/071
Andlrx'•.hodze• ••piwm ....Date
City of Costa Mesa pe... ) arks
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•
VERIFICATION
A city or county. which is required to give notice pursuant to Section 19830, shall attach to such notice, and,
as a condition precedent to issuing a building pemiit, require the completion and require the return of, an
owner-builder verification.
Attention Property Owner:
. An 'owner-builder' building permit has been applied for in your name and hearing your signature.
Please complete and return this information in the envelope provided at your earliest opportunity to avoid
unnecessary delay ih processing and issuing your building permit. No building permit will he issued until this
verification is received.
I. I personally plan to provide the maor or and materials for construction of the proposed
property improvement. ❑ Yes No
2. have ave not) signed an application for a building permit for
roposed work.
•
3. I have contracted with the following person (foe) to provide the proposed construction:
Name FIDI S�
Address City
Phone ( ) Contractor's Lic. No.
4. I plan to provide portions of the work, hut I have hired the following person to coordinate,
supervise and provide the major work:
Name � ,
Address City
Phone ( ) Contractor's Lic. No.
5. I will provide some of the work but I have contracted (hired) the following persons to
provide the work indicated:
Name Address Phone Type of Work
•
1
1042.46 (REV 9(98)
`p�QMF.s9 CITY OF COSTA MESA
,; • D P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200
fl' .4€4:74.11 a°
p +�. fir DEVELOPMENT SERVICES DEPARTMENT
J 9L
y60APaaPfl `9t'
BUILDING DIVISION
COURTESY NOTICE OF PERMIT EXPIRATION
June 19, 2006
Bay Storage LLC
203 Emerald Bay
Laguna Beach CA 92651-1210
PERMIT NUMBERS: E04-00549
FOR: 200A Service
PROJECT ADDRESS: 1648 Newport Bl., Costa Mesa
Our records indicate the above listed permits 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 your last inspection for the project and additional fees will be required to finalize
expired permits.
According to our records, the permits listed above have not had an inspection for a
period exceeding 180 days. If you have a signed inspection card indicating an
inspection was conducted within 180 days from the date of this letter, please contact this
office so we may correct our records.
If you need to request an inspection please call our Inspection Request Line at
714-754-5626. If you wish to request an extension, requests must be made in writing
addressed to Ed Petros, Chief of Inspection, at the above address, detailing
circumstances and listing an estimated date of completion. If you do not have an
approved final inspection, your permits will expire on July 3, 2006.
If you have any questions, please contact the Building Division at 714-754-5273,
between 8:00 a.m. and 4:30 p.m., and a staff member will be happy to assist you. The
accuracy of records affecting your property is our goal and we appreciate your working
with us to resolve this matter.
Sincerely,
xfra j
i / 1,',
Mary Jane Weidenkeller
Office Specialist II
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