HomeMy WebLinkAbout3216 IOWA ST - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 3216 IOWA ST
Suite No
Vicinity:
Parcel Nunmber: 13910204
Applicant: EM, ROEUNY SATIA
Address: . �
Owner:
SAMPLE, LISBETH ANN TR
Address 3216 IOWA ST
COSTA MESA, CA
PLUMBING PERMIT
Phone:
Zip:
Phone:
Zip: 926262005
Contractor: RELIABLE ENERGY MANAGEMEN
Address: 6250 PAR4MOUNT BL
� LONG BEACH CA
Arch / Eng :
Address:
Phone: (562)984-5511
2ip: 90805
License: 704414
Phone:
Zip:
License:
SCOPE OF PERMIT
CHANGE OUT OF A WATER HEATER.
ISSUE FEE
Backflow irrigation
Backtlow Preventer
Bathtub
Clarifier System
Connect (Ice,Soda,etc)
Dental Units �
Dishwasher
D2in, Floor
Drain, Rainwater
Drain, Roof
Drinking Fountain
Ezpansion Tank
Gas Earthquake Valve
Gas (1-0 outleLs)
Gas (Over 4 outlets)
Gas Repipe
Gas Service
Interceptors (Grease, Oiq
Interceptors (Sand Auto )
AMT
$23.50
50.00
$0.00
50.00
50.00
50.00
50.00
50.00
50.00
50.00�
50.00
50.00
50.00
so.ao
50.00
$0.00
$0.00
$0.00
$0.00
$0.00
aTl'
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
FEESUMMARY
AMT
Laundry Tub I Washer $0.00
Landscape Irrigation $0.00
P-Trap ' $0.00
Pressure Regulator 30.00
�Process Piping (per 10 k) $0.00
Receptors $0.00
Sep6c Tank 30.00
Sewer Cap tor Demo $0.00
Sewer Connect ' $0.00
Sewer Private Line 50.00
Shower ' $0.00
'Sink,bar $0.00
�Sink, commerCial - $0.00
Sink, Floor - $0.00
Sink, kitchen $0.00
Sink, service/map $0.00
Spa (private) $0.00
Spa (public) $0.00
QTY
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
COMMENTS I SPECIAL CONDITIONS
Status: ISSUED
Applied: OS/17/2002
Issued: OSI17I2002
ISSUED BY: �
SumpPump . �
Swimming Pool "
Trap Primer ,
Unnal
Vacuum Brkr Bkfiow(t-4)
Vacuum Brkr Bkflow(5+)
Wash Basin �
Wash Basin Set
Waste and Vent System
Water Closet (foileq
Water Heater / ven[
Water Piping (�nst or Rep.)
Water Re-pipe
Water Service
Water Softener
OTHER
VIOLATION
PLAN CHECK
REINSPECTION
AMT
$0.00
ao.00
$0.00
$0.00
ao.00
50.00
50.00
$0.00
$0.00
50.00
$12.30
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES: 535.60
Qn
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
NOTICE: The work authorized by this permit shall compty with all applicable handicap access requirements under Calilomia statutas and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void ii work is not commenced within 180 days, or it work is suspended or abandoned
for a period of 1B0 days.
INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inepeetlons end flnal approval musl be ob�ained. Fallure to obtain inspections and final approval will resul� in �he expiration of this permil.
FOR INSPECTIONS CALL: (714) 754-5626
zaaa+e �eAo�
WORKERS' COMPENSATION DECLARATION:
I hareby aHirm under penalry ot per�ury one of the lollovnnq dedarations: ,
❑� I have entl wlll maintain e ceRilicate ol consent to self-Insure br workers' compensation, es proNtled lor by saction 3700 0l the Lebor Catle, br the peAortnance of the
work lar w�ic� tMs pertnit is issueE.
I have arW wlll mainWin worKers' cpnpensalion in.w2rwe. gs r¢quiretl by secfion 3700 of the Lebor Code, tor Na pertortnance ot the work tw whkh this pertnit is iswetl.
My work com nsation Insurence card r end poliry number ere: � [ � (�^
Cartier ����ih PoliqNumber. �l%'i� O�� �J`'I I
(Thls secflon need not be comple�ed tl Ne permlt !s velued et one hundred dollare ($700) or less J �'—
❑ I certity that in the peAortna��e of fhe work lar which thls pertnit Is Issued, I s�all not employ any person in eny manner so es to hecome subject to Iha workers'
compensation laws ol Call}Omla, and apree Ihat it I shoulC come b�ect to the workers' � rovi5ions ol SacUory 3700 oi th Lebor atle, I shall la�hwlth
WA�Ilcant Sign�' P�ovisions. De ��/ I� � V�
FAILU SEWRE WOR (EFS' CW-APENSqiION GOVERAGE IS UNLAWRIL AND SHALL S1�0 CRIMINAL PENALTIES AN GVIL FlNES UP TOONE HUNDRED
�___4PF (<i9p,dpp), IN Ad RION TO TNE W5T OF ODMPENSATION, DMNGES PS PROVIDED FOR IN SECTION 3]OB OF THE LPBOR CODE.IMEREST, AND ATTORNEI^S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereb Ihat I am licensetl under pmvisions of C�apter 9(commendnp with Section 7000) of INsion 3 ot Ihe Business and Prote s Code, antl my Iicensa Is in lull
I c ec . M�� Class x �� i���
ignature: !M-� � L: � ��
CbNSTRUCTION LENDING AGENCY:
❑ I hereby ettirm Ihat Ihere is d�nstruction lentlinq egenty for t�e peAormance ol the wark lor which Ihis pertnit is issued. (Sac. 3097, Civil Cotle).
LentleYs Neme: Lendefs Atldress:
SlgnBiure:
OWNER-BUILDER DECLARATIONS:
Oate:
I hereby atfirm t�et under penalry of perjury �hat I am EXEMPT FROM THE CONTRAC70R5 LICENSE LAW for the tollawing reeson (Sec. 7031.5, euslness entl Professions
Cotle: Any ciry or counry which requires e permit to construct, atler, improve, tlemolish, or repeir eny stmcture, prior to its issuence, elso requlres Ihe applicant for such pertnit
to tile e slgnetl statement that he or she Is licensetl pureuant to Ihe provisians ot ihe Contractors License Law (Chepter 9(commencing with Sectlon 7000) oi DINSIon 3 of t�e
Business end Professions Cotle) or thet he or sha is eaempt therefrom end the basis for the elleged exemptloa Any violation oi Sectlon 7031.5 by any applicant for a pertnit
subjects the eppliwnt to a civil penalry of not more than five hundred tlollers ($500).):
❑ I, es owner ol Ihe property, or my employees with wages as thelr sole compensation, WILL DO THE WORK, entl the sirucwre Is not intended or ottereG for sele (Sec.
7044, Business and Professions Cotle: lTe Contractors License Lew tloes noI apply to an owner ol property who 6uilds or improves t�ereon, and who Ooes such work
himself or herseN or through his or her own employees, provided Ihai such improvements ere not Intended or oNered lor sala. tl, hov.•ever, Ihe builtling or improvement is
sold within one year of wmpletion, the owner-builder will heve t�e burden of proving that he or she ditl not builtl or improve lor purpose of sale.).
❑ I, as owner ot Ihe pmperty, am EXCWSIVELY CONTRACTING WI7H LICENSED CON7RACTORS to construci the pmjea (SecJ044, Business and Pmfessions
Coae: 7�e contractors License Lew tloes not appty to en owner of property who bullds or Impwves t�ereon, end who contrac�s for such project with a contrectoqs)
license pursuant to ihe Cont�actors License LawsJ.
❑ I em exempt under sec. Business end Professions Code tor this reason:
Signature: Date:
Owner ID verified by dnvef5liCenSe. ❑ Yes ❑ No Driver's LiCense No.
Vedficetion of Ownership by (rype of document, i.a. - property tax bill or tleetl):
DIVISION OF INDUSTRIAL SAFHT' iERMR CERTiFICA710N:
Expires:
❑ I hereby certify ihat no ezcaVetion tive (5) or more teet in depth into which e person is requiretl to tlescend, will be matle In connection wiN work euthoAzetl by t�is
pertnit, and ihat no building SfiiIXure, scaNdding, falsework, or demolition or dismantling Ihereof, will be more Ihan Ihirty-six (38) feet high. (C�ap. 32, Grp 2, Art 2, Sec.
341, Ttle B, Califomie Admin�stretive Cotle).
❑ As awner-builder, I will not amploy enyone to do work which waultl require e permil Irom ihe Divislon ot Indusirial Salery, es nototl ebove, unless such persan hes e
permlt to do such work irom the division.
SigneWre: Dele:
Division of Intlustrial Sefery Permlt Numhor:
CERTIFlCATE OF COMPLIANCE AND AUTHORIZATON OF ENTRY: I cenify untler penalry of perjury Ihat I heve read Ihis application an0 state Ihat ihe infortnation given is
correcL I egree to comply wlth ell s;a�e laws enC city oMinences relating to building consWction, end eu�hodze representetives ot Ne Ciry ot Costa Mesa to enter upon the
sbove-described property tor Inspection purposas. I agrae nat lo occupy o� allow occupancy ot eay 6uiltling authorizetl by this permit until liael inspection.
COOE 1.
1618
1266
200
Flaetl System Final Fire PrevenNon
Pool Spe Finel
Flnel Re-Roof
201 FIneI8locWReteinin0 Well
202 Final Factory Fire Placo
203 Final Sign
204 Final �emolition
Odg 4�EL4
COOE I INSYECLION TYPE
206 Finel Mechanlcal
20B Flnel Plumbing
210 Finel Electricel
212 Flnel Fire PreventlOn
220 Finel Planning Approval
222 FinalSite
250 Final Building/Occupenry
P�ff. It�
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OWNEF8IUMEIFqqWN: SAMPLE� LISbfi
; wo�s+: 3�10 IUWA ST
, Ci�STA MESA,CA
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ANN
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�IMN. ON FNR'S 110011E59: UNf:
��Ta,s� DEAN MULLIN5 CuNSTAUCTION (714)964-7019
CQRP�CTORSYNNIO 20372 DUBLIN
„��; H.H. CA „�� 669174
Szeao �„,:
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Date: ��:
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peAmrence d �M xak M nfiid� tAe P�1 e��ed (Swun ]081. Civ. C).
IENDER'S NMIE
LENDEN'S �DDHE34:
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'°'"'°°°'°"°"°°'� DEAN MU ,INS
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CITY GF CGSTA MESA - HOYLulNG FERMIT
PERMIT NG: b 085275 FLAN iHEC}C NG; N
CGNSTRUC7IuN TYPE: V-N PERMIT TYPE: S'fR
FERM NG: d �8527
GOVT; N SUPP: N
PURPOSE: OTH
JGb DESCRIPTIGN ;?iGFF ti RERGOF WiCGMF SHINGLES SQ FT: 2,o7u
CLAIM VALUE: 2,670.00 CALC-VALUE: 2,070.0"v GRuOP OCC: 1i--3 i
COMMENTS: AEROOF 26705F RESIDENCE H/COMP
iF iF if iEif if iF if iF if if if iFif if if iFif if if K if if ik i4iiiF iF w'se if if iF iF iF iF�FiFif if iF if K iF iF ie if ieif ii tiFiE w iF iiiF ir iF ii iF w ii w rf ie iF w iF ii if i't ie iF i'r iE if ri w� iF
Z O N I N G R E Q U I R E M E N I' S
S E T B A C K 5
------------ MAIN HUILDING ---------- --------- ACCESSuAY bUILDING ---------
FANT: FT IN R�:AR: FT IN FRNT: F'T IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: F'T IN RGHT; FT IN
PARKING AEQ: PROV: PAACEL: 1351G[V4 ZNE: REF NO:
PLANNING NOTES>
7 ".�i
iF iF iF iFiF iF3f ie iF iF ih iF iF iF if if if iF iF iE iF iF if iF if iF it �e if iE w ie'k if ie if ie if'sF ikiF if if iE if iF iE iF iF iF iFie iF ie iF iE iF iE iF if iF if if ii iF iF if if 3f ie iF if ie iF iFie iF if iF
L'c V E:�.L G P N E N T 5 E R J I i: t 5 k E[,i il 2 h �. M fi N-i S
� ~
ZGNING P,PPRUVED .BY UA'IE:
bUILDING APPROVEL BY : UArt:
APPLICATIGN ISSUED bY; LAiE; ��I�iiA1
iiii�ieifitiFiFieiiififiiifiiiFiFiFiFiFiFiFii �e se wwse s' wwsrw w x ��arxx+ea' iEifiF'sfififwiei''sirs�sr�i'seiiw
iEGALIZAI'IGN:N F E E S U M M A R Y S'IAUC7iiiiAL SEGMc'.N'Z;Y
bLLG PMT PLUHBING ELEC7RIC MECHANIC FZei£ SMIFiiiES GKFwTN�
FERMIT 74.75 SO
yp� SMIPiNvN-kF.S
ISSUE FEE
gUILLIWEi-L7IY-� PEAMIr ISbUE PLAN-GHECK IUTAL PAID iriic
T07AL5----> 75.25 0.00 0.00 ?5.25 75.25 .GO
REUENUE LIVISIGN iGTALS--> CULLECTEL; 75.25 Gti6RiSHGAT: ."v"v
bLLG FM'I PL'JMbING ELECTRIC MECHANIC FiRE SMIr/i0T GRALiNG PLAN-CHECR
74.75 .SG
ii ii iF i4 ie ii i'r �'t aF it ii'sF ii if # it iF iF 1e ii ie ii ii ii iF ie ii ie ii i' if # iF'sf ie if iF iF iF ii ie M w ii iF iF iF if ii iF ie'riie i't ie ii'se iF if i'r iF iF ih i'r iF w ie ii # ie i'r ie ii ie ii ie i'r ii i'r
I N L I V I L U A L F E E b k E A K L G W N
TYPE tjTY L E 5 C R I F'I I U N UNIT CGSi Tii'fAL CGST
SrR 2670 RERGGr bY VALUE RESILENTIAL NOZUNt 1."vG 2,o7"v."v"v
ENL UF FE65
IB-17-1997/09:86 NM/f75.25
RCDTN:81�814834
PERMIT:985275
,�
CONSTRUCTION ANDPLANNING POO. 3PA
APPROVALS Permix # Date I�spector qppROVAIS Permit # Date tn:pector
1. Temporary Electrical Service or Pole 52. Pool � Equipment Location
2, Soil Pipe�Undrgmd. 53. Steel Reinforcement .
'' =
,� y 3i.;�lectrical ConduiUUiilitV-Undrgrnd. 54. Forms r�
'� 4t''�lectrical Conduir-Undrgrnd. 55. Electrical Bonding •S
�1 S� $teel fieinforcemmt 56. Rough Plumbing & Pressure Test � -
"f 6'. �lectrical UFER &rnd. 57. APPROVAL TO COVER•GUNITE �
H
,.,'r7� �ootings � S �'7 58. Electrical Cqnduit-Undrgrnd. �
- 8. Foundation .. � 59. Gas Pipe, O Undrgrnd., Test
�9. Water Pipe�UndVgrnd.� 60. Backwash Lines,•P•Trap, O Undrgrnd.
�0. Strucwral Ftoo'r.System � 61. APPROVA�TO DECK
�
11;�Property Sewer Line.& Hous,e,Connection 62. Backwash & Receptor-Final,
12, ewer Cap �, ` � 63. Heater & Vent�Final
13. Roof Drains 64. Piumbin9 System - Final
14. Rough Plumbing �r� 65. Electrical-Final .
� 15. Rough Electrical-C6i�duit 66. Solac SYstem-Final
lJ
16. Rough Electric�,Wir'?9 67. Fencin� & Access Approval
17. Rough Wiring Sign G8. APPROVED FOR PLASTERJNG
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heacing & Air Conditioning FIRE DEPT�REnUIREMENT
� ' - ^ p T'.y �: u
20!�io(igh F�ctoy'y F�¢+place G�? �� � .S �y ,y ;. � APPROV.S�.�S,'��; F'g}mit #`�._
.. .. .- .� ' .:
21.�bucts, irtStr.uttuce. �.. .. 1 S +: S _:� �" 70:-'tlnde'Rjio e�d dro -
22 _Ducii, VentiFitin` ` � �•= ' � 'ZY "� `�', �
�:., �%� i � y'7 �S �7 k� �1. Produc4Niping�Cias �JOiI
23.:Gas.Bipe-Aough & test r S z� 'z' T•� r�� 72. Undergi�duhd FIuaM- R - ��
24.IRoci€ Framin � 'r r . •�� ' r. ;� .� 'r 5
� 5 A� K ��T y i ., ?3. Undergfpd. St�pJg3�e�'an�C O Gas Q�il
25. Roof Shfething j h .r ��n� p�,�(,�/`/ TQ;-Overhead Hydro K
- �(i`r� � l�
26. �i-61'r Ceiling (Struoturai) &R1�jtj�coat i ,] � '� �� � 7x5.�ry Chgfnical,�,> 'p � � ,�
27 fra!ne and Flashirjg� ��,, � � r � n+ 76. Dry Stanci�ipe-�L K ��
� 28. Latliing& SiBing� � : �<� z .� � "K 7�. FIXED:.�YST�IU�FINlj'�.� .-� �r
' 29, Insulation � ;;.� � � l 't �r � ,F T$, FIRE PIiEV. FIImAL K =' �� "
' 30, Drywall,Jyailmg 3 s� ✓ " _ �r' "'� "�H�AL'�i DEf�'T`.17EQUI�EMENT
-� C.�1 F� Y .S f•= + F
31. P�aster �own�Coatk � ' YT '$ � �i -- 7 . FINA�IWSPECh10N i � ' '�
� . ' . � � . .� , �.��
32.?Electricat Po�Ger f�ete� Final' K � �"� 8¢. FOOD CERTIF�hC�ATE ��SSWUED ,r
r .*1 / �• ^ n *
33.5-Fina'l Eleyetrie. •y ; � � Y. � r Notes. �J '�,it r 7 _ "� r
34.'Fin'dl He3tingi& FTirrConditioniJy: �-� � k S �'�:Z � 5^_
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' 37';find� Fattory Firep�ac� -� � r I F a, l'..
� 38. Final Plumbing K ��'� � � � y � F ` .5 " K � �
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39. Wate'r Servi "Final� s i � r .� ��.e R j:
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40. Gas Service-�nd� k"A =.'T''T' .5 p'n � 4 j L� .; !� �'
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� 41. 5olar pomes�t�'cFin1;1 � _' " k 1' ��`. " '� r
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42.-BackflowPreventer�� � � � (+. >T� �. � -
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-43. Backflow Irr�ation' � S � �' f � -•� ` _ �
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;44. Landscape Ir'oigation Systemr, r � , r Tl J '7 � . v '; ' � ^ �
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'46:.Nandicap.Reguiations - _ � � � '. • -� � " x
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_47, FIlJ'AL STR9CTURE & BU(i.DING /��d����L � 1 r �
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48. _fINAL PLANNING. - - - - � I �' � T� Z � ' ��
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; 49. ElecYric Releese to Edison , ' � �� : ^ . � , � =
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50. �Gas-Release to Southem Califocnia Gas Co i I ' {; " � �• �'r K ' "•
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51. CERiIFICATE OF�OCCUPANC - � � = - � - _
No. Date
JOB ADDR.FSS
I/ 'ECTIONS __ DATE I GROUP 1°t J
L .rground So' y�-�{ U.G. Water r-�_��
.._,_______,..__ ��srrcr-n$I SUBCONTRACTOR
L
OCCUPANCY
VALUE
Form 210—SM-11-59 SB P
� � _
:.
� .
. 1240�
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 817 C067A MEBA. CALIFORNIA '
For Applieanf fo Fill In Compietely
TYPE OR PRINT
BUILDING ..n� t T_—_ oi
� ARCNITEGT
GOSTA MESA CALIFORNIA
TEL.
FEE RECEIVED
�i,.-� JUN 211950
FINANCE DEPT.
cirv oF cosra MESA
APPLICATION FOR PERMIT
BUILDING
�For �O�ffice Use Only
� xdCEIPT NO. � Pp.�i y�1�0�
� G4 9
N6C81V6D !Y DATE HECfiIVED D�TE I68UCO
�. nt� L.� -, n ��.nl �or„r _.- ,esb,,
PIRE
COSTA MESA. CALIFORNIA
419 E. 17th St. ZONING
20 NO.OF UBE OF �
C09tA Mesa . I ruNe ��I BUIL��NG
93 No: Li. 8-1159 �°"� m
DHBCPIPf1pN y
_ __ I NO. OP BLDGB.
68TBACK LINB PNOM
CENrex pp erne6r � REAR YARD �
SIDE YARD I LEFT S� I RIGHi S�
DESCRIPTION OF WORK
OF
� EXTBRIOR
attached ara e. Plan 20CR
I XBq¢9Y ACKNOWL8D0B i11AT 1 NAVE qHAD TX18 APPlJGT10N
ANO eTAT6 TNrT TH8 A90VE IB GORRECT AtID AGRBE TO CAM•
PLY WITH ALL LIiY OftDINANC88 AND 8TAT6 LAWe NlODU.TINO
BUILDINO CON9�'MUR/IO/^N/�'
816NATURH OP c// �I ./ il./ n/
I AUTHORIZED AGEN7 �ke
EVES
ED ALLO
LIN6 9T.)
� �r
TNE AMOUM 9HOWN UNO¢H VALIIATION IB FON TNE
PUItPOBB OP E8TA9LI6HING ♦ PERMIT F88 ONLY.
S �.6�1�1•
CHECK $ ZH•
iEE � 54.