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Home My WebLink About3095 CASSIA AVE - Building Permits(714) 754-5273 • Fan (714) 754-4856 • www.ci.costa-mesa.ca.us BUILDING PERMIT Job Address: 3095 CASSIA AV Suite: Vicinity: Parcel Number: 13956205 Applicant: BURRSTEVE Address: 711 WEELO DR COSTA MESA, CA Owner: HOFFMAN,SUSAN Address 18'IS KINGLET CT COSTA MESA, CA Contracror: BURR ROOFING Address: 711 WEELO DR COSTA MESA, CA 2ip: 92626 Arch : Address: Zoning: R2 R2 Phone: (949) 548-2965 Zip: 92626 Phone: Zip: 92626-4866 Phone: (949) 548-2965 License: 635586 Eng: Address: 77 hA1H UHNh, GVJ I A MtJA, GA `JLbZb ISSUED BY: Status: ISSUED Applied: 02/10/2004 Issued: 02/10/2004 Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF INSTALL 130 FELT AND 30 YEAR COMP. SHINGLES. Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $0.00 $195.25 $ t .01 $0.00 $0.00 $0.00 $196.26 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0-0 PARKING Existin : o NOTES: Rear 0-0 Rear 0- 0 Required: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Praposed: 0 Calc Valuation: Claim Valuation Right 0- 0 Right 0- 0 s�o,�oo.00 Sio,ioo.00 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRA710N: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order tor the work authonzetl under this permit to be considered legal, such work must comply with all applicable codes, and all required inepeetlona and final approval must be obtained. Failure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 24aase lfl�oo� WORKERS' COMPENSATION DECLARATION: I hereby affirm under penel�y o� perjury one of �he following declaralion5: � 1 ❑ I have and wiil maintain a certiticete of consent to seif-Insure tor workers' compensation, as provided tor by section 3700 of the Labor Code, for Ihe perfortnance of the work tor which this permit is issued. I have entl will maintain workers' compensation insurance, as requiretl 6y section 3700 of lhe Labo� Code, tor ihe peAortnance of the work for which Ihis pertnit is issuetl. wor!ke!s' compensation Insurence carrier d policy number ere: [� CJ � arner 7�(Oi%'� �y/w� olic umber: Q__ (� ��/ ectlon need not be completed il fhe permit is valued a! one hundred dollars ($100) or less.) ❑ I certity Ihat in lhe peAormance ot the work tor which this pertnit is issued, I shall not employ eny person in any manner so as to become subject to Ihe workers' compensation laws of Cal' rnia, e that II I should become subject to the workers' compensation pmvislons of Section 3700 of ihe Labor Cotle, I shall forthwith hese � Appf ntSig Wre: � � � �— �0 � WARNI FAILURE TO SECURE WORKERS' CAMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARE (E100,000�, IN ADDRIIXJ TO THE COST OF CAMPENSATION, OAMAGE$ AS PROVIOED WR IN SECTION 3106 OF THE L4BOR CODE, INTEREST, AND ATTORNEI^5 FEES. LICENSED CONTRACTORS DECLAflATION: I here�b Gmmtll2t I am licensetl un er rovi c fomgerN'61i&i.ti Lic. q � � ��Fl � CONSTRUCTION LEN�ING AGENCY: of Chapter 9(commencing with Section 7000) oi Division 3 of the Business antl Professions Code, and my license is in full C�ass a e - 3 � _ ie: 2—/e -o Y ❑ 1 hereby attirtn that there is a constmction lending agency for the peAormance oi �ha work for which this pertnit is issuetl. (Sec. 3097, Civil Code). Lenders Neme: Lenders Address: Signawre: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that untler penalry of perjury that I am EXEMPT FROM TME CONTHACTORS LICENSE LAW for ihe tollowing reason (Sec. 7031.5, Business antl Professions Cotle: Any ciry or counry which requires a permit to consimct, alter, improve, demolish, or repair any stmcWre, prior to its issuance, also requires the applicant for such permit to tile a signed stetement Ihet he or she Is Ilcensed pursuent to the provlsions ot ihe Contractors License Law (Chapter 9(commencing with Sectlon 7000) of Dlvision 3 of ihe Business and Professions Code) or ihet he or she is e:empt thereirom and the basis for the alleged ezemption. Any violation oi Section 7031.5 by any applicant for e permit sublecis tha applicant to e civil penalry of not more Ihan five huntlretl tloltars ($500).): ❑ I, as owner of ihe properry, or my employees with wages as their sole compensation, WILL DO TME WORK, antl the structure is not intendetl or otterea tor sale (Sec. 7044, Business and Protessions Code: Tha Con�rectors License Ww does not apply to an owner of property who builds or improves thereon, and who does such work himself or hersetl or thmugh his or her own employees, providetl that such impmvements are not intended or oHered for sale. If, however, Ihe building or improvement is sold within one year oi completion, the owner-builder will have the burden of proving iha� he or she did no� build or improve for purpose ot sale.). • ❑ I, as owner of the property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the projact (Sac. 7044, Business and Professions Code: 7he coniractoro License Lew tloes not apply to an owner of property who builds or improves thereon, end who comracls for such project with a contractor(s) license pursuant to the Coniractors License Laws.). ❑ I em exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID venfied by dnver's license. ❑ Ves ❑ No Drivers License No. Venfication of Ownership by (type of documem, i.e. - properry tau bill or dead): DIVISION OF INDUSTRIAL SAFETY PERMI7 CER7IFICA710N: Expires: ❑ I hereby cetlity ihat no excavation five (5) or more feet in tlepih into which a person is required to descend, will be made in connection with work au�horizetl by ihis permit, and tha� no huilding swcWre, scaHolding, felsework, or demolition or dismantling ihereoi, will be more than thirry-si: (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title e, Califomia Adminisirative Code). ❑ As owner-builder, I will not employ enyona to tlo work which would require e permit from the Division oi Intlustrial Safety, as notetl above, unless such parson hes a permit Io tlo such work irom the division. SignaNre: Date: Division of Indusinal Safery Permit Number: CER7IFICATE OF COMPLIANCE AND Al7f}IORIZJITON OF ENTFiY: I certity untler penalry of perjury that I have read this application and state Nat ihe infortnation given is correct. I egree to comply with all sta�e laws and ciry ortlinances rela�ing to building consiruction, end authorize representa�ives of ihe Ciry ot Costa Mesa to enter upon �he above-descnbed propetly tor inspeclion puryoses. I agrea not to occupy or allow occupency of any building authorized by this permit un�il final inspection. COUE �, INSPECTIONTYPE ' 161fi Fised System Final Fire Prevention 1266 Pool Spa Finel 200 Finel Re-Root 201 Finel Block/Retalning Wall 202 Final Factory Fire Place 203 204 Finel Sign Final Demolition Owner(s) �i Appl�r(�— P9I€ INTRULS '!�L `�_ _" COOE� INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Elecirical 212 Final Fire Prevantion 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy Q� � pA� nmru�s r 'V ' � I�. 1�,�/av� GJ— /�.v,.�-�. �� Avolleant lo fill in all soatts except tnose within heavy oorOer Iines ane sign all approvriate tleclantions. CIT� oF COSTn M2esn CO-7N�STR CTION PERMIT Project Address ✓� �s C—J �!� s S/A Applicant's Mailin Address �S� 3 �� !��-�, � i Owner'sName ��T%7�� Phon� 7�� Addreu S�1"f✓1 e. Arch/Eng. License No. Address ^^,, h �/n Con[racmr's Nam �� 7 one L�/- �2�1� Addresslm��'�g��S.�.3 � ./.(J�L� �l�L//7�/LY/ City License No. �'�� LICENSEO CONTRACTOR DECLARATION I M1ereby aflirm tnat I am Iicensetl untler provisions of Charter 9(commencing with section 7000) of DiviSion 3 of the Business antl Profession5 Cotle, antl my license is in tull tor e an e fect. � Licens9 Class �� . i icenu N ��s` Dale/�'3' S'9 t ��i. -1�-.1�.L� WORKERS' COMPENSATION DECLARATION ' hereby aHirm tnat I have a certificate of consent to seli-insure or a certlficate Workers' CompenSatiOn InSuranGe, or a certitietl mpy thereof (5lCtlon .00YLab.C.)O,/�,/„ y�LG�I/lG/t' �f%5. Pollc NO. �� f-�� Compan rtifietl copy i5 hereby tumishetl. Certi ietl a�py� �i �IIeO wi[h the city/ �� i�l.tl.in�9 ynrv� Ion Date �� `� �"�/% Applicant/�5�� %��'�✓� EXEMPTION FROM WORKERS' COMPENSATION GECLARATION (Thi55ec[ion n¢etl not be cOmple[etl if [ne permit iz t0� one huntlr¢tl (§300) Or IessJ. I ceriity that in the performance of the work Por which this perm�t is iszuetl I zhall nol employ any pe�son In any manne� so as to become subjec[ to t{�e Workers' ComOensatlon LawS ot California. Date Signamre NOTICE: It, atter making this tleclaration, you shoultl become subject to tha Workers' COmOensation provi5ion5 Of [he labor Cotle, you muzt forthwlth comply wiln such O�ovisions o� this pe�mit snall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV 1 he�eby aifl�m that tM1ere is a consVuction lentling agency tor tho performdnCe of IM1e work for whith this permlt is issuetl (SectiOn 3097 Civ. C.) Lentl2r's Name Lentler's Atltlress OWNER BUILDEH DECIARATION I hereby af(irm that I am exempt from the Cont�actor'S LIcenSC Law fo� the followin9 reason ($ection J031.5 Business antl Professianal Cotle: Any city or county wblcM1 requires a permit to mnstruct, alter, improve, tlemolish or repalr any structure, prior to Its issuance, dlso requires tbe applicant tor Such po�mlt lo file a Signetl statement that h¢/She I5 licensetl pursuant to [ha provisions ot the Contraclor'S License Law (Ghapter 9(commencing with $ection ]000) of Oivision 3 of the Business antl Profes5ions Cotle) or tha[ he/sne is exempt eretrom antl the Dasis tor Ne allegetl ezempNon. Any violation ot Section 81.5 by any ap0licanl tor a permi[ subjects the applicant to a Civil enalty o/ not more [han five huntlretl tlollars (5500). ❑ I, as owne� of lhe property or my employe¢5 witM1 wage5 a5 thel� sole comoensation, wi11 tlo the work, antl the structure Is not intenGetl or oiferetl for sale (Sec[ion 7044, Business antl Professional Cotle: Tha Contractor's License l.aw tloes not apply to an owner of a proper[y who builtls or imDroves thereon, anE who Ooos such work himself/herseli or throu9h his or her own emplOyeez, provitletl [hat such imprOvements are not intentletl or ofter¢tl tOr sale. II, howev¢�, tne bulltlin9 or imptovement i5 SOIG within One yea� ot com- pl¢tion, tlte own¢r will have the burtlen of proving he/she dld not builtl or im- ��1/Ova fOr the pu�pose oi sale). u I, as own¢� of the p�operty, am exclusively Contrac[ing with Iicensetl con- traciors lo construct the project (Section �044, Business antl Professions Cotlo: The Contractor's License Law tloes not apply to an owner ot properry who builtls or Improves thereon, antl wno concracts tor such projects with a con- tlac[Or(sl IlGenie Oursuanl to tlle Gontfactor'S LicEnze Law). I am aware that proof of tM1alr Wotke�'S Compensation insurance sttoultl be PrOvitletl to me. ❑ I am exempt untler Section B. & P. C. tor thi5 reason Date a Signature /� _�/L Drivers' Llcense or 55 CMF 0865-46, rev. 10/84 _ Owner I have reatl this applicatlon antl state that tne above I a9ree to comply with all clty antl county ortlinances to builtling construction, antl he�eby au[horize r¢p�e- '' teo e�nter pu�pon th above-rrlentlonetl property for L.c�� /�J �/1-�il.� Date1Q=,3�� 2� � y� 'TVPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A P # � DESCRIPTIONOFWORK/USEOFBLOG. S Main Buildi TVPE OF PERMIT GRADirvG�-y FOuivDATIOrv STqUCTURAL T Front ❑ TENANT ❑ ELECTRICAL YJ PLUMBING ❑ MECHANICAL 6 Rear ❑ OTHER A PROJECT DESCRIPTION Sp. FT. OCCUPANCY C Right K Left CONSTRUCTIONTYPE VALUATION$ $ ZONE GRADING CU. VDS. ACRES Ping. Ref. # Remarks: � . Planning Notes: Sink Preventer Irrigation Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories P-Trap Roof Drains Feinspection Fee � $15 Duct- Under Ground Duct - Strucmral Duc[ - Venti�ating Exhaust System ❑ Multiple PirepVFact. BIL ICBO # Heating Sysrem & Ducting ❑0-100,000 BTU 0100,000 Reinspec2ion Fee � $15 White - Builtling; Canary - Applicant; Plnk - Accounting; Goltlen�otl - Asse55o� Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash Issue Fee Hood or Typel ❑ Canopy Typell ❑ Refrigeration System �0.100,OOOBTU ❑100,000 SVstem Repair/Alteration Fire Dampers Registers laue Fee FEES Automatic Washer Constructi0n Pole $ub. Cooking Unit D ishwasher Dryers OGas ❑Elea Fan F.A.U. Fixtures Device Boxes Outlets Zona Accessory Building: Parking Req./Provided ETLECTRICAL � Transformer ❑ 15-50 KW ❑ 50+ KW Garbage Disposal Generaror �0�5 KW �5-15 KW Meter LJup [o t00amps Meter ❑over100amps Sub Panel Motars �0-1 HP �1'h � 8 InaSolar �9-75 HP �16�15+ Microwave Pole Light Range Sign Standing Sections Trash �Compactor $ 3 I �— Reinspection Fea $15 luue Fee FEES �DEVELOPMENT SERVICES REQUIREMENTS: ZoninB Approvad By Building Approved By Appliwtion Issued Bv $ 3 SUMMARV OF FEES BUILDING PERMIT $ SMIP PLAN CHECK $ PERMIT PLUMBING g 5� ISSUANCE PLAN CHECK 25% $ ENERGV P.C. ELECTRICA� $ GRADING PLAN CHECK 50% $ MICROFILM MECHANICAL $ TOTALFEE PLAN CHECK 25% $ S FEES $ 3 2 O N I N G R E Q M T S � _� _ CONSTRUCTION AND PLANNING POOL & 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 56. Rough Plumbing & Press4re Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER'-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. - 8. Foundation 59. Gas Pipe, � Undrgrnd.,.T.est 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap,Ep Undrgmd. 10. Structural Floor System 61. APPROVAL TO DECK ;"� 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Fi el 12. Sewer Cap 63. Heater & Vent-Final �� <�� 73. Roof Drains 64. Plumbing System - Final �Z 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System�Final i6. 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. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74, Overhead Hydro _ - 26. T-Bar Ceiling (Structural) & Monocoat 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. Electriral Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: �_�-?j-� �rT (qiy�� j 34. Final Heating & Air Conditioning - / / 35. Final Gas Pipe-Test ' ' C oa.� O� �� 36. Hood or Canopy � 37. Final Factory Fireplace � „ 38. Finai Plumbing . ' 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date � �� f, ��z �1�52 COSTA MESA BUILDING-SAFETY DEPARTMEII P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely BUILDING ADDRE55 3095 Cassia Ave. OWNER FjgI'bQZ' MQ98 COi • MAIL Z ADDRESS a i1i ..�r., ot_—__ n..i.., n..i: s�ni � m :E.iioG cr ,�,�v; 'rP"—iDOOti29K ��*?0��.75 . Fnsr APPLICATION FOR BUILDING PERMIT REC E BV DATE REC�IVEO DATE ISSUED s i -7a 5-�6- �o A.P. NO. PE i 1��l!_ BUILDING ADDRESS � D '— � TRACT(�a�p� LOT�— BLOCK J � tlMaNcn J N OWNE mJ ADDRESS vALUE m ARCHITECT S S � � J Q OR ENGINEER �j N — FIRE W w ADORESS 1 6 r]. Robertson BZVd• ZONE TYPE GROUP � W Z �� APPROVED J O CONT C CO UIDS IAC• B1, DATE m Z d� J � ADDFESS w w TEI. NE � /� NO.OF USE OF NE � Z� CITV �18T'ID8T1 08]C$ �.`81 Q NO. g�j_ Q �'C�(� PLANS BUILDIN � w 0 STATE CITV �'�+RDS APPROVED VARDS APP OVED y� IIC. NO. LIC. NO. MAIN BVILDING ACCESSORV BUILDING _� SIZE NO.OF BLOGS. (FROM C/L STREET) OF LOT NOW ON LOT NORB FROM T. �� FT. USEOF SFT FT. EXISTING BLDG. I E F� SI2E OF NO. OF /�% Z NEW BLDG. AOOMS STORI ES L. SIDE (`� FT. � FT. a EXTERIOR WALL ROOF // V COVERING COVERING O�C AEAR � FT. 3 FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & a MAIN BLOGS. ACC6S. BLDCu. a � e � �RP#��-G 9 APPROVED D!o !c ~ ,� e 4-2� � ✓' � � �E '�, °" �ls-7a � z PEC AL REQ(1!„�'MENTS` O UI hereby acknowledge that 1 hava reatl this aDPlicatlon antl stete � thot tho above information is corract antl apree to comply �vlth � nll lews regulating builtlin8 construction, ontl I shell not amF��oy r nny person in violation ot the workmen's eompensatton laws o( y the State of Califa��ie. 2�� % l�� J � ? I horaby certity that I em properly licansatl as a contractor untler " SQ. FT.` v Gor-2�`�ir/ � Me 5[ero of California Business antl Professiona Cotla, D(visicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, antl thei s h licenws aro in full force entl atfett, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: Q nm exempt irom 2 P�ovisions ot the Ste f Callfornie Bucinecs VAIUATION antl Profassions tle, Division 3, Chap r PERMIT FEE 5 � / SO ) Sf netura o /� j'' .{/ � o r Permltte S �/��J Iv J PLP.N CHECK S � J/�`� E O ° 2o'i.�LL Auth rizetl A t TOTAL FEE 5