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HomeMy WebLinkAbout1208 HAZEL PL - Building Permits11111 PETRA COSTA MESA•SAN DIEGO•TEMECULA•LOS ANGELES June 24, 1998 J.N. 492-97 WILLIAM LYON HOMES, INC. 4490 Von Karman Avenue Newport Beach, CA 92660-3600 Attention: Mr. Gary Haddy Subject: Footing Observations, Lot 15, Tract No. 15570, City of Costa Mesa, Orange County, California. 0, 08 gaze- I Pt. References: See Attached References. Dear Mr. Haddy: Footing excavations for the proposed residence within the subject lot have been carried into firm, competent bearing soils and are considered geotechnically suitable for concrete placement. If you require any additional information, please feel free to call. Respectfully submitted, PETRA GEOTECHNICAL, INC. —7— a>, /u-1I<alp Ray Midhlenkamp Supervising Soils Technician RM/mel cc: 1998\400\492-97.15 PETRA GEOTECHNICAL INC. 3185-A Airway Avenue Costa Mesa,CA 92626 Tel: (714)549-8921 Fax:(714)549-1438 petracm@ibm.net REFERENCES • 1) Geotechnical Investigation,Proposed Residential Development,Tentative Tract No. 15570,Northwest Corner of Fairview Road and Adams Avenue, City of Costa Mesa, Orange County, California; a report by Petra Geotechnical,Inc., dated December 29, 1997. 2) Geotechnical Report of Rough Gradings,Lots 1 through 34 and Lot"E",Tract No. 15570, City of Costa Mesa, Orange County,California;report by Petra Geotechnical, Inc.,dated April6, 1998. 3) Geotechnical Recommendations for design of Post-Tensioned Foundations in Accordance with Design Specifications of the Post-Tensioning Institute,Tract No. 15570,City of Costa Mesa,Orange County, California; letter by Petra Geotechnical,Inc.,dated April 14, 1998. PETRA GEOTECHNICAL, INC. J.N. 492-97 PARDUE, CORNWELL & ASSOCIATES, INC. PIANNINq • ENCIINEERINCI • SURVEyiNCI June 23, 1998 City of Costa Mesa 77 Fair Dr. Costa Mesa, CA 92628 Re.: Tract 15570, Lot 15 Dear Sirs: The engineer of record inspected the building forms for Lot 15 for the above referenced tract on June 23, 1998. Upon inspection, the finish floor elevation on Lot 15 of Tract 15570 located in the City of Costa Mesa, CA. is within± 0.1' of the elevation specified on the approved Precise Grading plan. If you have any questions or comments, please do not hesitate to call. Sincerely, PARDUE, CORNWELL & ASSOCIATES, INC. • QROFESSi0 N AcO p CORN '9l Fred Cornwell, P.E. � 1/4Q� �F< 0). Principal l �� S No. 45592 rtrn Exp...22; (94), CIVIL < FCF CAUEO�� 151 KAIMUs DR.,SuircC-230. •COSTA MESA,CA 92626 •NONE(714) 241-3400 •FAx(714)241.3432 Insulation Certificate n•-0e -te.� c��e_ fl cJ eR Y-h-esck. Number and Saes trt —V c kC_1 15C -20 City ts�- County Subdivision L.ctSumbar Description of Installation ROOF - Material Brand Name Thickaus finches) Tu,mal Resistance(R-Value) CEILING Batt or Blanket Type 1. Brand Name i� %NVN.S '" rne'"b"v• \1t.- Thickness(inches) LI'r Thermal Resistance(R•Value) 30 Loose Fill Type Brand Name Contractor's minimum insuUed weight/ft' _ lb Minimum thickness Inches Manufachirer's installed weight per square(cot to aeheive Thermal Resistance(R•Value) EXTERIOR WALL 1 , Material '�� 1 1 Brand Name 3u\\v% ^ + r 1 \.J, Thickness(inches) 3 WSS> 11 Thermal Resistance(R•Value) (t- RAISED FLOOR Material Brand Name Thickness(inches) Thermal Resistance(R-Value) SLAB FLOOR Material Brand Name Thickness(inches) Thermal Rcsisunce(R-Value) Width(inches) FOUNDATION WALL Material Brand Name _ Thickness(inches) Thermal Resistance(R•Value) Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the California Administrative Code. General eeno actor(Builds) Licanse Number Sin rcaMTid --- Dau Sub-C uaci. (Lularion 4erraYs) l ,, e License Number-. u :� . f�s'�tIS�Y• f/ e - lar ‘q€1 9 1 1 Sianarwe and Tide Dtu: Cowptiante Yens 5anue7 I.7995 r„ WC-41,4 tri, etre-67.7.0-pti o-:60 e55t'zt:©t t —�. CITY OF COSTA MESA o . .:...._ .: y ,Thimar.�� BUILDING DIVISION t i `^"^' ' DEVELOPMENT SERVICES DEPARTMENT 698-00637 • �• PERMIT PERMIT NUMBER 4tbibor27 (714)754-5273 • Fax(714)754-4856 BUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 • Job Address: 1208 HAZEL PL Status: ISSUED Suite: Applied: 02/18/1998 Vicinity: Issued: 06/15/1998 Parcel Nunmber: TPN98030 Zoning: Applicant: FLYNN, DAN Address: Phone: Zip: Owner W. LYONS HOMES Address Phone: - Zip: Contractor: WILLIAM LYON HOLMES Address: 4490 VON KARMAN - Phone: 714-476-1361 C.M.CA Zip: 92660 , License: 661158 Arch/Eng: Address: HOLD.FOR SPECIAL REQUIREMENTS Phone: . Zip: License: SCOPE OF PERMIT 2 STORY SFD 1718SF,431 SF GARAGE.REF: PC#630-98A. 3 PARKING SPACES PROVIDED ON THE LOT;GUEST PARKING ON PRIVATE STREET APPROVED UNDER DR-97-0 FEE SUMMARY . Plan Check: $0.00 Calc Valuation: 149,283.50 Permit: $1,137.25 Claimed Valuation: $0.oa SMIP Res: $14.93 SMIP Com: $0.00 , Other: $0.00 Inspection: $0.00 Total: $1,152.18 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 15-0 Rear 16-0 Left 5-0 Right 5-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 3 Proposed: 3 NOTES: COLLI KJ 5/7/1998 PLAN CHECK FEES WERE VOIDED. ORIGINAL PLAN CHECK FEE WAS PAI • EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned fora 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 DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty 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. ❑ I have and wit 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: Cartier: Policy Number: (This section 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 California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these proviso. / (� Applicant Signature: P T�---� Date: (0 1 /Co f4 3 WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML TINES UP TO ONE HUNDRED THTYISAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I em licensed under provisions of Chapter 9.(commencing with Section 7000)of Division 3 of the Business end Professions Code,and my license is in full force and effect:Lic.4 Class# Contractor's Signature: 0 P Date: Co I t ( I / 9 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). Lenders Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penally of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business end 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 then five hundred dollars($500).): ❑ 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 employees,provided that such improvements ere not intended or offered for sale.11,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.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 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,felsework,or demolition or dismantling thereof,will be more than thirty-slx(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. Signature: Date: Division of industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I 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 et 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? ❑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 application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? j�Yes 0 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 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? 0 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. 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. ff nature Of Legal Owners) I CP I Gate •And/Or Authorized Applicant Date , MILL INSPECTION TYPE DAM REALS CODE f INSPFCTION TYPE DATE MISS 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 250 Final Building/Occupancy aB—24—qt 2446-4e tt CITY OF COSTA MESA a w4, BUILDING DIVISION F' ^''J' ' DEVELOPMENT SERVICES DEPARTMENT P98-00446 c/ *4,"- PERMIT PERMIT NUMBER (714)7'54-5w2773 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 1208 HAZEL PL - Status: ISSUED Suite No Applied: 06/05/1998 Issued: 06/15/1998 • - Vicinity: LOT 15 Parcel Nunmber:. TPN98030 Applicant FLYNN, DAN Address: Phone: Zip: Owner W. LYONS HOMES " Address Phone: , Zip: Contractor: WILLIAM LYON HOLMES Address: 4490 VON KARMAN Phone: 714-476-1361 , C.M.CA Zip: 92660 - License:661158 Arch I Eng: Address: Phone: Zip: License: SCOPE OF PERMIT .. .._Th FIXTURE FEES"FOR PLAN tA.LOT,15.4 FEE SUMMARY AMT QTY AMT QTY AMT QTY • ISSUE FEE $22.00 Laundry Tub/Washer - $8.75 1 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 , Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $17.50 2 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $35.00 4 Dishwasher $8.75 1 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain,Floor $0.00 0 Sewer Connect $22.00 1 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 0 Sewer Private Line $0.00 - 0 Water Closet(Toilet) $26.25 3 Drain,Roof $0.00 0 Shower $8.75 1 Water Heater/vent $11.00 1 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink,Floor $0.00 0 Water Service $8.75 1 Gas(1-4 outlets) $5.50 1 Sink,kitchen $8.75 1 Water Softener $0.00 0 Gas(Over 4 outlets) $1.00 1 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $8.75 1 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $192.75 COMMENTS/SPECIAL CONDITIONS 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 / DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty 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. ❑ 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: (This section 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 California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisl• �►' �r CO (/CO (9 Applicant Signature: Date:---- WARNING:FAILURE JO SECU-E WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUB1ECi AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND WLLARE(S100.000),IN ADDION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS 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. Class A // 2 Contractor's Sign iure: - 4 C. / CQ ( -1 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,CMI 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.My violation of Section 7031.5 by any applicant for a permit subjects the applicant toe 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.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,I.e.-properly 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,end that no building structure,scaffolding,felsework,or demolition or dismantling thereof,will be more then 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. 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 end 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 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 application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 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). 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(Duality 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 state 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. /� not L Owner(s) C (� (n -e • (SSS// /V//And/Or Authorfzed'A(ipllcant C--Dateq1 -- CQQLL IN5?ECI10N TYPE DATE ILLS cVQLi INSPECTION TYPE PATE 91IIDAL5 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 Anal Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 2446.06 ,�W CITY OF COSTA MESA ;`w' Vit, BUILDING DIVISION f DEVELOPMENT SERVICES DEPARTMENT tat rite. PERMIT PERMIT NU ER 4.44Powmm 4. M98-00218 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 . . MECHANICAL PERMIT Job Address: 1208 HAZEL PL Status: ISSUED Suite No Applied: 06/05/1998 • Issued: 08/04/1998 Vicinity: Parcel Nunmber: TPN98030 .. -- .. Applicant: FLYNN, DAN Address: , . Phone: , ter. Zip: . . - . . " Owner W.'LYONS HOMES Address: /i y - - _ , /�/' / Phone: ' -i_ .i/��V - Zip: / Contrector:,, WILLIAM,LYON HOLMES Address:, ; 4490 VON'KARMAN Phone' 714476-1361 C.M.CAZlp:- 92660 . / _ � Licesn e: 6611581 \„ • •Arch lEng: - '• ,i� - • _ , Address: - -- - - • _ ' - Phone: - , Zip: i License: - SCOPE-OF. PERMIT . . - • FIXTURE FEES FOR PLAN 1A-LOT 15. REF'B98-00637, INST.) FAU UNDER 100K BTU, 1 a FIREPLACE AAND 4 VENT FANS - " _ - - - FEE SUMMARY ' - Quantity -_ </ / Quantity / ISSUE FEE $22.00 Repair/Alt_Absorbtion Unit • $0.00 0 Inst FAO<100 k BTU $13.25 Repair/-Alt Refrigeration Unit - $0.00 0 Inst FAU'>100-k BTU .'',,,,- $0.00 Ventillation System ' $0.00 '0. Repair/Alt Cooling/Heat ' " $0.00 0 . Evaporative Cooler $0.00 0 Inst/Rep.Recess Wall Htr / $0.00 0 . --Commercial Incinerator _ - . $0.00 0 Refrig Sys<100 k BTU ' $0.00 0 Domestic Incinerator $0.00 0 Refrig Sys>100 k BTU . '� $0.00 0 -' Compressors/Absorption Systems Gas Piping \10.00 ^0' Up to 3 hp/100 k BTU $0.00 0 Factory Fireplace` / $9:50y.,1' - ,1'.3 To 15 hp/500 k BTU - $0.00 0 Hood w/Mech Exhaust - - - $0.00 ,0 / .15 To 30 hp/1,000 k BTU $0.00 0 VAV Box . /$0.00 -0 ' - ,/10 To 50 hp/1,750 k BTU $0.00 0 Vent Fan/Single Duct '- . ' - $26.00 . 4 - ‘ • _ , . , Over 50 hp/Over 1,750 BTU $0.00 0 Appliance -.$0.00 0 - Boilers Fire Dampers $0.00 0 Up to 3 hp $0.00 0 Smoke Dampers -$0.00 0 - ' 3 To 15 hp. - $0.00 0 Inst or Relocate Appl Vent $0.00 0 - 15 to 30 hp $0.00 0 Air Handlers< 10000cfm $0.00 0 30 to 50 hp $0.00 0 Air Handlers> 10000cfm $0.00 0 -Over 50 hp $0.00 0 Floor Furnace $0.00 0 • Other Mechanical Fee Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 ' Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES $70.75 COMMENTS/SPECIAL CONDITIONS • 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 / . DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have end 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. ❑ 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: (This section need not be completed I/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 California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code.I shall forthwith comply with these pro s. Q (1 Applicant Signature: ��_ Date: ( - s- - I O 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 DOLLARE($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.k /'a / Class/f (� Contractor's Signature: .4 !eDate: ' q_ �` / R 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 end 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).): ❑ 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 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.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 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: ❑ 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 8,California Administrative Code). O 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? ❑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 application appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 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). 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? 0 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 state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPUANCE 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. . Curs egal Owner(s) And/Or Authorized Applicant Date CODES WSPFCTN1N TYPE DAM INlALS CODES INSPECTION TYPE 1ATE 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1n- iQ -98 1266 Pool Spa Final _ 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final BlocldRetaining Wall 212 Final Fire Prevention 202 Final Factory Fire Placa 220 Anal Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 2446-46 r • CITY OF COSTA MESA �4;r ,f BUILDING DIVISION . F' `^"^h' ' DEVELOPMENT SERVICES DEPARTMENT E98-00510 '- J. frigt PERMIT PERMIT NUMBER (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT • .lob Address: 1208 HAZEL PL Status: ISSUED Suite No Applied: 06/05/1998 Vicinity: Issued: 06/15/1998 Parcel Nunmber: TPN98030 Applicant: FLYNN, DAN Address: Phone: Zip Owner W. LYONS HOMES Address Phone: Zip: Contractor: WILLIAM LYON HOLMES Address: 4490 VON KARMAN . Phone: .714-476-1361 C.M.CA Zip: - 92660 • License:661158 ' . -'SCOPE OF PERMIT • FIXTURE FEES FOR:PL•AN 1A LOT 15. FEE SUMMARY • Quantity Quantity ISSUE FEE $22.00 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) $85.90 1718 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 $1.00 1 up to 50 kva/kw $0.00 0 Recept Outlets $1.00 1 up to 100 kva/kw $0.00 0 Switches $1.00 1 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 I Ckt $0.00 0 Service to 200a $27.25 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 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $138.15 Intermed Pole $0.00 0 COMMENTS/SPECIAL CONDITIONS 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 DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penaltyygt 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.' ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the wo R for which this permit is Issued. My workers'compensation Insurance carder and policy number are: Cartier: Policy Number: (This section need not be completed ll 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 California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shell forthwith comply with these provisl /^/ / p • Applicant Signature: % V' T / Date: vP—( G, C 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 DOUARE(5100.000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS 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.qClass x Contractors Signature: /79 p �- (Date: 4P• - ((soi _ ( a 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,CMI 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 then 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 appy 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.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,Le.-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,felsework,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,Califomia 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: I 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 Califomia 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 end 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 Califomia 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 end 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 Califomia 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 application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 0 No (Section 65850.2 of the Califomia 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 Califomia 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? 0 es 0 No B (if"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I cent 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 Emiss ons.- 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. /Si netu 1 Oaner(s) _ / ` Datc R- An r Authorized Applicant 'r Date • LOPE I INSPFCTION TYPE OaIE MALS ODE I INSPECTION TYPE gaff Immass 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing /� 200 Final Re-Roof 210 Final Electrical if"149 201 Final BIocWRetaining 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 2446-46