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Home My WebLink About670 CAPITAL ST - Building Permits(714) 754-5273 • Fex (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Vicinity: Parcel Number: Applicant: Address: Owner: Address: Conlrector: Address: 670 CqPITAL ST 42217118 JENSEN, DANIEL J 670 CAPI70L ST COSTA MESA, CA JENSEN, DANIEL J 670 CAPI70L ST COSTA MESA, CA OWNER-BUILDER MECHANICAL PERMIT Phone: 949-631-7690 Zip: 92627-2502 Phone: 949-631-7690 Zip: 92627-2502 Phone: Zip: License: 000000 SCOPE OF PERMIT REPALC� EXISTING FAU IN THE ATTIC. < 100K BTU. ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU Repair / Alt Cooling/Heat Inst / Rep. Recess Wall Hlr Refrig Sys <100 k BTU Refrig Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Ezhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000cfm Air Handlers > 10000cfm Floor Furnace Floor or Suspend Heater 523.50 $14.80 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Duantity FEE SUMMARY Status: ISSUED Applied: 10/28/2004 Issued: 1028/2004 ISSUED BY: r r• � � - �. . ,' �, Repair / Alt Absorbtion Unif Repair / Alt Refrigeration Unit � Ventillation System Evaporative Cooler Commercial I ncinerator Domestic Incinerator Compressors�/ Absarption Svstems Upto3hp/t00kBTU 3To15hp/500kBTU �� 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Upto3hp 3To15hp 15to30hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee Reinspection Fee Duantiry $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 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 50.00 $0.00 TOTAL CALCULATED FEES $38.30 NOTICE: The work authorized by this permit shall comply wflh all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 1241-g2) EXPIRATION: This permit shell automatically expire and become void if work is not commenced within 180 days, or If work Is suspended or abandoned tor 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 required Inspeetlona and finel approval muat be obtalned. Failure to obtain inspections and final approval will result in the axpiration of this permit. FOR INSPECTIONS CALL: (714) 7545828 244&46 (6/00) WOHKERS' COMPENSATION DECLARATION: , . _ I hereby attirm under penelry of perjury one o� �he following decleratians: � ❑ I have antl will malntain a cartificate ol Consent to setf-Insure tor workers' compensation, es provided for by section 3700 of the Lebor Code, tor ihe pedormance of ihe work lor which this permh is Issuetl. ❑ I have antl will malntain workers' compePse�ion insurance, es requiretl by section 3700 of the Labor Code, for the partortnance ot the work for which this pertnit Is Issued. My workers' compensation Insurance carrier end policy number are: Cerrier: POIiCy Number: (This section need not be completed il fhe pe�it is velued et one huntlretl dollars ($100) or /ess.J ❑ I cetlify Ihat in Ihe pertortnance of ihe work for w�ich this permit is issued, I shall not employ any person in eny manner so es to become su�ject to the workers' compensetlon laws ot Celllornla, antl egrae �het Ii I should Oecome subject to Ihe workers' compensation provisions oi 5ection 3700 0� the Labor Cotle, I shell tonhwith comply with these provisions. Applicant Signeture: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL PN� SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND qVIL FINES UP TOONE HUNDRED THOUSAND OOILARE (§100,000), IN ADDITION TO7HE COST OF CAMPENSATIIXJ, DANAGES FS PROVIDED FOR IN SECTION 3]Ofi OF THE LABOR CAOE, IMEREST, AND ATTORNEV'S PEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm that I em Ilcensed under provi5ions of C�apter 9(commencing with Section 7000) of Division 3 0l ihe Business and Professions Code, and my license is in tull force and eHecL Lic. N Cless p CONrectors Signature: Dete: LONSTRUC710N LENDING AGENCV: ❑ I hereby aHirtn thet there is a constructiPn lentling agency for the performance ol ihe work for which ihis permit is issued. (Sec. 3097, Civil Code). Lendels Name: Lendets Adtlress: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby attirm that under Denelty af perjury Inat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor ihe tollowing reason (Sec. 7031.5, Busine5s entl Professions Code: Any ciry or coumy which requires e permit to construct, alter, improve, tlemolish, or repair any simcture, pnor ro its issuance, also requires ihe applicani for such pertnit to tile e signed stetement thet he or she Is Ilcensetl pursuant to the pmvislons oi �he Coniractors License Law (Chepter 9(wmmencing wi�h Sectlon 7000) of Division 3 of Ihe Business and Professions Code) or that he a� she is exempt t�erefrom and ihe basis for tha alleged eaemption. Any viale0on ol Section 7031.5 Dy eny applicent for a pertnit subjects the applicam to e civil penalry of not more than five hundred dollars ($500).): ❑ I, as owner ot Ne pmperty, or my empf0yees with weges as iheir sole compensaSion, W ILL 90 THE WORK, entl the siructure fs noi inlantletl or oHaratl tor safe (Sac. 7044, Business end Professions COGe: The Coniractors License Law dces not apply to en owner of OroDerty who builds or improves Ihereon, and who tloes such work himself or herself or through his or her own employees, provided that such Improvements are not intendad or oftered for sele. If, �owever, the 6uilding or improvement is sold within one year oi completion, the owner-builder will heve ihe burden of proving that he or she did not build or improve br Durpose oi sele.). es owner of the propeny, am E%CLUSNELV CONTRAC7ING WITH LICENSED CONTRACTORS to construct ihe project (Sec. 7044, Business end Professions G�ode: T�e coniremors License Lew tloes no� epply to an owner ot properry who builds or improves thereon, and who contracts for such pmject with e contractoqs) license pursuent to the ConVactors License Laws.). ❑ I am eze ec Business end Professions Cotle for Ihis reason: " Si ature: � Expi s: �G.-OS — � Verificatian of Ownership by (type ot daumen�. i.a. - propeny tax bill o DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTFICATION: ❑ 1 hereby cetlity ihat no excave�ion five (5) or more feet in depih into which a person is required to descend, will be mede In connection with work euthonzed by Ihis permit, end Ihat no building structure, sGeHoltling, talsework, or demolition or AismaNling thereof, will be more than ihirty-six (38) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, TUe 8, Calitomie Adminisirative COde). ❑ As owner-builder, I will not emplay anyone to do work which would require a permit irom ihe Division of Industnel Sefery, es noted ebove, unless such person has a pertnit to do such work irom ihe division. Signature: Date: Division of Intlustnal Safery Permit Number: CERTiFlCATE OF COMPLIANCE AND AUiHORIZA710N OF EN7RY: I ceM1ity untler penalry ot perjury Ihat I have read this applicalion and state ihat the information given is correct. I agree to comply with ellstat a end ciry oNinances relating to building construction, and authorize representatives of the Ciry of Costa Mesa to enter upon the above-desCn 6��ep tly for ins 6ction pu tlses. I egree not to ocapy or allow occupancy ot eny building authorized by Ihis permit until final inspection. io',2�3• �`/ Sign t Legal ner(s) D'�te �_i AnNOr Aulhonzed Applicant Date COOE I. INSFECTIONTYPE 1616 Fized System Finel Fire Preventlon 1266 Pool Spa Final 200 Finel RB-Root 201 Finel BIocWRetaining Wall 202 Finel Fectory Fire Place 203 Finel Sign 204 Finel Demolilion QdjE INTRIPLS CODEt INSPECTIONTYPE 206 Final Mechaniwl 208 Final Plumbing 210 Final Electrical 212 Final Fire Preventlon 220 Final Planning Approvel 222 Final Site 250 Final Building/Occupency � .�-Ll -09 1�� CITY OF WSTA MESA PLANNING DEPARTMENT !UI_-1-7Q�MShOO 049Ro***+=zj,Q� A. P. No. ll:i-/!(2-15 Bldg. Permit No. ,? l'�?/7 PARK AND RECREATIONAL FEES - Apartment Developments Fee Payment Receipt Project Address F7� CAPITAL STREE7, ceszn r'ES/1, CALIf-�f'NI11 Owner's Name C.47N�!'.It�C= N. �,P.IFFITII Bachelor or 1- Bedroom Units 2 - Bedroom Units 3 - Bedroom Units 4 - Bedroom Units @ $25.00 = <<�,�„q @ $40.00 = @ $55.00 = @ $70.00 = 5 - or more Units @ $75.00 = Total Fee •��,��, Total number of Dcaelling Units. � Planning Department Approval Date 7.7 7' Park Area No. ii By'• � � ��'" Applicant's Signature �� WNER GRIF6] JOB ADDRESS GENERAL CONTF AP No. 115 4 �INSPECTIONS SOIL GAS W ATEft ROUGH PLUMBING PROP. SWR. LINE � SPRINKLING SVSTEM MISCELLANEOUS ROOGH HEATING ANO AIR CON�1710NING TEMPORARY SERVICE OR POLE UNOERGROUN� � POWER �_ ROUGH WIRING TRENCHES � FORMS STEEL REINF. FLOOR SYSTE BON� BEAM � STEEL 0.EINFORCE ❑ SHEATHING FRAME ANO FLASHING LATHING - IN OUT PLASTER. BROWN COAT HEATING, VENT., ftEFRIG. AND PLUMBING, FINAL AND GAS TE ELECTFIC, PINAL BUIL�ING, FINAL DATE 7_1-70 VALUE SUBCONTRACTOR i�[Hl�:7Slil I *`� " :�2� � 1 Z . aU ZQ ON am J � J N CI J •m J Q U N Z a w � aw W2 J Q m Z J � w w O Z H W � N � � � lUL —1-70Pz1°OO 047� *�**39.00 CMSq COSTA MESA BUILDING-SAFETV DEPARTMENT P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626 ' APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RE I ED V DATE REC�EjIVED DATE ISSyUED ADIDRESS �p �� il /7/a!L �J� ` � �`" D �/�/(IRQa. OWNER C T fL� E R/F � A.P.NO. I I�� /� �I�j PER/�lly'V I� S/ MAIL BUILDING �� n � / ADDRE55� O��/ /{y f. ADDRESS c; �.w TEL. TFACT LOT BLOCK CITV CO �A P -A NO.`I�'j •'L/ / CANSTRUCfION W A D LENDER U L BRANCH � OWNER i ADDRESS � VALUE AflCHITECT TEL. S $ OR ENGINEER � FIRE ADDRESS ZONE TVP GROUP� / �e p APPROVED � O CONTRACTOR �,/GywGCG�wi BV DATE ' � AODRESS ZO NO.OF USE OF NEN! � TEL. � / p�p,NS a BUILDIN CITV NO. STATE CITY �ARDSAPPROVED YARDSAPPROVED LIC. NO. IIG. NO. MAIN BUI�DING ACCESSORV BUILDING SIZE 2 NO.OF BLIX'tS. ( R OF LOT O,J � NOW ON l0T FT. USE OF —f— ExI5TING BLOG. FT SIZE OF NO. OF NEWBLDG. ROOMS STORIES L.SIDE �FT. FT. EMERIOR WALL ROOF COVEFING COVERING REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BEf. MAIN & MAIN BLDGS. ACC65. BLDGS. � VAR. # DATE � � C.U.P.# APPRpVED I APPROVED � /� �!' C/ I hareby acknowledBe thet I have reatl this applicatlon antl stere that the above information is correct antl aB�ae 2o romply wlth all laws rag�latin8 builtlinB �ons[ruc[lon, antl I shall not amploy ony person in violatlan of the workmen'a eomponsation lawc ot Me Stete o( Celifornia. ,� � / � b � I nereby certify that 1 om properly licensetl es a contractor untler S�. FT. � tha State ot Californie Businass entl Professlons Cotle, Divlslcn 3, THE AMOUNT SHOWN UNDEfi VALUATION IS FOR Chapter 9, antl that such licenses ore in full torca antl effeti, or I THE PURPC6E OF ESTABLISHING A PERMIT FEE ONLV: � om exempt fram tha provisions of the Staro of Celifornia Business VALUATION nntl Professions Code, DWision 3, Chepter 9. 2 L� �j0 i 1 n`��%� PERMIT FEE $ sieneture or �GG� i" ' �� p � � `' � Permittee 5��p � PLAN CHECK 5 •� 6 Authorizetl ABent 3�� Q � � TOTAL FEE S At' IVo. 11,�-40L-1tl LU INSPECTIONS SOIL WS � �W1TER �'ROUGH PLUMBING �PROP. SWR. LINE �] HOUSE CON. ��SPflINNLING SVSTEM MISCELLnNE0U5 OUGH HEATING ANO AIR CON�ItI TEMPOFnRY SERVICE OR POLE ❑NDERGROUNO � �POWER � ROUGN WIRING TRENCHES FORMS � STE FLOOR SVSTEM BOND BEAM [] STEEL REINF( SHEATHING FRAME ANO FLqSHING LITHING — IN n OUT � PLASTER. BROWN COAT $TRUCTURAL, FINAI NEATING, VENT., REFRIG. ANO A. PLUMBING, FINAL AND GAS TEST ELECTRIC, FINAL BUILDING. FINAL SPFfIGI BFOIIIRFMFNTS _...� �_jU-/b BUILDING PERMIT N0. RIPTION of WORK Encl. Patio G ZONE VALUEf500.00 PE GROUP J 2 SUBCONTRAGTOR =�B va�u *s,�*�, �� ' Y G23�.9 4n 30-76�,.�•003479" 5.50 F C k7 a a � y S F- C W F Q ❑ J Q > r .� � w a � C a Z {t] 2 3 COSTA MESA BUILDING-SAFETY DEPARTMENT P,O. BOX 1200 COSTA MESA, CALIFORNIA 92626 APPLICA7'ION fOR STRUCI'URAL PERMIT For Applicant to Fi11 in Completely — Use Ink Only _ REC DATE RECEIVED E IS UE BUILD�NG ' ADORESS g '%j%� ST. CCOSTR /II S/I 1 ��7 � ERMITNO. OWNER YI T /)F_ I�J ITG A.P. NO. �- MAI� / BUILO�NG ADDRESS ` C S� ADDRESS (j�O C I% J�/ TEL. TRACTG7�V' LOT � BLOLK CITV C 5 NO. -�I CpPI$TFUCTION W ADD ALT R P LENDER BRANCH WNER e L� � � ADDRESS V UE V"a ARCNITECT TEL. S � � OR EN INEER FIRE ADDRESS 20NE v GR APPROVEO �� CONTPP.CTOR BV DATE ADDRESS 20 NO.OF USE OF NEW TEL. p�,q� 2 BUILDING � 0�� CITV NO. STATE CITY VARDSAPPROVED VARDSAPPROVED LIC. N�. UC. NO. MAIN BUILDING ACCESSORV BUIIDiNG 512E NO.OF BLDGS. IFROM C/L STREET) OF LOT NOW ON LOT Ol�ff FT. FT. VSE OF EXI5fING BLDG. 51 �� FT FT. Separate permits are required for L. SIDE �5 FT. FT. electric, plumbing and heating work. .L �� , REAp FT FT. USE OF UILDING AND WORK TO BE PER ORMED DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCFSS. BLDGS. � VAR.� DATE C.V.P.#� APPROVED 2 / APPROVED/�. i ��i� �-K, .o I horabV acknowletlBe that I hove rentl thif nDP��etion and ctafe '^ Not Ne above IntormeHon is wrrect a�tl agraa to comply wlth m ell IawB reBulatlnB builtlinp conctructlon, enG I shell not omploy � any pefson (n vtolallon of Me workman's compenaeLon lewa of d Me Sta�o of Celifornia. m I herebY certffy that 1 am proParly Iicensa0 az a contrector untler SQ. FT. a tha State of Californie Business antl Profauiona Cotla, Div(slon 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chaptaf 9, antl t�ei zuch licenzes ere in t�ll force an0 affect, or I THE PURPOSE OF ES7ABL5HING A PERMIT FEE ONLV: � am exemPt from Ma pravislons of tha Stata of California Businass VALU�+TION � antl Professions Cotle, Division 3, Chepter 9. PEFMIT FEE § � Q � N n SiB^atura of . PLAN CHECK E � ^ 0 Parmittae �/�U.ft �/il.H�r� S�O D TAX S � Q � �"7 U Authorizo0 Agant TOTAL PAID S � Costa Mesa Building Department •�«. ... - 171 EAST 20th STREET _�� -� " COSTA MESA� CALIFORNIA FOR APPLICANT TO FIL� IN Buildin9 12�� / / 1J // Address Ps iC//%'i Costa Me , Califorrua Nearest / Cross St. .¢�.�.�. ��.�.i4. !/ � APPLICATION FOR PERMIT 1190 BUILD,�NG ' FOR OI+'FICE USE O1VLY . _ Receipt No. Pe/rmit�jN / �A i Received by, Date Rec'd. ate Issu � ._ Building Add ress Costa Mesa, California Nearest Cross St. Zone �' I No.of I Tvpe/ I GrouR Date Metes and Setback Line from Center of Street DESCI New I Repair I Building /e / Size Exterior Wall Covering Uu of New ., City Lic. Block iA / RearYard �,{ S v Side Vard PTION OF WORH Alteration I I Addition Moving I I Demolish � No. of p , Rooms /_ Stories � � 4 I hereby acknowledge that I have read this Application and state that the above is rnrrect and agree to comply with all City Ordinances and State L.aws regulating building constryction. , APPROVALS �n loeation - Inspector Materials, ,'� 'inning � ire Stops, ;; , Bolts -� 'I' >> J PR Valuation V PfrmitFee $ a.1 -�' D n � Plan Check $ 3, o D Bond Beam � S C5� 3'� ' Tota� � � Fee $ 02- S, v FINAL o Date G� I 2 D r YLV'1' YLA1V Show locatlon and distances from propeMy line and between buildinga , , ,, _ ,.,' :. - � : . �_ , ,� , , � - - _.�,�. .�. .,.=; .._.-. _<.� , . _`- .,- _� ,