HomeMy WebLinkAbout2084 FEDERAL AVE - Building Permits •
CITY OF COSTA MESA
4taq BUILDING DIVISION r
' 41 8 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
Vi 4 PERMIT
B02-00343
(714)754-5273 • Fax(714)754-4856 • www-ci.costa-mesa.BUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 2084 FEDERAL AV Status: ISSUED
Suite: Applied: 03/12/2002
Vicinity: LIVING RM,BEDROOMS,8 BATHROOM Issued: 03/12/2002
Parcel Number: 42250103 Zoning:
Applicant: ROMERO, JORGE ISSUED BY:
Address: 2084 FEDERAL AVE
Phone: 949-722-8659
COSTA MESA,CA ' • Zip: 92627-4132
Owner: BARRANCO, JORGE R
Address 2084 FEDERAL AVE
Phone: 949-722-8659 _•
COSTA MESA,CA Zip: 92627-4132
Contractor: OWNER-BUILDER
Address: •
Phone:
Zip: License: 0
Arch : - . - . •'y� Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
REPLACE WINDOWS: 1 IN LIVING ROOM,4 IN THREE BEDROOMS,AND 1 IN THE BATHROOM.SAME HEIGHTH AND
WIDTH OF EXISTING TO COMPLY WITH 1997 UBC.DOUBLE PANE GLASS.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $3,600.00
Permit: $97.25 Claim Valuation: $3,600.00
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $97.75
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
NOTES:
•
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(6m0)
DECLARATIONS
1
WORKERS'COMPENSATIO.yDECLARATION:
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(5100)or less.)
Uy.—1 certify that in the performance of the work for which this pe is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of C;'L. '. "and agree..i..t II I shou• •, ome subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these t •' ______
p9cant Signature: • -fA ata: '- O3 //2 02
WARNING:FAILURE E(SloQi•9 RS'COMPENSATION PENS IS UNLAWFUL S A SHALL DED SUBJECT INi E EMPLOYER TO.CRIMINAL TAL R CODE. MID CML FINES TP TO ONE HUNDRED
THOUSAND DOLLARE(5100,••� N ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 31060E THE LABOR CODE,INTEREST,AND ATTORNEYS 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 Cale,and my license Is In full
force and effect.Lic.# Class M
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: Lenders 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 DMsion 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).):
rr-+
�',,.1'as owner of the properly,or my employees with wages as their sole compensation.WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himsett or herself or through his or her own employees,provided that such improvements are not intended or offered tor sale.Ii,however,the building or improvement is
sold within one year Of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of properly who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors Licens= :ws.).
,,,-
0
❑ I am axe.. •r!r.ec. v 1 Business and Professions Code for this reason:
TSIgnature'- - /•//aj/j
Expires:
Verification of LW nership by(type of docu -nt,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,fatsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,AR 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:
I 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 Flre Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the Califomia Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication aapermit 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 Two feet from the outer boundaries of a school? 0 Yes 0 No
(If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No
8 (If yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERT FiCATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property far inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Sig • ••e • Md4•• : (s) Da
•nd/Or uth
Audzed Applicant7 oto
CODE I I1ISPE ONTYPE PATE MALS CODEI INSPECTIONTYPE OdIE 1tl1111M4¢
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1288 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 Building/Occupancy 0 O
`3o-c2 irg-
DECLARATION OF AUTHORITY Bldg. Permit# t2-- a• '
FOR AGENTS OF PROPERTY OWNER This Permit# c—
TO APPLY FOR PERMITS
q/� S.)/
I ) g2621
Street Address: 2( o Leet eYci 1 ►nL.Ave • CnstN tuts c - ('A• AP Number:
1. I (we), X -Say () ��eyD &'/YGrn GU , declare that I am the Owner of Title of the above
referenced real property,and that I (we)hereby authorize:
•
Name: .JO Y N Q -ext) Telephone Number: ('1 q) 722 - E 6 59
Street Address: 210 �7 -red y a/ A'ue • los-14 MPS 4 at
City: CoSti M Q56% . State: CA Zip: 922 1
to obtain permits in my behalf,as owner/builder,for
at the above referenced property.
2. Should any person become an employee engaged in the improvement of the property, I (we) shall immediately provide Worker's
Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa
Mesa,as required by State of California laws.
3. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other person, company or
corporation.
4. I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or
personal injury to myself or any other parties as a result of work authorized by the permits from the City of Costa Mesa.
5. I declare under the penalty of perjury that the foregoing is true and correct.
Executed this day of 20 , at ,California.
Print Name:' ♦ _ di . Z1- to 4v'/ 0
Signature:',-� -at
-9�
Date: a. 93 12 0
Note: This authorization does not grant authorization to perform the work as owner,
it solely provides for limited power of attorney to secure this permit in any behalf.
0779-6(rev.11/00)
d eirel 01 eedeet Neat Fiay nisidecut
'_rl �� ° OWNER-BUILDER
" --i 7'- VERIFICATION
•
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.
I. I personally plan to provide the major labor and materials for construction of the proposed
property improvement. ] Yes ❑ No
LL
2. I (have/have not) Iktve signed an application for a building permit for
the proposed work.
0 1 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
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OWNER CALLAHAN, ROBERT DATE 4-13-79
JOB ADDRESS 2084 gederal Avenue BUILDING PERMIT NO. 47706
GENERAL CONTRACTOR Owner-Bldr. DESCRIPTION of WORK Add Bath
AI? ''. 115-471-03 LOT TRACT FIRE ZONE VALUES 3,500.00
:°?CTI ONS Signature Date TYPE V GROUP 8 ZONE R-1
SOIL PERMITS ISSI4ED
Dab Number GAS SUBCONTRACTOR I I
' Signature
WATER Plumbing
ROUGH PLUMBING O '/-IJrM 'C3g/7I
PROP. SWR. LINE ❑ HOUSE CON. f F
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER 0
ROUGH WIRING 'Hooting and Vent.
TRENCHES FORMS IJ STEEL REINF. 0f
FLOOR SYSTEM
BOND BEAM i1 STEEL REINFORCE I—I
SHEATHING
FRAME ANO FLASHING
LATHING - IN 17 OUT n
PLASTER. BROWN COAT
STR' 'RAL. FINAL I nElertr2 n fl ill is-4 I
HEA . VENT., REFRIG. AND A.C..�FINAL I Ifj V L I` I \ II A-/-131/1 -4$14 b
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PLUMBING, FINAL AND GAS TEST l l I U 11/4 H � I CI n
ELECTRIC, FINAL IJ � v `\� p Ni �� I La..—
BUILDING. FINAL I
ORANGE COUNTY BUILDING DEPARTMENT APPLICATION FOR PERMIT 4
636 North FORy N
SANTA ANA,, CALIFORNIALIv •
•
FOR APPLICANT TO FILL IN FOR.OFFICE USE ONLY
RECEIPT NO. PERMIT NO. .
BUILDING
ADDRESS 2084 Pedro-n- AVe_ 661/45N/0 ._J r339
SCHOOL DIST. RECEIVED BY DATE OF APPL. ,DATE ISSUED
OR TOWN
NEAREST /_2 3 .., / �) H ••S .j
CROSS ST. IN n}n»i O Avr,. tC� G� `J 10
BUILDING .P '/ T
OWNER BANNDCK HOMES, INC. ADDRESS U `A"v
MAIL 9363 WILSHIRE BLVD. SCHOOL DIST. /R� u /},.,
ADDRESS OR TOWN (�Q2i(Jv �/'LC.y�^
CITY BEV. HILLS No T .CR . 54361
NEAREST �f
1,p3 ♦ CROSS ST. ,(�[�"L'(�t�/l�
ENGINEERT eKIN & MCKERRAC HERNaLSY. 64�St ZONE, NO..PLAOF
NS I TYPE I GROUP.C
•
ADDRESS 2110 E. WALNUT 'ST. ,PASADENA SETBACK LINK FROM CENTER OF ST. - 5p ft
'TRACTOR NEWPORT VISTA CO LE& CR'.54361
APPROVED REAR YARD 5- ft- +610E YARD lite,l
ADDRESS
9363 WILSHIRE BLVD.,BE V.HILLS BY DATE
LEGAL CORRECTIONS •,
DESCRIPTION I LOT NO. 37 I BLOCK 1712 . '
(ATTACH METES & BOUNDS) _ •
TRACT '
SIZE OF LOT 67 x 110 I NO.OF
NOW ON LOTS 0
USE OFNO. OF NO. OF - -
EXISTING BLDG. I FAMILIES I ROOMS _ - - _ - . - . .
DESCRIPTION OF WORK
NEW g I ALTERATION I I ADDITION I O
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REPAIR I I MOVING I I DEMOLISH I Z
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SIZE DIN 35. x 38, ROOMS 5 STORIES 1 r
WALL I ROOF COMPO
COVERING STUCCO COVERING SR NM ES
USE OF NEW
BUILDING RESIDENCE
APPROVALS ,/4'.S
FOUNDATION: LOCATION INSPECTOR DATE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS FORMS. MATERIALS.Ra. J/��( )4,APPLICATION AND STATE THAT THE ABOVE IS CORRECT UNDERPINNING a.4
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FRAME: FIRE STOPS.
V
fes3 -4.5
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. BRACING. BOLTS ��� �j^ 7
LATH. INT. /"B 1_( 3_3
SIGNATURE OF NEWPORT V I ST O. LATH. EXT. ,_-k0-47".-65—.5
PERM ITTEF -
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AUTHORIZED AG -• -`A ��. pn`� f� q' _
PLASTER. EXT. , -I �� X•`!t
$ 4830.00 P. C. 3 .!... MASONRY REINFORCED
FEE 1•Y BOND BEAM '/
VALUATION S i Li.'
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I - 18287 NO V"2� �9s2
- COSTA MESA BUILDING-SAFETY DEPARTMENT
P. /y�vicE � [�}'�®
P. O. BOX 917 COSTA MESA. CALIFORNIA CITY Of COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT Sc ,/) BUILDING
ADDRESS BUILDINGoZ O g-`J / Cc C2/1" � Are
TCOSTTAA MESA. CALIFORNIA For Office Use Only
OWNER / / ,./ 7 /( a (J e a. /) I RECEIPT NO. �EjtM1 0.
MAIL (� �/5• j / RECEIyEO BY DATE RECEIVED DATE(JjISSUED
ADDRESS O6 "] Le-e Y/G n-2. � v7_' v/'f°/ I // /- -1' //^P747'
//ff /�� TEL. fI� v ��-g
CITY (i to,{ �� /"/CS/�J NO.1/L .LIh/7 gDDRESS
ARCHITECT TEL -^-- COSTA MESA. CALIFORNIA
OP 'GINEER NO.
ADDRESS FIRE
ZONE _.---,yTYPE� GROUP
/ //
CONTRACTOR O w/V ert_. -(I3:✓. L cl t4_ . APPROVED /I/ DATE ///< / /C9 a-
ADDRESS —
AN ZONING ' • /
//]] //� P ZONE [%/� NO.OF •� CUBE OP NEW S /�7
CITY a 0 S 729- ' "' es /� / PUNK {� BUILDING/ L�, /
STALIC.TNO. NO. DESCRIPTION r‘ /7i� L 0 l J
SIZE / X 7 ' // O l NO. OF BLOCS. // '/ /
OF LOT IO /� NOW ON LOT / A.P.NO. — 7 /
USE OFPYARDS EVES
SI
EXISTING BLDG, APPROVED ALLOWED
SETBACK LINE FROM �I E K (CENTER LINE BTJ
CENTER OF STREET T REAR YARD I--
FRONT 'S1� FT.A/ IN.
SIDE YARD I LEFT I RIGHT !- /` SIDE r/'/c2CR a FT. )('D EX/rt. IN.
DESCRIPTION OF WORK L.SIDE ✓• 1 FT. IN.
NEW I II ALTERATION / \ ADDITION IX"
REAR aSnt FT. IN.
REPAIR I II MOVING I II DEMOLISH I APPROVED._=rioy_(7,c DATE ///Z 7/`L
BUILDING ID L` NO. OFBY 'OI
SIZE cs-4 j ROOMS / STORIES / �'�
EXTERIOR W LROOF [ //
COVERING i I COVERING rile lz(Z c/as
USE OF /DAS r-ciNG AND BE PERFORMED.5 r } e
o c- CSR 6'e2T d- nit) LLDs eJ .
° des, . Y67--'"(--4. //a e__
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM• PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES ND-STATE LAWS REGULATING
BUILDING CONSTRUCTION. ( VALUATION
SIGNATURE OF '(/' PERMIT FEE $
7
PERMITTEE `� ' _ 1 lc/4-4 I �o�(lJ 0
St.::,..-1 PLAN CHECK $ �"
Z
AUTHORIZED AGENT �( 0
TOTAL FEE ..- 4