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1030 PALMETTO WAY - Building Permits
i CITY OF COSTA MESA BUILDING DIVISION F77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 - Fax (714) 754-4856 • www.costfamesaca.4ov FOR INSPECTIONS CALL: (714) 754-5626 2�Eefi PERMIT NUMBER: BX11-00393 PERMIT TYPE B MISC STATUS: ISSUED APN: TPNO08030 DATE ISSUED: 12/14/2011 Zoning: , ISSUED BY: KJB JOB ADDRESS: 1030 PALMETTO WY CM Suite/Unit: Vicinity: Primary Occ: 32. --=i_�.. Const Type :?? SO. FT: 180 Valuation: -,:.$2,901.60 - SCOPE OF WORK: 180 SQ FT ATTACHED PATIO COVER. OWNER: DANG, ALAN -. Address:: 1030 PALMETTO WY, " City/State: COSTA MESA, CA - Zip Code: _714-788-04-" Phone: 714-788-0478:` " APPLICANT: QUANG KIM HA. . " Address: City/State: - Zip Code: 714-788-04- Phone: 714.797.2420 CONTRACTOR: - ... License No. - Address: City/State: Zip Code:- - Phone - Cell: ARCHITECT: - - - . _ ` - " License No. -. Phone ENGINEER: License No. -" Phone FEE SUMMARY "t' Building Plan Check: •$54.11' - -" Building Permit: - - Electrical Permit: .'$83.25 - $0.00 - - - - ,�; SMIPResidential- $0.00"- - SMIP Commercial $0.00 " Bldg Std Admin Fund t Unit Unit: Unit: HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279 thru Friday - 7:00 am thru 7:00 pm. Saturdays -9:00 am thru 6:00 pm. Prohibited all hours - Sundays and the following Federal Holidays: A,� OTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related gulations. (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. 'GOOF S. INSPECTION TYPE DATE INTMAL CODEe INSPECTION TYPE DATE INMAL 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 j202 Final Factory Fire Place 220 Final Planning Approval 1203 Final Sign 222 Final Site I?' - 44 Final Demolition 250 Final Building/Occupancy f WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by bection 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 permit is issued. My workers' compensation Insurance carrier and policy number are: Carrier: (This sewn need not De completed e e �valuetl of one hu red tlol ars (8100) orless.) \// \�}'P-a'os)liCcy Number. ' V f certify that in the performance of the worV, for which this permit is ued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should - become subject to cop ers' compensation provisions of ection 3700 of the lab r ode s f hwit %comply with these pro visi ns Bran's ate WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF 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 and effect. Lic. # Contractors Signature Class # CONSTRUCTION LENDING 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). Lender's Name: Lender's Address: 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 Z red dollars ($500).): s owner of the property, or my employees with wages as their sole ation, 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 appy 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.). ❑ lam exempt under sec. Business and Prof ions Code for this reason: 1 Signature Dat 3 46 (3I0]) Owner ID verified by driver's license. ❑ Yes ❑ No Driver's 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, Art 2, Sec. 341, Title 8, 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. Applicant's 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 fled 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 Code provides that the Costa Mesa Fire Department may require the preparation, certification and fling 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 ❑ No 5. Does or will the applicant or present or future building occupant require for the work which is the subject of this application a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ 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? ❑ Yes ❑ 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 ❑ 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 state laws and city ordinances regarding Hazardous Materials and Emissions. 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. cJ.Kg90�0wner(s) -;) y Date &:Vfdlor AuthonzedAppLrant r Date 1 City of Costa 9Wsa �Buiuing Division 77 Fair Drive, Costa Mesa, CA 92626 M Costa esa 714-754-5273 / Fax 714-754-4856 OWNER BUILDER VERIFICATION Permit # v -✓ Disclosures & Forms for Owner- Builders Applying for Construction Permits IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has been(slp tte�d in y r e listi g ourself as e�builder of the property improvements specified at U �� (/\' We are providing you with an Owner -Builder cknowledgment and Information Verification For to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner- uilder' building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. q2. 1 understand building permits are not required to be signed by property owners unless they are re ponsible for the construction and are not hiring a licensed Contractor to assume this responsibility. �W3. I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. A04. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. 15. 1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. 4 6. 1 understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these las may subject me to serious financial risk. isid7. l understand under California Contractors' State License Law, an Owner -Builder who builds single-family reential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. 3148-30 CALBO Jan 1, 2009 OB Packet template 1 of 2 C-10 1 understand as an Owner -Builder if I sell the property for which this permit is issued, 1 may be held liable o any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. `0i 9. 1 understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.csib.ca.gov for more information about licensed contractors. �Kl0. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the following address: 1. 1 agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner -Builders as well as employers. CAO 12. 1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note:LA-copy of the property owner's driver's license, form notarization, 4enif;cation acceptable to the agency is required to be presented when the permit is ' suedoperty owner's signature. Signature of property ow r / — Date: Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Address of Authorized Agent: I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the ag cy is required to be presented when the permit '.s issued to verify the property owner's signat e. Property Owner's Signature: Date: /L 3148-30 CALBO Jan 1, 2009 OB Packet template 2 of 2 Rafter Header II ■�■WA I DETAIL OPTIONS ■��C'� pp OA EIB Oc OD CIE OF I ■��■sLattice Cover. Solid Cover: OA OD OF OF Lattice Cover -0 o Solid Floor CoverI L- Roof Covering 26 Go. L Roof Sheathing Lattice FRAMING PLAN Flashing Roofing 12" Sheathing ' Lattice 1. Rafter Header _ Rafter Joist Hanger Roof sheathing: Joist Hanger Post Ledger x Ledger SLAB FOOTING solid:2--x--L " CCX plywood or " lumber: 1" - 2'- 8"; 2" - 8'- 0" 2 f Rafters: o 2% Slab I ZD ro Slab 20/(v��,i Slope Ledger: _ _ CNSIop9 COS to Drain Fascia: _x Utv Lo,Rrai i�p1 7. Lattice Footing �; Ol Solid Roof, vol S. Cover SECTIONS Cover, Lattice Bolts Rafter Dummy Post rgvnlh" 9. • . • " thick (Expansive Soil Zone SPECIFY LUMBER: El DF [I Redwood ❑Hemfir Stitssew'�han9asnc°.,... esa. tr\akear`y r:;tofGosta4` ec;CwaUons SPECIFY GRADE: ❑ No. I ❑ No. 2 Joist to Header - Solid blocking with framing anchor andSa\eN,naofllis4la°`oVi;PnsotaM 'thes`evto�aUonota"`!Pt CONCRETE: 2500 psi min. @28 days Doubled joist or header to post - (2) 1/2" dia. thru bolts w/ washers °itoxp'rahYl'r ane, a CONNECTIONS: ICBG approved or equalPlf's Joist to Fascia - Metal framing anchors each side 3mmehred and m6n (min. capacity = D.5" joist span *joist spacing' 15) 1. Roof covering: Slope:;12 WotRts 2. Roof sheathing: Maximum spans: 750# maz lattice: x @ —" o.c.: 2x2 - 6'; 2x3 - 8'; 2x4 - 10' SLAB FOOTING solid:2--x--L " CCX plywood or " lumber: 1" - 2'- 8"; 2" - 8'- 0" 3. Rafters: �x 6 @ _" o.c_. E9 Single ❑ Double "4. Header: 10x_ rel Single ❑ Double 5. Ledger: _x_ (2x min) Fascia: _x (2x6 min) 7. Post: /1) x I n (4x4 min) Raise 1" min above slab surface S. Footing: _x_ 12"x12" min for up to 66 sf tributary area; 18"x18" min for 67-150 sf tributary area Lattice Bolts Rafter Dummy Post " depth (Expansive Soil Zone 9. Slab E " thick (Expansive Soil Zone 10. Connections: a. Joist to Ledger - Metal joist hanger Each Block Header 2 x Blocking b. Joist to Header - Solid blocking with framing anchor F c. Doubled joist or header to post - (2) 1/2" dia. thru bolts w/ washers d. Joist to Fascia - Metal framing anchors each side (min. capacity = D.5" joist span *joist spacing' 15) e. Header to Post - Column Cap f. Post to Slab or Footing - Metal Anchor/Post Base F g. Roof Sheathing - 8 d @ 6" o.c. Edges and 12" o.c. Field Post Anchor Post 6'min Footing Depth PAD FOOTING A 750# maz Per post Post 6- min t - SLAB SLAB FOOTING cR+�Cv/ i2k6. Min w /BDistJ -Pescia IVustin© Anchors wall& 2 p"+t root —' \\ ..pe, _. �s,A MairMlM{�iBPer�e ll EAV €'CON N E C T I O No ;C3 tr2( �I� behe�dtol�a�€hte re $J: ando l aimnandbe ,Sr�wesm,�0 sfio"1s1 Joist 'well Hanger Ledger WALL CONNECTION I D Lattice Bolts Rafter Dummy Post Support Post Beyond RAFTER/HEADER E Roof Sheathing or Lattice Rafter Framing Anchor Each Block Header 2 x Blocking Post Column Cap JOISTIHEADER I F 19971 IBr. epprova\ date law. oudd\n9 of )t issuance. - - -- -- r -- �I --I 1 DIVISION 0CITY 0 COSTAIMESAA LIANCF - - - - - - - I- --- — -- - - — ��- ETY REVIEWED -FOR- -ODE COMP 9 - - -- — -- �03�This set of plans erld specificatio 1. ,IJST be kept on this job at all times and it is unlavAul to ®j make an chap es or altem? ons on same enthoutwntten permission from the Division of Building j and Safely, Cily of Ystamping 0of.ld. pl p — — to P_approval/ — — — — — -- — — — — — — I — — — The a plans f amd ha s,OTS expire I talion enALL d becomT be e olds land ffa d/or Stbuildingte law: — b -- 1 1 -- _- - -- i,- - - he ---- , void I I YP Y ty d d work is not commenced and maintained active per CBC Sec. 105.5 within 180 da z, 0 1 - I I i i � •i �' 1 J I If1 I- i I ; t PropGA L nc Fj 7 _""I fC ,itµ0 �ilc%e - 1 I I t I I I i I j - - - - -- - -- - - - - - - - - - - -- -- - - - - -- - - -- - --- �. - - -- - - - - - - --- - -- - - - - - - - - -- - - - -- -- - - - - - - - - - - - - -- - ' - - - - - - L - - - t-- - - — -- - r- 7- I� I 15 I RtR_ I i f I I 1 i I i I I