HomeMy WebLinkAbout3071 CEYLON RD - Building PermitsCITY OF COSTA MESA '
.
BIIILDING DIVISION
> � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
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� ` FOR INSPECTIONS CALL: (714) 754-5626
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PERMIT NUMBER: M08-00146
PERMIT TYPE MECH STATUS: ISSUED
APN: 13996408 DATE ISSUED: 12/02/2008
ISSUED BY: RMD
JOB ADDRESS: 3071 CEYLON RD CM
Vi�inity: HALLWAY CLOSET
Sc�, FT: 0
Suite/Unit:
SCOPE OF WORK: CHANGE OUT FAU < 100 K BTU, LOCATED IN HALLWAY CLOSET FOR A SFD.
OWNER: FR.4NK C THAYER LTD PTNSHP Address: 307i CEYLON RD Unit:
PHONE: City/State/Zip: COSTA MESA, CA
APPLICANT: ZAMORA, CARLOS Address: Unit �
PHONE: 818-735-7676 City/State/zZip:
CONTRACTOR: SERVICE CHAMPIONS
Atldress: 22911 SAVI RANCH PKWYUnit:
CirylState: YORBA LINDA, CA ZipCode: 92887
MECHANICAL PERMIT FEE SUMMARY
MECH ITEM FEE: $38.30
PLAN CHECK FEE: $0.00
INVESTIGATION FEE: $0.00
REINSPECTION FEE: $0.00
TOTAL FEES: $38.30
License No. 799170
PHONE: 714-777-7777
CELL:
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NO710E: The work authonzed by this pertnit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulaGons. (Ord. No. 92-28, § 1, 12-21-92) �
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In ortler 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 obWined. FaiWre to obtain inspections and fnal approval will result in the expiration of this pertnit.
L�7DE1 INSPEL710NTYPE � IN7IilALS SO� INSPEL110NTVPE q �A1^,F �p INTRI�LS
1616 Fixed System Final Fire Prevention 206 Final Mechanical � d��d ` W C��N
1268 Pool Spa Final 208 Final Plumbing
Z00 Final Re-RooF 210 Final Electnral
Z01 Final BIocWRetaining Wall 212 Final Fire Prevention
202 Final Faclory Fire Place 220 Final Planning Approval
z03 Final Sign 222 Final Site
Z04 Final Demolition 250 Final Building/Occupancy
WORKERS' COMPENSATION DECLARATION+
I hereby aKrtn under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate o( consent to self-Insure (or workers'
compensation, as provided for by section 3700 of the Labor Code. for the
peRormanca of the work for which this permit is issued.
r�-?,�t� I have and will maintain v.orkers' compensation insurance, as required by
seCt�an 3700 of the Labor Code, fa the pertwmance of the wurk fa vfiich this
pertnit is issued. My warkers' compensaUon Insurance carrier an0 policy
number are:
Carrier. /� � I-( S �—� c ,
(ilrissertbrneeCrolOe redllhepemi4avaNeda�me�uiMmtlNNars(S100Jwless)
Policy Numher: ��d �� 77� ��S U l
❑ I certify that in the performance ot the work for which this permit is
issued, I shall not employ any person in any manner so as to become subjecl
to the vrorkers' compensation laws of Califomia, and agree lhat if I should
become subject lo lhe workers' compensation provision5 of Section 3700 0(
the Labor Cof� I shall (orthwith comply with Ihese provisions.
l 1 � 12-zo��
�B�aWre pa�e
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 DOLL4RS
($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 aNirm that I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business antl Professions Code, and
my license is in full force antl eHect. � �)
Lic. # G ��U Class # �,� �/"
�7�Z�O��L
Co ctor' naw Date
CONSTRUCTION LENDING AGENCY:
❑ I hereby affum that [here is a constructbn lending agency (w the
peRortnance of the work ta wfiich this pertnit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
OWNER-BUILDER DECLARATIONS:
I hereby aKrm ihat under penally of perjury that I am EXEMPT FROM TME
CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5,
Business and Protessions Code: Any ciy or county which requires a permil lo
construct, alter, improve. tlemolis�, or repair any structure, prior to its
issuance, also requires Ihe applicant for such permit to file a signed statement
thal he or she is licensed pursuanl lo Ihe provisions of Ihe ContraCtofS
License Law (Chapter 9(commencing with Section 7000) ol Division 3 of the
Business and Protessions Cotle) or that he or she is ezempt therefrom and
the basis for the alleged exemption. Any violalion of Section 7031.5 by any
applicant for a permit subjects Ihe applicanl to a civil penalry of not more than
fve hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole
compensation, WILL DO 7HE WORK, and the sWcture is not intendetl or
oflered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an owner of property vfio builds or improves
thereon, and who dces such vrork himselt or herself or through �is or her own
employees, provided that such improvements are nol intenaed or offered for
sale. If, however, Ihe builtling or improvement is sold wit�in one year of
completion, the owner-builtler will have the burden of proving lhat he orshe
did not build or improve for purpose of sale.).
❑ I, a5 ovmer of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CON7RAC70RS lo conswct the prqect (Sec. 7644, Business and
Professions Code: The conlractors License Law dces not appty to an owner of
propeAy who builds or improves thereon, and who contracts for such project with
a cmtractor(s) license pursuant to the Contractors License Laws J.
❑ I am exempt under sec.
Business and Professions Code for this reason:
SignaWre Oale
905]<6 (3I09)
Owner ID verifed by Arive, _ense. ❑ Yes ❑ No
Oriver's LicenSe No. Expires:
Vedfication of Ownership by (type of documenC i.e. - property tax bill or tleed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: �
❑ I hereby cetlAy that no excavation frve (5) or more feet in deplh into �Mich a
person is required to descend, will be made in connection with wark authorizetl
by this permit, and that no building slrucNre, scaffdding, falseaork, or demolition
or dismantling thereof, will be more ihan thirty-six (36) feet high. (Chap. 3.2, Grp
2. Art 2, Sec. 341, Ttle 8, Cali(omia Administralive Code).
❑ As owner-builder, I will not employ anyone to tlo work which would
require a permit (rom the Division of Industrial Sa(ery, as noted above, unless
such person has a permit to do such vrork (rom Ihe division.
Apdiwnl's SigreWre Dale
Division o! Industrial Safety Permit Numbec
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or (uWre building occupant need to file antl
ceAify a Business Plan for emergency response to release or threatened
release of a hazardous material7 ❑ Yes ❑ No
(Section 25505 0( the Calitomia Health and Safety Cotle requires, with some
exceptions, that a Business Plan be filed wilh the Costa Mesa Fire
Department by every business which has at any one time during a reportetl
year a quantiry of hazardous materials equal to or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cuhic feet of compressetl gas
at stantlartl temperature antl pressure�.
2. Does or will Ihe applicanl or present or tuture builtling occupant need to file
a registration form for acutely hazardous materials? ❑ Yes � No
(Section 25533 of Ihe Califomia Health and Safety Code, with some
exceptions, requires regislration wi[h the Costa Mesa Fire Department by
each business which at any one time has on hand a quantity o( acutely
hazardous materials equal to or grea[er [han a weight ot 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressetl gas at standard
temperature and pressure�.
3. Does or wi0 the applicant or present or (uture building xcupant neetl to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous materials)'t ❑ Yes ❑ No
(Section 25534 of [he Califomia Health and Sa(ety Code provides [hat the
Costa Mesa Fire DepartmeN may require Ihe preparation, certification and
filing with the Fire Department of an RMPP by businesses which are requiretl
lo register acutely hazardous matenals with Ihe Fire Department.
4. If an RMPP is presently required, has Section 25534 0� the Califomia
Health and Salery Code been (ully complied with? ❑ Yes ❑ No
5. Does or vrill the applicam or preseN or future building occupant require tor
the work which is the subject ot this aOPlication a permit for such wnsWction
of modification from lhe South Coast Air Quality Management District or (mm
any other air polWtion control tlistrict or agency? ❑ Ves ❑ No
(Section 65850.2 0l the Califomia Govemment Code requireSlhat the reque5ted
information be fumished on applications fa non-resitlential buil0inq permits).
6. Will any pah of ihe facility to be wnstructed under this permit be within
1000 feet from Ihe outer bountlaries o( a school7 ❑ Yes ❑ No
(If "yes", the facilily must meet Ihe requiremenl of Sections 25534 antl 42303
o! the Califomia Health and Safety Code).
7. If a permit from the South Coast Air �uality Management DisMcl or other
air pollution conirol district or agency is requiretl for the work which is the
subject of this applicalion, have all of the disclosures prescribed by Calitomia
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. Qf'yes", attach certificate of compliance from Ihe appropriate air polWtion
control oKcer). �
CERTIFICA7E OF COMPLIANCE: I cetlify that under penalty of perjury�the
information given above is correcl. I agree to comply with all state laws and
cily ordinances regartling Hazardous Malerials and Emissions.
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalry o! perjury that I have read this appliwtion and state that
the information qiven is correct I agree to comply with an state laws and ciry
ordinances relating to building construction, and authonze representatives of
the Ciry of Costa Mesa to enter upon the above-0escrihed property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until fnal inspection. .
Si9^aWreoflegaiOwneqs) Date
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ndlorAut tlAP�licanl Date �
(7�a) 754-5273 • Fa�c (714) 754-4856 • wviw.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 3071 CEYLON RD
Suite No
Vicinity:
Parcel Nunmber: 13916408
Applicant: EASTMAN,RNNIE
Address: 7229 VARNA AVE
NORTH HOLLYWOOD, CA
Owner: FRANK C THAYER LIMITED
Adtlress PARTNERSHIP
COSTA MESA, CA
3071 CEYLON RD
Contractor. ALAP ASSOCIATES GP
Address: 7229 VARNA AVE
NORTH HOLLYWOOD, CA
Arch / Eng :
Address:
WATER HEATER CHANGE OUT.
ISSUE FEE
Backflow irrigation
BackFlow Preventer
Bathtub
Clarifier System
Connect (Ice,Soda,etc)
Dental Units
Dishwasher
Drain, floor
Drain, Rainwater
Drain, Roof
Drinking Fountain
ExOansion 7ank
Gas Earthquake Valve
Gas (1-4 outlets)
Gas (Over 4 outlets)
Gas Repipe
Gas Service
Interceptors (Grease, Oil)
Interceptors (Sand Auto )
AMT
523.SD
50.00
50.00
50.00
so.00
50.00
50.00
50.00
50.00
50.00
50.00
50.00
50.00
50.00
50.00
50.00
30.00
50.00
50.00
50.00
�
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
PLUMBING PERMIT
Phone: (800) 444-8865
Zip: 91605
Phone:
Zip: 92626
Phone: (800) 444-8865
Zip: 91605
License: 771905
Phone:
Zip:
License:
SCOPE OF PERMIT
FEE SUMMARY
AMT
Laundry Tub I Washer 50.00
Landswpe Irrigation 30.00
P-Trap 50.00
Pressure Regulator 50.00
Process Piping (per 10 ft) 50.00
Receptors $0.00
Septic Tank $0.00
Sewer Cap for Demo $0.00
Sewer Connect $0.00
Sewer Private Line $0.00
Shower $0.00
Sink, bar 50.00
Sink, wmmercial 30.00
Sink, Floor $0.00
Sink, kitchen $0.00
Sink, servicelmop 50.00
Spa (private) $0.00
Spa (public) $0.00
QTY
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
COMMENTS I SPECIAL CONDITIONS
Status: ISSUED
Applied: 07/24I2001
I ssued: 07/24/2001
ISSUED BY:
SumpPump
Swimming Pool
Trep Primer
Urinal
Vacuum Brkr Bkflow(1-0)
Vacuum Brkr Bkflow(5+)
Wash Basin
Wash Basin Set
Waste and Vent System
Water Closet (Toilet)
Water Heater I vent
Water Piping Qnst or Rep.)
Water Re-pipe
Water Service
Water Softener
OTHER
VIOLATION
PLAN CHECK
REINSPECTION
AMT
50.00
50.00
50.00
50.00
$0.00
50.00
50.00
50.00
50.00
50.00
512.30
50.00
50.00
50.00
50.00
so.00
$0.00
50.00
50.00
TOTAL CALCULATED FEES: b35.80
Qn
0
0
0
0
0
0
0
0
0
0
7
0
0
0
0
0
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ortl. 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 woAc is suspended or abandoned
for a period ot 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 Inapeetions end final approvel must be obtained. Failure to obtain inspections and final approval will result in ihe expiration ot thls permit.
FOR INSPECTIONS CALL: (714) 7545626
zaaaae �eroo�
WORKERS'COMPENSAnON DECLARAnON:
I hereby eHirtn under penalry at perjury one of Ihe tollowing deGarations:
❑ I heve end wlll maintaln e certilicate of consent b sett-Insure for workers' compensetlon, es provltletl tor by section 3700 0l the LeDor Code, for the pertortnence ot the
j`'ork for which Ihis pertnit Is issueA.
\I have entl wlll maintaln workers' compensatlon insurance, as requireC by secllon 3700 0l Ne Labor Code, lor the peAortnance oi ihe work lor which this pertnit Ls issued.
My workers' compensation Insuran mer end policy number are: // /�
Certiar: /.J in . ���. Policy Number. ����.(,(lLl�`9") �'7U / �
(This secBon need nof be completed i/ e�rMtls veluetl et one hundretl dW/ers (5700) or less.)
�
ipTy with �he5e
SigneNre: _
of the work lor which this pertnit is issued, I shell not emplay eny
i, entl epree Ihat II I sh0uld betome 5ub�ec� lo lhe workers' Cor9p
so es to became sue�ect to the workers'
Secllon 3700 af)he Lebor Cotle, I s�all fonhwit�
WAR ' SEWREWORNERS'COMPENSATIONCOVEMGEISUMAWFULANDSHALlSUB1EC�VIiY2LpYFA'(OCRIMIWSLPENALTIESMl6GVILFlNESUPTOONENUNDRED
TIiOUSAND �OLLARE (5100,0OO�.IN AODRION TO TME CQST OF COMPENS�TION, UAMAGES PS PROVIDED Fdi IN SECiION 31O80F THE LPBOH CQDE, INTEREST, ANO ATfOiiNEY'S FEES.
LICENS A DECLARAl10N:
I h y ettirm t�at I em lice etl untler Drovislons of Chapter 9(commencinp wlt� Sealon 7000�y68 ion H e s antl Profeulons Gode, entl my license is in tull
ce end eXect. Lic. a � Class M � /i.��
ComrectorsSign : Dale� 7���/ �/
i._. _____—.__ .__ _.. _ .. . —T S^�
CONSTRUCTION LENDING AGENCY:
❑ I hereby attirtn that thera is a construction lending egenry Iw Iha peAortnence ol the work br w�ich this pertnil is issuetl. (Sec. 3097, Civll CoUe).
Lentlers Name: Lendefs Adtlress:
SignaNra: Date:
OWNER-BUILDER DECLARAT10N5:
I hereby effirtn that under penalry af perjury that 1 em EXEMPT FROM 7ME CONTRACTOqS LICENSE LAW for the following reeson (Sec. 7031.5, BuSiness antl Professions
Code: Any ciry or counry which requires a pertnit m construct, elter, Improve, demWish, or repair any sWcture, pdor to Its issuance, elso raqulres t�e epplicant for such permit
lo tile a signetl statement that he or she is licensetl pursuant ro the pmvisions oi Ne Conirectors Ucense Lew (Chepier 9(wmmendng wlth SecUon 7000) ot Division 3 of Ne
Business end Pmfesslons Code) or that he or she is eaempt iherefrom and the besis for tha ellepetl e:emptlon. Any vloletion oi Section 7031.5 by any applicant for e pertnit
sub�ects the eppllcant to a dvil penalry ot not more Ihan frve hundreA tlollars (5500).):
❑ I, es owner of ihe property, or my employees with wages as ihelr sWe compensatlon, WILL 00 7NE WORK, and Ihe swcture Is not Intendetl or ottered for sale (Sec.
7044, Business and Professions Code: The Conirectors License Law does nat apply to en owner of O�operty who 6uilds or improves thereon, antl who does such work
himself or herself ar through his ar her own employees, providetl thai such improvements ere noI intended or aHeretl tor sale. If, however, Ihe building or improvement is
sold within one year oi completion, the owner-builder will heve Ihe burden ot pmving thet he or she did not builtl or improve lor purposa of sale.j.
❑ I, as owner of iha property, am EXCLUSIVELY CONTRACTINC WITH LICENSED CONTRACTORS to construct the Oroject (Sec. 7044, 8usiness antl Professions
Code: The contracbrs Licensa Law does not appty to an ownar oi property who bulltls or Impmves thereon, entl who contracts lor such prqect with a coniractor(sj
licen5e pursuant Io Ihe Contractors License WwS.).
❑ I am ezempt under sec. Business end Professions Cade lor this reeson:
Signature: Date:
Owner ID verifietl by tlriver's license. ❑ Ves ❑ No Drivers License No. Expires:
Verllicatlon ol Ownership by (lype ol daument, i.e. - property tax blll or Eeetl):
DIVISION OF INDUSTRIAL SAFETY VERMIT CERTIFICATION:
❑ I hereby cenity that no excavetion five (5) or mora taet in depth into which a person Is requlred to descend, wlll be made in connectlon with work authodzed by tNs
permit, and that no building swcture, scattolding, lalsework, or demolition or dismantling thereof, wlll be more Ihen Ihiny-six (38) teet high. (C�ap. 32, Grp 2, A� 2, Sec.
341, Title B, Calilomia AdminislretNe Goda).
❑ As owner-bulltler, I will not employ enyone to tlo wark which would requlre e permit irom the Divislon of Intlustnal Sefety, es noletl above, unless such person has e
permit to do such work from the division.
Signeture: Dete:
Divislon oi Industrial Salety Pertnit Number.
CERTIFlCATE OF COMPLIANCE AND Al7THORIZATION OF ENTAY: I certity under penalty of perjury that I have read ihis epplication and stete Ihet the inlortnation given is
cortect I egree to wmpty with ell siate laws end ciry ordinances relating to Duiltling construction, end euthodze represeNatives of the City ot Casta Mesa to enter upon the
ebove-descnbed property tor inspection purposes. I egree not to acupy or allow occupenry of any building eulhorized by ihis permil until linal inspaction.
COOE I. INSPECTIONTYPE
1616 Fi:ed System Final Fire Preventlon
1268 Paol SDe Final
200 Flnal Re�Roof
201 FInaI BIacWReteining Well
202 Final Factory Fire Place
203 Finel Sign
204 Final Demolition ,
�Iz�S�r.mn�ti
COOE I INSPECIION TYPE
206 Finel Mechanical
20B Final Plumhinp
210 Finel Electncal
212 Flnal Flre Preven�lon
220 Finel Planning Approvel
222 Final Si�e
250 Final Bullding/Occupancy
�
. 9���
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 317 COSTA MESA. CALIFORNIA
FOR. APPUCANT TO f/LL /N COMPLETfLY
TYPE OR PRINT
ADDRESS � D � �G C +�� '�.(Jrry
COSTA MESA, CALIFORNIA
AooRess 10835 Santa Monica Blvd.
�T� Los Angeles TN8r23287
ARCHITECT L. C. Ma j or N��'
tlR FN[]INFFR
STATE
CONTRACTOR e IC.NO.
.............10835 Santa Monica Blvd..
� LEGAL
'$IZE 102.02 X 67.91 INO.OFBLDGS. O
OF LOT NOW ON LOT
SETOACK LINE FROM C� REAR YAR� �O
CENTER OF STREET J e e
SIDEVARD ILEFT J IRIGHT J
� DESCRIPTION OF WORK
: �sx.i
SIZ'EDINGl'�O'� ROOMS 7 STORIES �
EXTERIOR Nh��CCO I ROOF wood. shin
COVERING COVERING
USE OF B ILOING AND WORK TO BE PERFORMED
Dwe�.ling new construction
�� 4CC Att. Gar.
I HEHEBY ACKNOWLEOGE THAT � HAVE REwD THIS APPLICATION
AND STATE THAT THE /�BOVE IS CORRECT AND AGREE TO COM�
PLY WITH �LL CITY OFOINANCES AND STATE LqWS REGULqTING
BUILDING CONSTRU N. � y/�
SIGNATURE OF /. —/ � _ . � L
� AUTHORIZED
..-�.;(� 1959
' �i�ra; �nr (1�
, . _PT.
',-.,. =c.
APPLICATION FOR PERMIT
BUILDING
fox ofFic� usF o�cr
FIRE
ZONE
APPROVED
BV
ZONE ^
_!LT
APPROVED
BY
YARDS
REpUIRED
(CENTEH LIH
COSTA MESA. CALIFORNIA
ZONING
NO. OF lISE OF NEW
PLANB Q 9UILDING
ai
THE AMOUNT SHOWN UNDER VALUATION �S FOR THE
PURPOBE OF EBTABLIBMING A PENMIT FEE ONLY.
VALUATION ��
PERMIT FEE $
$ /�/ �3� PLAN CHECK S ��
TOTAL FEE 5 �f �