HomeMy WebLinkAbout250 FLOWER ST - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address: 250 FLOWER ST
Suite:
Vicinity: RESIDENCE ONLY
Parcel Number: 11721401
Applicant: ARD, WILLIAM
Address: 3080 SKYWOOD ST
ORANGE,CA, -
i' ,
Owner: ZIMMER, ROBERT.J
Address ,2284 LA LINDA CT � - �
�
. NEWPORT BEACH;�CA` � .
Contractor. �ECONO ROOF �v1AWTENANCE
Addiess: 3080 SKVWOOD ST
� - ORANGE,CA
� Zip:. 92865 L
Arch : ,
Address:
Zip:
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� -. , =. Phone:
� � � License:
Zoning:
ISSUED BY:
Phone: 714-974-0345 �- �
� 2ip: 92865 ,
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Phone: ' � � - ' �,
Zip: 92660 � , � � ��� ' � �
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Phone: 714-9740345 �� � .
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Icense: 485585 � � , �� ' `
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En9: , -� , _ ', ; _
Addressi - � � ' � �
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- � Phone: , � �
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License:
_ SCOPE OF PERMIT _ � '
/ i—: -,- . p ,- �,.�. �
REROOFRESIDENCE ONLY: T/O, 1 SIDE OF ROOF REPAIR AND FILL SPACEiSHTG AND APPLY 3 SIDES INSTALL ,.
15/32" PLYWOOD, 1 LAYER 30# FELT, "GAF SENTINENTAL 3-TAB" ON GABLED PART. FLAT AREA (WASH ROOM AND , �,�_ ',,,
PATIO) WILL BE TORCH DOWN. 1400 SF ' - � . �
� — � - " _ FEE SUMMARY/ %- � � > . � ' � - "
Plan Check: ' $0.00 � Calc Valuation: ", r Sa;�oo.00
Permit: $97.25 Claim Valuation: �� ' .' - $3,ioo.00
SMIP Res: $0.50
SMIP Com: $0.00
, Ofher: _ � $0:00 � , ,
Inspection: $0.00 ; ,'
' ;_,:::. �
Total: $97.75 � � � � "
Status: ISSUED
Applied: 04/17/2002
Issued: 04/17/2002
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front �0-0
PARKING Ezistin : o
C[�]i�'j
Rear 0- 0
Rear 0- 0
� , Requiretl: 0
PLANNING & ZONING
Lek 0- 0
Lek 0- 0
PropoSed: 0
Right � 0- 0 � �
Right 0-0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regula�ions. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned
for a period of 1 BO 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
requlred Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the axpiration of this pertnit.
FOR INSPECTIONS CALL: (714) 7545626
244646 (8�W)
WORKERS' COMPENSATION DECLARATION: '
I hereby aXirtn untler penelry ot perjury one of ihe tollowing declarations: .
❑ I have antl will maintain a ceniticate ot consent to selt-Insure tor woBers' compensation, as pmvided for by section 3700 of the Labor Code, for ihe pedormance of ihe
work tor w�ich this permit is issued.
�I have and will maintain workers' compensaGon insurance, as requiretl by section 3700 of the La6or Code, for the perfortnanca of the work tor which Ihis pertnit is issue0.
My workers' compensation Insuran�c^e � er end policy number ere: %�
CeMer�� ��(iN _ LP-olicyNu�m�9r.'� �1�.�'Z��— f'�
(This se on ee n t be�com l�ited�/ t permit is valued at wre hundred dollars ($100) or less.) � '
❑ I certify Ihat in the peAormance of the work tor which Ihis pertnit is issued, I shall not employ eny person in any manner so as to become subject to �he workers'
compensatlon laws oi Califo ' and agree that it I shoultl beco a suhject to the workers' compensation provisions of Section 3700 of the Lebor Cotle, I shall forihwith
comply with these pr7 i� ,��
ApplicentSignetur � /a�� �Date: �—/i.— r�9
+�e.ae... ..-.
WARNING FNILURE T CURE WORKERS' CAM NSATION COVERAGE IS UNLAWFUL AND SHP1L SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND CNiI FlNES UP TO ONE HUNDRED
TFiOUSANO DOILARE (51 W.OW), IN NDDITION TO THE CQST OF WMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]Ofi OF THE LABOR CADE, IMEREST, AND ATiORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby attirm that I am licensed under provisions of Chapter 9(commancing with Section 7000) of Division 3 ot the Business and Professions Code, antl my licensa is In full
farce and eHe R�. Lic`.,a Cless k '�,� �
Gontracror's5ignawre'/% ate: .�� .... '7_ �
�-�---� _.. _ . d �.� r �' —, 4 �- .
CONSTRUCTION LENDING AGENCV:
❑ I hereby aRirm Ihat Ihere is a conswction lentling agency tor the peAormance of the work for which Ihis permit is issued. (Sec. 3097, Civil Code).
Lender's Name: Lenders Address:
SignaWre: � Date:
OWNER-BUILDER DECLARATIONS:
I hereby atfirtn that untler penalry of perjury that I em E%EMPT FROM THE CONTRACTORS LICENSE LAW for the Following reason (Sec. 7031.5, eusiness and Protessions
Code: Any ciry or county which requires e permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires ihe epplicant tor such pertnit
to tile e signed statement ihal he or she is licensed pursuant to the pmWsions of Ihe Contrectors License Law (Chapter 9(commendng with Sectlon 7000) of Divislon 3 ot the
Business and Professions Code) or that he or she is ezempt therefrom and the basis For the alleged e:emption. Any violation of Section 7031.5 by eny epplicant for e pertnit
subjecls the applicant m a civil penalry ot not more ihan five hundred dollars ($S00).):
❑ I, as owne� of Ihe property, or my employaes with wages as iheir sola compensation, WILL DO 7HE WORK, and Ihe siructure is not intentled or ottered tor sale (Sec.
7044, Business and Professions Cotle: The Contractors License Law does not apply to an owner oi property who builds or improves Ihereon, and who does such woB
himselt or �erself or through his or her own employees, provitletl iha� such improvemanis ere not intended or oHered for sale. If, however, tha building or improvement is
sold within one year oi completion, ihe owner-builder wiil have ihe burden of proving that ha or she did not builtl or improve for purpose of sale.).
❑ I, as ownar of ihe propeny, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct Ihe project (Sac. 7044, Business end Professions
Cotle: The contractors License Law tloes not apply to en owner of property who builds or impmves Ihereon, antl who contracts for such project with a contractor(s)
license pursuant to tha Contrectors license Laws.).
❑ I am exempt under Sec.
Signature:
Owner ID verifietl by dnvers license. ❑ Ves ❑ No
Business and Professions Cotle for this reason:
Ventiwtion of Ownership by (type ot document, i.e. - pmDerty tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
Dnvers Licen58 No.
Data:
Expires:
❑ I hereDy cenify Ihat no excavation five (5) or more feet in depth into which a person is required to descend, will be matle in connection with work authonzetl by ihls
permit, and that no building sWcture, scallolding, talsework, or tlemolition or dismantling ihereof, will be more than thirry-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec.
341, Titla 8, Califomia Adminisiretive Cotla).
❑ As owner-Duilder, I will not employ anyone to do work which would require a permit Irom the Division of Intlustrial Satery, es noted ebove, unless such person hes e
permit to do such work trom Ihe tlivisian.
Signature: Date:
Division oi Industnal Safery Permit Number:
CERTIFlCATE OF COMPLJANCE AND AUTHORVJ1710N OF EN7AV: I cenity under penalty ot perjury tha� I have read �his epplication antl state that tha infortnation given is
correct I agree to comply with ell state laws and city ortlinances rela[ing fo building consiruction, and authonze representatives oi the Ciry of Costa Mesa to enter upon �he
ebove-descnbed property for inspection purposes. I agree not fo occupy or allow acupency oi eny building authonzed by this permit until fnel inspection.
COOE I. INSPECTONTYPE
1616 Fixetl System Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Roof
201 Final BIocWRetaining Well
202 Final Factory Fire Place
203 Final Sign
204 FinalOemoli�ion
PdIF U�«
as- a �_
COpE 1 INSPECTION TYPE
206 Final Mechanical
208 Finel Plumbing
210 Final Electncal
212
220
Finel Fire Preventian
Final Planning Approval
222 Final Site
250 Final Building/Occupancy
Data
PAIF. II�L$
_ . Aop�icant to fi11 in all spaces exce0< those within heavy Doraer Iines antl sign all apvroo��ate Oeclantions.
, CrrY OF cOS7d nnESA . CONSTRUCTION PERMIT
� ProjectAddress 'ZSV ��01.5E�2� .�T. �
� ApplicanCs Mcliin9 Address �� W<<'
� Owner'sName �����'✓Lr �i't'�'�'«�-('"f- PhoneB`�S'138�
Address !
Arch/Eng. � License No.
. ' Address - -
Contracror'sName ���1'� �IPL,j�LI �- Phone 5%�S�3y�"
� Addresslmailingl 5�'�� �%��%t'���- Y�-U� S"ifg.3
-FT� �rC�: -I?. i'/
. City License No. - L.� y F X�+
LICENSED CONTRACTOR DECLARATION
� I �iereby attirm tM1at I am licensetl untler provisions o( Charter 9(commencin9
� with section ]000) of DiviSion 3 of the Business antl Prote55ion5 Co�tl7e, antl
my license is in full torce antl ei�ecL / �O L 7�
LicenseG�s�� -�„G��� L�e'��JA�y�
Date j� � � 5
WORKERS' COMPENSATION CLARATION
. �ereby attirm lhat I have a certificate of mnsent to self-Insure or a certiticate
Workers' Compensation Insurance, or a certifietl,copy thereof (Section
e00, Lab. CJ
Policy No. ComOany
BCertitied copy i5 hereby fumishetl.
Ge�tifietl copy is tiletl wifh the city Builtlinq Divislon.
Date Applitant
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(Thissection neetl mt be campletetl if the permit is (or one huntlretl ($300) o�
iess).
I certlfy that in the perto�mance of the wOrk for whith tM1is p¢rm�t is i suetl I
shall not employ any person in any ma r so as to become bje t. t�e
WorkersyCo pe s t' n Lawz of Califor , `
. Date "�—Signature
NOTI[E: I, aiter makin9 this tleUara on, ou shoul ecome subject to tne �
Workers'-Compensation provisions the Labor CoB , you must forthwith
comply with such provisions or his permit shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCY
I hereby affirm ihat there i5 a'mnstruction lentling aqency for [he Oerfo�mance '
of Ihe work fon which this pe�mit is issuetl ($ection 3097 Civ. C.)
lentler'S � Name
Lentler's Atltlress � �
OWNER BUILDER UECLARATION
I hereby affirm that I am exempt irom the ConVactoYs License Law for the
(ollowing reason (Section ]031.5 Business and Professional Cotle: Any city or
county which requires a pe�mit to construct, alteq improve, tlemoli5h o� repair
any 5[�ucture, prior to itz issuance, also requires the applicant tor such permit
' to file a signetl statement that he/she is licensetl pu�suant to the provisions of
the Contractor's License Law_(Chapter 9(commencing with Section 7000) of
7ivision 3 of the Bu5ine55 and Prolessions COGe) or that he/She is exempt
M1ereirom antl the basis for the allegetl exemption. Any violation of Section
031.5 by any applicant for a permit subjects ihe applicant to a civil
� �enalty of not more than tive huntlretl tlollars ($500).
I,.as owne� of tM1e p�operty or my employees with wages as thei� sole
wmpensation, will tlo the work, antl tite st�uctur¢ i5 not intentletl o� offeretl
(O! Sd�E ($¢CilOfl i044� BI1510255 dlld PI0125510f1d1 Gotle: The COf1SYdG[O('S
LicenSe Law tloes not appty to an owner ot a property who builas or improves
thereon, antl who does such work nimself/herself or througn his or her own �
employees, provitletl that sucM1 improvements are not intentletl or o(feretl fo�
sale. If, howeve�, the builtlin9 or improvement is soltl wi[M1in one year of com-
' pletion, the owner will have ihe burtlen ot proving h¢/she tlitl not builtl or i�n-
' piove to� the purpose of sale). �
❑ I, as owner o( the property, am exclusivery contracting with licensetl con-
tractors to construct the oroject (Seccion 7044, Business antl Professions Cotle:
The ConVactor's License Law does not aPPry to an owner ot property who
' buiitls or improves thereon, antl who mntracts for such �proiects with a con-
t�actor(51 I¢ense pursuan[ to the Contractor'S;License Law). P am aware [ha[
proo(" of their Worker's Compensation insurance shoultl be provitletl to me.
� ❑ I am exempt untler Section _ � B. & P. C. for this reason
Da[e �� Owner
inspectior
, Signature
Orivers' L
CMF 0865-46
1-have reatl this a
1 agree to comply
to builtling const
� to enter ubon
�¢(152 OI $$ #`
rev. 10/84 1
tion antl state tnat the abave
all tity antl county orainances
�}, aptl he�eby authorize repre-
mentioned �p'yro��pe�rty, �f(o�r'
� Date�'Q: p n .
��3Zyyo � ....._..,_. I _`__.
TY�FCONSTRUCTION 'NEW ADD ALTERATION REPAIR
CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG. —�=r��![t! � �C"
, L
TVPEOFPERMIT GRAOING FOUNDATION ' STRUCTURAL ' �
� ❑ TENANT � ELECTRICAL ❑ PLVM9ING ❑ MECHANICAL
❑ OTHER . ` ' � �
PROJECT DESCRIPTION Sc3. FT. oCCUParvCv
CONSTRUCTION TVPE VALUATION $
20NE ' GRA�INGCU.VDS. ACRES
o....,.o-.. A _ .. _ � _ _ ._ . v. _i _ ._. � .f- -r�_ .
/ �T r +e- •
F
IBar Sink
Backflow Preventer ,
Roor Drains
Floor $inks
Gas Service
Interceptors
Kitchen Sink
Lavamries
P-Trap
Roof Drains
Reinspection Fee
Outlets
$15
Boiler
Duct - Under Ground
Duct-Structural �
Duct - Ventilating
Exhaust System ❑ Muitiple ❑
Firepl/Fact Blt. ICBO # '
Heating System & Ducting � � -
❑ 0-100,000 BTU 0 7 00,000 eTi
Reinspection Fee' ' I ' $15
Builtling;�Canary - Applicant; Pink - Accountin9� Goltlenrotl - A55es5or
Service Sink � � .
Sewer Cap
Sewer Connection
Soiar. Col lectors
Solar Piping '
Solar Tank �
Swimming Pool w/Spa
Urinal
Water Claset
Water Heater
Water Service
Auto-Wash
laue Fee
Hood or Typel ❑
Canopy Typell ❑
Refrigeration System
❑o-ioo,000aTu Oioo,000
System Repair/Alteretion
FireDampers -
Registers �
Isue Fee
A.P. # ' '
S Main Builtlin9:
E
T Front
ARear
C Right '
K left
S
Ping. Ref. #
Planning Notes:
Auromatic Washer
Construction Pole Sub.
Cooking Unit �
Dishwasher '
F,A,U.
Pixtures
Device Boxes
Switches
Garbage Disposal
Generator �0.5 KW
^ Zon
Accessory Building: '
Z
' O
N
I
'_ N
G
R
Parking Req./Provided � E
Q
� M
T
S
ELECTRICAL . .
Transformer ❑ 15-50 KW
. ❑ 50+KW "
� Meter �p to 100amps
, Mete,r ,Dover 100 amps
I Sub Panel
. Morors �0-1 HP �1 %- 8.
Inc.Solar �9�15 HP �16-75+
Microwave
� Pole Light
Range
' Standing Sections
5 KW Trash Compactor
Y
$ 3 —__
Reinspection Fee $15 .Issue Fee
FEES
DEVELOPMENTSERVICESREQUIREMENTS:
Zoning APProved By
Building Approved By
- Appliwtion Issued By :L�a. �'
$ 3
- SUMMARV OF
BUILDING PEFMIT $
PLAN CHECK $ �
PIUMBING . S
PLAN CHECK 25% $ �/� �-�-�
EIECTRICAL $ -/Lr�`�
PLAN CHECK 50% $
MECHANICAL $
PLANCHECK� z5% $
FEES -
a
SMIP $
PERMIT � - � ,' :
ISSUANCE $ ,
ENEPGV P.C. $ � '
GRADING $
MICROFILM $
TOTAL FEE $ �
. . . . . . fi" _ " " f � '
CONSTRUCTION AND PLANNING . �� . . n r) � POOL & SPA � • � .
� �,� Date Inspector � Date Inspector
qPPROVALS Permit # / APPROVALS Permit # _
r •
t,��Temporary Electrical Service or Pole 52. Pool & Equipment Location � ,�� •
�
2. Soil Pipe-Undrgrnd. 'Y 53. Steel Reinforcement �
3. Electrical Conduit Utility-Undrgmd. 54. Forms' � '� �
4. Electrical Conduit-Undrgrnd. 55. Electriral Bonding "
5. Steel Reinforcement �. � , 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd:d ' 57.. APPROVAL TO COVER-GUNITE .
i.�
�s .
7. Footings � f` 58. Electrical Conduit-Undrgrnd. �
S. Foundation .� � � ' � 59. Gas Pipe, O Undrgmd., Test , .
9. Water Pipe-Undrgrnd�% 60. Backwash Lines, P:Trap, � Undrgrnd.�
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line°& �House Connection � . 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains � ' 64. Plumbing System - final
14: Rough Plumbing � � � 65. Electrical-Final
15. Rough Electrical-Conduit . 66. Solar System-Final
16. Rough Electric Wiring � 67. Fencing & Access Approval _ �
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T 8ar Ceiling� � 69. POOL/SPA SYSTEMS FINAL �
19. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT
��
20. Rough Factory Fireplace APPROVALS Permit# .
21. Ducts, in Structure • 70. Underground Hydro �. ' ��
�
22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil. �
23. Gas Pipe-Rough & Test � 72. Underground Flush � ' ��
r ,-.
24. Roof Framing � . 73. Undergmd.StoregeTank OGas ❑Oil �' �
25. Roof Sheathing � - 74, Overhead Hydro �_ �_
j i
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical .
27. Frame and Flashing ' 76. Dry Standpipe , r '"
26. Lathing & Siding 77. FIXED SYSTEM FINAL� '
29. Insulation 78. FIRE PREV. FINAL� �,, � ' � �
30. Drywall Nailing ' � HEALTH DEPT. REQUIREMENT � -/
37. Plaster Brown Coat � 79. FINAL INSPECTION i; �� i, �� ' �
32. Electrical Power Meter-Final �j 80. FOOD CERTIFICATE ISSUED - <" �
� � i, , �
33. Final Electric ",3J� Notes: /�. f ,�� �,x. r_ �
34. Final Heating & Air Conditioning ay ' t,,
3 � �:' �
35. Final Gas Pipe-Test -
- - .j/o�9 /�2� .' o ' �o
36. Hood or Canopy n�� �� � . '
37. Final Factory Fireplace • � � .
38: Final Plumbing ' � . .
39. Water Service-Final � �
40. Gas Service-Final - - ,-� � •
• 41. Solar pomestic-Final . � •
42., Backflow P.reventer . � `" . ` .
�43. Backflow Irrigation . ,
. 44. .Landscape Irriqation System . � �
45. Sound Attenuation , � . ,
46. Handicap Regulations �
47. FINALSTRUCTURE&BUILDING . .
48.�Special Requirements Completed � � . �t
49. Electric Release to Edison � �
50..Gas Release to Southern California Gas Co ' �' ^
. 51. CERTIFICATE OF OCCUPANCY - �
No. Date
i