HomeMy WebLinkAbout1598 CARAWAY DR - Building Permits III i
• CITY bF COTA MESA
BUILDING DIVISION
441411t..y' A
F I
77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
4. FOR INSPECTIONS CALL: (714)754-5626
PERMIT NUMBER: BX07-00041
PERMIT TYPE B_MISC STATUS: ISSUED
APN: 13949227 DATE ISSUED: 07/2512007
Zoning: R3, ISSUED BY: RMD
JOB ADDRESS: 1598 CARAWAY DR CM Suite/Unit:
Vicinity: FRONT FACADE Primary Occ: - - Const Type :??
SQ. FT: 0 Valuation: $1,200.00
SCOPE OF WORK: REMOVE (E) WOOD SIDING AND REPLACE WITH STUCCO AT FRONT FACADE WITH 1 NEW AND 1
RELOCATED LIGHT FIXTURES .
FOR SFD. - '
OWNER: BONCA,MIRON TR . . Address:: 3153 COUNTRY CLUB DR Unit
City/State: COSTA MESA,CA Zip Code: - 92626-2354 •
Phone: 714-434-9176, .
APPLICANT: BONCA, MIRON TR - • Address: 3153 COUNTRY CLUB DR Unit:
City/State: COSTA MESA, CA Zip Code: 92626-2354
Phone: 714-434-9176
CONTRACTOR: OWNER-BUILDER License No. 000000
Address: Unit:
City/State:
Zip Code: Phone • Cell:
ARCHITECT: License No.
Phone
ENGINEER: - License No.
Phone
FEE SUMMARY
Building Plan Check: _ $0.00
Building Permit: $44.85.
Electrical Permit: -• $25.70
SMIP Residential $0.00
SMIP Commercial $0.00
$0.00TOTAL FEES $70.55
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.
CODE P. INSPECTION TYPE DATE INTITIALs CODE INSPECTION TYPE DATE INTRIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical `,`,"�,y��y
1266 Pool Spa Final 2081Final Plumbing 6101�f ` E' U
200 Final Re-Roo( 210 Final Electnral,A p�y /�//D/n 7
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Signm 222 Final Site �� _/
204 Final Demolition 250 Final Building/Occupancy i�p�{/ ,py__LU(_(X/o,
Ilk
WORKERS'COMPENSATION DECLARATIO9 . 'Otaner ID verified by dri nse. 0 Yes 0 No
I hereby affirm under penalty of perjury one of the following;declarations: - Dii jr's License No. Expires:._• • .
0 I have and will maintain a certificate of consent to self-Insure for workers' Vacatian 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 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
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
(This section need not be competed d the permit is valued al one hundred dollars(5100)or less)
2,Art 2Sec.341,Title 8,California Administrative Code).
Policy Number:
❑ As owner-builder, I will not employ anyone to do work which would
Lcertify 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 �j
become subject to the workers' compensation provisions of Section 3700 of
Applicant's Signature Dale'-
the Labor Co shall forthwit mply with these provisions �jy
dreier'
{ ^b<C-Q%hi� Ay/) C '--/J 4 Division of Industrial Safety Permit Number:
Applicant's Signature C/"C��/ /Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
ING: 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//t6 release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑'No j
($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). C\-1. ' ,t
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? ❑Yes:: '0-No
Lic.# Class# (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\time5has on hand a quantity-of acutely
contractor's signature Date 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 .: (
C]
I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant\or present �ent or future building occupant need to
performance of the work fix which this permit is issued,(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention`Program for acutely
Lender's Name: hazardous materials)? 1❑yes 0 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 1/ \tom_ -
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/
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or hiture 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 districtar,gency? ❑Yes ❑No
issuance,also requires the applicant for such permit to file a signed statement ]' in �' l
that he or she is licensed pursuant to the provisions of the Contractors (Sectgnt658e fumif the California Govemrneo Code requires that the requested
information be furnished on applications`for non-residential building permits).
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the \\ W\tt 7i
Business and Professions Code)or that he or she is exempt therefrom and 6.\Wil\anyrpart 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�im the outer boundaries of a school? ❑Yes 0 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).
CO—I,s 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.
employees, provided that such improvements are not intended or offered for 8. (If"yes", attach certificate of compliance from the appropriate air pollution
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 Dale
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 permit until final inspection.
1):--7612.--40I ature pHs.. swner(s) Date �1
/(Si9nature� Date/ / /� //2
.A6(3/0])
And/or Authonzed Applicant Date V
+ •CITY OF CA MESA
r4'T` BUILDING DIVISION
F" All 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
-,. f . FOR INSPECTIONS CALL:1714)754-5626
%%-a m
PERMIT NUMBER: BX07-00041
PERMIT TYPE B_MISC STATUS: ISSUED
DATE ISSUED: 07/25/2007
ISSUED BY: RMD
-
JOB ADDRESS: 1598 CARAWAY DR CM.: • I Suite/Unit:
Vicinity: FRONT FACADE • Primary Cod: , ' • Const Type
99 • -
SQ. FT: 0Valuation: $1,200.00,
SCOPE OF WORK: REMOVE (E).WOOD SIDING AND REPLACE WITH STUCCO AT FRONT FACADE
OF SFD.
OWNER: BONCA, MIRON TR -Address:: 3153 COUNTRY CLUB DR Unit
City/State: COSTA MESA, CA - . Zip Code: 92626-2354
Phone: 714-434-9176 ' .
APPLICANT: BONCA, MIRON TR • Address: 3153 COUNTRY CLUB DR Unit:
City/State: COSTA MESA, CA . . . Zip Code: 92626-2354
Phone: 714-434-9176
CONTRACTOR: OWNER-BUILDER - License No. 000000
Address: Unit:
City/State: - •
Zip Code: Phone Cell:
ARCHITECT: - • License No.
Phone
ENGINEER: License No.
•
Phone -
FEESUMMARY
Building Plan Check: $0.00
Building Permit: $44.85
Electrical Permit: $0.00
SMIP Residential $0.00
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.
CODE A. INSPECTION TYPE DATE INTITIALE CODE! INSPECTION TYPE Mgr INTUTALE
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Fin / Final Plu •. ,g
200 Final Re-Roof / ` 210 Final' rival , N
201 Final Block/R aini W.II 1 .•. Fire Prevention
202 Final Factory ire ace 2 0 nal Planning Approv
203 Final Sign 22 Fi .1 Site
204 Final Demolition V - 250 Final Building/Occupancy
WORKERS'COMPENSATION DECLARATION: Apt Owaer ID verified by driv nse. I:14"i 0 No .1. .,
I hereby affirm under penalty of perjury one of the,.__sing declarations: Driver's License No. ' Expires:, C-2-0a
0 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.
O 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
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
(This secrbn need not be completed d the permit is valued at one hundred dollars($100)or less)
2,Art 2,Sec.341,Title 8,Califomia Administrative Code).
Policy Number:
❑ 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 Califomia, and agree that if I should
become subject to the workers' compensation provisions of Section 3700 of
the Labor Cod ,I shall forthwi comply with these provisions. Applicant's Signature Date
/6(1.401/ � 2--.25--o7 Division of Industrial Safety Permit Number:
Appliral's5ignaWre Datez-----.. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
W 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 0 No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safely 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
Lic.# Class# (Section 25533 of the Califomia 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
Contractor's Signature Date 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 0 No
(Section 25534 of the Califomia 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: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 0 No
issuance,also requires the applicant for such permit to file a signed statement
that he or she i5 licensed pursuant to the provisions of the Contractors (Section 65850.2 of the Califomia Govemment Code requires that the requested
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
information be famished on applications for non-residential building permits).
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? 0 Yes 0 No
applicant for -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 hundr dollars($500).): of the California Health and Safety Code).
❑71 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
co(m ensation, 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? 0 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
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 permit until final inspection.
icil
//(y�' Weef2_" zs 'Si ature of Legal inert Date -
r�J--G'(/ 'Signature Date. iD� -+-a——07
57 a8 t3/07) C. / Ana/or Authorized Applicant / Date
ADOREss DPBMLWC: 1598 CARAWAY DR UMT: CITY OF COSTA MESA - BUILDING PERMIT
onnN.MEIpIoIa*n: WONG, HAANS / /PERM NO: B 079458
4 awss: WONG, JULIE ,
BOX 3526 PERMIT NO: B 079458 PLAN CHECK NO: N GOVT: N SUPP : N
COSTA MESA,CA 92628545-0650
APPL.MING ADORES& CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: OTH
ARCRRECT OR ENGINEER: uc ND.: JOB DESCRIPTION : T/OFF 6 REROOF W/COMP . SHINGLES SQ FT: 4 , 750
ARCH OR END'S ADDRESS: WIT:
CLAIM VALUE: 4 , 750 . 00 CALC-VALUE : 4 , 750 . 00 GROUP OCC : R-3 /U-1
CONTRACTORS NAME
ca4wACTOR9 MARINO COMMENTS : X
***********************************************************************3**33***
ADDRESS: LIC N0.:
' UMT; ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby em under penally et perjury that I am licensedxnsed under provisions of Chapter9 SETBACKSaffirm
(commencing with Section 7000)of Division 3 d the Business and Professions Code.end my license is in full force end effect.
CffYLIC.NO.: L1C.CLASS: UC.NO.: EXP : MAIN BUILDING ACCESSORY BUILDING
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR : FT IN
Date: Contractor:_ LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penny of perjury that I ant exempt from the Contractors License Law for the
following reason(Secton 7031.5 Business and Professions Code:Any cityor county whim requires a perms toconstmd,al«.Improve, PARKING REQ: PROV: PARCEL : 13949227 ZNE: REF NO:
demolish.or repel any structure,prior to is issuance,also requires the applicant for such permit to fib a signed statement that he or she PLANNING NOTES>
is licensed pursuant to the provisions of the Contractors License Law]Chapter 9(commenting with Section 7003)of Claim 3 of the
Business and Professions Code]or that he or she is exempt therefrom and the basis fa the alleged exemption.My violation of staion >
7031.5 by any applicant for a perms subjects the applicant to a civil penalty of not more than One hundred ddweMOOD. *******************************************************************************
❑ I,as owner of the PrOPOrtV Or MV eMPIOYWAS with wages as their sole compensation.will do the walk and the structure a nor intended DEVELOPMENT SERVICES R E Q U I R E M E N, T S
or offered for sale(Section 7044.Business end Professions Code:The Contractors License Law does not apply to an Owner of property
who buids or inproves thereon,and who does such work Nmseff or herself or through his or her own employees,provided that such
improvements are not intended or offered for sale.ff,however,the building or inprovement is sold within one year of completion.the ZONING APPROVED BY DATE: -
isownerbuiMer will have the burden of proving he or she did not build or improve for the purpose of sale).
I.as owner o the properly.am exdudvwly contracting with licensed contractors to construct the project(Section 7044,Business and BUILDING APPROVED BY : DATE: '
Professions Code:The Contractors License Law does not apply to en owner of property who builds or Improves thereon and who
contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law). '•
• Iern exempt Section: B.APC..or thio I�.AS)•5 APPLICATION ISSUED BY: - DATE:
40
vs
************************************* ***************************** *k*** *
'� °x"° LEGALIZATION:N' F E E SUMMARY STRUCTURAL S GMENT:Y
do hereby sonify Ilial I am aware of end understand the requirements al'omie Health and Safely Code Sections 25505,25533,and
25534.and the I or any future building occupant will(will not(drcle one)need lo comply with saM state codes end the requiremems for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
.
e pent famrrebucticn a from am the Ak Quality Management District.Residential constnrdon appfutors are exempt from these PERMIT 9975
provisions. . 50
Dale: mart' PLAN SMIP/NON RES
WORKERS COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: ISSUE FEE e
❑ them and wDmantaiecertificate dowmtloselltiuunfor workers'compensation.as Provided fobySectiOn3700oftheLeber BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL ' PAID DUE
Code.for performance TOTALS----> 100 . 25 0 .00 0 . 00 100 . 25 100 . 25 . 00
o I have and win maintai workers'compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the
work for which this « elswm
permit is capolicyrriernumber
ae: REVENUE DIVISION TOTALS--> COLLECTED : 100 . 25 OVER/SHORT: . 00
policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT,' GRADING PLAN-CHECK
(This section need not be completed I the wont is for one noodled dollen;MOO/o•less) 99 . 75 . 50
o I cedry Nat in the performance of the work for which this permit is issued.I shall not employ any person in any manners°as to
benne subject to the worker.'compensation laws o Clb«nie.and agree thel if I should become eubied to the w«brs' *******************************************************************************
compensation provisions o Seam 3700 o the Labor Code,I shag forthwith comply with those provisions. INDIVIDUAL F E E B R E A K D O. W N
Owe: Applicant:
Warning:Failure to secure workers'compensalion coverage Is unlawful,and shall subject en employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil fines up to one hundred thousand dollars alma OA In eddltlon 10 the coat of compensation,de .as provld d for In
ro
$ecnon3sof" Interest,aLaborCods,Int ' andadorney'afees meSFR 4750 REROOF BY VALUE RESIDENTIAL NOZONE 1•
.00 4 , 750 . 00
CONSTRUCTION LENDING AGENCY: I hereby affirm under pens of perjury that there is e construction I.ndong agency for the END OF FEES
performance of the work for which the perms u issued(Section 3097,Cl.C).
LENDERS NAME: '
LENDER'S ADDRESS:
I certify that I have read this application and stare that the above information is coned.I agree to comply with all city and county ordinances ,
and stale laws reltlng to building construction end hereby authorize representatives of this city to enter upon the above-mentioned progeny
to inspection purposes. WONG, HAANS
ittawny
0100214777-00214778 TCT 100.25
""i%jir�3Date: 7/a- g DATE: 09/12/95 TIME: 10:18
gip Owner/ AppfcantFmtnda
(5151dd.WP) White-Suddi.g&Safety,Green-Fb:Canary-Appicant:Pink-Revenue:Oold«uod-Assessor
CONSTRUCTION AND PLANNING Pt. & SPA
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. : 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. . 55. Electrical Bonding
5. Steel Reinforcement I 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd.
10. Structural Floor System - 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater& Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace - APPROVALS Permit#
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough& Test 72. Underground Flush
24. Roof Framing. 73. Undergrnd.StorageTank OGas OOil
25. Roof Sheathing
1' 14/(7_ 6�x1�"-74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat I w 75. Dry Chemical
27. Frame and Flashing - 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 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:
-
34. Final Heating& Air Conditioning •
,
35:Final Gas Pipe-Test
•
36. Hood or Canopy s
37. Final Factory Fireplace • -
38. Final Plumbing - -
39. Water Service-Final.
40. Gas Service-Final
41. Solar Domestic-Final •
42. Backflow Preventer l j -q4'- %-e 'A Cc`h c/ _z
43. Backflow Irrigation •
r!t 4S4ct (� .k.k.e,/'-
44. Landscape Irrigation System - 'L )`
45. Sound Attenuation
46. Handicap Regulations ,�
47. FINAL STRUCTURE & BUILDING t-'7 6'wf/y
48. FINAL PLANNING f
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co -
51. CERTIFICATE OF OCCUPANCY - -
No Date
CITY OF COSTA MESA
' 4 BUILDING DIVISION
. rf�..�, DEVELOPMENT SERVICES DEPARTMENT PE 'NUMBER
V• � PERMIT
%romnso°c LP01-00478
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
PLUMBING PERMIT
Job Address: 1598 CARAWAY DR Status: ISSUED
Suite No Applied: 08/08/2001
Issued: 8/08/2001
Vicinity:
ISSUED BY: •
Parcel Nunmber: 13949227
Applicant: WARREN, ROBERT
Address: 358 S MAIN ST
SUITE 43 Phone: (714)525-5858
ORANGE,CA Zip: 92868
Owner: BONCA TRUST .
Address 3153 COUNTRY CLUB DR
Phone:
COSTA MESA, CA Zip: 92626
Contractor: CAPITAL PLUMBING, HEATING &AIR
Address: 358 S MAIN ST
SUITE 43 Phone: (714)525-5858
ORANGE,CA Zip: 92868
License: 670418
Arch / Eng :
Address:
. Phone:
Zip:
License:
SCOPE OF PERMIT
PLUMBING PERMIT FOR PARTIAL REPIPE
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) $0.00 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 $0.00 0
Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0
Expansion Tank $0.00 0 Sink,commdrcial $0.00 0 Water Re-pipe $9.80 1
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
Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00
Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0
Interceptors(Sand Auto) $0.00 0
TOTAL CALCULATED FEES: $33.30
COMMENTS I SPECIAL CONDITIONS
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
244&48(6/00)
DECLARATIONS
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.
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.
My .others'compensation Insurance carrier and policy number are:
Carrier: , ./ • Policy Number: vVi 011 5-7/ 02)
(This section n:ed not be corn•eta•it the permit is valued at one h ndred dollars($100)or less.)
❑ 1 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 become subject to the workers'
compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisio -
Appliidant Signature: / r Date: e, �( CC
WARNING:FAILURE TO SECURE WO- ERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE 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 I am Iicens d under rg ''Ins of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Prgss tons Code,end my license Is in full
force and effect.Lic.# (0(lb ` L Class#
C..�7((O
Contractors Signature: ,i . dA i .Date: 4r Q 0
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),
Lenders Name: Lenders 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:My 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 toe 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 will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Cale: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 am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. 0 Yes 0 No Drivers 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,faisework,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? 0 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? ❑Yes 0 No
(Section 25533 of the California Health and Safety Cade,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 Cade 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 apPermit for such construction or modification
from the South Coast Air Duality Management District or from any other air pollution control district or agency? Yes LJ 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? 0 Yes ❑No
(If yes',the facility must meet the requirement of Sections 25534 and 42303 of the Califomia 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? 0 Yes 0 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 and 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.
4fg:n�ature Of Le(ggalallOOwner(s) — vy/ Date_
AnE/O�Authoriz-ed Applicant
GODS I INSPECTION TYPE PATE ODE# INSPECTION TYPE PAIF. INTITIAL4
1616 Fixed System Final Fire Prevention 206 Final Mechanical 'in )
1266 Pool Spa Final 208 Final Plumbing
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
2631 7 OCT 11-66 001303* ***210.75
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92620 -
For Applicant to Fill In Comp/kNly APPLICATION FOR PERMIT
TYPE OR PRINT / / � BUILDING
ti./ For Office Use Only
BUILDING fi '
ADDRESS" 1598 Caraway Dr. -
RCIFNO, PERM ND.
COSTA MESA. CALIFORNIA 2OLS I I
R[ [9r, T REC"EI�D DATE ISSUED
OWNER Kal -South Devel. Corp. RY- AV'1d '�i �0 x`66
rim, 1442 S. Euclid ADDRESS BUILDING 74198 dein/knit ,�1 .
w
q ,,.,, FIRE /
CITY
Fuller- ton NO R71 -82'3 ZONE TYPE �G GROUP
ARCHITECT TEL APPROVED rtf DATE/���-d'e
OR ENGINEER NO. BY'
ZONING
ADDRESS z
No.Or um Or NEW at �� /
Allied Constr. Inc . g-3 I runs el- I BUILDING .Q i, ,
CONTRACTOR /, . y9 �(q�(j�/ /el
LBSCR div, (C26 IM PS
ADDRESS 1442 S. Euclid DESCRIPTION VV✓(/ / /
Fullerton A.P.NO.
CITY
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
LIt1/4.70 ST . gB102641O.'871- 8233 SO•TO SIDE&REAR p.L.
EAVES
SIZE I NO.OF ELDOS. ALLOWED (U.B.C.REQUIREMENT/
OF LOT 73 x 109 6 NOW ON LOT 0
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. N ( ' --
(FROM C/L/STREETT)_
SETBACK LINK FROM �.,.¢ / �� J C2 FRONT .7/ FT. ✓ PT.
CENTER OP STREET 'T12 5 REAR YARD �f
t R.SIDE O tit FT•
HIDA YARDI LEW 18 I RIGHT
DESCRIPTION OF WORK L SIDE 9FT. PT.
NEW ALTERATION ADDITION REAR 7PT. FT.
DISTANCE BIT. BET.MAIN&
REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDOB.
BUILDING NO.OF VAR.# DATE
SIZE 46 x $7 ROOMS 1.3 STORIES 2 c.v.p,# APPROVED{ b /`
COVERINGEXTERIOR
W .tcco I COVERING Rock APPROVED JR 4/ DATE �.1-/-2 -/p+'
USE OF BUILDING AND WORK TO BE PERFORMED (LJ O.
S
4 unit residence /
plus 5 car Garage j J�J`�3HQ.FT.�9/��li a 7?. 7a° 'r
I HEREBY ACKNOWLEDGE THAT.1 HAVE RIAD THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE O
AND STATE THAT THS ABOVE iS CORRECT AND LORIS TO CON. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORD',
AND STATE LAWS OYMTNG
BUILDING CONSTRUCT VALUATION // h f.,
E OF / PERMIT FEE a/ (/•pL0 E
SIGNATURinatbu / s ! ;/27----'✓ PMN CHECK S 70. 'v w
AUTHORIZED AGENT Sa/0 '/•75
- TOTAL FEE �J
City of Costa Mesa
Building Safety Department C E R T I F I C A T'E OF OCCUPANCYN? 2450 C.
P. 0. Box 317
Costa Mesa, California • .
The Building located at ma Camay trivet, den
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group II OS Occupancy.
se of Building lb Ott Escortarrat ruildiagwith attached mamas ext latmdry
Legal Description ' 6259, 12
(See reverse side for Metes and Bounds) �'�,.
Building Permit No. 263U Electrical Permit No. 26593 Plumbing Permit No. 49045
Floor Load Signs have been installed as Room Capacity Signs have been instaled as
required under Sec. 2308 U. B. C. —. required under Sec. 3301 (1) U. B. C.
17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied
until the owner or operator has been issued a valid certificate of occupancy by the enforcement agency.
(b) A new certificate of occupancy shall be obtained whenever there is a change in:
1) Occupancy classification of a building or portion thereof
2) The number of apartments or guest rooms
3) Ownership
If Group H Occupancy, number of apartments and/or guest rooms -as required under:Sec. 17050.1 (d), California
Administrative Code, Title 8, Chapter 9, Article 8.
Number of apartments b and/or guest rooms
ISSUED TO: Building • ici.
Eel So
14h • by `Ai Elul —
Date Mach 9� 1967
This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed
except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C.
Form auas tat—tt-s3 s_s P