HomeMy WebLinkAbout1616 CARAWAY DR - Building Permits CITY OF COSTA MESA
DUILbING DIVISION
q � DEVELOPMENT SERVICES DEPARTMENT PER NUMBER
/ PERMIT
B05-01262
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(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.a,usLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
BUIJob Address: 1616 CARAWAY DR Status: ISSUED
Suite: Applied: 07/29/2005
Vicinity: ROOF Issued: 07/29/2005
Primary Occ: Type of Construction: V-N
Parcel Number: 13949230 Zoning: R3 /�
Applicant: KIM MCCLAIN ISSUED BY: S1"v
Address: 12812 VALLEY VIEW ST
STE 33 Phone: (714)897-1780
GARDEN GROVE CA I - Zip: 92845
Owner HASELBECK, HERMANN TR
Address 6 VIA SOLANO _
CA." - Phone:
RANCHO SANTA MARGARITA _ 'Zip: 92688 _
.„
Contractor: MCCLAIN ROOFING INC
Address:. 12812 VALLEY VIEW ST
STE 33 Phone: (714)897-1780
GARDEN GROVE CA
Zip: - 92845 License: 625013 - -
Arch : Eng:
Address: - - - Address:
-Phone: - - - Phone:
Zip: License: - Licenser
. SCOPE OF PERMIT
TEAR OFF EXISTING ROOF AND INSTALL 2-PLY 13#ASTM FELT AND 30:YEAR,COMP SHINGLES ON;4-PLEX ONILY,APPROX 4900 SF
(GARAGE NOT INCLUDED). - - - ,
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $8,500.00
Permit: . $167.25 Claim Valuation: $8,500.00
SMIP Res: $0:85
SMIP Corn: $0.00
Other: $0:00
Inspection: $0.00 •
Total: $168.10
•
•PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front -0-0• Rear 0.0 :Left: 0-0
ACCESSORY Front 0,-0 .,; Rear 0-0 -. .Left ,0=0Right ,0;0
PARKING Existing: 0 "-,Required: 0 - ..,Proposed: 0
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
244646(6/00)
•
•
DECLARATIONS'
WORKERS'COMPENSATION DECLARATION: l }
•
I hereby affirm under penalty of perjury one 01 the following declarations:
O 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
J work for which this permit is issued.
Ly I.:tiave and will maintain workers'compensation insurance,as required by section 3700 of the Labor Cede,for the performance of the work for which this permit is Issued.
L/-My work om ens`atI`on Insuranceucarrier and policy number are: __ ,'1
�Camei:`- --� .IfV��.1 Policy Number: /. .-7 /3700 —100)
(Thissection'reed 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 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 p9vDa - - in/DT i` _
Aplicant Sgn'atire /C
-
WARNING_FAILURE TO SECURE WORKERS'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 licensedy oder provisions of Chapter 9(commencing with Section 7000)of Division 3 ot.ihe.Busines and-professions Code,and my license is in full
force.and'effect,Lic.�E- /22-9),3 LClassa L
ContractorsfSig re: /1A>t C--.- Date:
7 /if/
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: 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 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.). '
O I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. _ _ Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. 0 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:
O 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? 0 Yes 0 No
(Section 25505 of the Califomia 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 Calitornla Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required.has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this,application aka rmit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No
(If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 It 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
B (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.
Signature Of Legal Owner(s)
kin *4
Cate
('And/Or'AuthodzedApplicant LDate —7
CODES INSPECTION TYPE 29IE INITIALS CODES INSPECTIONTYPE . all D(TTflAU
1616 Fixed System Final Fire Prevention 206 Final Mechanical
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 �j
204 Final Demolition 250 Final Building/Occupancy pA A-or/ (�r?
City of Costa Mesa
Building Safety DepartmentCERTIFICATE OF OCCUPANCY N? 2454 C
P. 0, Box 317
Costa Mesa, California
The Building located at 1616 carnurrer Thrive, *Al
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group II_(b J Occupancy.
Use of Building .4 Unit Arertztent Deadixt$ vith attar-hal paring ezd laundry
Legal Description 'Tract 6259, hOt 15
(See reverse side for Metes and Bounds) •
Building Permit No. t+ Electrical Permit No. 26513 Plumbing Permit No. 26053
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 4 and/or guest rooms
ISSUED TO: Building Official
KAIrainit EITZAP,IENT Cm. by .d //��
Date !larch 10. 1961
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 BU34-1as-113--s B P
ROBERTS,UWNtK Lewis UAlt 2/6/73
iN,JOB ADDRESS 161Caraway Dr. BUILDING PERMIT NO. 36068
GENERAL CONTRACTOR Airf)o Awning DESCRIPTION of WORK patio Cover
'AP No.139_422_90 LOT TRACT FIRE ZONE VALUE $ 240.00
`JINSPECTIONS Signature Date GROUP ,T TYPE V ZONE 9.3
SOIL SUBCONTRACTOR PERMITS ISSUED
kGAS Date Number I Signature
*WATER Plumbing
y.\ROUGH PLUMBING
'\.PROP. SWR. LINE Q HOUSE CON. n
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER El
ROUGH WIRING Heating and Vent.
TRENCHES n FORMS n STEEL REINF. [� -
FLOOR SYSTEM
BOND BEAM in STEEL REINFORCE ❑
SHEATHING
FRAME AND FLASHING
LATHING - IN n OUT in
PLASTER, BROWN COAT
STRUCTURAL, FINAL _ Electric
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST in
ELECTRIC, FINAL 1ry yy�� ^
BUILDING, FINAL .2
�//t� 7-- 23
36068 Pt,'B ::,:, .
COSTA MESA BUILDING-SAFETY DEPARTMENT
-FII -7-73-c on 278 *1'55 c
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
'PP IC TION FOR BUILDING PERMIT
For Applicant to Fill in Completely
) II �,a�p (� RE IV D Y DATE ECE ED DATE
I ISSUED
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LDINGADDRESS /t0 / t0 CO ' A Waif (� IL_._- �y (�yyr'r . --(.0-773Q
A.P. NO. I3 1— l-I .Z-3° PERM3gC568
OWNER L e W,t s R n e rt-
BUILDING �J7(Ol\1 CJ
MAIL BUILDING 1 1 n
Z ADDRESS S Vvl r ADDRESS 11 i c in f-4 u n L)
CL c) CITY CnS 'Ea C Ra TEL
TRACT 11,Q4 LOT 15
z C CONSTRUCTION NEW ADD, ALTER REPAIR MOVING. rBLOCK
FMOLISH
Q I- LENDER N.---
am
JD BRANCH AiOK2
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OWNER '� Le1L1 .5 enberf-s
a LU m J ADDRESS VALUE
-CO ARCHITECT a TEL. E fJ- Cd
JQ OR ENGINEER T k NQ b l) AM NO. 361': USE 7tYi71 OOPN Ono �y�
U N
Q ` FIRE r�
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w ADDRESS j�dd A i NCrIJN yJ l' S . 177, ZONE I TYPE GROUP
APPROVE /I / /
Lu Z CONTRACTOR A� r Pin -4tUH i ny ^BY
DATE P
• Z ,�f ✓
":1,:c ADDRESS
/Jl•/3 errnsAcrw I�IVaa
W W l ZONE NO.OF USE OF NEW.�f ,yy
O= /� / TEL. ?.Z/ (f 3, PLANS a BUILDING ry 1 LA ,tom r1�
ZF- CITY Ca rrLon a- NO. 0/l/.3 c17lirrng t-'If'�Ift01
Wo STATE CITY YARDS APPROVED YARDS APPROVED
j O LIC. NO. 3a no O LIC. NO. MAIN BUILDING ACCESSORY BUILDING
SIZE Q I NO.OF BLOCS. (FROM C/Lr STREET)
OF LOT NOW ON LOT FRONT �7'li FT. FT.
USE OF .tX as 71T 1h dl,f/G
EXISTING BLDG. ,AAs C may(( p ter ✓ R SIDE FT. F
H SIZE OF NO.OF
Z NEW BLDG. ROOMS STORIES L.SIDE T. T.
UEXTERIOR WALL I ROOF L(,
_ COVERING COVERING A/LA/'I REAR FT. FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
0-
0- MAIN BLDGS. ACCESS. BLDGS. .
Q /' " � VAR.# DATE
p 7 %_7 ,50r if pet h110 OQ t.r r Tii C.U.P.# APPROVED(
zb� .Alfrp,err Pu 7 _BY APPROVED I r l„11J DATE �L-`�73
0 f W
UI hereby acknowledge that I have read this application and state SB
✓ that the above information is correct and agree to comply with TAD
TA
CC all laws regulating building construction, and I shall not employ /
H any person in violation of the workman's compensation laws of
N m
the State of California. 1/ m
ZI hereby certify that I am properly licensed as a contractor under SO. FT. w, o
the State of California Business and Professions Code, Divisicn 3, THE AMOUNT SHOWN UNDER VALU S FOR
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: a
CC
am exempt from the provisions of the State of California Business
VALUATION /'� ���) m
and Professions Code, Division 3,Chapter 9. PERMIT FEE $ Oft ,9-O N
V al
Signature of m
Permittee .4 ./ / /////I01 ✓$ J PLAN CHECK $ -•—• E
a
Authorized Agent - in—) LL
TOTAL FEE $
9.11111110,
3 1 4 OCT 31-66 001309* ***210.75
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 120 COSTA MESA, CALIFORNIA 9282E
For Applicant to Fill In Completely + - ' APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
For Office Use Only
G
ADDRESS 1616 C:arAw Dr Pi-
`� I
RECEIPT no. 2( 71TNO.
COSTA MESA. CALIFORNIA tJ a ! (^F
BECEI By/ DATE RECEIVED DATE ISSUED
OWNER Kat-South Bevel. Corp . 7Tf /d— r--'6C/6"-c2X66
1, BUILDING I/_// .ft ,Q//'U.
MAIL 1442 S. Euclid BUILDING a S( 4 l U
ADDRESS
FIRE TE ZONE ' TYPE may— GROUP
CITY Fullerton No�:871-823: U
ARCHITECT TEL. BYPROVED i'.//g DATE/O Lt/V,/
4
OR ENGINEER NO. •�.�
Z NINO
ADDRESS 72,_, I No.0: I DSEOP �� ( /
Allied Constr. Inc.
CONTRACTOR 1 / /1/yy
LEGAL ^'7/_ . 1.41e-19
� // /G
ADDRESS 1442 S . Euclid DESCRIPTION `{.//7% @ 7 ;
CITY Fullerton A.P.NO.
NOTE: NO SAVE OVERHANG SHALL BE LESS THAN
STATE . B102641 Mr 871-8233 SO•TO SIDES REAR p.L.
SIZE 73 x 109.6 I NO.of BLDGS. 0 AAVES
LLOWED (U.B.C.REQUIREMENT)
OF LOT NOW ON LOT YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG.
- (FROM C/L ST.EET)
SETBACK LINE FROM '/
CENTER OF STREET ? REAR YARD /.j b FRONT 7�FT. PT.
.L84
91 R.SIDE 7 FT. FT.
SIDE YARD FT LERIGHT
II DESCRIPTION[ OF WORK L.SIDE a1 FT. FT,
R
NEW I I MOVINGTION DEMOLISH D
ADDITION
DIST r FT.
EA
STANCE BET. BET.MAIN&
REPAIRMAIN BLOCS. ACCESS.BLDGS.
BUILDING NO.OF VAR.# DATE
SIZE 42 }{ 82 ROOMS 1 .3 STORIES 9 C.U.P.# APPROVED
EXTERIOR VEdbuCCo i ROOF Rock APPROVED 4• A/ DATE /Q�T(J�] [�_4O
COVERING COVERING PT
USE OF BUILDING AND WORK TO BE PERFORMED p,
4 unit residence _ 9
plus 5 car garages
(�,5a3 SQ.FTY-90617 fizod. 2 ° :
I HEREBY ACKNOWLEDGE THAT.I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE O
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
et
PLY WITH ALL CITY O ES AND STATE LAWS eEGULATING VALUATION
BUILDING OONBTRU OL//� P
PERMIT FEE 5 /1(l•6 v N
SIGNATURE ' ->"p"....../......4......../4,
�1 //��++
P.
PERMITTED y y/77.--
�j y� 7 a
$ (/ // PLAN CHECK $ / (((...��� W
AUTHORIZED AGENT �I/O �
- _ TOTAL FEE $ 6