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HomeMy WebLinkAbout105 ASPEN LN - Building PermitsCOSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 F orplicant to Fill i plpletely —Use Ink Only G O MAIL V St. #225 TEL. Newport Beach No -752-5( TION t> oil S796 ,10/27/76 216.51 TI 7796 10/27/76 '216*51LKT1 7796 0000446960 JON FOR STRUCTURAL PERMIT RECEIVED BY I 087F RECEIVED ,.T� c icciicn BUILDING OWNER ADDRESNeW O t $eacFi ZONE PE GROUP ^ APPROVED LNa CONTRACTORJJJ BY DATE V ADDRESS ZONEQ NO. OF USE OF NEW CITY NO. /�'� PIANS BUILDING STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO. OF BLOGS, (FROM C/LZEE T) OF LOT NOW ON LOT FROM FT. FT. USE OF EXISTING BLDG. R. SIDE FT. Separate permits are required for L. SIDE Jk FT. FT. electric, plumbing and heating work. REAR L<rT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & Project MAIN SLOGS. ACCESS. SLOGS. C VAR. "�?',245 DATE APPROVE/DJp—,��r i� IO APPROVE A �'©z eW tO 2 U7—%6 HOLD FOR SPECIAL REOUIREMENTS I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under SO. FT. the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION 15 FOR Chapter 9, and that su h licenses are in full force antl effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: a S ate of California BusinessVALUATION am exemp4Aget antl Profes,pt PERMIT FEE LAN CHECK $ *ovslsionse Signature o Permittee $ TAX $ � Af I� Authorized ) / TOTAL PAID s *71 An CITY OF COSTA MESA 06 BUILDING-DMSION F77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 7544856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: P08-00100 PERMIT TYPE PLUM STATUS: ISSUED APN: 43917215 DATE ISSUED: 04115/2008 ISSUED BY: RMD JOB ADDRESS: 105 ASPEN LN CM Suite/Unit Vicinity: h SCOPE OF WORK: WATER HEATER CHANGE OUT FOR SFD ' ri ,v J'i iS rP' i.-. t `•�• � C ~L l'u OWNER: RUGG, EDWARD L JR, „ ' :Address: 195AS PHONE:^ y=. =City/State/Zip: ! COSTA APPLICANT: LINGFORD;,`SEAN `, !'" Address 30300 PUERTO VALLARTA' PHONE: 800-727-0977 '+ )` # _ City/State/zZlp., ,,,MENIFEE, CONTRACTOR: ALL STAR WATER' HEATERS INC License No'' x'812894 J ; a, Address: 30300; PUERTO VALL'ERTA PHONE: 800-727-0977 City/State: MENIFEE CA ZlpCode 92584 "'= ' .-. CELL ,i ARCHITECT: __ Llcerise No � PHONE ENGINEER: / r, ',- License No r PHONE 2 A , �Y 1 ( r A A { 1 1 PLUMBING PERMIT FEE SUMMARY PLAN CHECK FEE. $0 00 PERMITi'FEE TOTAL FEES `_ $35.80 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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 vnll result in the expiration of this permit. CODE 6. INSPECTION TYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re -Roof 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition DATE INTITIAL CODES INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy DATE 11,17MALS �i ) WORKERS' COMPENSATION DECLARATION Owner Owner ID verified by driv, :r C] Yes ❑ No 1 hereby affirm under penalty of perjury one of theclarations. Drivers License No. Expires: ❑ I have and will maintain a certificate of consent to self -Insure for workErs'•-`'^Veiification of Ownership by (type of document, i.e. - property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for, which this permit is issued: I. , ❑ 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 numb is issue wor gDmpensation Insurance carrier and policy number are: !Uhl I mein (Tfns sedan need net be completed s the pennA is valued atone hundred dollars (8100) w less.) DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ' ❑ I hereby certify that no excavation five (5) or more feet in depth into which a penton is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition ordismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp l �� 2, Art 2. Sec. 341, Title 8, California Administrative Code). Policy Number: (�— ❑ As owner -builder, I will not employ anyone to do work which would ❑ 1 certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety, as noted above, unless Issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to rkers' compensation provisions of Section 3700 of the Labor Code I ell rthwilh comply with these provisions. Applicants Signature Dale _1 y I /moi Division of Industrial Safety Permit Number: vP , ra S19nalure ' til/—�� D�atts, >,� WARNING: FAILU E TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), 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 1 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 a ect. : Lic.��CT1 Class.# r : c( on�t r' Si ature— 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: I Lender's Address: 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 subjects the applicant to a civil penalty of not more than 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 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 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 within one year of completion, the owner -builder vrill have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ 1, 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.).i ❑ I am exempt under sec. Business and Professions Code for this reason: .i Signature Date 3057-46(3/07) , 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? ❑ Yes ❑ 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? ❑ Yes ❑ 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? []Yes ❑ No 5. Does or will the applicant or present or future building occupant require for the work which is the subject of this application a permit for such construction or modification 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? ❑ Yes ❑ 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? ❑ Yes ❑ No 8. (If "yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty, of perury•the information given above is correct. I agree to comply with allstate laws and city ordinances regarding Hazardous Materials and Emissions. 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 city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa- to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final .nspection. Signature of w (s) Date Andl Who d ppticant— e