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Home My WebLink About3121 BARBADOS PL - Building Permits(714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT JobAddress: $121 BARBADOS PL Suite: Vicinity: PITCHED AREA OF EXISTING SFR Parcel Number: 13915113 npp�icant: CRANK, JIM Address: 126 COMMERCIAL WAY COSTA MESA, CA owner: KENWORTHY, JAMES H Address 3121 BARBADOS PL COSTA MESA, CA Zoning: R1 R1 Phone: (949)548-5569 Zip: 92627 Phone: Zip: 92626 Contractor: CRANK BROS ROOFING CO INC Address: 126 COMMERCIAL WAY COSTA MESA, CA Zip: 92627 Arch : Address: Phone: (949)548-5569 License: 794724 Eng: Address: Status: ISSUED Applied: 08/27/2001 Issued: OS/27/2001 ISSUED BY: � Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF PITCHED AREA OF EXISTING SINGLE FAMILY RESIDENCE. TEAR OFF EXISTING ROOFING, INSTALL 30# FELT UNDERLAYMENT. & REROOF WITH 25 YEAR ELK COMPOSITION SHINGLES. Plan Check: $0.00 Permit: $111.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $111.75 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING Existinq: o NOTES: Rear 0-0 Rear 0- 0 Required: 0 FEE SUMMARY PLANNING & ZONING LeR 0- 0 LeR 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0-0 Right 0- 0 $4,317.00 $4,317.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis 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 tor the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspeetiona 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) 7545626 2d46�a8 (6/00) WORKERS' COMPENSATION DECLARA710N: - I herehy aifirm under penalry of perjury one of the following declarations: ❑ I have and will maintain a cenificete of consent to self-Insure tor workers' compensetion, es provided tor by section 3700 of the Lebor Cotle, for ihe perfortnance of ihe work for which ihis permit is issued. �I have and will maintain workers' compensation insurance, as required by section 3700 oF the Lebor Code, for Ihe pedortnance ot the work for which lhis pertnit is issued. My workere' compensation Insurence arner and1 �policy number are: /� Carrier: ,�.�� 1 PolicyNumber��n� / ��/) � � � (This sectian nee no m lefed il the permr is v d et one hu tlollars 100) or /essJ T� ❑ I certity that in the pe rme e of the work �or which ' ertnit is iss , I shall not employ any person in any manner so as to 6ecome subject to the workars' compensation laws oi lif ie, end egree ihat if I ould become ject ro ihe workers' compensation provislons of Section 3700 oi ihe Labor Cotle, I shell fonhwith Comply with Ihese provisi ApplicenPSignature: --� f Date_,�S',r -2 � -' � / WARNING FAIWRE SECU WORKERS'COMPENSATIONCOVEPAGEISUNLAWFULANDSHALLSUBJECTANEMPLOVER�TOCRIMINALPENALTIESANOCIVILFINESUPTOONEHUNDRED THOI/SAND00LL4 �($100 ),INADDITIqJTOTHECOSTOFCOMPENSATION,DAMAGESASPFiOVI�EDFOPINSECTION3]WOFTHELABORCODE,INfEREST,ANDATTORNEYSFEES. LICENSED CONTRACI I hereby eHirm thai I am forca end eHect �Lic. # CONSTRUCTION 4�NpfNG AGENCY: 9(commencing with Section 7000) of Division and P��e�ipns Code, antl my Ilcense is in full ❑ I herehy affirm thet there is a construction landing agency for the peAormance of the work for which ihis pertnit is issued. (Sec. 3097, Civil Code). Lendefs Neme: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby eHirtn ihat under penalry ot perjury thet I em EXEMPT PROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business end Professions Code: Any city or counry which requires e permit to constmct, alter, improve, damolish, or repair any strucNre, prior to its issuance, elso requires ihe applicant for such permit to tile e signed statemeM that he or she Is licensed pureuant to the provisions af the Cantrectors License Lew (Chapter 9(cammencing with Section 7000) of Divisian 3 of Ihe Business and Professions Code) or that he or she is exempt theretrom and ihe basis for the allegetl e:emption. Any violation of Section 7031.5 by any applicant for a perm�' su6jects the applicant to a civil penalry of not more then five huntlred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as iheir sole compensation, WILL DO 7HE WORK, and ihe simcture Is not Intended or oHaretl for sala (Sec. 7044, Business and Professions Code: The Coniractors License Law does not apply to an owner of Oroperty who builds or improves Ihereon, and who tloas such work himself or herself or ihrough his or her own empioyees, provided thet such improvemenis are not intended or oHered for sale. H, however, the buiiding or Improvement is soltl wit�in ona year of complation, the owner-buiider will have iha burden of proving that he or she did not build or improve for purpose of saie.). ❑ I, es owner of the properry, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law tloes not apply to an ownar of propeny who builtls or Improves thereon, end who contrects tor such project with a contractor(s) license pursuan� to ihe Coniractors License Laws.). ❑ I am exempt under seC. Signature: Owner ID ventied by drivers license. ❑ Yes ❑ No Business antl Professions Code tor this reason: Verification of Ownership by (type of document, i.e. - property tez bill or deed): Drivefs License No. Date: Ezpires: DIVISION OF INUUS7RIAL SAPE7V PERMIT CERTIFICATION: ❑ I hereby ceriify that no excavation tive (5) or more feet in depth into which a person is required to descend, will be made in connection with work authonzed by this permi�, and ihat no building sirucNre, scaRolding, falsework, or demolition or dismantling thereot, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle 8, California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit trom the Division of Industrial Safery, as noted above, unless such person has a permit to do such work irom the divisian. Signawre: Date: Division ot Indusirial Satery Permit Num6er: CERTPICATE OF COMPLIANCE AND AUTHORIZATON OF ENTAY: I certity under penelty oi perjury that 1 have read ihis epplication and state ihat the infortnation given is correct. I egree to comply with ell state laws and ciry ordinances relating to building constmction, and authorize representatives of the Ciry of Costa Mesa to enter upon the ebove-tlescribe�roperty for inspection purposes. I agiee nyYfd�occupy or allow occupancy of any building authorized by ihis permit until final inspection. 761A-� Fixed System Final Fire Preventian 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIocWRetaining Well 202 Final Factory Fire Place 203 Final Sign 204 FinalOemolition %-(/-v/ � � ��i Dat� / � � r�'Date"—�-.. COpE� INSPECTIONTVPE 206 Final Mechanical 208 Final Plumbing 210 Final Electncal 212 Final Fire Preventlon 220 Final Planning Approval 222 FinalSite 250 Final euilding/Occupancy ]il CYiuC1b . ADP��ant to fill in all spaces except tnase within �eavy OorEer lines an0 zign all appro0riate Ceclarations. PERMIT NO. TRACT NO. LO NO. UNIT NO. ^7 cITY oF COSTn MESA CONSTRUCTION PERMIT �� 23� — A•P• # s Project ;4ddres;.� �/ Z— % B�F/4 � Q QI"�s _ Applicant'sMailingAddress r�%�� Owner's Name --�e ey I�6 L�t�yO�Phone ��3i Address f�'� F � Arch/En9. License No. Address Contracror'sName 1e � � ^ Phone Address Imailing) �A� City License No. IICENSED CONTRFCTOR DECLARATION I nereby affirm that I am licensetl untler provisions of Charter 9(commencin9 with section 7000) of Division 3 ot the Business antl Professions Cotle, antl my license is in full force antl eftect. Lir?nse Class Licenze No. �e Signature RKERS' COMPENSATION DECLARATION ereDy affirm that I have a certificate ot mnsent to selt-insure or a tertitiwte of Workers' Compensation Insurance, or a certifietl copy thereof (Section 3800, Lab. C.) Policy No. Comoany 8 Cer[ifietl copy is hereby tumishetl. Certifietl mpy is fileU with the city Builtlinq Oivision. . Date Applicant � EXEMVTION FROM WORKERS' COMPENSATION DECIARATION (This section neetl no[ be completetl if the permit is for one huntlretl ($100) or less). I cer[ify that in the perfo�mance ot the wo�k for wh ch this pe�mk is issued, I sha11 not emoloy any person in any manner so as o become sub'ect to the Worke�s' Compe s n s of Calit ia. Date � Signature �+ NOTIC If, a er aking this tlecia ' n, you should become subj t to e Workers Compensation provizions the Labor Cotle, you must (orthwith camply witM1 such provisions or this permit shall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV I hereby af9rm that there is a construction lentlin9 a9ency for the pertorman<e o( the work ta� which thls pe�mit is i55uetl ($ection 309] Civ. CJ Lentler's Name . Lentler's Atltlress OWNER BUILDER DECLARATION �� I hereby aftirm Lhat I am exempt from the Contractor's License Law tor the Ifollowing reason (Section 7031.5 Business antl Professianal COEe: Any city or ounty whicb �equir¢s a pe�mi[ to consGUC[, alte�, imptove, tlemoli5n o� repair structure,-prior to its is5uance, al5o reqWres th¢ applicant for Such pe�rtilt ❑IC d si9netl statement thdt he/she I5 licensetl punuant lo th¢ proV1510lIS Oi � ContractorY License Law (Chapter 9(commencing with Section 7000) of �vision 3 oi [he Business antl P�ofe55ion5 Cotle) O� that he/sh¢ is exemp[ therefrom antl the basi5 for tbe alle9etl exemption. Any violdtion of SectiOn ]031.5 by any applicant for a permit subjects tM1e applicant to a civil ppnalty of not more than five huntlretl tlollars (5500). Q� I, as owner of the property or my employees with wages as their sole �compen5ation, will do Ihe wo�k, antl the st�uGtu�e is not intentletl o� offe�etl (or sale (Section ]044, Business antl Protessional Cotle: The Contractor's License Law tloes not apply to an owner of a oroperty who builtls or improves the�eon, antl who tloes such work himself/herself oi through his or her own employees, provitletl that such improvements are not intentletl or o/teretl for saie. If, however, the builtling or improvement is soltl within one year of com- pletion, the owner will have the burtlen ot provin9 he/she tlitl not buila or Im- prove tor the Ourpose of sale). ❑ I, as owner of the property, am ex<lusively con[racting with IicenseG con- Irattorsto construct the project (Section ]044, Business antl Professlons Code: The Corttractor's License law tloes not apply to an owner oi property who builtls or imoroves thereon. antl who wniracts tor such aroiects with a con- tractor(sl hcense pursuan[ ro me Conttactor•s License Law). I am aware tnat praot of thei� Worke�'s ComPensatlon insurance Shoultl be provitletl to me ❑ I am exempt untler Section B. & P. C. for this reason Date Owner� I hereb cerY y that I have read ihis 10(O(ffld�l00 IS COII2C[. I dqI¢C f0 COTO �.ing to bw Inq consVucUon, ana nereby aumonze repre- city tp e ter upon thg above-mentioneG property for 3—` O S Main Buildi TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR E ❑ CONVERSION ❑ DEMOLISH ❑ OTHER ' 7 Ffont � DESCRIPTION OF WORK/USE OP BLDG. A Rear �.; �. . TVPE OF PERMIT ' GRA�ING � FOUNDATION STRVCTURAL � C Right ( �e K IZ�'� ❑ PLUMBING ❑ MECHANICAL ' g� L2ft ❑ TENANT EIECTRICAL p ❑ �OTHER IL�� p�ng. Ref. # PROJECT DESCRIPTION 5�. FT. gO ��_ocGVGnNCv�� • Planning Notes: CONSTRUCTIONTVPEFiQ.. ST�V[(�G VALUATIONS_��' �� ZONE GRADINGCU.VDS. ACR 5 �{LF� Remarks: /� �� I r i� =i% �.. JI v�n �—�t' $Q Preventer Irrigation athtubs Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavarories P—Trap Roof Drains Reinspection Fee � $15 Duct-UnderGround Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. iCBO # Heating System & Ducting ❑0-100,000 BTU 0100,OOOBT peinspec[ian Fee � $�5 Showers Service Sink Sewer Cap " Sewer Connection Solac Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash Leundry Tra'ys laue Fee Hood or Typel ❑ Canopy Type I I ❑ Refrigeration System ❑0.100,OOOBTU ❑100, System Repair/Alteration Fire Dampers Registers � ES /automatic Washer Construction Pole Sub. Cooking Unit Diihwasher Dryers ❑Gas ❑Electric Fan f.A.U. i Fixtures , Device Boxes r (� Outleti Switches Garbage Disposal zuoe Accessory Building: ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW KW LJ5-15 KW Meter LJup to 100 amps Meter ❑over 100 amps Sub Panel Motars O0.1 HP O1'h - 6 InaSoiar 09�15 HP 016-15+ Microwave Pole Light Range Standing Sections Trash Compactor FEES O N I N G R E U M T S. / Reinspection Fee $15 Issue Fee —�'3' $ 3 � DEVELOPMENTSERVICESREQUIREMENT$:._�� Zoning Approved By �f' I Date� FEES Building Approved By Date�---�-�— i i' Aooliwtion Issued Bv . . . Oatw @' L 1 iT Issue Fee � $ 3 SUMMARV/ OFFEES BUILDING PERMIT S �I av SMIP PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE PLAN CHECK 25% $ �'�f�� ENERGV P.C. ELECTRICAL $ _LL� GRADING PLAN CHECK 50% $ MICROFILM MECHANICAL $ TOTAL FEE PLAN CHECK 25% $ $ O� _� ..L:. '- f'rC:'i : tl " " L. ,._ i�t :i'., 5.'r~ . _ CONSTRUCTION AND PLANNI & SPA APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector 1! Temporary Electrical Service or Pole � 52. Pool & Equipment Location 2.��Soil Pipe-Undrgmd. 53. Steel Reinforcement �: Electrical Conduit Utility-Undrgrnd. 54. Forms � 4: Electrical Conduit-Undrgrnd. 55. Electrical Bonding � ::" Steel Reinforcement 56. Rough Plumbing & Pressure Test � �� 6, Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings �S�L (� �' �� 58. Electrical Conduit-Undrgrnd. . S: Foundation 59. Gas Pipe, O Undrgrnd., Test , '� 9 Water, Pipe-Undrgrnd. ' 60. Backwash Lines, P-Trap, O Undrgrnd. ^ 10. Structural Floor SYstem ({ p`j' �-' ' 61. APPROVAL TO DECK • 11. Property Sewer Line & House Connection � 62. Backwash & Receptor-Final 12. Sewe� Cap � 63. Heater & Vent-Final ' 13. Roof'Drains 64. Plumbing SYstem - Final 74. Roygh Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit � 66. Solar System-Final 16. Rough Electric Wiring �-� Et� p 67. Fencing & Access Approval 37. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electriral-T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace � APPROVALS Permit # 27. Ducts, in Structure _ 70. Underground Hydro 22. Ducts, Ventilating • 71. Product Piping O Gas� ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framin • ` 9 . 73. Undergrnd. Storage Tank � Gas ❑ Oil 25. Roof Sheathing •- � � (J 74. Overhead Mydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing B �� 76. Dry Standpipe 28. Lathing & Siding � 77. FIXED SYSTEM FINAL 29. Insulation ' � B 78. FIRE PREV. FINAL 30. Drywall Nailing �:• �� HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat �: .� 79. FINAL INSPECTION 32. Electrical Power'Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 7 30 �,.,�, -� �� 34. Final Heating & Air Conditioning C�D ��,oV 35. Final Gas Pipe-Test � �G 36. Hood or Canopy �� 37. Final Factory Fireplace � 38. Final Plumbing , - 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer , . 43. Backflow Irrigation ' 44. Landscape Irrigation System � 45. Sound Attenuation • 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING ' 2 I 48. Special Requirements Completed 49. Electric Release to Edison - , 50. Gas Release to Southern California Gas Co • ' 51. CERTIFICATE OF OCCUPANCY No. Date Plan Check # Permit # Address: � � City of Costa Mesa MEASURE "G" EXEMPTION 265-89s 3121 Barbados Applicant: Jim Kenworthy Exemption # 89-497 Case # FACTS: 0 Residential ❑ Commercial/Industrial ❑ Other ❑ Existing Lot ❑ Not Part of Larger Project Unit: Project Description: 80sq.ft. room addition to existing dwelling No. of Dwelling Units NA Gross Floor Area NA Square Feet F.A.R. NA Estimated Traffic Generation: NA Avg. Trips/day FINDINGS: The above described project is exempt from compliance with Measure "G" for the following reaso�s: ❑ 1. Project is a commercial/industrial development which meets all of the following criteria: gross ❑ � floor area is equal to or less than 10,000 square feet or has an average daily trip generation of less than 130 daily trips, has buildable floor area ratio of less than 0.5, on an existing lot, and is not part of a larger project. 2. Project is a residential project of four dwellings or less on an existing lot. 3. Project is residential construction that does not increase the number of permanent housing units on the parcel where the construction takes place, such as remodeling or rebuilding of an existing house. ❑ 4. Project is commercial/industrial construction that does not increase the footprint or square footage or change the use on the parcel where the construction takes place, such as remodel- ing or rebuilding an existing structure. ❑ 5. Project is a public benefit facility, which is defined as public libraries, public administration facilities, public parks, public utilities, and religious facilities. ❑ 6. Project is a facility serving the health and safety of the people, which is defined as hospitals, police, fire and safety facilities, and schools. Exemption ratified by: ❑x Planning Commission ❑ City Council Date Mav 22,19� Date cosGa mcs ,6<a-� _ 3 3 -- r t ' . COSTA t �.�JJ' MESA BUILDING DEPARTMENT P.O. BOX 31] COSTA MESA. CALIFORNIA FEE RECEIVED '� �� '�, � � S'� ��: � fINANCE DEPT. FOR APPLICANT TO FILL IN APPLI'C:A�FONSFUKSYERMIT ADDRE's5 121 Barbados Place BUILDING COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY wECEIPT NO. PERIyT�1jGy^ /� L��I V OWNER ,r a T& d z.iz.� PECEIVE� BY DATE RECEIVEO qTE SSUEO I MAIL 5•-d- S Al� § 195� ADORESS TEL. 001 LDI NG CITY , Q na .S (�A NO. ADORESS aRCHiTecr -��c. COSTA MESA. CALIFORNIA OR ENGINEER ��i�� '(is NO. FIRE AOORE55 ZONE C�)y/�marland Land CITY LIC. �DNE p��Ns TYPE GROU CON�RAC70R (! NO. j V TEI. APPROV D ADDRE55 NO. BY DATE "`"` 1OT CORRECTIONS DESCaIPiiOrv NO. 1 BLOCK TftACT 2 A.P. NO. SIZE NO.OF BL�GS. oF �oT �7�� now orv �or none USE OF E%ISTING BLDG. SETBwCK LINE FFOM �+ ' CENTER OF STPEET }O� REAR VARD � SIDE VARO RIGHT I LEFT 1 DESCRIPTION OF WORK NEW ALTERATION ADDITION REPAIR MOVING OEMOLISH BUILOING��r` ROOMS STOR�ES 1 SIZE V +- EXTERIORWALL ROOFCOITI�JOSZI+lOiS COVERING GOVERING tll Ct� P�` USE OF NEW BLIILOING C!' l. Pnmi i r . l l • U{� --'– J ' -- �V 12 ll�i I HEREBY ACNNOWLEDGE TMpT I XAVE FEA� THI$ APPLICATION RNO $TATE THTT TME RBOVE IS CORRECT AND FGREE TO MPIV WITH ALL CITV OflOIN/�NCE$ /�ND ST TE / FEGULA lrlG UING CONSTRUC- norv. VAWATION SIGNATURE O ��/7� � / V`—. PERMIT FEE $ � PERMITTEE N l $/�i �O �� PLAN CHECK S l � � AUTHORIZED AGENT TOTAL FEE $ � � OO �Mi OWNER SUrII�'R,LAND-LAND CO, DATE S- -S7 JOBADDRESS 312]. Barbados Place BUILDINGPERMITNO. #(y9(y9 GENERALCONTRACTOR Owner BZdT. VALUE $ 10�909.00 �oT 17 BLOCK TRACT 2353 Res. w/att. gar. GROUP I& J TVPE V ZONE RZ FIRE DISTRICT L�999 PERMITSISSUED INSPECTIONS DATE SUBCONTRACTOR DATE � NUMBER Footing Trench �r/� `,� ' Foundation Forms and Grade to Garage Rough Framing � Plumbing, Rough to Slab �j g„� Plumbing, Raugh Complete Temporary Pole Wiring, Rough T� �_2 Heating, Rough Heating, Final � i-/-$ 72-'�j" ewer House % Sewer, St. �/j(�5 �n..y: Septic Tank or Cesspool Lathing, Inx Out � �Q ^, Plastering /� �Q' Plumbing, Fin�al, Fixtures Complet�/y��S 2$-� Plumbing, Fin,al GasTest /,$� /,VJ//S �2-3 Wiring, Final _�'?� )� _� {<=h Occupancy �� T i2- A. iORM 210 3M 10-•v5 si� _ / /i �'� %� I % f�