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HomeMy WebLinkAbout1630 BEECHWOOD - Building Permits • F 9 CITY OF COSTA MESA BUILDING DIVISION > • (4 743:7•71.1 `r • DEVELOPMENT SERVICES DEPARTMENT PE MIT NUMBER (. t �'r ja • PERtv11T -``'"*M�ooammmm • 802-00951 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1630 BEECHWOOD Status: ISSUED Suite: Applied: 06/27/2002 Vicinity: 3RD CAR GARAGE INTO 5TH BEDROOM Issued: 06/27/2002 Parcel Number: TPN00069 Zoning: Applicant: ROBERTS, PEGGY ISSUED BY: �- Address: 15326 ALTON PARKWAY Phone: 949-650-5730 IRVINE,CA Zip: 92618 Owner: STANDARD PACIFIC HOMES Address ,1565 W MAC ARTHUR - - COSTA MESA, CA • Phone: 714-668-4300" Zip: 92626 Contractor: STANDARD PACIFIC OF ORANGE COUNTY INC 'Address: P 0 BOX 57061 - Phone: 949-789-1600 IRVINE,CA Zip: 92619 License: 726223 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT • REPLACE 179 SF PORTION OF THE THIRD-CAR GARAGE WITH AN 179 SF FIFTH BEDROOM OPTION-PLAN 2-FOR NEW SFR FOR"STANDARD PACIFIC HOMES." " REF: B00-01536 FEE SUMMARY Plan Check: $34.00 Calc Valuation: $11,277.00 Permit: $209.25 Claim Valuation: $11,277.00 SMIP Res: S1.13 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $244.38 • PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: • 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 • 2446-46(6/00) DECLARATIONS - ' (J. L J 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 workkers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the rk for which this permit is issued. I have and will maintaintinworkers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My wo ars'comps tiyfi Insurance carrier and policy number are: Cartier: _/�e'6t, ( Policy Number: Cr" \6 (This section need not b mpleted it 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 lifomi and agree that if I should b�e subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pro yn} Applicant Signature: 4 r ! / I/ C Date: - 3-- D.___ 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 li •nse• nd'r•.ovi ons• hapter 9(commencing with Section 7000)of Division 3 of the Busing and Professions Code,and my license is in full force and effect.Lic.# I i - Class# {�'-� Contractor's Signature: 'MAWS r C Date: 7 -3- 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: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.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business end 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 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,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,Califomia 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? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management 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 9 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes L-I No (Section 65850.2 of the Califomia Govemment 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 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by Califomla Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If ryes",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 purpo/Ses.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signet r 6�Lr,(,Al 9wner(s) • -7 — Date And/ r Authorized A plicant Date CODE F. INSPECTION TYPE PAIS INTITIAIS CODE It INSPECTION TYPE DATE 1NTfTIAL@' 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 204 Final Demolition — 250 Final Building/Occupancy 7".5 ' 07P `, ' F 9 CITY OF COSTA MESA 4 BUILDING DIVISION ' J Q,. , DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT ' ,'4. /B01-00436 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1630 BEECHWOOD Status: ISSUED Suite: GOT 37 Applied: 04/04/2001 Vicinity: PLAN 2 Issued: 04/16/2001 Parcel Number: TPN00069 Zoning: t Applicant: PHILIPP, ROLAND ISSUED BY: i . Address: 15326 ALTON PARKWAY - Phone: 949-789-1600 IRVINE,CA Zip: 92618 Owner: STANDARD PACIFIC HOMES Address 15326 ALTON PARKWAY - • Phone: 949-789-1600 IRVINE, CA Zip: 92618 Contractor: OWNER-BUILDER Address: Phone: Zip: - License: 0 - . - Arch : BASSENIAN LAGONI Eng: . Address: 2031 ORCHARD DR Address: - STE 100 Phone: 949-553-9100 - .- Phone: NEWPORT BEACH,CA " Zip: 92660 License: License: — Jr r �' ` SCOPE OF PERMIT:' `:,-: - .. . CONSTRUCT NEW SFR-PLAN 2'-FOR STANDARD:PACIFIC HOMES:2816 SF SFD&606 SF GARAGE, 94 SF PATIO. `- . - _ . .-. . _ . __ _ - . . ._ _ " REF: B00-01536 ` _ — FEE SUMMARY i' -._ �','' Plan Check: " $303.45Calc Valuation: 41/ • • . $255 918 28 Permit: ` ' $1,867.35 - - - _ Claim Valuation:`;;; : ', :so.00 - SMIP Res:- - $25.59 - ii/ SMIP Corn: '- ':$0.00 r_-.. 1��� j Other:' $0.00 s.- , �...,..; � - Inspection: $0.00 �% Total: $2,196.39- " ' , :� _ `NN PLANNING &ZONING t2 \",' ;)v / j' SETBACKS /f - . - - - \'�vA i MAIN STRUCTURE Front 13.,0 - // Rear; 23-/O Left 57 0 ,-1\ Right '-- 520". ) '1, L - - � - . -_ y ACCESSORY Front 0-0�� -, Rear 0-0 Left 0-0- - / Right/<-10-0 PARKING Existing: 0 '-Required:- : .3 - Proposed:-_;:3` - NOTES: • 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 y 2446-46(6/00) -N. DECLARATIONS (�-� rTh 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 workers'compensation Insurance carrier and policy number are: Carrier: Policy Number:---- (This umber: - (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to 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 provisions. Applicant Signature: Date: 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 licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full force and effect.Lit k Class 4 Contractor's Signature: Date: 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.). 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 exam nde__r s �{. Business and Professions Code for this reason: �( Signature: c7`�4 Date: �t ( r/ 0( Owner ID verified by driver's license. 0 Yes No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 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 California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management 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? ❑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 apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? I�Yes U 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 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 01 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. Si fur f L O r(s) to (? c 9l And/Or Autho zed zed App ate CODE II INSPECTION TYPE PIIS I<iIILALS CODE# INSPECTION TYPE PATS raTMALS 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 I/(YIO z <{ Sent By: SOUTHWEST IBT; 562 946 0026; Dec-7-01 4:09PM; rage tt • Conrinuous Inspection d Materials Testing SOUTHWEST a+.a--'`s'`--- ---s Inspection & Testing, Inc. 10826 South Norwalk Blvd.,Santa Fe Springs,CA 90670 December 7, 2001 (562) 941-2990• (714) 526-8441 FAX (562)946-0026 Building Official City of Costa Mesa • Department of Building and Safety 77 Fair Drive Costa Mesa, California 92626 • Re: Final inspection for the Mesa Verde Collection.Costa Mesa CA Tract 15882. Building Permit Number Building Permit Number 26 80I-00439 57 801-00437 27 ROI-00436 58 1301-00440 28 • B01-0435 59 1301-00433 29 001-00438 30 1301-00441 31 MI-00434 Dear Building Official' Southwest Inspiration ection and Testing was retained by the Owner as provide special inspection sal materials testing in the areas that were requirod by section 1701 of the Uniltxm Building Code,approved projcxt drawings and specifications,this work was witnessed by the Mowing special inspectors. Concrete placement was observed and compressive strength samples were cast by,Craig Frampton(1030#5012814-49),Roy Lyndsay (IC130#503699849)and Clyde Lacher(OCEMA#0131). Compressive strength samples were picked up by Southwest and tested in our laboratory.1 MI work was done in accordance with the project plans,specifications and workmanship provisions of the Uniform Building Cult Stressing of'A-post tensioned tendons was observed by Clyde Lacher(OCEMA#0131). All work was done in accord/mon with the project plans,specifications and worlarnmship provisions of the Uniform Building Code. Based upon sptxial inspiration and materials testing written repeats of this work,it is our judgement that the inspected mai;was perfanned to the bast of our knowledge,in aousdance with the approved plans,specifications and applicable workmatlehip provision of the Uniform Building Code. S . p// �7s • L. C',..n �� ' �A • .� 4 (11D tab/txW SZU/I W:klg • _ tlitp 3^31-+.11 • For inspection and testing only, no design responsibility • • • 1 eaehvamt mqe v..:.,at6i r a aee*awa tame I.haa4.y by the Met, City dra.4epp4a CtRT,roma,956,City etfaa n.m.MIA and The Deponent t nr wain.ed Pawn rW"LY'LK11 Cq.l1 r(K-I NV\\ V Iwo 11'\ ./I J—JJW IU: (1.1C07.•1CjU r.eeteeel ' • � Rl1 FINAL GRAI)ING CERTIFICATION Project Address: 1 & 4-S P.*7 vA S Lot Number. 2,-t - ?, t S7-5 TtA[ t Isas2 Permit Number: G ere" 5t. By Civil Engineer: I certify to the satisfactory completion of grading in accordance with the approved plans, specifications. local and state codes: All drainage devices required by the grading permit, grading plan and grading ordinance have been installed #tquase:provisions have been made for drainage of surface water from each-building site. The minimums are: • • + 2% Fall from structures within 5 feet from exterior walls. I% Fall for asphalt surfaces and landscaped areas. 0.5% Fall for concrete surfaces to approved disposal areas. The final monuments as shown on the recorded tract map were set. All final grading elm- dons are within ± 1/10 of the designed elevation ' Supervising Civil EngineerlAti� �/ Re . No. 394"18g (signature) 8 r Date 12t2't`01 CSS �� Q' 7` • ► tn.. cht atit• ft oFcsucw1 J' . ;� ,ah.y1n CITY OF COSTA MESA • 466 BUILDING DIVISION H -a( DEVELOPMENT SERVICES DEPARTMENT PERMI MBER .4 4 PERMIT o Os P01-00213 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 - PLUMBING PERMIT Job Address: 1630 BEECHWOOD Status: ISSUED Suite No Applied: 04/13/2001 Issued: 04/16/2001 Vicinity: PLAN 2 Parcel Nunmber: TPN00068 _ ISSUED BY: ____*_____ Applicant: PHILIPP, ROLAND Address: 15326 ALTON PARKWAY Phone: 949-789-1600 IRVINE, CA Zip: 92618 - -.. Owner: STANDARD PACIFIC HOMES Address 15326 ALTON PARKWAY Phone: 949-789-1600 IRVINE, CA Zip: 92618 Contractor: OWNER-BUILDER . • -. Address: - , - Phone: - - • Zip: , _ - Licen_se: 0 . .- -. - - - -� - Arch / Eng : . ' .. -- -_ , • Address:i. - `7i ; Phone: - . - -- _- - - - L• icense: J//- -. - ,i SCOPE OF PERMIT �_H_ t- ,` 3�R . CONSTRUCT NEW SFR-PLAN 2-FOR STANDARD PACIFIC HOMES:2816SF SFD,606SP.GARAGE,. �,,. . j i 94SF PATIO.2 BATHTUBS, 1 DISHWASHER, 1'EXPANSION TANK, 1 GAS(1-4 OUTLETS);3GAS C, �'r� \ \ ��� (OVER`4 OUTLETS, 1 LAUNDRY TUBANASHER;1 PRESSURE REGULATOR, 1 SEWER CONNECT, 1- / - / ,/ -SHOWER;1 KITCHEN SINK, 1 SERVICE/MOP SINK,3-WASH-BASINS, 1 WASH BASIN SET, 3 WATER / CLOSETS; 1-WATERHEATERNENT, 1 WATER SERVICE. Th • - // / REF B01-00430. v�\ // /2i � '''.-1.`h<- - JEE SUMMARY . � j ' i/ ,� 't AMT.// QTY- - - - _ AMT J:: - - (-�\%i 4 / AMT QTY ISSUE FEE ' '-$23 50 . , // i,/ - Laundry Tub/Washer - -$9.80- "1 1`�,vSump 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 $19.60 - -'2- ',Pressure Regulator ' $9.80;:.',1 Urinate! $0.00 0 Clarifier System $0.00 _ •0; Process-Piping (per l0 ft) ' $0:00- -"0 7�Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 ....Receptors $0.00---0-,i 'Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank >,$0.00'_-2�,0-- -. Wash Basin $29.40 3 Dishwasher $9.80 1 Sewer-Cap for.Demo . $0.00_ 0 Wash Basin Set $9.80 1 Drain, Floor $0.00 0 Sewer Connect $24.65 1 Waste and Vent System $0.00 0 Drain, Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $29.40 3 Drain, Roof $0.00 0 Shower $9.80 1 Water Heater/vent $12.30 1 Drinking Fountain $0.00 0 Sink, bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $9.80 1 Sink, commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $9.80 .1 Gas(1-4 outlets) $6.15 1 Sink, kitchen $9.80 1 Water Softener $0.00 0 Gas(Over 4 outlets) $3.30 3 Sink, service/mop $9.80 1 OTHER $0.00 Gas Repipe $0.00 0 Spa (private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) 50.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES- $236.50 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statues and related ieyulatiunn.(Oid. No.92 20,§ 1, 12 21 02) _ COMMENTS /SPEC AL CONDITION EXPIRATION: This permit shall automatically expire an. •ecome voit i wor . . . . .. .. in 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 � 2446-46 / (6/00) �j DECLAMATIONS (-''') 1 WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have end 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 workers'compensation Insurance carrier and policy number are: Carrier: , Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to 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 provisions. Applicant Signature: Date: 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(5100,000),IN ADDmON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Mc.tl Class# Contractor's Signature: Date: 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: 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.). 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: 4 f(1/ll Signature: Date: Owner ID verified by drivers license. 0 Yes 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,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,An 2,Sec. 341,Tale 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 WIII 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? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature end 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 0N (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 a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes U No (Section 65850.2 of the California Government Code requires that the requested information be 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 ❑No (It"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all 01 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. igna re Oy¢8g9 w s // ed ti 7/0/Date And/Or Author Aplicpt / Date CODE E INSPECTION TYPE PAIS INTmALS CODES INSPECTIONTYPE OAS INTITIAL5 1616 Fixed System Final Fire Prevention 206 Final Mechanical r� C T� 1266 Pool Spa Final 208 Final Plumbing IrY`18-0 i a N 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 IOW) CITY OF COSTA MESA BUILDING DIVISION Y ,�1. 1 �,,,• , DEVELOPMENT SERVICES DEPARTMENT PER NUMBER kqk PERMIT ' e4° M01-00191 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 1630 BEECHWOOD Status: ISSUED Suite No Applied: 04/13/2001 Issued: 04/16/2001 Vicinity: PLAN 2 Parcel Number: TPN00069 ,:i2:-- ' ISSUED BY: a J. Applicant: PHILIPP, ROLAND • Address: 15326 ALTON PARKWAY - - Phone: 949-789-1600 - ' IRVINE, CA Zip: 92618 • Owner: STANDARD PACIFIC'HOMES Address: 15326 ALTON PARKWAY • Phone: 949-789-1600 IRVINE, CA Zip: 92618 Contractor: OWNER-BUILDER - • Address: - - - _ -Phone: ' Zip: License:0 - ' SCOPE OF PERMIT CONSTRUCT NEW SFR-PLAN 2-FOR STANDARD-PACIFIC HOMES:2816 SF SFD,606 SF ' GARAGE,94 SFPATIO:2 FAU<100K BTU°1 FACTORY FIREPLACE, 1 HOOD W/MECH ' EXHAUST,2 VENT..FANS/SINGLE DUCT;2 COMPRESSORS ODIC)3 HP/100K BTU. - REF: B01-00436\ z • _- - FEE SUMMARY /'.2.-''/:, - Quandt - . . . Y - ' f Quantity ISSUE FEE $23.50 Repair/Alt Absorbtion Unit f,;'% so.00. -0 /p", Inst FAU<100 k BTU- $29.60 2 Repair/Alt Refrigeration Unit f11 $0.00- ::0 :ti' , Inst FAU>100 k BTU $0.00 0 Ventillatioh System • 4��� -$0.00,--/ 0,rt, ,' Repair/Alt Cooling/Heat`: $0.00 0 Evaporative Cooler 7/// -$0.00 • 0 - r Inst/Rep. Recess Wall Htr $0.00 0 ;Commercial Incinerator „j/i' $0:00, -0� Refrig Sys<100 k BTU $0.00 0 ,- aa.„ ' Domestic Incinerator /,;� $0.00 ; %0 T Refrig Sys>100 k BTU $0.00 0 Compiessors/Absorption SvStems/' 1 /. Gas Piping `mop 0 - , Up to 3 hp/:100.k BTU.,7.o, ,// • ;: $29.40 /2 Factory Fireplace ‘,.:$1,0.65m:,:1 -a' : 3 To 15 hp./500'k:BTU"',''/-' -- $0.00 0 Hood w/Mech Exhaust $10 65, 1 `- / - -;/15 To 30 hp/1,000 k BTU>' 6..-:\.� $0:00' 0 VAV Box -'v 2./V '7) $6:60.'.)))) 0‘. � /' r :r 3 ,30 To/; 0 hp/.1750 k BTUZ y //, /$0.00 0 Vent Fan/Single Duct:-\,. <f f $14 50`' 2`.-.,� ? = c,: - Over 50 hp/Over ip750-BTU (" V ' $0.00 0 Appliance / $0'00 0----:-S-'1--------,:-,,"- ' _ �" l i _Boilers ,r//" ��A��� .„ Fire Dampers ':,$0 00' 0, - .- - Up to 3Thp 'VA,'., Smoke Dampers -$0 00 --r0 - �� $0.00 0 P 1 3 To 15 hp.,- ,A A,v� % / - $0.00 0 Inst or Relocate Appl Vent _, .$0.00" r0 - /- - - -15 to 30hp;„ . j `_ $0.00 0 Air Handlers< 10000cfm $0.00 0' ', - -30 to 50 hp;;, _,� %/ $0.00 0 Air Handlers> 10000cfm $0.00:''-0 ,, Over 50ihp-' i'/> $0.00 0 e , , Floor Furnace $0.00- 0. ,:--- _ ' ' Other Mechanical-Fee Floor or Suspend Heater $0.00 0 -. ` - Investigation-Fee- - $0.00 - - 1_.-_---__T- r Plari Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES $118.30 • COMMENTS/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 /p l / 2446-46(6/00) DECLARATIONS ; (Th 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 workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: , (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to 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 provisions. Applicant Signature: Date: 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 licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.# Class# Contractor's Signature: Date: 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: 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 c'vil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the prop§rty,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 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 un se Business and Professions Code for this reason: / Signature: Date: Lti n ( 1 Owner ID verified by driver's license. ❑Yes No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. • Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 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 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 Califomia 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? ❑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 apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes L-I 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 ❑No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 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. Si atu O L I erSs) ,r '7Dat r An r Authorized App a 1716 O to ;ODE C INSPECTION TYPE DEE INTRUL$ CODE( INSPECTION TYPE f� Pk E INTRTUL 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 204 Final Demolition 250 Final Building/Occupancy a CITY OF COSTA MESA BUILDING DIVISION F 11 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER k PERMIT JE01-00288 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 1630 BEECHWOOD Status: ISSUED Suite No Applied: 04/13/2001 Vicinity: PLAN 2 Issued: 04/16/2001 Parcel Nunmber: TPN00069 . �/ . Applicant: PHILIPP, ROLAND ISSUED BY: /�iA cif, Address: 15326 ALTON PARKWAY - _ • Phone: 949-789-1600 • IRVINE, CA Zip: 92618 , Owner: STANDARD PACIFIC HOMES • • Address 15326 ALTON PARKWAY Phone: 949-789-1600 IRVINE, CA Zip: 92618 Contractor OWNER-BUILDER . . - - Address: • . Phone: . Zip: License: 0 SCOPE OF PERMIT, ' ' `' -' CONSTRUCT NEW SFR:-PLAN 2-FOR-STANDARD PACIFIC HOMES:2816SF SFD,606SF GARAGE, , 94SF PATIO. 1 NEW RES(1 UNIT),2 LIGHT FIXTURES, 3 OUTLETS,2'SW)TCHES, 1 MOTOR TO ' • - .1 HP. ,.. - • REF: B01-00436 j,. N ,. . , - - 7, --- - - -- _ _ .i. FEE SUMMARY j�', �- r ; . 'Quantity moi- Quantity',%- ` ISSUE FEE • $23.50 Temp Dist System/Lighting $0.00 /07,/ :+) ' Temp service test 50.00 '---Busway/100 ft $0.00 /•0 Res.a/c package" 50.00 -_I ''�h' Standing Section $0.00 L!%/0 , '� ':r/ ' New Res(1-2 units) 5757.70 2816 Misc ElectrlcaLEquipment $0.00 ;>i 0New Res(3+units) .-50.00 0 '. " 'Transformers,up to 1�kva(kw_ _ $0.00%1/ 0 c t_ Pool/Spa $0:00 N -,"r 01i".4', w` - up to 10 kva/kw '.'.;') -x$0.00' 0: Lighting Fixts,' . ` $2:20," 2 , c - up to 50 kva/kw ;; $6.00/ V 0 ' Recept Outlets �,/ $ 30"$' 3 2 1 'upito,100 kva/kw�!/ $0 00-2. 0 ' Switches v \ $2'20„ N-2 y1 - -• 'over 100.kva/k`vv,2 $0 00 0 '//" Non Res Appl - , ,50 00 2' 0" _ ' Low Voltage Equipment=` j $0.00-)0-/��,% Res Appl . 5000 %. . ' 0 - - Low Volt Wiring'System/Ckt-'\ ' $0.00 /0; Service to 200a 50:00 0 Misc. Conduit _ ,,� .50.00 '2' 0/ Service to 1000a -_ 50.00' / ' 0- r. . Misc. Conductor. ` V �',A''$0.00,, 0 Service over 1000a '-,50.00 0 . , ,Circus(gen orridey, ) x$0.00; - 0 Motors to 1hp $4.75 . 1 • ,•Circus(mecli ride:or lights),_-,",i $0.00 0 ' Motors to 10hp 50.00 - '� 0 - _ "" Clfristmas Tree Stand %,(2;250.00 0 Motors to 50hp $0.00 - 0 - Fireworks.Stand,,- "' -"� $0.00 0 Motors to 100hp $0.00 0 . %Other Electrical Fee -- ,.-- $0.00 Motors over 100hp 50.00 0 . . _-_ Communication drops 50.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES 5193.65 Intermed Pole 50.00 0 COMMENTS/ 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 /J 2446-46(6/00) v�// DECLARATIONS j 1 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 workers'compensation Insurance carrier and policy number are: _ Carrier: Policy Number: • (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to 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 provisions. Applicant Signature: Date: • 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($108000).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 licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.# Class# Contractor's Signature: Date: 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.). Pi 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 der s . Business and Professions Code for this reason: Signature: Date: 41/0 o0 Owner ID verified by driver's license. ❑Ye 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: __. Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I 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 California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management 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 end 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 a ppermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes LJ No (Section 65850.2 of the California Govemment 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 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 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. Sig ur Le caner ) Da `1 17 0/ And/Or uthorized p cant Date • CODE INSPECTION TYPE Pitt INITIALS CODES INSPECTION TYPE DATE IBTITIAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical j 2-(©-DJ 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