HomeMy WebLinkAbout1165 AUSTIN ST - Building Permits •
CITY OF COSTA MESA
04151 4 q BUILDING DIVISION
F( ,)a 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
°. FOR INSPECTIONS CALL: (714)754-5626
°imiceD PERMIT NUMBER: B10-00387
PERMIT TYPE B_ROOF2 STATUS: ISSUED
APN: 14160207 DATE ISSUED: 12/13/2010
ISSUED BY: RMD
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JOB ADDRESS: 1165 AUGUSTA ST CM Suite/Unit:
Vicinity: HOUSE AND GARGE ROOF - •
Squares: 4800 Valuation: $4,800.00
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SCOPE OF WORK: TEAR OFF EXISTING ROOF MATERIALS, INSTALL 1 LAYER OF 30#FELT AND REROOF WITH 30 YEAR COMP \
SHINGLES ON AN ATTACHED HOUSE AND GARAGE,APPROX 24 SQUARES. REPAIR AND REPLACE SHEATHING AS
NEEDED. COMPLIANCE FORMS ATTACHED TO JOB CARD AND CITY PERMIT.
OWNER: HEASLIP, DAVID P TR Address: 1165 AGUSTTA ST Unit:
PHONE: 714-721-8050 - City/State/Zip: COSTA MESA, CA
APPLICANT: LEHMAN,JEFF Address: Unit: :
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PHONE: 949-887-3563 City/State/Zip:
CONTRACTOR: J S L ROOFING INC License No. 747706
Address: 2415 MARGARET DRUnit: PHONE:- ' ;'. 949-646-3571 •
City/State/Zip: NEWPORT BEACH, CA 92663 CELL:
ARCHITECT: License No. PHONE:
ENGINEER: License No. PHONE:
FEE SUMMARY
Reroof Plan Check: $0.00
Reroof Permit Fee: $111.25
Reinspection Fee: $0.00
•
Bldg Std Admin Fund $1.00 •
TOTAL FEES $112.25
HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010 -PER CMMC Sec. 13-279
Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibitied all hours-Sundays and the following Federal holidays
New Years Day, Memorial Day, Independence Day, Labor Day,Thanksgiving Day and Christmas Day
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 will result in the expiration of this permit.
CODER. INSPECTION TYPE DATE INTITIALS CODER INSPECTION TYPE DATE INTITIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final (�,} 208 Final Plumbing
200 Final Re-Roof XI2-Itp '/O rim � 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
110 •
WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's license. ❑Yes ❑No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
O I have and will maintain a certificate of consent to self-Insure for workers' Verification 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 have and will maintain workers'compensation insurance,as required by DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
section 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My vp rkers' corr7pensatiorVfl6urance carrier and policy ❑ I herebyq certify that no d,will en fivear mnfeet in depth woo into oa
number are: �I/i' i// �/(/ I/// 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
Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
(Thu need not be%mpar�nma pe is vdlu o9�npndetl donors(S100)or 2,Art 2Sec.341,Title 8,Califomia Administrative Code).
Policy-Number: (/7(�� ^` $ ((LUJJZ
�,�. ❑ As owner-builder, I will not employ anyone to do work which would
O I certify that in e 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 e •loy 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' co •ensation aws of California, and agree that if I should
become subje t to he work- 'compensation provisions of Section 3700 of
Applicant's Signature Date
the Labor C••-, .hall fort th comply with these provisions.
/` )7 -O-5- Division of Industrial Safety Permit Number:
s.Si .cure... L Daley
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WAR •a U 'E TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS U •WF AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑ No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions. that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. 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
LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons. or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in full fort- and
e;4 �• 'Z a registration form for acutely hazardous materials? ❑Yes 1:1 No
Lic.#�� / Class.#•__ G J ? (Section 25533 of the California Health and Safety Code, with some
//�' 1z —t p exceptions, requires registration with the Costa Mesa Fire Department by
each business which at any one time has on hand a quantity of acutely
`a•ji9.r.St ere Dales 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
CONST" CT,•-N LEN 9 G AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? ❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: 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.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes ❑ No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes ❑No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Govemment Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits).
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 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑ No
applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I. as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application. have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑No
thereon,and who does such work himself or herself or through his or her own
8. (If"yes",attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of control officer).
completion. the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify-that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
LICENSED CONTRACTORS to construct the project(Sec.7044, Business and
Professions Code: The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: 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 ••rmit until final ins tion.
/
' /re of Legal Ownpr(s) Date /�
Signature Date Lee • .__ _ j2^ 13` to
)57-46(3/07)
ut, zed'Applicant
4 PreScriptiye Certificate of Compliance. Residential CF-IR-ALT -
, � Residential Alterations (Page 1 of S)_
Pl rnjee:hie: //4 f t Chm• eZ6ne it ,r,s - i!of Stories,.
b /
General Information
!!��
Site Address: //6 s ��LS LI Enforcement Agency: C I V 1 I Late: 1--,Z.--- ,'"1.0
Building Type/Single Family 0 Multi Family Circle the Front Orientation:N,E,S.W,or degrees
Project Type: 0 Alterations 0 Envelope D Fenestration Loot 0 HVAC
Conditioned Flom Area(CFA). Replacement or Change Out 0 Duct Replacement 0 Water Heater
NOTE: This form is not to be used/or Newly Constructed Buildings or Additions
• insulation Palues For Opaque Surfaces(for Fun-lug use the Mass and Furring Snips Construction table below) � '' \
Assembly Alteration
-D Opening of framed cavity alone-Alterations that involve the opening of the framed cavity ofa wall,ceiling, or floor must install the
mandatory minimum insulation value per,§150 for the altered assembly. Fill in Columns A-C and enter mandatory insulation value in Column H.
D Replacement of entire assembly-Replacement of an entire wall, ceiling,orfloor assembly requires the installation of Component .
Package-D insulation values in Table 151-C Fill in Columns A-J.
•
Opaque Surface Details For the furred portioned of Mass Walls see Furring Strips Construction Table below.
.A B C 1) E - F G H ' • • •I• . 1 J
Proposed see hole r Standard Values From JA4 Table •
Framing Thickness, Framed Continuous JA4 I Proposed
Tag/ Assembly Name Material Spacing, U- JA4 Table Cavity Insulation Assembly i Assembly
DI or Type' and Size2 or Other' factor4 Number' R-value6 R-Value' Cell Values U-factor9
-
Note:For furred assemblies,accounting for Continuous Insulation R-value,see Page JA4-3 and Equation 4-1. For calculatingfurred walls use the Mass and
:Furring Construction table below.
1.For Tag/ID indicate the identification name that matches the building plans.
2.Indicate the Assembly Name or type:Roof/Ceiling, Walls,Floors,Slabs, Crawl Space, Doors and eic...lndicate the Frame type and Size:For
Wood, Metal, Metal Buildings,Mass, enter 2x4, 2x6, or etc...see JA4 for other possible frame type assemblies.
3. Enter the thickness for mass in inches or Spacing between framing members enter; 16"or 24"OC;or Other for all other assembly description
such as Concrete Sandwich Panel,Spandrel Panel,Logs,Straw Bale Panel and etc....
4.Based on the Climate Zone;enter the Standard U-factor from Table 151-B, C or D for each different assembly Name or type.
5.Enter the Table number that closely resembles the proposed assembly.
6. Enter the R-value that is being installed in the wall cavity or between the fuming; otherwise, enter "0".
7. Enter the Continuous Insulation R-value for the proposed assembly; otherwise, enter "0".
8.Enter the row and column of the U-facto'value based on Column F Table Number and enter the Assembly U factor in Column.]
9.The Proposed Assembly(Hamer, Column J. must be equal to or less than the Standard U-factor in Column E to comply.
Furring Strips Construction Table for Mass Walls Only
A B C D E _ F G H 1 I J K L M
Proposed Properties of Masonry and Concrete Added interior or Exterior Insulation
Walls From Reference in Furring Space from Reference
Joint A pendia Table 4.3.5,4.3.G.4.3.7 Joint Appendix Table 4.3.13
U c o - U
4 G tfr
Assembly �� � i � �o �' ~ c d;'v . �.0 v � Final
Mass None or JA4 Table - v E E E °o t ': v _ Assembly
Thickness' Type? t Nunthe' < : c = LI; r2 - ri u` 5 S � m r.. U-factor" Comment
- L
Registration Number. Regi.stranion Dote/Time: HERS Provider:
20(18 Residential Compliance Forms August 2009
Prescriptive Certificate of Com) .e: Residential CF-1R-ALT
Residential Alterations /// • (Page 3 df 3)
. , UgjecttNntrte:/ sr. v s 4 etimate•7¢n'e a tkof•'jries
ROOFING PRODUCTS (COOL ROOFS)§151(1)12 C
When the area of exterior roof surface to be.replaced exceeds more than 50%of the existing roof area,or'more that 1,000 fr-', whichever is
Ices, the new roofing area inns!meet the roofing product "Cool Roof'requirements of§152(b)IHi,152(b)1Hii, or 152(b)1Hilt' '
Check applicable alternative or exception below if the roof alteration is exempt from the roofing product "Cool Roof'.requirements.Note:If any
one of the alternatives or exception below is checked, the Aged Solar Reflectance and Thermal Eminence requirements for roofing products in
:1118(0 are not applicable.Do not fill table below.
❑C oafs Not Required in Climate Zones I-12, 14, 16 ww ope2:]2t
ool Roofs Not Required in Climate Zones I through 9 aandnd 16withitha LoaSteepSl-Slopedd. Less Roofsor (pitchpitch.greater than 2:12)and product unit weight less
than Slb/f.
Alternatives to§152(b)IHi and §152(b)Hii,Steep-slope roof(pitch>2:12)
�O Insulation with a thermal resistance of at least 0.85 hrfl °F/Bra or at least a 3/4 inch air-space is added to the roof deck
i
over an attic;or
❑ Existing ducts in the attic are insulated and sealed according to§151(f)10;or .
❑ In climate zones 10, 12 and_13,with 1.112.of free ventilation area of attic ventilation for every 150 ft of attic floor area,and
where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge;or
❑ Building has at least R-30 ceiling insulation;or
❑ Building has radiant barrier in the attic meeting the requirements of§151(1)2;or
❑ Building has no ducts in the attic;or
❑ In climate zones 10, 11,13 and 14,R-3 or greater roof deck insulation above vented attic.
Exception to§152(b)1Hiii,Low-slope roof(pitch 52:12)
❑ Building has no ducts in the attic.
Other Exceptions
O Roofing area covered by building integrated;photovoltaic panels and solarthermal panels are exempt from the below Cool Roof criteria.
.o Roof constructions that have thermal mass over the roof membrane with at least 25 lb/ftl is exempt from the below Cool Roof criteria.
• Note:If no CRRC-I label is available,this compliance method cannot be used,use the Performance Approach to show compliance,otherwise,
Check the applicable box below if Exempt from the Roofin Products"Cool Roof'Requirement:
Roof Slope Product Weight Product Aged Solar Thermal
CRRC Product ID Number' _ < 2:12 >2:12 < Slb/ft' > 51b/ft2 Type2 Reflectance3'4 Emittance SRI5
0 0 . ❑ 0 04
❑ ❑-
0 0 ❑4
0 0 0 0 o
-
❑ ❑ 0 0 ❑4
0 0 0 ❑ ❑4
/. The CREW Product ID Number can be obtained fr ora the Cool Roof Rating Council's Rated Product Directory at www.coolroofr.orc/products/seorch.ohp
2. Indicate the woe of product is being used for the rooftop,i.e.single-ply roof asphalt roof metal roof etc.
3. If the Aged Reflectance is not available in.the Coot Roof Rating Council's Rated Product Directory then use the Initial Reflectance value from the same
directory and use the equation(0.2+0.7(pi„itiat—0.2)to obtain n calculated aged value. Where p ii the Initial Solar Reflectance. r
4. Check box i/the Aged Reflectance is a calculated value using the equation above.
3. Calculate the SRI value by using the SRI- Worksheet at hrar://wunr.enerj'.ca.gov/title24/and enter the resulting value in the SRI Column above and attach acorn;of
the SRI- Worksheet to the CE-1 R.
To apply Liquid Field Applied Coatings,the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage
recommended by the coatings manufacturer and meet minimum performance requirements listed in §I 18(i)4. Select the applicable coating:
in Aluminum-Pigmented Asphalt Roof Coating 0 Cement-Based Roof Coating 0 Other
Registration Number: Registration Date/Time:: HERS Provider:
2008 Residential Compliance Forms • August 2009
Prescriptive Certificate of Complian.. jtesidential CE-IR-ALT
.ti
I?esideniiatAlterations (Pagettt5 of 5)
g'rTijecl iV:u p.�� �f / Climate 2,i14I aiS tie
•
ITERS VERIFICATION SUMMARY The en/or-cement agency should pay special anentlo)?to the HERS Measures specified in this
checldur below. A completed and signed CF-4It Form fm oll the measurer specified shall be submitted io the building inspector beforefinal
inspection.
Duel Sealing & Testing HERS verification is requiredfor fhb measure.
Q YES 0 NO YES:In Climate Zones 2 and 9-I 6,if more than 40 linear feet of new or replacement ducts are installed in unconditioned
space,the ducts are to be sealed per§152(b)IDii and the newly installed ducts are to be insulated pet §I 51(010.
O EXCEPTION: Existing duct systems that are extended, which are constructed,insulated or scaled with asbestos.
a YES 0 NO YES:In Climate Zones 2 and 9-16, if the existing space-conditioning system(HVAC equipment and ducting)is replaced,the
ducts are to be sealed per§I52(b)I Di.
0 YES 0 NO YES:In Climate Zones 2 and 9-16,if the existing HVAC equipment is replaced (including the replacement of the an handler,
outdoor condensing unit of a split system, cooling or heating coil,or the furnace heat exchanger)the ducts are to be
sealed pet §152(b)1E.
❑ EXCEPTION:Duct systems that are documented to have been previously sealed confirmed through HERS
. verification in accordance with procedures in the Reference Residential Appendix RA3.
❑ EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space.
❑ EXCEPTION: Existing duct systems constructed,insulated or sealed with asbestos.
Refrigerant Charge - Split System HERS verification is required far this measure . •
0 YES 0 NO YES:In Climate Zones 2 and 8-15,when the existing HVAC equipment is replaced(including the replacement of the air
handler,outdoor condensing unit of a split system A/C or heat pump,cooling or heating coil,or the furnace heat
exchanger)a refrigerant charge measurement shall be verified per§152(b11F.
Central Fan Integrated (CFI)Ventilation System and Fan Watt Draw •
The ventilation requirements of§150(0)do not apply to existing residential homes.
Ducted Split Systems-Air Conditioners and Heat Pumps: Airflow HERS verification is required far this measure.
- 0 YES 0 NO YES:In Climate Zones 10 through 15.when the existing space-conditioning system(HVAC equipment and ducting)is
replaced.the airflow and fan watt draw shall be verified per§152(b))Ci to meet the reouirements of§I 5 I(f)7B1,
il
Documentation. Author's Declaration Statement ` .1
• I certify that this Certificate o Compliance documentation is accurate and corn ry,. ��
Ptc /Le ce--,
Name: 7 ) Signatory
'i Gompfif' L.. Dates: /w
• �:5. a2�o � /z— /3—
Addre�y 'RS— 1f Applicable 0 CEA or CEPS
L L'c p�f 1,. �o y� f (Certification II): $5-7/.. —
.
C/" fie Zf e ( 2 l 5 Phone:Y / 7 l/ e `�'
_ Lesponsible Building Designer's Declara ion Statement
• I ant eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on .
this Certificate of Compliance.
• 1 certify that the energy features and performance specificationy for the building design identified on this Certificate of Compliance conform
to the requirements or Title 24,Parts I and 6 of the California Code of Regulations-
• The building design features identifier) on this Certificate of Compliance arc consistent with the information provided to document this:
building design on the other applicable compliance loons,worksheets; calculations,plans and specifications submitted to the enforcement
agency for approval with this building permit application.
Name: Signature:
Company: Date:
Address: • License:
City/State/Zip: I Phone:
I
Pot assistance or questions regarding the Energy Standards, contact the Energy Hotline al: 1-800-772-3300.
Itegisrrotion Number It egtsiralion Late/Time. HERS Provider:
2001:Itcsit(en tial Compliance Fortin August 2009
. CITY OF COSTA MESA
BUILDING DIVISION
ROOF COVERING CERTIFICATION
//6c
[� ,(/� Permit No. -�3 i )
Property Addres (/6 / 3 b'$ S
Owner
I
Contractor J . S L• is -
State Contractor License Number 7 `/77 0 6 Classification
I hereby certify that I have installed, or caused to be installed, a minimum Class B roof covering at the above
address in conformance with Chapter 15, of the latest adopted edition of the California Building Code, and the
installation instructions of the manufacturer.
❑ I further certify that I am the owner of the property. (Owner-Builder permittee only).
❑ I further certify that I am:
❑ Owner of sole proprietorship company
❑ Full partner of the company
❑ d partner of the company
Officer of the corporation
I certify that as an authorized officer or agent of the company or corporation, I am empowered to make this
certification, which shall be binding on all successors or assigns of the company or corporation.
I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building
Division for acceptance.
Asp
Company or Corporate
Lit, ivuei✓`s c �^
Address
Received by Building Division Al #g EI c / g'z 4 .45
By:
/Z,-/3 - /D
ign ure ate
l*as
;61117In Dae Printed or Typed Name
0990-46 MW Bros White-Building Div.:Canary-Contractor;Pink-Owner
otlik, SO
CITY OF COSTA MESA N
;
`;� '• BUILDING DIVISION •
' "'-"i' ' DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
°4t PERMIT P00-00211
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
PLUMBING PERMIT
Job Address: 1165 AUGUSTA ST Status: ISSUED
•
Suite No Applied: 05/01/2000
Issued: 05/01/2000
Vicinity:
Parcel Nunmber: 14160207 ISSUED BY: NA-
Applicant: NOCK ,RON '
Address: 11612 KNOTT ST
Phone: (714)895-1246
GARDEN GROVE,CA Zip: 92841 .
Owner. ' WILLIAMS, KENNETH J '
Address '1155 AUGUSTA ST - _
Phone:
COSTA MESA, CA Zip: 92626
Contractor: NOCK PLUMBING v�0),1_
iip
Address: 11612 KNOTT ST . . S�S� � /
Phone: (714)895-1246 pp►
.GARDEN GROVE,CA Zip: 92841
License: 707775
• Arch/Eng :
Address:
Phone: '
Zip:
License:
' - SCOPE-OF PERMIT'
WATER HEATER. '
FEE SUMMARY -
AMT QTY AMT QTY AMT QTY
ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0
Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0
Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0
Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0
Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0
Connect(Ice,Soda,etc) 40.00 0 Receptors $0.00 0 - Vacuum Brkr Bkflow(5+) $0.00 0
Dental Units $0.00. 0 Septic Tank $0.00 0 Wash Basin $0.00 0
Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0
Drain, Floor $0.00 0 Sewer Connect - $0.00 0 Waste and Vent System $0.00 0
Drain, Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0
Drain, Roof $0.00 0 Shower $0.00 0 Water Heater/vent $12.30 1
Drinking Fountain $0.00- 0 Sink,bar -$0.00 0 Water Piping(Inst or Rep.) $0.00 0
Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0
Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0
Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0
Gas(Over 4 outlets) $0.00 0 Sink,service/mop , $0.00' 0 OTHER $0.00
Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00
•
.r. -.
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
•
DECLARATIONS • ( u
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.
LF
l 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.
.r My workers'compensat on Insurance carrier andel icy number are:
Carrier: C20( t Policy NumbereVa_rT 743 /([9C
(This section need not be completed if the permit is valued at one hundred dollars($100)or less.)
❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to be •me subject to the workers'
compensation laws of California,and agree that if I should becomes bject to the workers'compensation provisions • echo 700 of Labor Code,I shall forthwith
comply with these pro isio .
-
:Applicant SignaWre: . "Date::
WARNING:FAILURE TO SECURE WORKERS'rr•- NSATION COVERAGE IS UNLAWF I n•• -ra I IECT AN EMPLOYER TO CRIMIN• PENALTI AND CIVIL FINES NE HUNDRED
THOUSAND DOLLARE($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,l,am,gcensed under•rovisio of . ..ter 9(commencing with Section 7000)of Division 3 of the Business and Profession Code,and my license is in full
force'and effect.L'Ic:A Class-Cc
Contractor' Ss gnature: Irak— Date: Alt.aa..
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issu:.. -- .3097,Civil Code).
Lenders 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
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 onee 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.).
0 I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions
Code: Tfielconlractors;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 theContractors:License Laws.).
❑ I am exempt under sec. C=+ef\.. d Business and Professions Code for this reason:
Signature: �� Date:
•Owner ID verified by drivers license. J'
< tp;Yes 0 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? ❑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 andd Prevention Program for acutely hazardous materials)?
❑Yes 0N
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and tiling 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 OT will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes U No
(Section 65850.2 of the California Government Code requires that the requested information be fumished 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 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? ❑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 perjury the information given above is correct. I agree to comply with all state laws end 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 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 inspection.
' Si'.ature Of Legal Owners it —4-0
/
CODE# INSPECTION TYPE PAE INTmAL$ ' CODEI INSPECTION TYPE PAM 1NTRIAL$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing S=Y_oy by 6414202-
200 Final Re-Roof 210 Final Electrical J
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
?04 Final Demolition 250 Final Building/Occupancy
446-46
03-10-2009 Inspection Request Reporting Page 9
1:14 Costa MPS CLQ-.City_Of
Requested Inspect Date: Tuesday,June 30, 2009
Site Address: 1165 AUGUSTA ST CM
A/P/D Information
Activity P00-00211 Type: PLUM2 Sub Type: Status: EXPIRED
Const Type Occupancy: Use: Insp Area:
Owner WILLIAMS KENNETH J
Contractor NOCK PLUMBING Phone: (714)895-1246
Applicant NOCK RON Phone: (714)895-1246
Description WATER HEATER.
Notice PERMIT IS EXPIRED BY LIMITATION -WEIDE_MJ
Requestedlnspection(si
Item 150 MISCELLANEOUS INSPECTION Requested Time 08:00 AM
RequesterPhone
Assigned To ",."'`..,. Entered By ZWART_B K
Action Time Exp:
Ciao::_,.,•
Inspection History
tern 52 SOIL PIPE-UNDERGROUND
tern 54 WATER PIPE- UNUNDERGROUND
tern 56 SEWER LINE CONNECTION
tem 62 ROUGH PLUMBING
tem 72 GAS PIPE-ROUGH Q F
tern 90 GAS PIPE TEST- FINAL �.J
tern 92 WATER SERVICE-ANAL
tern 102 ROUGH PLUMBING & PRESSURE TEST
tern 108 GAS PIPE/UNDERGROUND TEST 5 - 11 -9
tem 110 BACKWASH LINES,P-TRAP UNDRGRND
tern 150 MISCELLANEOUS INSPECTION
tern 208 FINAL PLUMBING
05/07/04 Inspector: MJW Action: EXP Expired
Comment:
REPT131 Run Id: 12232
A e% ttj-asr/ E'er
07483 4"/'��it"- `t-ea`e - FEE RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT JUL 1 01962 f
P. O. BOX 517 COSTA MESA. CALIFORNIA FINANCE DEPT.
For Applicant to Fill In Complete CITY OF COSTA MESA
PPP zL APPLICATION FO PERMIT
TYPE OR PRINT
BUILDING 74°h -J 4•41! .li � BUILDING
ADDRESS '. / -'/- i. L
. �N"
COSTA MESA. CALIFORNIA For
._.J p` For Office Use Only
OWNER J SA4r0/. zL-� iyWGJ- —Jy!; _ RECEIPT NO. PBRMyT483
L+ , y`{J
MAIL / //II RECEIVED BY
BY DATE RECEIVED DATE
ISSUED
ADDRESS/602 /,// AL/+.7 s2 P( I aJ (7- ( -&.1
CITY V�p TNO.EL. BUILDING // / /7i��l./ �Z.. --J/=. / '
ARCHITECT Rf'AR16GLD� c rE �473� COSTA MESA. - LIFORNIA
OR ENGINES (ILO NO. ' , ��((J i
ADDRESSrL/Z7 //! /5i{JiA/ C/94-79 A/P4 ZONE TYPE V/ GROUP CONTRACTORS 1• 11,,,n'S.�J/ r'¢SOivC APPROVEDDATE •
ADDRESS/co' - Fr714,9 /'6—a . ZONING' - d
CITY /. eti�/�/ /)A ZONI,._/ I NO.OF a I BUI OF N!W s'.4 /Iey
I( /� /, / /ll/ PLANS �T BUILDING lf/7 .al/
LIG.NO.ATE IV y�7�7 NO.I op 72,�% / DEBCRI PTI ON Z G. �� r ""---1 O���I
SIZE //'' NO. OP BLDG(I ih ------
USE
�� (o
OF LOT 1!J.0 X/(J NOW ON LOT L/ A.P.NO.
USE OF YARDS EVES
EXISTING BLDG.- APPROVED ALLOWED
SETBACK LINE PROM ,STT .!- 6 (CENTER LINE ST.)41_5_...
CENTER OF STREET —S `1 REAR YARD-.l/ FRONT . FT. IN.
SIDE YARD I LEFT /0 I RIGHT S/y // R.SIDE �� FT. .6... IN.
DESCRIPTION OF WORK L.SIDE /0 FT. IN.
NEW I 1'7-ALTERATION I II ADDITION I REAR 3o FT. 6 IN.
REPAIR I II MOVING I II DEMOLISH I APPROVED, /ll��� DATE 7/S�6z-
SIZE NQ/9.6 Y`S(y/ROOM6 STORIES / IIJT CT
SIZE 7 V/1 / , L� •
EXTERIOR WALL5T&CCO I ROOF CU'/N' y"-
COVERING c j,./,Y•i` COVERING S /NCG/l,S
USE OF BUILDING AND WORK TO BE PERFORMED -
/,VC, GG ,C1/4r///y / n,6%ti//v0 f�.Lr.,e .f opj /snd if
73/44z —
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 OP ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING -
BUILDING CONSTRUCTION. // ^ /� VALUATION '/
PERMAITTEF OF 4'411
G/', cy,CJ,t .A rison`y G// �j� PERMIT FEE $ y /�� NN
'// /i/�P// �-� S///�,�'�' PLAN CHECK $ ,/�� N'
AUTHORIZED AGENT 2 Ia
✓ N TOTAL FEE $ 7i 4.
0
OWNER NEWPORT HOMES Inc. _ DATE 7-9-62
JOB ADDRESS S7. a-.aa - /06 U _1,7 BUILDING PERMIT NO. - l7)_t�3'✓
GENERAL CONTRACTOR S. V. Hunsaker & Sons VALUE $ 111;253.00
Al' No. LOT 22 TRACT 4653 FIRE ZONE DESCRIPTION OF WORK Res/Att.Gar,
INSPECTIONS Signature DATE GROUP T&J TYPE V ZONE R-1
S /14/-S 7—/G-a. PERMITS ISSUED
Gas S b.. .6s. SUBCONTRACTOR DATE NUMBER
Water 7-4S-07-
Rough
-•d-07-Rough Com. Refrig. 0 Air Cond. '>
Rough Heating Nm r77?-&2 - _ C.e -�Z!- --Yt ✓
Rough Plumbing NffS C-/V v -�J- Z (Q7//✓ �,,1
Miscellaneous �✓ir�iw,.eesn.e.�ea 40 /. ✓ _ 1,_d
Prop.Swr.Line,2-House Con. l-St.Swr. 0 Q,�'( Jt[ C.I —PLUMB _Mai, > /,e• / c` > rr .tet'
Sprinkling System - - /r Ivq/
Construction Pole _ �Ily(
Underground ❑ Power ❑ _,�/,„,��_//_ __
Rough Wiring _ raid y 'Cr.G't e �w Jra! r-ai—,4z',.X-07./-raa / 34d
Trenches Er Forms Q Steel Reinf. 0 rayl '7,f- 7-1?-41-
Floor System V
Bond Beam 0 Steel Reinforce ❑
Sheathing °.% 4 -22,-C Z - •
Frame and Flashing- /?, ;a-fl-6,-
Lathing — In lf-"" Out p— iii 644 9-7.-61
Plaster, brown coat /irSf•-: IO-7-%-OZ.
R 0 Air Cond. 0 Final
Ii .Ig, Final A6 // 4-2i "--
Plumbing Fixtures, Final Ric
J //_7-Y,.',:-- ,
Final Gas Test/a
Electric Fixtures, Final Za4f / / yr )>y-e
Building, Final /--)7-/ // ?tin-
OCCUPANCY _z� /14.(0-
FORM 6114.5M — 7-61 " ' 17h81