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Home My WebLink About1594 PONDEROSA ST - Building PermitsJob Address: 1594 PONDEROSA ST Suite No Vicinity: WATER HEATER Parcel Nunmber: 13931111 Applicant: EASTMAN, RONNIE Address: 7229 VARNA AVE - NORTH HOLLYWOOD, CA Owner: FOX, DONALD R Address 1594 PONDEROSA ST COSTA MESA, CA Contractor: ALAP ASSOCIATES GP Address: 7229 VARNA AVE Arch / Eng : Address: NORTH HOLLYWOOD, CA PLUMBING PERMIT Phone: (800)444-8865 Zip: 91605 Phone: Zip: 92626 Phone: (800)444-8865 Zip: 91605 License: 771905 Phone: Zip: License: SCOPE OF PERMIT WATER HEATER CHANGEOUT QTY ISSUED BY: Status: ISSUED Applied: 07/19/2001 FEE SUMMARY AMT ISSUE FEE $23.50 Backflow irrigation $0.00 Backflow Preventer $0.00 Bathtub $0.00 Clarifier System $0.00 Connect (Ice,Soda,etc) $0.00 Dental Units $0.00 Dishwasher $0.00 Drain, Floor $0.00 Drain, Rainwater $0.00 Drain, Roof $0.00 Drinking Fountain $0.00 Expansion Tank $0.00 Gas Earthquake Valve $0.00 Gas (1-4 outlets) $0.00 Gas (Over 4 outlets) $0.00 Gas Repipe $0.00 Gas Service $0.00 Interceptors (Grease, Oil) $0.00 Interceptors (Sand Auto ) $0.00 QTY ISSUED BY: Status: ISSUED Applied: 07/19/2001 FEE SUMMARY AMT QTY AMT QTY Laundry Tub / Washer $0.00 0 Sump Pump $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 P -Trap $0.00 0 Trap Primer $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Process Piping (per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Sewer Private Line $0.00 0 Water Closet (Toilet) $0.00 0 Shower $0.00 0 Water Heater / vent $12.30 1 Sink, bar $0.00 0 Water Piping (Inst or Rep.) $0.00 0 Sink, commercial $0.00 0 Water Re -pipe $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 Sink, kitchen $0.00 0 Water Softener $0.00 0 Sink, service/mop $0.00 0 OTHER $0.00 Spa (private) $0.00 0 VIOLATION $0.00 Spa (public) $0.00 0 PLAN CHECK $0.00 REINSPECTION $0.00 0 COMMENTS / SPECIAL CONDITIONS TOTAL CALCULATED FEES: $35.80 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) 7545626 2""-46 (6=) WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the fallowing 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. ❑ 1 have and will maintain Workers' nsation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker m enation I a mer and policy number are: gyp, Cartier. Policy Number: c7C'/Y/ It (This section n ed not be completed It the permit Is valued at one hundred dollars ($100) or less.) ❑ I comity 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 3;00 of th Labor Code, I shall forthwith comply with these provlsl�p / �} -1 Applicant Signature: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER T ) CRIMINAL PEN TIES AND'CIVIL"FINES UP TOME HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I em licensed or p I o pLChapter 9 (commencing With Section 7000) of Division 3 of the Business P fessions q e my license is in full force and effect. Uc. M Class a 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). &defs 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) 01 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 perm+: 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. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 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). ❑ 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 prose or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous materiel? ❑Ves (Section 25505 of the C tomie 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). ........_._.............................an"t.'o" r.plie,..._..._...........................l-d'i__.............an't..............__ iie,..........................................._._...................a"z'..._........................"a' I'............. .................................................................. 2 Does or will the applicant or present or future building occupant need to file a registration torn for acutely hazardous materials? ❑Ves (Section 25533 of the California Health and Safety Cade, 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 th applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes o (Section 2 534 the California Health and Safety Cade 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 Ii en RMPP is presently required has Section 25534 of the California Health and Safety Code been fully compiled with? Ves ❑ No ............................ .............................................................. ......................................................................................... ... ................................................ ....................................................................................... _............................................. difi................ 5 Does or Will the applicant or present or future building occupant require for the work which is the subject of this a pllcelion ege/mit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agonal? Spy 1�N0 (Section 65850.2 of the California Government Code requires that the requested information be fumished on applications fo on-rresidentlal 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? ❑Ves o (It 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 a lied 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? ��Yaas ❑ No ......................................................................................................................................................................................'''............................................................................................................... ....... B (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. acute Of Legal Owner(s) Rn — I And/Or Authorized Applicant / ter) CODE., INSPECTIONTYPE PATE INTITALS CODE. INSPECTION TYPE 2AM INTMA 1616 Fixed System Final Fife Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing ?? a 200 Final Re-Root 210 Final Electrical P 201 Final Block/Retaining Well 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 i.n JLC, 4o COSTA MESA BUILDING -SAFETY DEPARTMENT P. O. BOX 317 COSTA MESA. CALIFORNIA AOR 4MICANT TO HLC /N COMPLETELY TYPE OR PRINT COSTA MESA, CALIFORNIA CITY Costa Mesa, Calif. TNEL O. LI ARCHITECT ar son & LIC. OR ENGINEER V4AAI-4--Ai NO Garden Grove egrove, nc FIRE ZONE FEE RECEIVED FINANCE DEPT. APPLOFfX-6FDS103T0?FMMRMIT BUILDING FOR OAA/CE USE ONLY RECEIPT NO. I 1F7 COSTA MESA, CALIFORNIA 419 E. 17th Street ESTABLISHING A PERMIT ZONING VALUATION ADDRESS PERMIT FEE $ LEGAL LOT I 1� 13487 ZO NO. OF (PLANS USE OF NEW �l DESCRIPTION NO. 6 BLOCK TRACT �I BUILDING UL A.P. NO. APPROVE12 BY L DATE J SIZE 701 X IGGI 1 NO. OF BLDGBlOne YARDS V S OF LOT i now ON LOT1V REQUIRED ALLOWED USE OF None (CENTER LINE ST.) EXISTING BLDG. FRONT FT. IN. SETBACK LINE FROM 501 21 CENTER OF STREET REAR YARD R. SIDE S FT. IN. SIDE YARD ILEFT 51 1RIGHT 51 DESCRIPTION OF WORK NEW I X II ALTERATION( 11 AnDITInN OF SIZE 601 RO IE DING 1OMS 6 STORIES 1 EXTERIOR WALL U t(ROOF COVERING SUCCO COVERING Shake USE OF BUILDING AND WORK TO BE PERFORMED Single family residence with attached garage 1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. (ZED AGENT Dike & 61olegrove, Inc. THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. VALUATION PERMIT FEE $ PLAN CHECK $ 136.00 18.00 $ 16,424 Vffi TOTAL FEE 5 54.00