HomeMy WebLinkAbout1294 BELFAST AVE - Building Permits CITY OF COSTA MESA
111114,- BUILDING BUILDING DIVISION
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F � 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
PERMIT NUMBER: P09-00063
PERMIT TYPE PLUM STATUS: ISSUED
APN: 14104102 DATE ISSUED: 05/13/2009
ISSUED BY: cac
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JOB ADDRESS: 1294 BELFAST AV CM • Suite/Unit:,
Vicinity:
SCOPE OF WORK: C/O OF WATER HEATER SAME LOCATION
OWNER: WARRICK,STUART C JR TR Address: 1932 KAUA'PPL
PHONE: - City/State/Zip: COSTA MESA,CA
APPLICANT: VENTID RAGON • Address: 1235 GRAND AVENUE -:
PHONE: 800-898-0008 City/State/zZip: SPRING VALLEY,CA
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CONTRACTOR: CALIFORNIA DELTA MECHANICAL INC License No. 811114
Address: 1235 GRAND AVENUE PHONE: 800-898-0008
City/State: SPRING VALLEY,CA ZipCode:'91977 • • - CELL: 866-692-5273
ARCHITECT: License No. - • PHONE:
ENGINEER: License No. PHONE:
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PLUMBING PERMIT FEE SUMMARY
PLAN CHECK FEE: $0.00
PERMIT FEE: $35.80
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TOTAL FEES: $35.80
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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.
CODES. INSPECTION TYPE DATE INTITIALS CODES INSPECTION TYPE DATE INTITIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing . Q r
200 Final Re-Roof 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
WORKERS'COMPENSATION DECLARATION: Owner ID verified by drivers license. ❑Yes ❑ No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
❑ 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.
C-le 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a
number are: person is required to descend,will be made in connection with work authorized
carrier:..
STATE /UN7-2 by this permit,and that no building structure,scaffolding,falsework,or demolition
.----(This or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Grp
section need not be completed dOthe pe,r„rtk valued al one hundred dollars(StOm)aless) 2,Art 2,Sec.341,Title 8,California Administrative Code).
Policy_Number: A6 70�3
❑ As owner-builder, I will not employ anyone to do work which would
❑ I 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 the workers' compensation provisions of Section 3700 of Applicants Signature Date
the Labor Co e,I shall Jorthwith comply with these provisions.
`EN 77 , ,e9Go' FX//3/65 Division of Industrial Safety Permit Number:
Applicants Signature ✓ Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
L-/
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL 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? 0 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 force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No
0
Tic.a� 0���� • CIa35.#Thk �i 3Fl (Section 25533 of the California Health and Safety Code, with some
e/1/7j ���GeCN os/ArVag exceptions, requires registration with the Costa Mesa Fire Department by
f� each business which at any one time has on hand a quantity of acutely
contractor's slgnaiure rDate'� 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
CONSTRUCTION LENDING 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 0 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:Arty 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? 0 Yes 0 No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications fcc 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 0 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 control officer).
sale. If, however, the building or improvement is sold within one year of
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
0 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 permit until final inspection.
Signature or Le, Owner(s))� Dat
Signature Date te/v77 // //-9/V�`/ 557/3/9".
3057-46(3007)
And/or Authorized Applvant (Date
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QL D i t RECEWE •
COSTA MESA BUILDING DEPARTMENT cIIVAP.CE (9EPT.cp
COSTA MESA. CALIFORNIA CITY Of COSTA MESA
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
BUILDING BUILDING '
ADDRESS 1294 Belfast Avenue i
COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY
RECEIPT NO. Pygr 2
OWNER COLLEGE MESA COMPANY VjUU
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RECEIVED BY ,,// DATE RECEIVED_ DATE ISSUED
ADRESS P. 0. Box 2277, Brookhurst Station
�j(/E /j-�7/-/7—al NUV 2 0 1 59
MADL
BUILDING
CITY Anaheim TNO., KE 3-3161 ADDRESS •
ARCHITECT Bulot, Quigley LIC.
OR ENGINEER and Clark NO- RE 7191 COSTA MESA. CALIFORNIA
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ADDRESS1102 W. 17th St. , Santa Ana ZONE
CITY LIC
ZONE NO.DF
PLANS TYPE GROUP
CONTRACTOR The Hale Company NO. 7350 1 > 1/ d Q
TEL. APPROVED "f i/z o -c
ADDRESS17Z7 W.Lincoln,Anaheim NO KE 3-3161 BY ,n, DATE
LEGAL LOT CORRECTIONS
DESCRIPTION NO. 143 BLOCK TRACT2671
Plan 2-B
A.P.NO. •
SIZE NO.OF BLDGS.
OF LOT 65 x 100 NOW ON LOT Nnne
USE OF C
EXISTING BLDG. '
SETBACK LINE FROM '
CENTER OF STREET ' 50' REAR YARD 331 _
SIDE YARD RIGHT 7' LEFT 71
DESCRIPTION OF WORK
NEW X ALTERATION ADDITION -
REPAIR MOVING DEMOLISH
BUILDING 1440' -Gar. NO. M 5 1 ,
NO.OF STORIES
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EXTERIOR WALL ROOF
COVERING Stucco COVERING Compo
USE OF NEW -
BUILDING Single dwelling w/att. garage
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC-
TION. COLLEGE MESA COMPANY VALUATION
SIGNATUPERMIT FEE $ 30 00
PERMITTEEREO FBy: The ale Company,Gen.Par
PLAN CHECK 5 15"00
�1 4,P7(Z .,/j 12,890
AUTHORIZED G TOTAL FEE $ 45.00 fte,
OWNER COLLEGE MESA COMPANY DATE . 11-20-58 _
JOB ADDRESS 1294 Belfast Avenue BUILDING PERMIT NO. 8042
GENERAL CONTRACTOR The Hale Company - VALUE $ 12,890.00-
AP. No. LOT 143 TRACT 2671.FIRE ZONE DE ..tIPTION OF WORK Res. w/att. gar.
GROUP I & J TYPE V ZONE R1 -PLAN NO.
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER _
Trenches Forms Steel 49 0 a'
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam / .41
Frame and Flashing o
Lathing, In Out - vim. pg
Plaster, brown coat e , -t /c/9- v -
Underground soil/ W/G Pipe Tes - / ' -2?- '
Top Out i-as-te Srurnace Ift ffl L�13%'� 1(YL7 - fr 6�'
Gas Vents ONENIMOIA
IN
Rough Plumbing 4.W / , -2.5- ' /�% USZi AW-A` 1V
Cesspool Septic Tank -
Prop. Swr. Lin Sr Ho ,/ on. St. Swr. IMMEMIEMMIrragliffinillniejet
Sprinkling System MIIIIIMINMNI 1
Heating Final .-- ' Firgnill `V
Plumbin. Fixtures, Final //t_ 4 .0,.�-c !
Final Gas Test /4)25. 4/ ' g'- FO •
Construction Pole
Underground Power x'
Rough Wiring w = r �r_���lrr
1I
Fixtures, Final fienifrfal elle
OCCUPANCY ' yrs it.,-71.1 t
Form 210-5M-1-57