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HomeMy WebLinkAbout2054 PRESIDENT PL - Building Permits `t410 MF 9 CITY OF COSTA MESA 4 BUILDING DIVISION sr e, >:J,,, ,r6 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER kr: rir..�.al i PERMIT °. ` • E017 41 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 2054 PRESIDENT PL Status: ISSUED Suite No Applied: 04/06/2004 Vicinity: Issued: 04/06/2004 Parcel Nunmber: 42249415 Zi,k_--- Applicant: GARCIA, RAFAEL ISSUED BY. Address: Phone: 714 293-9943 Zip: Owner: TAPPE, ELISSE Address 2054 PRESIDENT PL Phone: COSTA MESA,CA Zip: 92627 Contractor: COAST MANAGEMENT Address: 2010 WEST MARTHA LANE Phone: 714 273-9943 SANTA ANA,CA Zip: 92706 License: 808142 SCOPE OF PERMIT REF:B03-02165; EXPAND EXISTING BEDROOM AND ADD NEW BATHROOM-TOTAL ADDITION IS 268 SQ.FT. ELECT.PERMIT FOR 8 LIGHTS,5 OUTLETS,&4 SWITCHES& 1 MOTOR FOR JACUZZI TUB. REVISED 06/17/04:UPGRADE SERVICE TO 200 AMPS. 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 $8.80 8 up to 50 kva/kw $0.00 0 Recept Outlets $5.50 5 up to 100 kva/kw $0.00 0 Switches $4.40 4 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 $4.75 1 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 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 thispermit. FOR INSPECTIONS CALL: (714)754,5626 • 2446-46(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm underfenalty o(15er(ury one of the following declarations: tl+ 1 ❑ 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 se ion need nal be completed if the permit is valued at one hundred dollars(POO)or less.) ('certify that in the perform ce f 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 C ornl and agree that III become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provis . // G �plicanLSigneture: -1ln,_/< .QC. (—Dew-- G// 7 6/ WARNING:FAILURE.TO SECURE WORKERS'COMPENSATION COVERA IS U LA L AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($10gW0),IN ADDITION TO THE COST OF COMPENSATI 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.# Class x Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agony 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).): Iras 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 purs9anito the Contractors License Laws.). 0 I am axe t under.sec. - Business and Professions Code for this reason: SlgraWre: 4 L l A4a. irate:' 6/i7/ 0 Y • Owner ID verified by driver's license. ❑ es 0 No r—Drivers•License No. Expires` OC 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,end 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. Signature: Date: Division of Industrial Safely 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? ❑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 aEermit for such construction or modification from the South Coast Alr Duality Management District or from any Other air pollution control district or agency? U Yes U No (Section 65850.2 of the California Govemment 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 II 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: CERTFI COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application end state that the information given is correc I agree to comply with to laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above esc' ed perty for inspectio u oses.I agree riot to occupy or allow occupancy of any building authorized by this permiyunhl final in action, P c_�_"ature.O 1 6lL j `te_ ll L-� re Of Ng fOwner(s)" ( Date •} And/Or Authorized Applicant Date CODE 0 INSPECTION TYPE RATE INTIf1ALS CODE INSPECTION TYPE PAM INIITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Root 210 Final Electrical 201 Final 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 11I(c CITY OF COSTA MESA 4` ` - - BUILDING DIVISION 4 > _ l( DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER t.4, �ti . PERMIT ,�-fom r-�`+a� E04-00341 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 2054 PRESIDENT PL Status: ISSUED Suite No Applied: 04/06/2004 Vicinity: Issued: 04/06/2004 Parcel Nunmber: 42249415 Applicant: GARCIA, RAFAEL ISSUED BY: Address: _ Phone: 714 293-9943 Zip: Owner TAPPE, ELISSE ' Address 2054 PRESIDENT PL Phone: COSTA MESA,CA Zip: 92627 Contractor: COAST MANAGEMENT Address: 2010 WEST MARTHA LANE Phone: 714 273-9943 SANTA ANA,CA Zip: 92706 • License: 808142 SCOPE OF PERMIT REF: B03-02165;EXPAND EXISTING BEDROOM AND ADD NEW BATHROOM-TOTAL ADDITION IS 268 SOFT. - . . ELECT.PERMIT FOR 8 LIGHTS,5 OUTLETS,&4 SWITCHES. 4 L11 '(,1,ob( A 1 vaunt_JJt �7b, FEE SUMMARY 9 `JCII'7 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 n 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 $8.80 - 8 up to 50 kva/kw $0.00 0 Recept Outlets $5.50 5 up to 100 kva/kw $0.00 0 Switches $4.40 4 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 . $0.00 • 0 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 1 hp $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 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 2466446(6/00) DECLARATIONS WORKERS'COMPENc-TION 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. 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: (This section need not be completed If the permit is valued et 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' Ccompensatlon laws of California,and agree th t if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these proviwdh �"� Applicant Signature: /�/\ r_Dete / ',WARNING;FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAn�ENALT185 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 license. nder provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business an. - ofessions Code,and my license is in full force and effect.Lic.a • el. Class at ?Contractors Signature: -i • e/tDate< ATD O' 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: 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 Processions 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. ❑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,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. 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? ❑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 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 agermit 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 In A 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 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 agr_' •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-des. bed• operty for inspeciyt.urposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. // Signature Of Legal Owner(s) \ , / ) / Date 11 And/Or Authorized Applicant Date CODE I INSPECTION TYPE INTIIALS coon INSPECTIONTYPE OATS 1N1TIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing /I 200 Final Re-Roof 210 Final Electrical la l —01 201 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 `,sip MF CITY OF COSTA MESA 4 BUILDING DIVISION F • ,,,,,' -,i DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER priprias Ca •• PERMIT 'hagad°' BO -0 65 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 • BUILDING PERMIT Job Address: 2054 PRESIDENT PL Status: ISSUED Suite: Applied: 12/17/2003 Vicinity: Issued: 04/06/2004 Parcel Number: 42249415 Zoning: Applicant: GARCIA, GUSTAVO ISSUED BY: Address: Phone: 714-273-9943 Zip: Owner: TAPPE, ELISSE Address 2054 PRESIDENT PL Phone: COSTA MESA,CA Zip: 92627 Contractor: COAST MANAGEMENT - -Address: 2010 WEST MARTHA LANE Phone: 714 273-9943 SANTA ANA,CA Zip: 92706 License: 808142 Arch : Eng: COOKE &ASSOCIATES Address: Address: 400 E COMPTON BL Phone: Phone: 310-608-5408 COMPTON,CA Zip: License: 90222 License: 51597 SCOPE OF PERMIT EXPAND EXISTING BEDROOM AND ADD NEW BATHROOM-TOTAL ADDITION IS 268 SQ.FT. EXISTING HOME IS 2 BEDROOM 1 BATH. FEE SUMMARY Plan Check: $254.31 Calc Valuation: $24,763.20 Permit: $391.25 Claim Valuation: $0.00 SMIP Res: $2.48 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 • Total: $648.04 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 47-0 Left 5-6 Right 32-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 2 Required: 0 Proposed: 0 • 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 Woo) 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 • E 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 CCCyyyhhhfff�il1 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 pray!7s/ „ .....— WARNING: 9 � J Applicant Signature: L/ (�1 Date: d// WARNING:FAILURE TO SECURE RAKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL ENALTIE AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE(S100.DDo),IN ADOMON 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 herebyaffirm that I am licen u er visions of Chapter 9(commencingwith Section 7000)of Division,3 of ti]Business Professions Code,and my license is in full p/q P Ifo and effect.Lic.a /If L Cl�ss# Contractors 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). Lenders 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).): ❑ 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 em exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,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 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 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 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 California Health end 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 LJ No (Section 65850.2 of the California Govemment 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'lyes",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 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. Sign e Of Legal Owner(s) ate D (�/ C -� And/Or Authoriz:. .•I c / D(�ate/ / CODE I INSPECTIONTYPE au INTITIALS SODS( INSPECTION ME PAIS INDRAL4 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 � 144.01 204 Final Demolition 250 Final Building/Occupancy 16-11-1-16-11-1-0)1' -O"!/ M1 pST�b 9Izuntra • CITY OF COSTA MESA BUILDING DIVISION >• , DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER ww f l � �a • PERMIT IPPW44' 4-00245 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT • Job Address: 2054 PRESIDENT PL Status: ISSUED Suite No Applied: 04/06/2004 Issued: 04/06/2004 Vicinity: ISSUED BY: Parcel Nunmber: 42249415 Applicant: GARCIA, RAFAEL Address: 2010 WEST MARTHA LANE Phone: 714 273-9943 SANTA ANA,CA Zip: 92706 Owner: TAPPE, ELISSE Address 2054 PRESIDENT PL Phone: COSTA MESA,CA Zip: 92627 Contractor: COAST MANAGEMENT Address: 2010 WEST MARTHA LANE Phone: 714 273-9943 SANTA ANA,CA Zip: 92706 License: 808142 Arch / Eng: _ Address: - • Phone: Zip: License: - SCOPE OF PERMIT REF:B03-02165;EXPAND EXISTING BEDROOM AND ADD NEW BATHROOM-TOTAL ADDITION IS 268 SQ.FT. PLUMBING PERMIT IS FOR, 1 SHOWER, 1 SINK,& 1 BATHTUB. • FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 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 $0.00 0 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 $9.80 1 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 0 Sewer Private Line - $0.00 0 Water Closet(Toilet) $9.80 1 / Drain,Roof $0.00 0 Shower $9.80 1 Water Heater/vent $0.00 0 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) . , 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: (_Th�s section need not be completed if the permit is valued at one hundred dollars($100)or less.) .L� I&artily 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 Cal lnmi and a re hat If I should become subject to the workers'compensation provisions of Sectlo 3700 of the Labor Code,I shall forthwith damply with these provisi n (Applicant Signature: Dater WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMI ENALTI ES AND CIVIL F1NES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDrION 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 licens, urner p{gvisjons of Chapter 9(commencing with Section 7000)of Division 3 of the Business aail Professions Code,and my license is in full • force and'effect.Lie.# gc' r CD", a /✓ - 'Contradtor'sSignature: • « if ` Da ,/ (Ifni ( 1,. 4'� 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).): ❑ I,as owner of the properly,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 properly,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.-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,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,Califomla Administrative Code). 9 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 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 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 Califomla 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 Califomia Health and Safety Code been fully complied with? 0 Yes ❑No 5 Does or will the applicant or present or future building occupant require for the wort;-which Is the subject of this application a ermit 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 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? ❑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 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. Sign: Of Legal Owner(s)Crt- /Y- aate4,(aft A •r•r AulhonZntApplicant D CJ 'ate 000E# INSPECTIONTYPE PEE INTIRALS CODE( INNSPECTIONTYPE PAIS QUAL& 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing JO-14-OW [�!J w 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 ORANGE COUNTY BUILDING DEPARTMENT APPLICATION FOR PERMIT 1— 636 NorthN , B7RRdism1RY BUILDING SANTA ANA, C/ 1RNIA / FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY RECEIPT NO. PERMIT NO. ADD ESS 2054 President Place Q 333 SCHOOL DIST.costa Mesa RECEIVED BY DATE RECD. DATE ISSUED OR TOWN V L+ RECEIVED NEAREST Oak St_ IC9 `'I q—P —h 3 �/ —3 0._3 CROSS ST. OWNER Oneida Homes Inc. ADDRESS �® S f lik f,�,.,t 1t ADDRE59363 OOL Wilshire Blvd./t c SLC OR T TOWN IST. 1 �2�f.._ ,I s Rov r1 y H111 q TEL 54361 CROSS Stee. tW�.. CITY NO. NEAREST ,[� ARCHITECT,O LIC. ZONE NO. OFJ! TYPE GROUP ENG!NEER UFan & McKerra chem he' / I PLANS ADDRESS 2110 E.Walnut-Pasadena ' 1 i Cr" j Y ]]11 BYPROVED/'A�lol DATE "('('.]3- CONTRACTONeWpOrt Vista No.135882 �y' Ir/_ ADDRESS 9363 Wilshire-Beverly Hills CORRECTIONS LEGALLOT ^ DESCRIPTION I NO. 1 93 BLOCK I TRACTI 7n 12 (ATTACH METES & BOUNDS) 1 NO.OF BLDGS. SIZE OF LOT 60 x 120 NOW ON LOT 0 USE OF I NO. OF I NO. OF EXISTING BLDG. FAMILIES ROOMS -SET . CENBACK TER OFINE ST STREET 50 ft. SIDE YAREE ..51 DESCRIPTION OF WORK 0 Al • NEW I X I ALTERATION I I ADDITION I O Z r REPAIR I MOVING I DEMOLISH D BUILDING f�fItf� OF „y SIZE 1034 sq iRAPMS 5 SJORI ES 1 .//� EXTERIOR WALL0 4_ .., COVE (�Shing P. d/�®' COVERING COVERING om o l 'S USE OF NEW BUILDING Be side nde-At t.Carport Vp7 I APPROVALS FOUNDATION: LOCATION INSPECTOR '(DATE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS UNDER-PINNING RMIALS I -,E;//) / (/;S7 3 APPLICATION AND STATE THAT THE ABOVE IS CORRECT //�/;��,f� 1 (y 1 AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FRAME:BRACING. BOLTS TOPS. /W- //_W. J "A AND STATE LAWS REGULATING BUILDING CONSTRUCTION. --s TNS../ CoLATH. INT. . f(/- 1 7 -� SIGNATURE OF Newport Vi CLATH. EXT. PERMITTEF y/ o /1/� PLASTER, INT. n �/ (� AUTHORIZED AGT/ �(Ka 1"11.111111111.1.4PERMIT PLASTER, EXT. /A"• 7L7 ,j (((SSS��/ (� FEE MASONRY REINFORCED I VALUATION $4830.00 PLAN CHECK S di.' BOND BEAM TOT® FEE S/ FINAL 3- -3;5 y 5M S-9(I-9S . — - - . . . - W a Z - . . - _ 'a a cc - o — • _ ._ 3'S_ - _ ... - ' .z - - u I STREET. - I PLOT PLAN - . Show location and distances from - - property line and between buildings. - — . ..^ _ _ . .tet . �.. _ 1 y ...2. .. ' . ' -- ..' r-, ' -- •• 1 ` .