HomeMy WebLinkAbout2019 FEDERAL AVE - Building Permits CITY OF COSTA MESA
4
- BUILDING DIVISION
A
}; es DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER
1 eleem'%' I PERMIT
B05-02447
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(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.BlifLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 2019 FEDERAL AV 'let
Status: ISSUED
Suite: .ri,•. Applied: 12/29/2005
Vicinity: ROOF ' :, Issued: 12/29/2005
Primary Occ: R Type of Construction: V-N
Parcel Number: 42250314 Zoning:
Applicant: FRISBEE, STANLEY G rift*, aRR
.
Address: 2019 FEDERAL AVE - -0•11.111111111111/
� ,/
Ph. !• 548-4726 ISSUED BY: '/ /'
COSTA MESA,CA Zi92627
Owner: FRISBEE, STANLEY G
Address 2019 FEDERAL AVE
Phone:
COSTA MESA,CA Zip: 92627
Contractor: OWNER-BUILDER
Address:
Phone:
Zip: License: 000000
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING ROOF.INSTALL 2 LAYERS OF 15#FELT,30 YEAR COMPOSITION SHINGLES AND REPAIR/REPLACE SHEETING AS
NEEDED.WORK TO BE DONE CONCURRENTLY FOR S.F.D.AND DETACHED GARAGE.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $7,000.00
Permit: $139.25 - Claim Valuation: $7,000.00
SMIP Res: $0.70
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00
Total: $139.95
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 .Required: 0 Proposed: 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No.92-28,§1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2446-46(6/00)
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workers'compensation Insurance carrier and policy number are:
Carrier: Policy Number:
(This section need not be completed it the permit is valued at one hundred dollars($100)or less.)
D ,{Lcdertityithat In the performance of the work for which this permit is issued, shall not employ any person in any manner so as to become subject to the workers'
' dbrn ensation laws of California,end a ree that shout bac•
P g e subject to the workers'compensation provisions of Section 3700 of the Labor Code, shall forthwith
comply with these r•ve.a ,
A••Ii
.natures V} ✓ / e -+— _ 2)
( � SLLI
FA RETO E�1
SECURE WORKERS'.. PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN BLOYER TO CRIMINALPENALTIES AND CIVIL FINES UP TO ONE HUNDRED
1 ••DOLLARE(5103.0 0).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
Contractor's 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).
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
subje is the applicant to ar civil penalty of not more than five hundred dollars($500).):
as owno pf 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
imself 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.). '
O I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
O I am exam, _ / Business and Professions Code for this reason:
g Signefire —:,(�— awn-� - Date:
Yom' Owner ID ve.' ry drivg/ilcense. ❑Yes ❑No Driver's License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding.falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a2ermit for such construction or modification
LJ
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 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? 0 Yes 0 No
(If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No
8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and cit ordinances r lating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described prop for. ion purposes agree not to up or allow occupancy of any building authorized by this permit until final inspn.
SIg a0 (e p... - Date 4
"AndOFlltthorized Applicant Date
CODE it, INSPECTION TYPE PEE INTITIAIE COPElt INSPECTIONTYPE PAIL INTIfIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final208 Final Plumbing
200 Final Re-Roof Ilan; 71" 210 Final Electrical
201 Final BlocldRetaining 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
. = 4e� 7� Fadden rpt
- `"' OWNER—BUILDER
tratii. VERIFICATION
_ , cosn9 I-262.-7
/ / Address:\‘\ 2._oy f wec ',`}� 4f4 �4permit#:
(\ )
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.
a
aI personally plan to provide the major labor and materials for construction of the proposed
property improvement. ® Yes ❑ No
IC
10 ave not)0
/ \ 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 1 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
1042-46 (Rev.11/04)
OWNER FRISBEE, Stanley DATE 10-5-76
,.^-JOB ADDRESS 2019 Federal Avenue BUILDING PERMIT NO. 42814
GENERAL CONTRACTOR Owner/Bldr. DESCRIPTION of WORK Add Liv.Rm. & Din.Rm.
`jAP No. 115-472-14 LOT TRACT FIRE ZONE VALUE $,000.00
\. yi*:b?CTIONS Signature Date TYPE V GROUP I ZONE R-1
• ' SUBCONTRACTOR PERMITS ISSI/ED
\ GAS Data I Number I Signature
WATER Plumbing
ROUGH PLUMBING
PROP: SWR. LINE[] HOUSE CON. fl
SPRINKLING SYSTEM
MISCELLANEOUS I
ROUGH HEATING AND AIR CONDITIONING .
TEMPORARY SERVICE OR POLE
UNDERGROUND D POWER
ROUGH WIRING '/4' o fo-,277C, Heating and Vent.
TRENCHES L� FORMS El STEEL REINF.
FLOOR SYSTEM
BOND BEAM [-I 'STEEL REINFORCE n
SHEATHING
FRAME AND FLASHINf//�}� L-1,'-/,u tit
LATHING - IN I OUT I--I /i_yA��.���
PLASTER, BROWN COAT iP
STRUCTURAL. FINAL ^ Ele t
I VG, VENT.. REFRIG. AND A.C., FINAL '�/y/{-,,�,�A-.f/ • /0-g-1 ,��Iay�
P. .GING. FINAL AND GAS TEST 0 VW" '44.. • 11 S- TI S3� �'
ELECTRIC. FINAL /QG -0 I '
BUILDING. FINAL m c 3-2,127
_ 7
.. ..- 42814 fCT —5-7%F 00 2t:2" ..... :,30.5C
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 ,
CA ON FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only qlJ
/� /JFe-aro/eel/ / R C ED DATE RECEIVED (PATE ISSUE
BADDRESS 10 If de �(
OWNER -s7W/LE 1 F/1 a de 45/ (PERMIT NO.
A.P. NO.IIs� / 7Z� /y
MAILB IL IIN LDNG G 1017 Fe y&A4L Ay
ADDRESS
�� SAr e
TELCITY 4s7 7 MC/l N0.Sy63S� TRACT /7/L I LOT4 O
` BLOCK
CONSTRUCTION NEW ADD ALTER I REPAIR I MOVING OFMOLISH
LENDER
BRANCH
OWNERA '^/qc-e-, Ai see
ADDRESS R}'OD bv, /.I(// VALUE �t/�y�/��
ARCHITECT TEL. , USE D(ryl�1/� $l/t7/Tt/
OR ENGINEER NO. �r�-
FIRE 1
ADDRESS ZONE /YPE GROUP i-
AP
CONTRACTOR owAl�,e - gar,- BYPROV ED r DATE /°-5?p
ADDRESS l..'
ZON NO.OF USE OF NEW&vx`s. t1/4a
CITY NO` �' PLANS BUILDING'Dv'✓' �xari
F STATE CITY YARDS APPROVED YARDS APPROVED
gLIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING -
6t7 SIZE I NO.OFBLDGS. (FROM C/L STRE EyT)
0. OF LOT NOW ON LOT FRONT SO FT. FT.
Q USE OF
en EXISTING BLDG. R,SIDE 41 FT. FT.
rn
tbf/
9 Separate permits are required for L.SIDE /1- Q�T. FT.
electric,plumbing and heating work. /
C - REAR Z / FT.N r FT.
GU USE OF BUILDING AND WORK TO BE PERFORMED
F MAIN BLD BET. BET.MAIN&
MAIN BLDGS. ACCESS. BLOCS. /
...1e2f
VAR.¢'� 'e5C-7l0'�/SL DATE /o-f/-76CUP.qW �jAPPROVED
APPROVED/( ��- �i��s///HHK HOLD 1F�ORT SPEC AL REQUIREMENT
DATEa
0.
O I hereby acknowledge that I have read this application and state ecf roof Pr' ;en
yv that the above information Is correct and agree to comply with az
Vqr CgJP ,a nn.
0.. all laws regulating building construction, and I shall not employ i
i
Z any person in violation of the workman's compensation laws of m
the State of California.xi. ^ m
I hereby certify that 1 am properly licensed as a contractor under ✓✓� SD. FT. N
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the State of California Business y
and Professions Code,Division 3,Chapter 9. VALUATION PERMIT FEE 5�O. Bd N
��///��f �J r PLAN CHECK § /� �U M
Signature � �/ /�yJ//./y/ il/ -�1
Pormlttea �� $ �V r SU U
. 1 TAX
/ �) V
Authorized Agent \ TOTAL PAID $ "it 4 )
ORANGE COUNTY BUILDING DEPARTMENT. APPLICATION FOR PERMIT
•, •
North Broadway U `® � OC
SANTATA ANA, CALIFORNIA
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
EC EI///P'''T NCO) PERMIT NO.
BUILDING Ave. (/ r / /�R�/
ADDRESS 2019 Federal AIT�,.\l 'b 7 (>
SCHOOL DIST. RECEIVED BY DATE OF APPL. DATE ISSUED
OR TOWN 1
NEAREST ‘ -,25-n D -4 15
CROSS ST. 19th.St.
OWNER BUILDING 1�n�J 7,� _/ /
BANNOCK HOMES, INC. ADDRESS O0f 9 _ / CO�C,y, pe'
MAIL C TOWN IST �S
ADDRESS 9361 ILSI WILSHIRERBLVD. Cos
/✓( q
CITY BEVERLY HILLS . TEL.
CR. 54361 NEAREST /.<%
CROSS ST.
ARCHITEC OR TEL. ZONE NO. OF TYPE I GROUP
ENGINEER,AI N & MCKERRACHER NO. S`(. 64891 f I PLANS I
ADDRESS'T110 E. WAI NUT Si. . PASADENA SETBACK LINF2F 0IN CENTER.------e
S
OF ST. 55 ft.
TELREAR YARD 'f,orz. •r SIDE YARD 1 ] I A__i n L
r 4TRACTOR NEWPORT VISTA CO.NO.. CR. 54361 APPROVED
CRY DATE
ADDRESS 9163 WILSHIRE BLVD., BEV.HI LLS
n CORRECTIONS
LEGAL
DESCRIPTION ( LOT NO. 420 I BLOCK 1712
(ATTACH METES fl BOUNDS/ _ -
TRACT
NO.OF
SIZE OF LOT 67 x 110 I NOW ON LOTS 0
USE OF I NO. OF I NO. OF
EXISTING BLDG. FAMILIES ROOMS
DESCRIPTION OF WORK
X I ALTERATION I I ADDITION I 0
NEW 0
C)
REPAIR I I MOVING I I DEMOLISH I A y
IES r 104 SQ.FT ROOMS 5 STORIES 1
COV RING STUCOO WALL
I COVVERING F COMPO / /�
USE OF NEW �HI NG_Ee IIY
BUILDING RESIDENCE c Qr ` `(j
( 6 V
APPROVALS
FOUNDATION: LOCATION INSPECTOR DATE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS FORMS. MATERIALS, _ ,,,t% f f � .;
•
APPLICATION AND STATE THAT THE ABOVE IS CORRECT UNDERPINNING �:.„,,,I.3
7
AND AGREE COMPLYWITH ALL COUNTY ORDINANCES FRAME: FIRE STOPS,
AND STATE LAWS
REGULATING
LATING BUILDING CONSTRUCTION. BRACING, BOLTS
LATH. INT. y� Lj ' �3
SIGNATURE OF LATH. EXT. .1 .2- ( ` /•'[/-4,-
PERMITTE al,:
R PLASTER. INT.
AUTHORIZED AG' J /tj3 /o-'+ -c y
PLASTER, E%T. �j V
$ 4830.00 P C s Z MASONRY REINFORCED
FEE /Z
BOND BEAM �
VALUATION FEE s J4 FINAL ..-.4//�J/ 3 /— /.-i
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- PLOT PLAN)
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Costa Mesa Building Department APPLICATION FOR PERMIT
-S11 EAST 20th STREET 2y34--
BUILD1NG 1
l-""- COSTA MESA, CALIFORNIA
- FOR OFFICE USE ONLY
FOR APPLICANT TO FILL INReceipt No. Permit No.
Building r / /.l I I a///
Address �i y / ,�cJ k n°41.,
Costa Mesa, California Receir y Date Reed. Date Issued
Nearest / 1 //- .:o -1 S //-.3a -�C
Cross St. J Buildin
Address
Owner lob 4 0 1.7, Z ere Costa Mesa, California
Mail /
Address a(, / 7 /=e4 C RA >, ____. _ Nearest
' Tel. Cross St.
City Cm s f,a fri , S 4 No. N^A.44/44z_ Zone,ej I No.of I Type/ Group T
Architect or Lic. Plans
Engineer No. Approved
by Date
.Idress CORRECTIONS
e- City Lie.
_,.itractor ,-7-L,lti —4�(,,, +to.
Address
Legal
Description No. 4�.,6 1 Block 1 Tract/7/A.
c-�1 r 7:a � _
(Attach Metes and Bounds) I fi'/�� I (I I f
i N` g1
Size of Lot 4.57 X///7 I Nowo.ofonBidLots. / (�l W c A li III
Use ofNo.of 1I No.of _ "--J z
Existing Bldg. fd-- Families Rooms j' 6
Setback Line from � !
v 45 U '1y55 2
Center of Street 6 . Side Yard -- • y 3o y
DESCRIPTION OF WORK -Y r
OF •
New I id Alteration I I Addition I cos'it lif CM
Repair I I Moving I I Demolish I
Building , No.of
Size (20 X Rooms Stories
rior Wal Roof n
ering n I Covering ' n�4r APPROVALS
Use of New
Building (2�IFoundation Location '3 Inspector Date
- --7/ 2 --":2--1 Forms,Materials,
V Under-Pinning '.,
Frame: Fire Stops, ;H
Bracing,Bolts t. -9
I hereby acknowledge that I have read this Application o r
and state that the above is correct and agree to comply Lath.Int min r Zinn
with all City Ordinances and e Laws regulating r'44 - ,-
building construction, Lath.Ext. D
Signatureo / f� ,
Permittee Plaster, Int. '0 'R
Authorize gt. Plaster,Ext. .�
1 :}
Valuation Permit Fee $ (o. C 0 Masonry Reinforced
ge O Plan Check $ y, e a "
- -.I�
Bond Beam -� -,
$ Total /�/
Fee $ 7 ��- FINAL o ....2.7 -J4
FORM 204 5-BP 2M 6-55
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Street -
PLOT PLAN _
Show location and distances from
property line and between buildings