HomeMy WebLinkAbout1218 DONEGAL PL - Building PermitsEW -Webb Engineering, Inc ew-webb.com
2023 Chicago Ave B-14
Riverside CA 92507 Phone (951) 76&2050 Fax (951) 788-2075
COMMUNICATION / TRANSMITTAL
June 6, 2006
Attention: 1D1
Pat DeCrona
De Crona Addition
1218 Donegal Place
Costa Mesa CA 92616
Phone (949)453-3705
Fax 4=4)369-OA33
GKWI-4S3-3i5Yi
Pat,
Our Job Number: 2005-485
De Crona, Addition, Costa Mesa, Dr Remodel
1218 Donegal Place
Costa Mesa CA 92626
Total Pages Including this Cover: 1
Please call (951) 788-2050 regarding reception problems.
You may use 2500 psi concrete in place of the 4500 psi concrete called out in note #13 on
sheet D-2 of you plans. Please contact us if you have any further questions.
Thank you,
EW -Webb Engineering, Inc., by
,�';r4 ExP.6.30.2006
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(714) 754-5273 - Fax (714) 754-4856 • www.ci.costa-mesa LDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
1218 DONEGAL PL
Suite:
Vicinity:
Primary Occ:
R-3 Dwellings/ Cony Res <10
Parcel Number:
14104613
Applicant:
DE CRONA, PATRICK
Address:
1218 DONEGAL PL
COSTA MESA, CA
Owner:
DE CRONA, PATRICK J
Addfess
1218 DONEGAL PL
COSTA MESA, CA
Contractor:
OWNER -BUILDER
Address:
Zip:
Type of Construction: V -N
Zoning: R1
Phone: 714-3E
Zip: 92626
Phone:
Zip: 92626-2750
Phone:
License: 000000
Status:
Applied:
,.,- Issued:
ISSUED BY:
ISSUED
03/10/2006
05/05/2006
sly
90
Arch : Eng: EW-WEBB ENGINEERING INC
Address: Address: 2023 CHICAGO AVENUE
_ Phone: STE B14 Phone: 951-788-2050
RIVERSIDE, CA
Zip: License: 92507-t4icense: C37384
SCOPE OF PERMIT�r
CONSTRUCT 903SF ADDITION TO AN EXISTING SINGLE -STORY SFD. WORK TO 11, M �OM/BATH WITH A WALK-IN C
RELOCATION OF THE LAUNDRY ROOM, AND ANEW FAMILY ROOM. ANEW 44SF WILL T CTED AT THE FRONT ENTRY.
REF: MM -02-25 A ®II „
3 BEDROOM/213ATH WILL BECOME 4 BEDROOM/3 BATH '" —e
PLANNING: ` "�-
LOT SIZE = 8.230 SO.
RESIDENCE + GARAGE
= 2,521 SO. Ff.
DRIVEWAY c 243 SO. FT.
LOT COVERAGE = 2,764 SO. FT. (34%)
OPEN SPACE = 5,492 SO. FT. (67%)
6/6/06: REVISED PLANS TO INSTALL A BAY WINDOW TO FOUNDATION, INSTEAD OF A PRE -HUNG BAY WINDOW.
FEE SUMMARY
Plan Check: $726.02 Calc Valuation: $121,347.68
Permit: $1,116.95 Claim Valuation: $0.00
SMIP Res: $12.14
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $1,855.11
PLANNING & ZONING
SETBACKS
MAIN STRUCTURE Front 20- 0 Rear 37-0 Left 13-6 Right 5-0
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) 7545626
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
work for which this permit is issued.
❑ 1 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 carder and policy number are:
Carder: Policy Number:
(This section need not be completed if the permit is valued at one hundred dollars ($100) or less.)
❑y 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 provisions.
Applicant Signature:
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,ODo). 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. If Class N
Contractors Signature: _ Date:
CONSTRUCTION LENDING AGENCY;
❑ 1 hereby allimt 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
sub' is the applicant to a civil penalty of not more than five hundred dollars (5500).):
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 Cade: 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. It, 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: T11o4ontractors License w s not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractors)
licens ur t t he ra to Ic nse Laws.).
❑ I a e m t d ec Business and Professions Code for this reason:
Signamr :
Owner I v ifi b driver's ansa. ❑ Yes ❑ No Drivers
.License No. Ex fres
Verificatio nership 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 feel 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, talsework, or demolition or dismantling therect, 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? ❑ Yes ❑ 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).
........................................................................................................... .............................................................................................................................................. .......................................... ........................... ................................................. I............
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? C] Yes ❑ 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 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 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? ❑ Yes ❑ No
(If "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
..................................................... .............................................................................................................................................................................................................................
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? El Yes [I 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:
CE ATE OF CO CE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and slate that the information given is
co act. gre I I i all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
a ova- ri r or spection purposes. I agree not to occupy or allow occupancy of any building authorized by this permi( UJI iinpl inspection.
Signage 01 Legal Owners) /V•/ D/a��/O
And/Or Authorized Applicant Date
CODE 1 INSPECTION TYPE PATE INITIAL�4 CODEII INSPECTION TYPE DATE INTMAL6
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 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
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.(SIALDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 1218 DONEGAL PL
Suite:
Vicinity:
Primary Occ: R-3 Dwellings/ Cong Res <10 Type of Construction: V -N
Parcel Number: 14104613 Zoning: R1
Applicant: DE CRONA, PATRICK
Address: 1218 DONEGAL PL
Phone: 714-360-0021
COSTA MESA, CA Zip: 92626
Owner: DE CRONA, PATRICK J
Address 1218 DONEGAL PL
Phone:
COSTA MESA, CA Zip: 92626-2750
Contractor: OWNER -BUILDER
Address:
Phone:
ISSUED BY:
Status: ISSUED
Applied: 03/10/2006
Issued: 05/05/2006
Zip: License: 000000
Arch : Eng: EW-WEBB ENGINEERING INC
Address: Address: 2023 CHICAGO AVENUE
Phone: STE B14 Phone:951-788-2050
RIVERSIDE, CA
Zip: License: 92507 License: C37384
SCOPE OF PERMIT
CONSTRUCT 903SF ADDITION TO AN EXISTING SINGLE -STORY SFD. WORK TO INCLUDE A NEW MASTER BEDROOM/BATH WITH A WALK-IN
RELOCATION OF THE LAUNDRY ROOM, AND A NEW FAMILY ROOM. A NEW 44SF PORCH WILL BE CONSTRUCTED AT THE FRONT ENTRY.
REF: MM -02-25
3 BEDROOM/2BATH WILL BECOME 4 BEDROOM/3 BATH
PLANNING:
LOT SIZE = 8,230 SQ. FT.
RESIDENCE + GARAGE = 2,521 SQ, FT.
DRIVEWAY = 243 SQ. FT.
LOT COVERAGE = 2,764 SQ. FT. (34%)
OPEN SPACE = 5,492 SQ. FT. (67%)
Plan Check:
$722.38
Permit:
$1,111.35
SMIP Res:
$12.02
SMIP Com:
$0.00
Other:
$0.00
Inspection:
$0.00
Total: $1,845.75
SETBACKS
MAIN STRUCTURE Front 20-0 Rear 37-0
ACCESSORY Front 0-0 Rear 0-0
FEE SUMMARY
PLANNING & ZONING
Left 13-6
Left 0-0
Calc Valuation:
Claim Valuation:
Right 5-0
Right 0-0
$120,146.48
$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.
r/
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
eano-aa law)
I
WORKERS' COMPENSATION DECLARATION:
,
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and willmaintaina 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 carder and policy number are: .
Carder: Policy Number:
(Th' section need not be completed if the permit is valued at one hundred dollars ($100) or less.)
i
Lcertity-that in the pertormanc of the work for is his permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
/compensation laws o e or e, a at t ould become subject to the workers' compensation provisions of Section 3700 of the Labor Coda, I shall Forthwith
comply with the p v' i s
/
App12an1*Signetu�-�7I5I�
WARMNG:'FAILURE TO SECORKERS' PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
THOUSAND DOLLARE($10q , 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. Lia If Class N
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
,a b'ects thapplicant to a civil penalty of not more than five hundred dollars ($500).):
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.
704x, 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 do s not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractors)
to ih Contract rs Li se Laws.).
licensOofnarship
❑ I am es Business and Professions Code for this reason:
Signature:—
Owner ID Vdrivers lic e. Yes ❑ No DrivelsLcense.No.r, � Expires: 10Verification
by (type of doc Ant, i.e. - property tax bill or deed): -� L_�
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, talsework, 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, 1 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
materiel? ❑ Yes ❑ 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 teand...........................................................................................................................-.................................................................
............................ ................................................
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.
.......................................................................................... ................................................... ............. ........................ .............................................................. ................................... .................. .._................................ ....................... I.........................
4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No
........................................_..............................................................................................................................................................................................._.................................................................................................................................I............
5 Dces or will the applicant or present or future building occupant require for the work which is the subject of this a plication a permit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes J No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
..................................................................................................................................................................................................................................................................................
s will eny ry Dart of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑ No
(If "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
............................................................................................................................................................................................................................................................................................................................................................................................
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject Of this
application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
............................................................................................................. ..........-..................................................................
e (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:
CERTIFI ATE 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
correc I gr e t mply611hill laws and city ordinances relating to building construction, and authorize representatives of the Ciry of Caste Mesa to enter upon the
-de ri sd ro artye io Purposes. I agree not to occupy or allow occupancy of any building authorized by this per it until final inspection.
S��olo
Signature Of Legat Owner(s)-
And/Or Authorized Applicant Date
CODE a, INSPECTIONTYPE IIITMALS CODE# INSPECTIONTYPE 266 IINTMALSS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Fi I Plumbing
200 Final Re-Roof 0 at Electrical
201 Final Block/Retamin Final Fire Pr tion
202 Final Factory FI a Place 220 Final Plan Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
OWNER-BUILDER
VERIFICATION
Address: /2—/p Permit•#: ' -:M
A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and, as
a condition precedent to issuing a building permit, require the completion and require the return of, an owner -
builder verification. _
Attention Property Owner:
An `owner -builder' building permit has been applied for in your name and bearing your signature.
Please complete and return this information in the envelope provided at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit will be issued until this
verification is received.
0�_,I personally plan to provide the major labor and materials for construction of the proposed
property improvement.. IIZYes ❑ No
have ave not) tYldul- signed an application for a building permit for
e
the proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction:
Name
Address City
Phone ( ) Contractor's Lic. No.
4. I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise and provide the major work:
Name
Address City
Phone ( ) Contractor's Lic. No.
5. I will provide some of the work but I have contracted (hired) the following persons to
provide the work indicated:
Name Address Phone Type of Work
104246 (Rev. 11/04)
I hereby affirm that I have received a copy of the information set forth in Section 19830 of the State of
California Health and Safety Code and have completed the above information to the best of my personal
knowledge, in compliance with this State law.
L-1' (Printed or Typed)
CC DD;L. # OR S.S. #
Date:. 515'�lO
LI- —
For more information call City of Costa Mesa Building Division at (714) 754-5273.
104246 (Rev. 11104)
To:
Applicant:
Address:
Telephone
NEWPORT -MESA UNIFIED SCHOOL DISTRICT
CERTIFICATE OF COMPLIANCE OF DEVELOPMENT FEES
PURSUANT TO AS 1600 AND AS 181
5901
(✓) City of Costa Mesa District Receipt No.
( ) City of Newport Beach /
( ) County of Orange Plan Check No 8o(a -tV313
Tract/Parcel and Lot Number(s):
Location of Project: 1a
Number of Square Feet of:
Residential Space
Commercial and
Industrial Space
CommercialAndustrial Project is: (Check One)
Warehouse
R&D
_ Movie Theater
Mini -storage
Heavy Industrial
Regional Shops
Light Industrial
This project is exempt because
$1.64
x $ .30
Motel
_ Bank
Neighborhood Shops
Racquet/Health
Hotel
_ Medical Office
Office Park
Total I )Lei 3 ^Po
Total
Preschool
Auto Repair
Hospital
Large Office
Office Bldg.
Restaurant
Fast Food
This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code sections
53080 and 65995. The Building Permits for this square footage in this proposed development may now be issued by your jurisdiction.
Checks are to be made payable to Newport -Mesa Unified School District.
Authorized
The above representation as to square footage is true. Applicant agrees that if it is later determined that such representations are not
true, then this certificate shall automatically terminate and the a opnate City/County shall be notified.
Date: 516I01� — (:�w
February 13, 2009
CITY OF COSTA MESA
P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200
DEVELOPMENT SERVICES DEPARTMENT
BUILDING DIVISION
COURTESY NOTICE OF PERMIT EXPIRATION
Patrick J. De Crona
1218 Donegal Place
Costa Mesa, CA 92626-2750
PERMIT NUMBERS:
PROJECT ADDRESS:
FOR:
B06-00393, E06-00807, M06-00747, P06-00498
1218 Donegal Placf, Costa Mesa, CA
Room Addition
Our records indicate the above listed permit(s) were obtained for property improvements or
alterations at the above address. Per the 1997 Uniform Building Code, Section 106.4.4
Expiration, permits are valid for 180 days from the date of such permit, or the date of the last
inspection for the project.
Our records do not show an inspection for these permits within the last 180 days nor have
they had an approved final inspection. If you have a signed inspection card showing that an
inspection was made within 180 days, or that the final inspection was approved, please
contact this office so we may correct our records. If you do not have an approved final
inspection, your permits will expire on February 25, 2009. Additional fees will be required to
finalize expired permits.
Requesting an inspection—If you need to request an inspection, please call our Inspection
Request Line at 714-754-5626.
Requesting an extension—If you wish to request an extension, requests must be made in
writing addressed to Ed Petros, Chief of Inspection, at the above address, detailing
circumstances and listing an estimated date of completion.
If you have any questions, please contact the Building Division at 714-754-5273, between
8:00 a.m. and 4:30 p.m., and a staff member will assist you. The accuracy of records
affecting your property is our goal and we appreciate your working with us to resolve this
matter.
Since
"r�eI
f`
Barbara J. art
Office Specialist II
Building Division (714) 754-5273 • Code Enforcement (714) 754-5623 • Planning Division (714) 754-5245
FAX (714) 754-4856 • TDD (714) 754-5244 • w .ci costa mesa ca us
Job Address: 1218 DONEGAL PL DATE-6
� 11 C 6
Suite No
Vicinity:
Parcel Nunmber: 14104613
Applicant: DE CRONA,PATRICK J
Address: 1218 DONEGAL PL
Phone
COSTA MESA, CA Zip
92626-2750
Status: ISSUED
Applied: 07/21/2006
Issued: 07/21/2006
ISSUED BY: CA
Owner: DE CRONA,PATRICK J & MICHELLE RV�� ;-!
Address 1218 DONEGAL PL
Phone: 714-360-0021 �$
- COSTA MESA, CA Zip: 92626-2727 50
Contractor: OWNER -BUILDER
Address:
Phone:
Zip:
License: 000000
SCOPE OF PERMIT
CONSTRUCT 903SF ADDITION TO AN EXISTING SINGLE -STORY SFD. WORK TO INCLUDE A NEW
MASTER BEDROOM/BATH WITH A WALK-IN CLOSET, RELOCATION OF THE LAUNDRY ROOM, AND A NEW
FAMILY ROOM. A NEW 44SF PORCH WILL BE CONSTRUCTED AT THE FRONT ENTRY.
REF:1506-00393
24 LIGHTS 27 OUTLETS 15 SWITCHES 1 SERVICE T02 00 AMP AND 1 SUBPANEL.
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) /
I
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. J
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
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
$24.92
24
.......:.........up to 50 kva/kw
$0.00
0
Recept Outlets
$27.11
27
. .................up to 100 kva/kw
$0.00
0
Switches
$16.50
15
- :.................over 100 kva/kw
$0.00
0
Non Res Appl
$0.00
0
Low Voltage Equipment
$0.00
0
Res App]
$0.00
0
Low Volt Wiring System / Ckl
$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 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
Sub panel to 200a
$30.50
1
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
$153.03
Intermed Pole
$0.00
0
rnuueurc� r On=^l car ^^L4MM1^L10
i
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) /
I
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. J
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
.Ap�
WORKERS' COMPENSATION DECLARATION:
I hereby affirm undei 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.
[] 1 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:
(chis 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 provisions.
Applicant Signature: Date:
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 ADDITIONTOTHE COSTOF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706OFTHE 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. 1f Class a
Contractor's Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby affirm that there is a construction lending agency for the performance of the wont 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 1 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
so ltl 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.). ,
1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The contractors Licen does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s)
license su t t in on a r License Laws.).
❑ 1 am e t of s c. Business and Professions Code for this reason:
Signa Dafen Q' Zi Ob
Owner ID a Ili by drives license. as ❑ No Lice ns o. Expires:�—
�Driver:s
Verification wnership by (typed document, i.e. - property tax bill or deed):
i
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 Industnal 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? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be tiled 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 a pplicaN or present w 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? ❑Yes ❑ No
..................................................................................................................................................................................................................................................................................................................................................................ific...tion...
5 Does or wilt he applicant or present or future building occupant require for the work which is the subject this a plication a permit for such construction or modification
�
c Yes jJ No
toragency?
from the South Coast Air Quality Management District or from any other air pollution control district or agency?
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
................................................ .................................................................................................... ._..................................... .................. .... ..................... ............................................... .............................................................................................
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(If "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
.......... .... ............... ............ ........... .... ................................. ............................................................................... ........................................................................................ ... ........................................................................................................................
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No .....
............. ....................................................... ............................... .........................
.. .
...................................................................................................................................................._..................................................................................................
8 (If "yes", attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
NCE AND AUTHORIZATION OF ENTAV: I certify under penalty of perjury that I have read this application and state that the information given is
ith a laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
p ti n purposes. agree not to occupy or allow occupancy of anybuilding authorized by thispermit until final inspection.
lic;r7r
rSig re Of Legal Owner(sJa
�� ��
And/Or Authorized Applicant Data
Copg N. INSPECTION TYPE PATE INTRIALS CODE N INSPECTION TYPE PATENl TNJ965
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 BuildinglOccupancy
,r
eat od emu �ed�g arm
' OWNER -BUILDER
VERIFICATION
Address:
Permit #:
A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and, as _
a condition precedent to issuing a building permit, require the completion and require the return of, an owner -
builder verification.
Attention Property Owner:
An `owner -builder' building permit has been applied for in your name and bearing your signature.
Please complete and return this information in the envelope provided at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit will be issued until this
verification is received.
1. I personally plan to provide the major labor and materials for construction of the proposed
�property improvement. ElYes
"❑ No
(� 2. /j (have/have not) l LSF signed an application for a building permit for
the proposed work.
hhave contracted with the followin person (firm) to provide the proposed construction:
Name 1 IIF' K
Address City
Phone ( ) Contractor's Lic. No.
4. I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise and provide the major work:
Name
Address City
Phone ( ) Contractor's Lic. No.
5. I will provide some of the work but I have contracted (hired) the following persons to
provide the work indicated:
Name Address Phone Type of Work
104246 (Rev. 11104)
I hereby affirm that I have received a copy of the information set forth in Section 19830 of the State of
California Health and Safety Code and have completed the above information to the best of my' personal
knowledge, in compliance with this State law. .
�L2ate, -1 61 I010
2 . )(EGeeMp�
(Printed or Typed)
C.D.L. # OR,S.S. #
For more information call City of Costa Mesa Building Division at (714) 754-5273.
1042-46 (Rev. 11104)
February 2, 2010
CITY OF COSTA MESA
P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200
DEVELOPMENT SERVICES DEPARTMENT
BUILDING DIVISION
COURTESY NOTICE OF PERMIT EXPIRATION
Patrick De Crona
1218 Donegal Place
Costa Mesa, CA 92626
PERMIT NUMBERS: B06-00393, E06-00807, M06-00747, P06-00498
1218 Donegal PI., Costa Mesa, CA
FOR: Additional Square Footage
Our records indicate the above listed permit(s) were obtained for property improvements or
alterations at the above address. Per the 1997 Uniform Building Code, Section 106.4.4
Expiration, permits are valid for 180 days from the date of such permit, or the date of the last
inspection for the project.
Our records do not show an inspection for these permits within the last 180 days nor have
they had an approved final inspection. If you have a signed inspection card showing that an
inspection was made within 180 days, or that the final inspection was approved, please
contact this office so we may correct our records. If you do not have an approved final
inspection, your permits will expire on February 15, 2010. Additional fees will be required to
finalize expired permits. ,
Requesting an inspection - If you need to request an inspection, please call our Inspection
Request Line at 714-754-5626.
Requesting an extension -If you wish to request an extension, requests must be made in
writing addressed to Bill Nunes, Chief of Inspection at the above address, detailing
circumstances and listing an estimated date of completion.
If you have any questions, please contact the Building Division at 714-754-4871, between
8:00 a.m. and 4:30 p.m., and a staff member will assist you. The accuracy of records
affecting your property is our goal and we appreciate your working with us to resolve this
matter. \
Sincerely,
t W
Barbara J. Zwart
Office Specialist II
Building Division (714) 754-5273 - Code Enforcement (714) 754-5623 - Planning Division (714) 754-5245
FAX (714) 754-4856 • TDD (714) 754-5244 • w .ci.costa-mesa.ca.us
(714) 754-5273 • Fax (714) 754-4856 • www.ci.cosla-mesa.ca.us
Job Address: 1218 DONEGAL PL
Suite No
Vicinity: ADDITION
Parcel Number: 14104613
Applicant: DE CRONA, PATRICK
Address: 1218 DONEGAL PL
COSTA MESA; CA
MECHANICAL PERMIT
Phone: 7P360-0021
Zip: 92626-2750
DE CRONA,PATRICK J & MICHELLE R
1218 DONEGAL PLS
Z - Ph -
COSTA MESA, CA
y
OWNER -BUILDER
77 FAIR DR!Y.E, COSTA MESA, CA 92626
Sta�ISSUED
lied: 11/20/2006
oA'S Issued: 11/20/2006
ISSUED BY:
SCOPE OF PERMIT
MECHANICAL PERMIT TO CONSTRUCT 903SF ADDITION TO AN EXISTING SINGLE -STORY SFD.
REF#'B06-00393
WORK TO INCLUDE: 1 ISNT FAU < 100 K BTU, 1 REPAIWALT COOLINGIHEAT, 1 HOOD
W/MECH EXHUST, 1 VENT FAN/SINGLE DUCT. ,
Quantity
ISSUE FEE
$23.50
Inst FAU <100 k BTU
$14.80 1
Inst FAU >100 k BTU
S0.00 0
Repair/ Alt Cooling/Heat
$13.70 1
Inst / Rep. Recess Wall Hlr
$0.00 0
Refrig Sys <100 k BTU
$0.00 0
Refrig Sys >100 k BTU
$0.00 0
Gas Piping
$0.00 0
Factory Fireplace
$0.00 0
Hood w/Mech Exhaust
$10.65 1
VAV Box
$0.00 0
Vent Fan / Single Duct
$7.25 1
Appliance
50.00 0
Fire Dampers
$0.00 0
Smoke Dampers
50.00 0
Inst or Relocate App) Vent
$0.00 0
Air Handlers < 10000cfm
$0.00 - 0
Air Handlers> 10000cfm -
$0.00 -0
Floor Furnace _
$0.00 0
Floor or Suspend Heater
$0.00 0
FEE SUMMARY
Repair / Alt Absorbtion Unit
"- Repair/ Alt Refrigeration Unit
Venlillalion System
Evaporative Cooler
Commercial Incinerator
Domestic Incinerator
Compressors / Absorption Systems
- Upto3hp/100k BTU
3 To 15 hp 1500 k BTU
15 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 BTU
Boilers
Up to 3 hp
3 To 15 hp
15 to 30 hp
30 to 50 hp
Over 50 hp
Other Mechanical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
TOTAL CALCULATED FEES
COMMENTS / SPECIAL CONDITIONS
1+2
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
S0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
S0.00
$0.00
$0.00
$69.90
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California,6tstutes 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, orif wo 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 comp) th 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
244646 (6100)
DECLARATIONS
WORKERS' COMPENSATION DECLARATION: '
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
work for which this permit is issued.
❑ 1 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 carder and policy number are:
Carder: Policy Number:
(This action need not be completed i/ the permit is valued at one hundred dollars ($100) or less.)
(Th
that in the pert0 of 1 Work for hi this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensefiondewsoi elifor , a d a e t t i ould become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
-
comply with these pro
Applicant Sig Dater ((�Z0�0�
IR
W9RNIN0: FAILURE TO SECU ERS' tRNA ENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,0001, ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION =6 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
farce and effect. Lic. o Class N
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY: - e,
❑ 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
sub' cts the applicant to a civil penalty of not more than five hundred dollars ($500).):
0§f, 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 off ared 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 con ctors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractors)
license pur nt t t e C nt for 'c a Laws.).
❑ I am axe pt untl C. Business and Professions Code for this reason:
Signature: --- =Date: + Zo Ob I r
(viler to Verdi U dri ers license. ❑Yes ❑No Dd aPekLicense'No`.� •Eiplres:,,_
Verification of Qw Ip 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 thirly-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title 8, California Administrative Cade).
❑ 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 e
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? ❑ Yes ❑ 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 er 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 aqua 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
Fir
RMPP is presently required, hes Section 25534 0l the California Health and Safety Cade been fully complied with? [I Yes
❑ No
5 Does or will the applicant or present ar fpture builtling occupant require for the work which is the subject of this a plication eEerm. R for such construction or motllficaiton
from the South Coast Air Quality Management District or from any other air pollution control district or agenuyt Yes (� No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
.........—.._................__._..........................................._._._...._.................__....................._.._........................___.......................__..._............. __.......................................................................... _.........................................
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(It 'yes", the facility must meet the requirement of Sections 25534 and 42303 of the Calitomia 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 proscribed by Califomla Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
..............___......................_.....................___.___.........._............._.._.............._.._....................__........................._............._.... _...................... _.... _.................... _._.__............ ___............. _... _................. _..
B (It yes', attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: 1 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 LIANCE AND A ORl7AT10N OF ENTRY: I canify, under penalty of perjury that I have read this application and state that the information given is
corect. I agree o comp W h all s t I w city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above-descdb d prope fo inspe ion as . I agree not to occupy or allow occupancy of any building authorized by this l'rrjl.I u yl final inspection.
2 lige
r-$ gpatn( d-Le alOwner(s)
a-
And/Qr Authorized Applicant Data
CODE If. INSPECTIONTYPE PATE INTMA CODEJI INSPECTION TYPE 2&g IITRIGLS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
2DO Final Re-Roof . , 210 Final Electrical
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
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.cams 77 FAIR DRIVE, COSTA MESA, CA 92626
PLUMBING PERMIT
7-1
b
F10
Job Address: 1218 DONEGAL PL Status: ISSUED
Suite No DE �� Applied: 06/22/2006
Issued: 06/22/2006
Vicinity:
ADDITION AND LAUNDRY ROOM
FEE SUMMARY
Parcel Nunmber:
14104613
Tl�'
-QTY
'
AMT
Applicant:
DE CRONA, MICHELLE RAddress:
$23.50 -- Laundry Tub//.Washer ---$0.00/ .%'0 r
-..,
:'� Sump Pump �
1218 DONEGAL PIL_Phone
,
0
Backflow irrigation
$0.00 0 •'^
7]4-36
_ $0.00 ;/ 0'
- �i�"'
COSTA MESA, CA / 1 �: ,'
, r Zip - 92626-2750
0
Backflow Preventer
$0.00 0
Owner:
DE.CRONA,PATRICK J 8 MICHELLE:R
Address
1218 DONEGAL PL._-*-'_-
0
Bathtub
$0.00 0_,
.�
Phone: 714-360-0021
-
$0.00
,,COSTA MESA, CA/
Zip 92626-2750
$0.00 0
Process Piping (per 10 fl)
� $0.00-: , '0
ISSUED BY:
®%**�
Contractor: OWNER BUILDER
Address:,c
Phones!-,
Zip'
License: >000000,
_SCOPE OF PERMIT
PLUMBING PERMIT TO CONSTRUCT 903SF ADDITION AND RELOCATION_' OF LAUNDRYROO, M TO AN'
EXISTING -SINGLE-STORY SFD.�
- .REF#: B06-00393
WORK TO INCLUDE: -1 SHOWER 1 -WASH BASIN,,1 WATER CLOSET-,1,WATER REPIPE AND TGAS 1
(14 OUTLETS) ✓.:�_.,- .,r /rr sC_lia�s .-..1 .. .r �� �I __. l l .
COMMENTS /-SPECIAL" CONDITIONS
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
J
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
2446-46(11Y00)
FEE SUMMARY
AMT QTY "_-",'„��,-�,AMT
-QTY
'
AMT
OTY
ISSUE FEE
$23.50 -- Laundry Tub//.Washer ---$0.00/ .%'0 r
-..,
:'� Sump Pump �
.
-$0.00'
,
0
Backflow irrigation
$0.00 0 •'^
-Landscapelrrigation , =
_ $0.00 ;/ 0'
,;;
-- Swimming Pool - •
f
$0.00
0
Backflow Preventer
$0.00 0
P -Trap
$0.,00", 0
Trap Primer ,`
$0.00
0
Bathtub
$0.00 0_,
Pressure Regulator
{$0.000
Urinal,!
$0.00
r 0
Clarifier,System ` `'
$0.00 0
Process Piping (per 10 fl)
� $0.00-: , '0
Vacuum Brkr Bkflow(1�4)_"
,$0.00
0
Connect (Ice,Soda,etc)_•,°-"•
$0.00 0
Receptors
x$0.00 - 0
Vacuum Brkr:Bkflow(5+)
�� $0.00"
0
Dental Units-- _-
x$0.00 0.
Septic Tank._,.,::'�ro�?_.,-.-,
$0.00 0
�
Wash Basir��i �•
�
t $9.80'
1
Dishwasher
"$0.00 0
Sewer Cap.fdr Demo" `'y.
$0.00 0
Wash Basin Set �,
,$0.00
0
Drain, Floor',
x$0.00, 0
Sewer Connect
'1$0.00 0
Waste grid Vent System
' $0.00
0
Dram, Rainwater
$0.00\� 0'
Sewer Private Line ��
$0 00';? 0
Water Closet (Toilet)
�,�/$9.80
1
Drain Roof""' .r
so00`���0 y -s.
"Shower ;<
$9.80 jozl �,.
�.
r';ti; Water Heater/vent'
$0.00
0
Drinking Fouritain.
$0 00,`.;x0
Sink, bar '-'" `
• $0.00 -0 -
%Water Piping (Inst or Rep:) I$0.00
0
Expansion Tank'
-$0.00 �0^.
' Sink, commercial
$0.00 ^ 0
,' jWater,Re'pipe,
$9.80
1
Gas Earthquake Valve
��
1$0.00 0'
�� Sirik, Floor -`
$0.00 0 '-
%%Water -Service /"�
$0.00
0
Gas (1 -4 outlets)
,
$6.15%, :-1
': Sink,. kitchen ?
-Sink, service/mop
$000 - 0
%`
water Softener ,�,�
/�
$0.00
0
Gas (Over 4 outlets\
,,$0 00 ( 0
-., ;_ _
- $0 00'--'-0
OTHER%
$0.00
Gas Repipe \'--s0.00
a(private) -
_ -$0.00'-0
\",;\VIOLATION��/
$0.00
Gas Service
A $0.00_ 0"//
U Spa (public)
$0.00-,r0-. `,
'�rPLAN CHECK-
$0.00
Interceptors (Grease, Oil)
$0.00\0'REINSPECTION
$0.00
0
Interceptors (Sand Auto)
$0.00-' =-0:
TOTAL CALCULATED FEES:
$68.85
COMMENTS /-SPECIAL" CONDITIONS
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
J
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
2446-46(11Y00)
DECLARATIONS I
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.
❑ 1 have and will maintain workers' compensatlon 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: .
Carder: Policy Number:
("This section need not be completed it the permit is valued at one hundred dollars ($100) or less.)
I cerUfy.ttiat 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,nd 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. pA /
AppllcaM'Slgnat- u> re:rC��i'�`��" !/ C��l X1.1 Date: - -- to -
WARNING' FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN E� VER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE ($100,OOD), 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. S 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).
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, em 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 axetride ec. Business end Prfe
ossions Code tot this reason:
Signature?' /z'/t o B ,Date: ZOO
OwnerID verified by drivers license. ❑ Yes ❑ No Drivers LToense 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? ❑ Yes ❑ 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 200cubic 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 Corm 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 Ii en RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No
............................. .................................................................................................................................................................................................................................................................
.............................................lirawent
5 Does or will the applicant or present or future building it occupant require for the work which Is the subject c 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? � Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for nonresidential building permits).
.............................. ............... ................................................................ ................................................................................................................... ....................................... I ............. .... ..........................,...............................................................
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(If "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
............................................................................................................................................. .................................. ................................:................................................... ...............................................................................................
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this
application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
............................................................................................................................................................................................................................................................................................................................................................................................
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 COMPLJANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that 1 have read this application and state that the information given is
correct. I agree to comply with all sta a laws d city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for in y n pu es. a e not to occu or Ilow occupancy of any building L authorizeQ by thi e�it until fi�spppeection.
tura Of LegabOwner(s) . (/y, !/ Date
And/Or Authorized Applicant Date
CODE I. INSPECTIONTYPE P9IE INTITAL@ CODE INSPECTIONTYPE DAM INTMELS
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
OWNER -BUILDER
VERIFICATION
Permit #:
A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and, as
a condition precedent to issuing a building permit, require the completion and require the return of, an owner -
builder verification,
Attention Property Owner:
An `owner -builder' building permit has been applied for in your name and bearing your signature.
Please complete and return this information in the envelope provided at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No buildintzpermit will be issued until this
verification is received.
[:-;1 personally plan to provide the major labor and materials for construction of the proposed
property improvement. X Yes ❑ No
��)(�1� signed an application for a building permit for
the proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction:
Name
Address City
Phone ( ) Contractor's Lic. No.
4. I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise and provide the major work:
Name
Address City
Phone ( ) Contractor's Lic. No.
5. I will provide some of the work but I have contracted (hired) the following persons to
provide the work indicated:
Name Address Phone Type of Work
104246 (Rev. 11104)
I hereby affirm that I have received a copy of the information set forth in Section 19830 of the State of
California Health and Safety Code and have completed the above information to the best of my personal
knowledge, in compliance with this State law.
(Printed or
Typed)
For more information call City of Costa Mesa Building Division at (714) 754-5273.
104246 (Rev. i 104)
March 3, 2009
CITY OF COSTA MESA
P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200
DEVELOPMENT SERVICES DEPARTMENT
BUILDING DIVISION
EXTENSION NOTIFICATION
Patrick DeCrona
1218 Donegal Place
Costa Mesa, CA 92626
PERMIT NUMBI!RS: B06-00393, E06-00807, M06-00747, P06-00498
FOR: Additional Square Footage
PROJECT ADDRESS: 1218 Donegal Place, Costa Mesa, CA
This is to advise you that an extension on the above permit has been approved by Ed
Petros, Chief of Inspections. The extension is valid for 180 days. The new expiration date
is August 30, 2009. You must call 714-754-5626 for inspection at any time prior to this
date or the permit will expire. Additional fees will be required to reinstate expired permits.
If you have any questions, please contact the Building Division at 714-754-4871, between
8:00 a.m. and 4:30 p.m., and a staff member will assist you. We appreciate your working
with us to resolve this matter.
Sincerely,
Building Division (714) 754-5273 • Code Enforcement (714) 754.5623 • Planning Division (714) 754-5245
FAX (714) 754-4856 • TDD (714) 754-5244 - v ,ci.costa-mesa.ca us
Barbara J.
Zwart
Office Specialist
II
Building Division (714) 754-5273 • Code Enforcement (714) 754.5623 • Planning Division (714) 754-5245
FAX (714) 754-4856 • TDD (714) 754-5244 - v ,ci.costa-mesa.ca us
March 3, 2009
City of Costa Mesa
Attn: Building Dept. - Ed Petros (Chief of Inspection)
77 Fair Drive
Costa Mesa, CA 92626
Dear Mr. Petros,
I am writing to request an extension of the following permit #s (1306-00393, E06-00807, M06-00747,
P06-00498). There were unforeseen circumstances causing the delay of the project completion.
We have reviewed the remaining projects and devised an action plan to complete the remaining
projects. In good faith, the project will be complete by September 30, 2009.
We will call within 2 weeks for the inspection of wrap prior to stucco.
I apologize for any inconvenience this may have caused and would appreciate your understanding in
granting the extensions.
Should you have any questions, please contact me...
PeleCrona
1218 Donegal Place
Costa Mesa, CA 92626
Work: (949) 453-3705
r
February 13, 2009
CITY OF COSTA MESA
P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200
DEVELOPMENT SERVICES DEPARTMENT
BUILDING DIVISION
COURTESY NOTICE OF PERMIT EXPIRATION
Patrick J. De Crona
1218 Donegal Place
Costa -Mesa, CA_92626-2750_.
PERMIT NUMBERS: B06-00393, E06-00807, M06-00747, P06-00498
PROJECT ADDRESS: 1218 Donegal Place, Costa Mesa, CA
FOR: Room Addition
Our records indicate the above listed permit(s) were obtained for property improvements or
alterations at the above address. Per the 1997 Uniform Building Code, Section 106.4.4
Expiration, permits are valid for 180 days from the date of such permit, or the date of the last
inspection for the project.
Our records do not show an inspection for these permits within the last 180 days nor have
they had an approved final inspection. If you have a signed inspection card showing that an
inspection was made within 180 days, or that the final inspection was approved, please
contact this office so we may correct our records. If you do not have an approved final
inspection, your permits will expire on February 25, 2009. Additional fees will be required to
finalize expired permits.
Requesting an inspection—If you need to request an inspection, please call our Inspection
Request Line at 714-754-5626. .
Requesting an extension—If you wish to request an extension, requests must be made in
writing addressed to Ed Petros, Chief of Inspection, at the above address, detailing
circumstances and listing an estimated date of completion.
If you have any questions, please contact the Building Division at 714-754-5273, between
8:00 a.m. and 4:30 p.m., and a staff member will assist you. The accuracy of records
affecting your property is our goal and we appreciate your working with us to resolve this
matter.
Sincerer
Barbara \\TTUUJJJ►►. art
Office Specialist II
Building Division (714) 754-5273 - Code Enforcement (714) 754-5623 - Planning Division (714) 754-5245
FAX (714) 7544856 • TDD (714) 754-5244 - w .ci,Costa-mesa ca.us
03-03-2009 Insppection Request Reporting Page 1
M
9:07 am Costa esa G - City_Of
Requested Inspect Date: Tuesday June 30, 2009
Site Address: 1218 DONEGAL PL CM
A/PID Information
Activity: B06-00393 Type: BLD_SUB Sub Type: ADD SFR Status: EXPIRED
Const Type: V -N Occupancy: 7 Use: — Insp Area:
Owner: DE CRONA, PATRICK J
Designer: WILLIAM ANGELL Phone: 949-584-5919
Plan check: SHA
Contractor: OWNER -BUILDER
Plan check: HT
Engineer: EW-WEBB ENGINEERING INC Phone: 951-788-2050
Aplicant DE CRONA, PATRICK Phone: 714-360-0021
Dpev coor: BJK
Description: CONSTRUCT 903SF ADDITION TO AN EXISTING SINGLE -STORY SFD. WORK TO INCLUDE A NEW
NEW FAMYO. BEDROOM/BATH EWI44SF WALK-IN
BETCONSTRUCTOEDOAT THE FLAUNDRY
ONT ENTRY, NEF: A
MM-OTZaFciBFDROOM/ABAn(`FW9L BEGOMT4BRDROOM/3Ba'1S�PTANOITG:C)vORQrF_8y2A
qn
Notice: EXPIRED BY LIMITATION - ZWART B
Notice: 2/13/09- 10 DAY NOTICE MAILED-ZWART_B
Requested Inspection(s)
Item: 150 MISCELLANEOUS INSPECTION Requested Time: 08:00 AM
Requester: Phone:
Assigned To: "***"""" Entered By: ZWART_B K
Action: Time Exp:
J
Inspection History �t \
Item: 1 BLDG PLAN CHECK
Item: 3 JOB SITE CONSULT
Item: 4 FOOTINGS/UFER GROUND —Approved-
06/15/06
"Approved'"06/15/06 Inspector: GWH Action: AP APPROVED \ d
Comment:
Item: 6 SLAB \\v
Item: 10 ROOF FRAMING
Item: 12 ROOF SHEATHING/BLDG HEIGHT "Approved" U
08/02/06 Inspector: GWH Action: NR Not Ready �� L
Comment:
08/07/06 Inspector: GWH Action: CAN CANCELLED
Comment:
08/11/06 Inspector: HM Action: AP APPROVED
Comment: NO JOB CARD TOO SIGN.
Item: 16 SHEAR PANEL **Approved** ZL /
10/03/06 Inspector: BE Action: PA Partial approval r
Comment: EXTERIOR.
01/07/08 Inspector: GWH Action: AP APPROVED
Comment: COMPLETE
Item: 18 FRAME & FLASHING Approved "
11/20/06 Inspector: BE Action: PA Partial approval
Comment: FRAMING AT MASTER BEDROOM AND BATH ONLY.
01/07/08 Inspector: GWH Action: AP APPROVED
Comment: COMPLETE �\
Item: 20 LATHING & SIDING
Item: 22 INSULATION ** Approved
Commeos PART INSUL. OK AT MASTER BEDROOM -EAST rtWINOproval
t
01/07/08 Inspector: GWH Action: AP APPROVED �v
Comment: COMPLETE
Item: 24 DRYWALL NAILINGApproved'" �1
01/03/07 Inspector: GWH Action: NR Not Ready
Comment:
01/05/07 Inspector: GWH Action: PA Partial approval
Comment: PART. DRYWALL OK AT EAST SECTION OK pp
Com/mentt: 08 PARTIAL OF GARAGE,COMPLETE SEPARATION TOPA Partial app ME
02/11/08 Inspector: GWH Action: AP APPROVED
Comment: DRYWALL AT INTER. COMPLETE
Item: 26 PLASTER BROWN COAT
Item: 34 TEMP ELEC SERVICE OR POLE
REPT131 Run Id: 12150
03-03-2009
02/25/09
Inspector: BJZ
Action:
EXP Expired
Comment:
EXPIRED BY LIMITATION
Item: 8 STRUCTURAL
FLOOR SYSTEM **Approved**
06/29/06
Inspector: GWH
Action:
AP APPROVED
Comment:
FLR.INSUL.OK
07/18/06
Inspector: GWH
Action:
AP APPROVED
Comment:
STRUC. FLR. OK AT WEST BAY WINDOW
Item: 31 NPDES/BMP
01/02/08
Inspector: BE
Action:
CONT Continued
Comment:
PRE RAIN BMP IN PLACE.
Page 2
REPT131 Run Id: 12150
Request
Requested Inspect Date: Tuesday, June 30, 2009
Site Address: 1218 DONEGAL PL CM
A/PID Information
Activity:
E06-00807 Type: ELEC
Const Type:
V -N Occupancy:
TRICK & R
Owner:
Contractor:
BAP J MICHELLE
OWNEDEER
Applicant:
DE CRONA PATRICK J
Description:
CONSTRUCT 903SF ADDITION TO AN EXIS
Item:
MASTER BEDROOM/BATH WITH A WALK -It
ELEC CONDUIT - UNDERGROUND
NEW FAMILY ROOM. A NEW 44SF PORCH
40
00393 24 LIGHTS 27 OUTLETS 15 SWITCH
Notice:
EXPIRED BY LIMITATION - ZWART B
Notice:
2/13/09 - 10 DAY NOTICE SENT - ZWART B
Requested Inspection(s)
ROUGH ELECTRICAL - WIRING ** Approved "
Item: 150 MISCELLANEOUS INSPECTION
Requester:
Assigned To;
Action: Time Exp:
Sub Type: Status: EXPIRED
Use: Insp Area:
Phone: 714-360-0021
Requested Time: 08:00 AM
Phone:
Entered By: ZWART_B K
Inspection History
Item:
1
BLDG PLAN CHECK
Item:
34
TEMP ELEC SERVICE OR POLE
Item:
36
UFER GROUND
Item:
38
ELEC CONDUIT - UNDERGROUND
Item:
40
ELEC UFER GROUND
Item:
42
ROUGH ELEC - CONDUIT
Item:
44
ROUGH ELECTRICAL - WIRING ** Approved "
11/20/06 Inspector: BE Action: PA Partial approval
Comment: MASTER BEDROOM AND BATH ONLY.
01/02/08 Insoector: BE Action: AP APPROVED
Item: 46 ROUGH ELECTRIC CONDUIT
Item: 48 ELEC. T -BAR CEILING
Item: 50 ELEC. POWER FINAL/METER RELEAS
07/25/06 Inspector: HM Action: CO Corrections) Requuired
Comment: NEEDS TO COMPLETE GROUND ELECTRODE AND WATER BOND PRIOR TO METER
RELEASE.
07/27/06 Inspector: BE Action: CONT Continued
Comment: OK FOR METER RELEASE,NEED CLAMPS THAT BOND OUTER SHEATH.
Item: 100 ELECTRICAL BONDING
Item: 106 ELECTRICAL CONDUIT - UNDRGRND
Item: 118 POOL ELECTRICAL FINAL
Item: 150 MISCELLANEOUS INSPECTION
Item: 210 FINAL ELECTRICAL
02/25/09 Inspector: BJZ Action: EXP Expired
Comment: EXPIRED BY LIMITATION
REPT131 Run Id: 12150
I
03-03-2009 Inspection Request Reporting Page 4
9_07 am Costa_Aesa GA -City Oi
A/P/D Information
Activity: M(
Const Type: V-
Owner: DE
Contractor: O\
Applicant: DE
Description: ME
Notice: EXPIRE[
Notice: 2/13/09 -
Requested Inspect Date: Tuesday June 30, 2009
Site Address: 1218 DONEGAL PL CM
ADDITION
MECH Sub Type: RRIP Status: EXPIRED
Use: Insp Area:
LE R Phone: 714-360-0021
Phone: 714-360-0021
-RUCT 903SF ADDITION TO AN EXISTING SINGLE -STORY SFD.
'LUDE: 1 ISNT FAU < 100 K BTU, 1 REPAIR/ALT COOLING/HEAT, 1
- ZWART B
Requested Inspection(s)
Item: 150 MISCELLANEOUS INSPECTION
Requestor:
Assigned To:
Action: Time Exp: _
Requested Time: 08:00 AM
Phone:
Entered By: ZWART_B K
Inspection History
Item: 1 BLDG PLAN CHECK
Item: 63 PREWRAP
Item: 64 ROUGH MECHANICAL Approved'*
11/20/06 Inspector: BE Action: PA Partial approval
Comment: MASTER BEDROOM AND BATH ONLY.
_01/09/08 Inspector: BN Action: AP APPROVED
Item: 66 ROUGH -FACTORY FIREPLACE
Item: 68 SEWER SYSTEM
Item: 70 DUCTS VENTILATING
Item: 72 GAS PIPE - ROUGH
Item: 86 HOOD OR CANOPY
Item: 90 GAS PIPE TEST - FINAL
Item: 108 GAS PIPE/UNDERGROUND TEST
Item: 114 POOL HEATER & VENT
Item: 150 MISCELLANEOUS INSPECTION
Item: 202
Item: 206 FINAL MECHANICAL
02/25/09 Inspector: BJZ Action: EXP Expired
Comment: EXPIRED BY LIMITATION
REPT131 Run Id: 12150
03-03-2009 Inspection Request Reporting Mage b
9n7 am nsta Maca CA _ City of
Requested Inspect Date: Tuesday June 30, 2009
Site Address: 1218 DONEGAL PL CM
A/P/D Information
Activity: P06-00498 Type: PLUM Sub Type: Status: EXPIRED
Const Type: Occupancy: Use: Insp Area:
Owner: DE CRONA PATRICK J & MICHELLE R Phone: 714-360-0021
Contractor: OWNER -BUILDER
Applicant: DE CRONA, MICHELLE Phone: 714-360-0021
Description: PLUMBING TO INCLUDE: 1 SHOWER 1 WASH BASIN, 1 WATER CLOSET, 1 WATER RE -PIPE AND 1
GAS (1-4 OUTLETS). REF.: B06-0030
Notice: EXPIRED BY LIMITATION - ZWART B
Notice: 2/13/09 - 10 DAY NOTICE SENT - ZWART B
Requested Inspection(s)
Item: 150 MISCELLANEOUS INSPECTION Requested Time: 08:00 AM
Requester: Phone:
Assigned To: "'"""""' Entered By: ZWART_B K
Action: Time Exp:
Inspection History
Item: 1 BLDG F
Item: 52 SOIL F
Item: 54
Item: 56
Item: 58
Item: 59
Item: 60
Item: 62
Item: 72
Item: 74
Item: 76
Item: 78
Item: 80
Item: 82
Item: 84
Item: 88
Item: 90
Item: 92
Item: 102
Item: 108
Item: 110
Item: 116
Item: 120
Item: 150
Item: 208
" Approved "
Action: AP APPROVED
D "Approved "Action: AP APPROVED
3H PLUMBING "Apgroved " Action: PA Partial a royal
5/27/06 Ins ector: BB pp
mment: UNEERFLOOR DWV OK NEED 60PSI TEST ON UNDERFLOOR COPPER
1/20/06 Inspector: BE Action: PA Partial approval
mment: WEST SIDE ADDITION ONLY/MASTER BEDROOM AND BATH.
1/03/08 Inspector: BN Action: PA Partial approval
mment: island sink less clean-out at footvent
1/07/08 Inspector: PT Action: AP APPROVED
TEST
ApprovedAc"
tion: AP APPROVED
IH. NO TEST
02/25/09 Inspector: BJZ Action: EXP Expired
Comment: EXPIRED BY LIMITATION
REPT131 Run Id: 12150
CITY OF COSTA MESA, CALIFORNIA
tb=b 11, 1963
Mr. Robert Davis
1216 Donegal
Costa Mesa, California
Dear Mr:
on Ebbruary.6, 1963, I sp
tion being performed at the ab
was issued wherein you were eA
required a permit. To date we
You are hereby nota
permit
for
the const110H S
cause why tris strut youshall
If we can assi in t
tact this office.
FJM:dh
u
is regarding construe-
v1
hop Work order J2968
type of construction
from you.
be taken to obtain a
b. 290 1963,0 or show
bee.
do not hesitate to con -
Yours very truly,
MICHAEL BIUM M
Building official
by .
Francis 1. Mahoney, Jr.
Deputy Building official
OWNER COLLEGE --MESA COMPANY DATE 10-11-56
JOBADDRESS 1218 Dnnegal Place BUILDING PERMIT NO. #3830
GENERAL CONTRACTOR` he Hale go VALUE $ 10.Z48.00
_---174 BLOCK TRACT 2671 Single dwelling w/det. Ear.
GROUP 1 & J TYPE V ZONE Rh FIRE DISTRICT 3860
INSPECTIONS
/Brewer,
DATE
SUBCONTRACTOR
PERMITS ISSUED
DATE
NUMBER
Footing Trench
Foundation Forms and Grade to Garage
Rough Framing _
Plumbing, Rough to—Slab b +- S
I /Y
..,,� d�D..
m -36 SG
7a P9
Plumbing, Rough Complete
Temporary Pole
Wiring, Rough /LG11
1;o 5'A
Heating, Rough 1'y{ e -
Heating, Final /(��S
S -2.i`)
,,�E�.t'�>»-�.''•
�' - ...+
7�0 9
Nouse Sewer, St.
_
ep is ank or Cesspool
lathing, In*t, Ou
altering
Plumbing, Final, Fixtures Completemj+4
'29-s7
_
Plumbing, Final Gas Test/,j— /y%i'ts
%R4'S)
pp __r'
��'
yt•�6
Wiring, Final
Occuoancv
Costa Mesa Building Department APPLICATION FOR PERMIT
P. O. Box 317 :1960 BUILDING
COSTA MESA, CALIFORNIA
FORM 204 1015 O. P. GS.
FOR OFFICE USE ONLY
FOR APPLICANT TO FILL IN
Receipt No.
Permit No.
o
Dao
Building
Address 1218 Donegal Place
Costa Mesa, California
Received by
Date Recd.
— - s
Date Issued_
/O
Nearest
Cross St. Loren Lane
Building
Address
Owner College Mesa Company
Costa Mesa, California
Mail
Address 1777 W. Lincoln Avenue
Nearest
St.
city Anaheim Telcross
XEY 3-3161
Zone
I No. of
Plans
I Type Group
Architect or Lic.
Engineer Davis & Quigley No. C-1790
Approved
by Date
"Iress4l Malaga Cove Plaza, Palos Verde
CORRECTIONS
City Lic.
Contractor The Hale Company No. 3422
Address 1777 W. Lincoln Ave. Anaheim
Legal
Description I
Lot
No. 174 I
I
Block Tract 2671
_
(Attach Metes and Bounds)
No. of Bldgs
Size of Lot 69 x 120 Now on Lot None
Use of No. ofI
Existing Bldg. Families
_
No. of
Rooms.
o
m
Z
_
Setback Line from Rear Yard 61Z-8
Center of Street 50 Side Yard I&IS
y
DESCRIPTION OF WORK
New I X I Alteration
I
I Addition
Repair I I Moving I
Demolish
Building No. of
Size 1181 Rooms 5 Stories 1
�xterior Wall
Covering Stucco
Roof
Covering Rock
APPROVALS
Use of New
Budding Single family dwelling with
Foundation Location
Forms, Materials,
under -Pinning
Inspector
Date
dd.. tached garage.
Frame: Fire Stops,
Bracing, Bolts
I hereby acknowledge that I have read this Application
and state that the above is correct and agree to comply
with all City Ordinances and State Laws regulating
building construction.
Signature of
Permittee THE HALE CO ANY
Lath. Int.
Lath. Ext
--
Plaster, Int
Authorized Agt.
Plaster, Ext.
Valuation
$10,248.00
11126.700
0
FF.�$
Masonry Reinforced
Bond Beam
FINAL
0
FORM 204 1015 O. P. GS.
C
u
c
i
w
G
C.
O
rn
O
Cr
CO
PLOT PLAN
Show location and distances from
property lint, and between buildings.
Gl'
W
s..t t
J
6
c,
La
r
a
Street
PLOT PLAN
Show location and distances from
property lint, and between buildings.
Gl'
W
s..t t
GENERAL CONTRACTOR Owner—Bldr.
AP_N_o— 141—O4—13...__LOT _ _ _ TRACT
FIRE ZONE
BUILDING PERMIT NO.
M3rigfa*
DESCRIPTION OF WORK Add Pat. CVr. tQ
E
INSPECTIONS Signature
DATE
GROUP S TYPE V ZONE R-1
SUBCONTRACTOR
PERMITS
ISSUED
u_,
DATE
NUMBER
Water
Rough Com. Refrig. p Air Cond. ❑
Rough Heating
Rough Plumbing
Miscellaneous
Prop. Swr. Line ❑ House Con. p St. Swr. ❑
Sprinkling System _
Construction Pole
Underground, Power ❑
Rough Wiring
Trenches,LJ Forms ❑ Steel Reinf..❑
Floor System
Bond Beam ❑ Steel Reinforce ❑
Sheathing
Frame and Flashing
Lathing — In,0 Out ❑
Plaster, brown coat
4efrlg. ❑ Air Con. ❑ Final
Tating, Final
Plumbing Fixtures, Final
Final Gas Test
_
Electric .Fixtures, Final
Building, Final
y. _
OCCUPANCY
Form BU4- 5M-3-63--g-B P I np40
• '- ! 9362
s
COSTA MESA BUILDING -SAFETY DEPARTMENT
P. O. BOX 817 COSTA MESA, CALIFORNIA
For Applicant to Fill In Completely
TYPE OR PRINT
F
ING /2_ ESS
COSTA MESA. &LIFORNIA
-
CITY
--,
STATE
TEL.
LIC. NO.
N
C—
SIZE �+1
O
AND STATE THAT THE A®OVS IS
NO. OF SLOGS. //�
I
OF LOT A
PLY WITH ALL CITY ORIR CHS
AND ST.yTq LAWS REGULATING
NOW Ory LOT r
USE OF
BUILDING CONSTRUCTION
EXISTING BLDG.
VU 2
��r
8ET6ACK LINE FROM
•
PERMITFEE $
CENTER OF STREET
l'(X\JJ/y\I--
REAR YAR 3
SIDEYARDI LEFT
Q
I RIGHT 9
DESCRIPTION OF WORK
I BUIELDING7 `��6p[%�] 4 NO.OF
�Vf' /X215 ROOMS STORIES
EXTERIOR WA ROOF � /_ x
N
FEE RECEIVED
APR 2 9 1963 \
FINANCE - DEPT. -F -VU
r08P�LICAl4wTFOK' PERMIT
BUILDING
For Office Use Only
RECEIPT NO. I PE[
ZONING yN'
Z12 / NO. OF U6E OF NEW
1(A�/ FLANS euaomo
LEGAL
DESCRIPTION L I / :t 1z 1\V [
APAP NO I TI"' 6 -/3
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
BO" TO SIDE 3 REAR P. L.
EAVES
ALLOWED (U. B. C. REQUIREMENT)
YARDS APPROVEDYARDS APPROVED
MAIN BUILDING ACCESSORY BUILDING
(FROM C/L STFV.W /
PER
VAR.* DATE
C. U. P. A APPR
APPROVED IIA A
SQ. FT.
I HEREBY ACKNOWLEDGE THAT 1
HAVE READ THIS APPLICATION
THE AMOUNT SHOWN UNDER VALUATION IB FOR THE
AND STATE THAT THE A®OVS IS
CORRECT AND AGREE TO COM-
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORIR CHS
AND ST.yTq LAWS REGULATING
VALUATION
BUILDING CONSTRUCTION
"
PERMITFEE $
SIGNATUREOF
PERMITTE
l'(X\JJ/y\I--
0d -O
/)
$ 1•_'
C E
AUTHORIZED AGENT.
r.�LAN
r:� vice c G