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Home My WebLink About3025 FILLMORE WAY - Building Permits. � � � CITY OF COSTA MESA BUILDING DIYISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754•5626 PERMIT TYPE B_ROOF2 APN: 14113446 PERMIT NUMBER: B08-00115 STATUS: ISSUED DATE ISSUED: 04/0712008 _ ISSUED BY: KJB JOB ADDRESS: 3025 FILLMORE'WY CM `_ �, Suite/Unif: ,M� Vicinity: TRIPLEX � ' --- , , � � - Squares: 2400 � � � - � "� ` � . � �� Valuation: � - � ��. $6;500.00 � :x,,� . . .- _ . SCOPE OF WORK: RE-ROOFtTRIPLEX: TEAR`OFF EXISTING ROOF, REPAIR AND REPLACESHEATHING AS NECESSARY, COVER WITH 30 YEAR COMP $HINGLES. CCASS A ROOFING. APPROXIMATELY 24 SQUARES. REF: BC08-00122 FOR '`.. FIRE DAMAGE REPAIR WORK...�' ' - . � . �� ', OWNER: SOLI, LISA ANN TR�NANCY•RHEA HADDEN TRUST Address: %HEREDIA, ARIEL TITO - Unit: COSTA MESA. CA � ..�,. i '• � .'c " . . . . - s _ . PHONE: '�' . - r � ". � ��Cify/State/Zip: 929PAULARINOAVE � �. � �t ;f��' . . - - � . , .. � - . . � APPLICANT: BENSON,�DON'� �.. � Address: 2106AYWOODAVE ,, Unit: : PHONE: 800-000-9353 . `��-�, �� , � � __, City/State/Zip: ORANGE, CA � � � CONTRACTOR: AMERICAN TECFINOLOGIES INC ' � License No. 571784 Address: 270BAYWqOD�AVEUnit �.-� � __PHONE: ' ; 800-000-9353.� City/State/Zip: ORANGE,CA k:� �'� �92865 � , � � � �� - � CELL: � � � . ARCHITECT. ' LicenseNo. ' PHONE:� � ENGINEER: - � ��, LicenseNo.�- ��PHONE: FEE SUMMARY Reroof Plan Check: Reroof Permit Fee: Reinspection Fee: TOTALFEES $0.00 $13925.. ` $0.00 _ ` $139.25 'Ff"t NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requiremen45 under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In ortler for the work authorized under lhis 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 �inal approval will result in the ezpiration of this permit. CO�E� INSPEGTONTYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final . 200 Final Re-Rool 201 Final Block/Retaining Wall 202 Finai Factory Fire Place 203 Final Sign 204 FinalOemolition DRTE INIRIAL cooea ixsaecnoxrrre 206 Final Mechanical 208 Final Plumbing 210 Final ElecMcal 272 220 222 250 Final Fire Prevention Final Planning Approval Final Site Final Building/Occupancy onre ixTITIRLS WORKERS' COMPENSATION DECLARATION: � I hereDy aKrm untler penalty of perjury one of the tollowing declaiations: ❑ I have and will main[ain a certificate of consent to self-Insure (or workers' wmpensaGon, as providetl for by section 3700 of the Labor Code, for the pertortnance of lhe work (or which [his permil is issued. �ave and will maintain v.orkers' compensation insurance, as required by secUon 3700 of the Labor Code, fa the peAwmance of the Nork fa which this pertnit is issuetl. My wnrkers' wmpensation Insurance cartier and policy numberare: , � Cartier: G9(/) Uy� fQ (7htrsMmneetlnd0eUmn feElNe�mmRisvdAiedatmehundieticb0ars(ff001a1eu1 PolicyNumber 1� f �.� ❑ I certify that in the pedormance of lhe work for which this permit is issueC, I shall not employ any person in any manner so as to become su�ject to tha workers' compensation laws ot Califomia, an0 agrea that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwit� wmply with these provisi ns. � Z A�d�m��'s Signalure Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLP.WFUL AND SHALL SUBJECT AN EMPIOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLAF2S ($100,000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEI^S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrm that I am licensed under provisions of Chapter 9(commencing wiN Section 7000) of Division 3 of the Business an0 Professions Code, and my license is in full force antl eRect. ' . i� � Class # G CamratlWs Sie��ure Dale CONSTRUCTION LENDING AGENCV: ❑ I �ereby affirtn that lhere is a constnutbn IerMing agency la the peAortnarxz of the xork fa wtiich tlris pertnit is ssuetl. (Sec. 3097, Civil Code). Lender s Name: LenCer's Atldress: OWNER-BUILDER DECLARATIONS: I hereby aKrtn that under penalty of perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for Iha following reason (Sec. 7031.5, Business and Professions Code: Any city or couny whith requires a permit to construct, alter, improve, tlemolish, or repair any structure. prior lo its issuance, also requires the applicant for such pertnit to file a signed statement that he or she is licensed pursuaN to the provisions of the Contractors License Law (Chapler 9(wmmencing with Section 7000) of Division 3 of the Business and Professions Cotle) or lhal he or she is exempt lherefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant For a pertnit subjecis the applicant to a civil penally of no1 more Ihan five huntlred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as iheir sole compensation, WILL DO THE WORK, and the structure is not intentletl or oHered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an ovmer of property who builds or improves thereon, and who tices such work himself or herself or through his or her own employees, provideC that such improvements are not intentled oi oflered for sale. If, however, the buildinq or improvement is sold within one year of completion, the owner-builder will have the burden of proving ihat he or she did not build or improve for purpose of sale.). Owner ID verified by dnver'�_ �n. J Yes ❑ No i � Driver's License No. Expires: Verifiwtion of Ovmership by (type of document, i.e. - property tax Dill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby ceAify that no excavation five (5) or mae feet in tlepth into wfiich a person is required to descend, will be matle in connection with wnrk authorized by this permit, and that no builtling structure, scaffdding, falsev.ork, a demolition or tlismantling thereof, will be more than thirty-siz (36) feel high. (Chap. 3.2, Grp 2, M 2, Set. 341, Tille 8, Califomia Administ2�ive Code). ❑ As ovmer-builder, I will not employ anyone to do work which would require a permit (rom the Division of Induslrial Safety, as noted above, unless such person has a permit to tlo such work from the tlivislon. Ap01iwn1'S Signalure Date Division of Industrial Safery Permit NumDer: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will lhe applicant or present or fuNre building occupant need to file and certify a Business Plan for emergency response lo release or threateneC release of a hazarCous matenal7 ❑ Yes ❑ No (Section 25505 of the Califomia Heallh and Sa(ey Code requires, wilh some exceptions. that a Business Plan be filed with the Cosla Mesa Fire Department �y every business which has al any one lime tluring a reported year a quantity of hazartlous materials equal �o or grea[er than a weight of 500 pounds, or a volume of 55 gallons, or 200 cuhic feet ot compiessed gas at slandartl temperaWre and pressure). 2. Dces or will lhe appliwnl or present or future 6uilding occupant need to file a registration fortn for acutely hazartlous matenalsl ❑ Yes ❑ No (Sec[ion 25533 of ihe Cali(ornia Health and Safety CoCe, wilh some exceplions, requires regislration vrith the Cosla Mesa Fire Department by each business which at any one time �as on hand a quantiry ot acutely hazardous matenals equal to or greater �han a v+eigM of 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressed gas at stanCard temperature and pressure). 3. Does or will the appliwnt or present or future builAing occupant need to prepare an RMPP (Risk Management an0 Prevention Program for acutely hazardous matenals)7 � Yes ❑ No (Seclion 25534 of the California Health antl Safery Code provides that the Costa Mesa Fire Department may require ihe preparation, ceM1ification and �linq vnth tha Fire Department of an RMPP by businesses which are requiretl lo register acutety hazardous malenals with Ihe Fire Department. 4. If an RMPP is presently required, has Section 25534 of Ihe Califomia Health and Safety Code been (ully complietl with? ❑ Yes ❑ No 5. Dces or vrill the apDlicant or present or future builtlinq occupaN require for Iha work which is lhe subject ollhis applicalion a permit br such consWclion or modification from ihe South Coast Air Quality Management DisMct or from any other air pollution control dislrict or agency? ❑ Yes ❑ No (Secl'pn 65850.2 of the Califomia Govemment Coae requires Ihat the requestetl informatan ba fumished on applications fp rqmresbential building pertnits). 6. Will any part of the facility to be consWcted under this permit be vnthin 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (If'yes". the facility musl meet the requirement of Seclions 25534 antl 42303 ol the Califomia Health and Safery Code). 7. I( a pertnil from lhe Soulh Coast Air Oualiry Managemenl Disinct Or Other air pollution control tlistrict or agency is required for ihe work which is the subject of lhis applicalion, have all of the tlisclosures prescribed by Calitomia Health and Safety Code Seclion 42303 been made? ❑ Yes ❑ No 8. Qf yes", altach certifiwte of wmpliance from the appropriate air pollution cantrol oKcer�. CERTIFICATE OF COMPLIANCE: I certify that under penalty o( perjury t�e intortnation given above is covect I aqree to comply with all sfate laws and city ordinances regarding Hazardous Materials and Emissions. ' � U i, as owner oi me pmperry, ain �n�.�uaivur �.vrv��w�.iirvv �nin LICENSED CONTRAC70RS to constmcl the project (Sec. 7044, Business and ' Professbns Code: The contractors License Law dces not apply to an avner of Signawre oaie property who builds or improves lhereon, antl who cont2cls fw such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZA710N OF ENTRY: I a contracta(s) license pureuant ro Ihe Contractors License Laws.). �ertify under penalty of perjury that I have read this application and state t�at ❑ I am exempt under sec. � the information qiven is correct. I agree to comply with all state laws and cily ordinances relating to building consWclion, and aulhorize representatives of Business and Professions Code for this reason: lhe Ciry of Costa Mesa ro enter upon the abovetlescribed properry tor inspection purposes. I agree not to occupy or allow occupancy of any builtling authorized by this permit until final inspection. ' naWreoll.eB��eqs� Da�e Signawre Dme 305)-46(3I01) - Analw AolM1oriietl Ap0l�canl "te � 3� '�'_/� February 17, 2010 CITY OF COSTA MESA P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 OEVELOPMENTSEftVICES OEPARTMENT BUILDING DIVISION COURTESY NOTICE OF PERMIT EXPIRATION Lisa Ann & Nancy Rhea Hadden Trusts c/o Ariel Tito Heredia 929 Paularino Avenue . Costa Mesa, CA 92626 PERMIT NUMBERS; B08-00115 3025 Fillmore Wy., Costa Mesa, CA FOR: Re-roof 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 lasY 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 March 2, 2010. Additional fees will be required to finalize expired permits. Requestinq an inspection - If you need to request an inspection, please call our Inspection Request Line at 714-754-5626. RequestinQ 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, �W.�vv� � Barbara J. Zwart Office Specialist II cc: American Technologies Inc. euilding Division (714) 754-5273 • Code Enforcemenl (714) 754-5623 • Plannin9 �ivision (714) 754-5245 FAXp14)>54-4856 • TDD(714)754-52aa • unw.�.ci.costa-mesa.ca.us � .��---�.�-,,.�.�..�•�,, ��.' ' �us::n._..e ;r__ ll. ' jr�-� i yt`.� �}�"—�r�)-s-'`� y�s.tn_ I �Y'� r J � . r �,.� � s• " C�"'�'"3' ! ^� �� ,'',�i; � PI � '.' .-4 �a � , �T \ � I f•� ': �^' I�i. � 9 �A t �. y'_ . I � 1 -A'U �.a `�' —_�.... , ' i � F i r;� �,•. �,-�,: .,.� ��:'� �� ' '�?I -l'` {I! '� '��`-fi�-L `� �'�_ a-f. —v. i � 1L J_� r � - ._=i`Jl ;' ' �__�-•` �� .. � �..�_ _.�_�_ _ . � � .�. `� -.� �� - �; �; ��,. -=�-�;�= ��!� -��Y_-��-==�: _�,��,. �-� �= j� � �,- -- �-�.,; � � � I�i�F' �.��,, . ,-1 � � �� _ 1)`1 "'{�; ��.� i�+.�� '�:Y'� � Ei�"�j,�t�-±,'JEj'i ��l`—. fl� � . � ll�— 'F i ` � r n �� 1 f �� . - 'f ^ � �+ � •f � M . l _ � 1 + � � { I If' I `.' 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'�,� � �� '�,� � � �� a I � ! ��t-_. �' �oe..;=;i.�� r`=�F'�c-�;Ft `�.7� ��„�l` �`_'��or_11. , _,,�- � �ai.:�> A� �G-za` . �f�E , �Ir_..nr= d� _ r � ; �' Y� y ' _...�w . ;� � � ' �._: .� �T i'(-1 U `Ir-�,�.-�'`: `�i r=�� ..: G _ i, � ,: �= - �I n 1.,,� - 11 1p4 �_ ,�__, . � _��-.,�`"�� "—]i-�,� --� i �� << � � � r-_ r � �E t� � �� _ II � � .�� ff r� �. �, , �.�; „ . ri .� _�. �� ' ' I� iJ ,� ': I � Gh _-�.� -r =,� • �� F�1 � �� , � -.� ..—u—ffv 'i,s ti � ��1,.- .t��'. � ..4. i ' � . , CITY OF COSTA MESA BUILDING DIVISION ' • F� � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us � � FOR INSPECTIONS CALL: (714) 754-5626 �'�� PERMIT NUMBER. BC08-00122 PERMIT TYPE: B COMBO STATUS: ISSUED Sub Type: RES_ALT DATE ISSUED: 03/2512008 - ISSUED BY: �oe aoDREss: 3025 FILLMORE WY CM" �' Suite/Unit: APN: 14113446 . � ZOning:. , � � ` Vicinity: UNITS 131 AND 132 " �- - - �- Primary.Occ: R-2 . Const Type: V-B . SQ. FT: 0 „ Valuation: $40,000.00 SCOPE OF WORK: FIRE DAMAGE REPAIR TO THE BATHROOMS IN UNITS 131 AND 132. WORK TO INCLUDE: REPAIR OF FRAMING, ROOF RAFTERS, INSULATION, DRYWALL, DRYWROUGHT IN SUBFLOOR (LIKE FOR LIKE), 2 SWITCHES, 2 OUTLETS, 2 LIGHT FIXTS, 2 WASH BASINS, 2 WATER CLOSETS AND 2 BATHTUB/SHOWER. OWNER: SOLI, LISA ANN TR NANCY RHEA HADDEN TRUSTAddress:� , � COSTA MESA, CA _ - � " - - � � Phone: . � ' City/State/Zip: 929 PAULARINO AVE ,; � . %HEREDIA, ARIEL TITO Unit: N APPLICANT: BENSON, DON Address: , 210 BAYWOOD AVE - � Unit: : Phone: 714-240-0776 � � ��City/State%zZip: �ORANGE,�CA � �� . � CONTRAC70R: AMERICAN TECHNOLOGIES INC � License No. 571784 - Phone: 800-400-9353 Address: '210�BAYWOODAVEUnit: � Cell: , City/State: �bR4NGE, CA � __ ZipCode 92865 ARCHITECT: � License No. PHONE: ENGINEER: License No. . PHONE: COMBINTATION PERMIT FEE SUMMARY Building Plan Check: $0.00 Building Fees: � $543�.25 Electrical Fees: $30.10 Mechanical Fees: $0.00 Plumbing Fees: � $78.40- SMIP Residential; � � �,.$0.00 SMIP Commercial: � $0.00- TOTAL FEES: $651.75 "Re(er to tee recelpts for all fees paltl for project - ... .. . , .. .;,, NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulaGons. (Ord. No. g2-28, § t, 72-21-92) EXPIRATION: PERMIT EXPIRES 780 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPEC710NS: In order for the vrork authorized under this pertnit to be considered legal, such work must comply vnth 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. c o � ixsrecnoNrne 1818 Fixed Sys�em Final Fire Prevention 1288 Pool Spa Final _ 200 Final Re-RooF ZOI Final BiocWRetaining Wall 202 Final Factory Firp place 203 Final Sign 204 Final Demolilion ORTE INTIIIRL CODE� INSiECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 272 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy -P/� pATE INTITIRL .� r/ � � 1 . i. . � WORKERS' COMPENSATION DECLARATIOA. I hereby affirt; under penally of perjury one of tha following declarations: ❑' I fiave antl will maintain a certificala ot wnsent to self-Insure for workers' compensation, as provitletl (or by section 3700 of the Labor Code, for the perfortnance ot the work for whic� ihis permit is issued. ❑ I have antl will maintain v.urkers' compensation insu2nce, as required by secl'pn 3700 of the Labor Code, for the pedormance of the v.ork for which ihis pertnit is issuetl. My workers' compensation Insurance carrier antl policy number are: rCarrier. �o.�'(ov�c�l �in r (This sec( n neetl nol �e qcompleletl �the permR is valu et one nunOreO tlollars (5�00) or less ) PolicyNumber. (t/ � /SS 33 7S ❑ I certify that in the peAormance 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 Califomia, and agree that if I should become subject 10 the vrorkers' compensation provisions of Section 3700 0l the Labpr Code, I sh I(orthwith comply with these pmvisions. ��),,, 3-25� o � ' AppiWm'sSipreWre Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL FINES UP TO ONE HUNDRED THOUSAND DOLLAFtS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF iHE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing wilh Seclion 7000) of Division 3 of the Business and Professions Code, and my license is in full force and eftect. ^� Lic. # %�� Class # L ) c 3 -25- D (S �Comrano/s Signawre �aie CONSTRUCTION LENDING AGENCY: ❑ I hereby aKrm �hat Ihere is a construclion lending agenty for [he pertortnance of the work lar which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Atldress: OWNER-BUILDER DECLARATIONS: I hereby aKrm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Cotle: Any city or county which requires a permit to construct, alter. improve. demolish, or repair any sWcture, prior lo its issuance, also requires the appliwnt for such pertnit to file a signed statement that he or she is licensed pursuant ro the provisions of lhe Contraclors License Law (Chapler 9(commencing with Section 7000) of Division 3 of Ihe Business and Professions Code) or tha[ he or she is exempt therefrom and the basis for the allegetl exemption. Any violation of Section 7037.5 by any applicant for a permit subjects the applicant [o a civil penalty of not more lhan 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 sVucture is not intended or ottered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builtls or improves thereon, and who does such vrork 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 vrithin one year of completion, the owner-builder will have lhe burden of proving that he or she did not build or improva for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS lo const�uct Ihe project (Sec. 7044, Business and Pmfessbns Code: The contractors License law tices not appy to an owner of property who builtls or improves thereon, and who con[racts for such project with a contraclor(s) license pursuant ro lhe Contrac[ors License Laws.). ❑ I am exempt under sec. Busine55 and Professions Cotle (or this reason: SignaWre 305�-46�]IO]) Owner ID verified by Om . lice�.__. ❑ Yes ❑ No � � Driver s License No. Expires: Venfication of Ownership by (type of document, i.e. - property Wx bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certAy Ihat no eacavation frve (5) or more (eel in depth into which a person is requiretl to descend, will be made in connectbn with work auttwrizetl by this pertnit, and that no builtling sWcture, scaffdCing, false�wrk, a demolition or dismantling thereo(, will be more Ihan thirly-six (36) feet high. (Chap. 3.2, Grp 2, AA 2, Sec. 341, Title 8, Califomia Atlministrative Code). � As ovmer-builder, I will not employ anyone to do vrork which would require a permit from lhe Division of Industrial Safety, as noted above, unless such person has a pertnit to tlo such vrork /rom the division. AOPlitanl'S SignaWre Division of Induslrial Safery Permi[ Number. _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future building occupant neea to fle antl cenify a Business Plan for emergency response to release or threatened release of a �azardous material? ❑ Yes ❑ No (Section 25505 of the Califomia Health antl 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 reportetl year a quantiry of hazardous matenals equal to or greater than a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet o( wmpressed gas at stanCard temperaNre and pressure). 2. Does or will the applicant or present or future builtling occupant need lo fle a registralion torm for acutely hazardous materials7 ❑ Yes ❑ No (Section 25533 of the California Health and Safery Code, with some ezceptions, requires registration vnth the Costa Mesa Fire DepaAment by eath business which at any one time has on hand a quantily of acutely hazardous malenals equal to or greater t�an a weight of 500 pounds. or a volume of 55 gallon5. or 200 cubic feet of compressetl gas at stantlard temperature and pressure). 3. Does or will the appliwnt or present or future building occupanl need to prepare an RMPP (Risk Management antl Prevention Program for acutely hazartlous materials)7 ❑ Yes ❑ No (Section 25534 of the California Health antl Safety Code provides that the Costa Mesa Fire Department may require the preparation, certifcation antl filing with lhe Fire Department of an RMPP by businesses which are requiretl lo register acutely hazardous materials with the Fire Departmen[. 4. II an RMPP is presently required, has Section 25534 of Ihe Califomia Health anC Safery CoOe been (ully wmplied with? ❑ Yes ❑ No 5. Does or will the applicanl or present or fWure building occupam require for Ihe work which is Ne subject of [his appliwlion a pertnit for such construclion or modification from the South Coast Air Quality Management District or from any other air polWlion control districl or agency? ❑ Yes ❑ No (Section 65850.2 Of the Califomia GOvemment Coae require5lhat the reque5ted inlorma�ion be (umishetl on applications for ron-residential builtling pertnits). 6. Will any part of the faciliry to be consiructed under Ihis permil be within 1000 feet from ihe outer boundaries of a school7 ❑ Yes ❑ No (If'yes", Ihe facility must meet the requirement of Sec[ions 25534 and 42303 of the Calitomia Health and Satery Code). 7. II a permit from Me South Coast Air Quality Management DisMct or other air pollution control district or agency is required for the work which is Ihe subject of this application, have all of the disclosures prescnbeC by California Heallh and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. Qf'yes", attach certifcate of compliance from the appropriate air pollution control oKcer�. CERTIFICATE OF COMPLIANCE: I certify Ihat under penalty of perjury the inlormation given above is correcL I agree to comply with all state laws and city ordinances regarding Hazardous Matenals and Emissions. Signature Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certity under penalry ot perjury that I have read this application and state that the information given is covect. I agree to comply with all state laws and ciry ordinances relating to building construc[ion, and aulhorize representatives of the Ciry of Costa Mesa to enter upon the above-0escribed property for inspection purposes. 1 agree not to occupy or allow occupancy o! any builtling authonzed by this permit until final inspeclion. Signa o1 Legal Owner(s) Oate ., > 3-�S-O� . orAul�wzeEAP01¢anl .Da�C. " NOTICE TO CONTRACTOR DATE: 03/20/08 CLIENT: American Technologies, Inc. PAGE NUMBER: ] of 1 PROJECT: 3025 Fiilmore Way-132, Costa Mesa PROJECT NLJMBER: 970-11 •02960 WORK AREA (S): Bedroom & Hallway ONSITE HYGIENIST: Rick McKenna CONTRACTOR: American Technologies, Inc. The following notice is hereby given to the Conhactor. The Contractor may proceed with the�neat phase of the Work as stipulated in the Contract Documenu. Failure of the Orvner, Ptoject Manager or onsite I3ygienist to uotice unacceptable methods, materials, pmcedures, or results during progress of the Work will not absolve the Contractor from his responsibiliry to complete the Work in accordance with t6e Contract Documents. NOTICENLJMBER: 0320 PRE-DEMOLITION VISUAL: POST•DEMOLITION VISUAL: POST-DEMOLITION CLEARANCE: PRE-ABATh"MEN7 VISUAL: POST-ABATEMENT VISUAL: X POST ENCAPSULATIQN VISUAL: FINAL AIR CLEARANCE: X COMIv1ENT5: Based on the onsite-observalions and Project data, the abatement phase of the Project (approx. 85 SF of spray- applied acoustic ceiling materiai i'rom the bedroom & haliway) has been determined to the best of the Onsite HygienisYs knowledge, information and belief ro be complete and in accordance with the Coutract Specifications. This includes the final air sampling that documents that airbome fiber concentrations for the Work Area are within the guidelines estabfished by the Environmental Protection Agency (EPA) for abatement activities. The final air clearance sample concentrations were less than or equal to 0.01 f/cc. As of ihe Date of Issuance of this notice, the area is available for re-occupancy. SIGNATURE OF ONSITE HYGIENIST: 1 .-� � i �� ,'" --. - _ DATE: . Signature of the Contractor's Representative is acknowledgement of receipt of this Notice and is not an admission of non-compliance with Contract Documents. � �-- ._ -, -- _ SIGNA7'URE OF CON'IT2ACTOR'S REPRESENTAT] VE: �:-= �� PRINTED NAME: �- -: TITLE: DATE: :� : �.: .: . � �c.Q� •� ��v jz>7 Bl. .�ING AND SAFETY DIVIS, .V ' ' FIRE DAMAGE INSPECTION REPORT - (Required Prior To Permit Issuance) - � .- _ Address: %!- � � � � � ��'_" Owner. J� r' f=` � /_. /," � i ��< <� --- pwner's Address (if different from above): ,-, i i '�i : �=l �;�, � � -, r.,�, �.v _. - _ L-- t Street i � ��' ,-^ �-/% � ,.City� � Structural permit required. 0 Repair or replace as necessary. ❑ Plans required. � � Comments: � • �� ; : / ..; ,.'; _ y �:,; '/ %� c G<_:' ' --' f�_ . � %.� � i � 1 �I/% . i!: / . � `l,.�.%. .. . , �i-" c /',:...P . i : �a, i , . .. �' Electrical permit required. � Repair or replace as necessar Comments: ` � i �" +' � % � �� 0� Plumbing permit required. 0 Repair or replace as nece Comments: �` • � �t � J �r': ` �� LL..� r (.% ( � ; j : �. ' ..1 �i �' {_r"' . / -! / Unit: ' � ' State � � i :��,_ L..' t r j' , ❑ Mechanical permit required. ❑ Repair or replace as necessary. Comments: " r- .� , � ;-,`,. ,! :ri - - ;/� - % � ,� _ ! :' ,f: i: : i��;-" : �.r ' ;'i / ; Inspector � -Date Phone � I612�<6 Thpiicaie: Origmal-Owner', Yella«-Conlrator Pink�Buildmg Onivan LOT �8 TRACT 428� � is�a� � COSTA MESA BUILDING-SAFETY DEPARTMENT - P. O. BOX 917 COBTA MgBA. GAI-�FORNIA For Applieani fo Fill In Complefely TYPE OR PRINT BUILDING � ADDRH83 COSTA MESA CALIFORNIA FE AN��,��IVED FINANCE DEPt. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING For Office Use Only qo�pEss 1 PLACENTIA AVENUE I l�— . I '��U�� GI7Y NEWPORT BEACH� CALIF NpMI 63z27 BUILDING ADDRE68 ARCHITECT 7E�. COSTA MESA. CALIFORNIA OR ENGINHER NONE NO. -�----- / __"'__'_'�_'_____'�"__'___' FIRE � ./� ADDRE66 ZONE TYPE GROUP �� I CONiRAGTOR K. W. Ko � � APPROVED BY OATE •AODRE6S L CENT�A AVENUE ZONING NEWPORT BEACH zone I NO.OF I use ov rvew Tv. ' cin /S _ 3 PUNB Z a��Ho � ucTNo. 611 r�. o: M I. 6- 22 �c�� - /�"j' %/� G� L8/ oeecrtirt�oN 61ZE I No. oP BLDaB. O . OF LOT � � Now ON LOT p, p, NO. UBE OP YAR08 EVE6 EXIBT G BLD APPROVED ALLOWED BHT9�CR LIN[ PROM fCENTeR LINe 8TJ cenr¢a oP enaHei � REAR YARD j � FRONT S� FT. �— IN. SIDE YARD LEFT � RIGHT � R.61DE �� F� IN. DESCRIPTION OF WORK L. SIDE �o FT. — IN. NEW I IIAL7ERATION I IIADDITION I REAR �s- � FT. �// IN. - I II MOVING I II DEMOLISH I APPROVED ��(J �/9 GZ REPAIR BY `? DATE I BUILq INC[iAR: SF No. oi 81ZE CfU i LD: SF ROOM9 �Y`� 2 sTOR1E5 2 � / EXTERIOR WA ROOF GOVERING ICOVER�NG ROCK . C 7 USE OF BUIL�ING AND WORK TO 9Q PERFORMED / 1 XHR6GY ACKNOWLBDGB TMAT 1 HAVB RUG TH�B APPIJGTION THE �MOUNT BXOWN UNOHR VALUATION IB POP THH AND BTAT6 TNAT TX8 ABOV¢ IB COpF6CT ANO A6ReE TO CON- pUPP09! OF E9T/�BLIBHINO A veRNIT FeE ONLY. PLY WITX ALL GiY ORDINANCHB ANO BTATB UW! REGULATINO oU�LDINa CON6TRUCTON. VALUATION 81GNATURE OF �'ERMIT FEE $ ��` PERMITTB ��+ /3`�.r n �/ � , , ' $ � � PLAN CHEGK $ ,�c 0 � AUTHORIZED AGENT ('%(/,� Q TOTAL FEE O y