HomeMy WebLinkAbout2671 CLUB MESA PL - Building Permits• CITY OF COSTA MESA �
BUILDING DIVISION
� r
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754�856 • wv+w.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754-5626
PERMIT TYPE B_ROOF2
APN: 43921331
JOB ADDRESS: 2671 CLUB MESA PL CM
Vicinity: RESIDENCE AND GARAGE
Squares: 1600
PERMIT NUMBER: B09-00249
STATUS:
DATE ISSUED:
ISSUED BY:
Suite/Unit:
Valuation:
ISSUED
1 0/3 012 0 0 9
KJB
$3,500.00
SCOPE OF WORK: TEAR OFF EXISTING ROOF. REPAIR OR REPLACE SHEATHING IF NECESSARY. COVER WITH 40 YEAR COMP PER
CODE. ROOF PITCH IS 4:12. INCLUqES ATTACHED GARAGE. 1600 S� FT.
OWNER: WARREN, PETER L
PHONE:
APPLICANT: ALVAREZ, AUSCENCIO
PHONE: 714-785-7378
CONTRACTOR: 3 A ROOFING
Address: 762 NUDSON AVUnit:
City/State/Zip: COSTA MESA, CA
r:
ARCHITECT:
ENGINEER:
��1�1�I�I�I�G�:,��
Reroof Plan Check:
Reroof Permit Fee:
Reinspection Fee:
Bldg Std Admin Fund
TOTALFEES
'1 :
92626
$0.00
$97.25
$0.00
$1.00
598.25
Address: PO BOX 5474
City/State/Zip: BALBOA ISLAND, CA
Unit:
Address: 762 HUDSON AV Unit: :
City/State/Zip: COSTA MESA, CA 7 r-,,n,
. +_/:T��liJ?<SJ
License No. 873754
PHONE: 714-785-7378
CELL: 714-957•2825
License No.
License No.
PHONE:
PHONE:
Y� eIt i;i%iJ�P PLF
•. �if:
U���;. .
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NOTICE: The vrork authorized by thig permit shall comply with all applicable handicap access requirements under Califomia sUtutes and related
regulations. (Ord. No. 92-28, § i, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this pertnit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approyal must be oblained. Failure to obtain inspections and final approval will result in the ezpiration of this permil,
C dE t. INSPEG710N TYPE DRTE IN IIAL COOEI INSPELTON TYFE ORIE „=� �� NTII T^pL5
1616 Fixed System Final Fire PreveNion 206 Final Mechanical
1266 Pool Spa Final 208 Final Plum6ing
200 Final Re-Roof �_1_� � 210 Final ElecMcal '
207' Final Block/Retaining Wall p12 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 FinalSign 222 Final Si�e ' `� �! ��
204 Final Demolition 250 Final 8uildingiOccupancy
•
WORKERS' COMPENSATION DECLARATION:
I hereby aHirm under penal[y of perjury one of the following declarations:
❑ I have antl will maintain a certificate o( consent to sel4lnsure for workers'
compensation, as provided (or by section 3700 of the Laboi Code, for the
pe, ance of ihe work !or which ihis permit is issued.
P�have and will mainlain v.orkers' compe sation insurance, as requiretl by
sec n 3700 of the Labor Code, (or the ped mance o/ the vrork for which this
pertnit is issued. y vrorkers' ompensati n Insurance carrier and policy
number are:
Garrie�. - .
4'Rv.!e��^nissecfbnneetl bemmy¢letl0(hepermrtisvlvedalwenundmtldollars(St00)a�ess)
Paicy�. u-l�m 'ber7 23 o gY�p�, g- ��
❑ I ceAi(y lha[ in the pertormance of the vrork for which Ihis permit is
issued, I shall not employ any person in any manner so as to become subject
ro the workers' compensation laws of Califomia, antl agree that i� I should
bewme suhj e vrorkers' c� en ation provisions of Section 3700 of
ihe Labor de, I all forthwith ompl Ihese provi ons.
c� 3d J
- Kem's ^9�im3 Ie�
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAI
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLAFtS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrtn that I am licensed under provisions of Chapter 9(commencing
wilh Section 7000) of Division 3 of the Business and Professions Cotle, antl
my license is in full force and effect.
C�rc- � �'a3s�a — �,l
� V
co nnr:y�E19^awrew `-Da1e !
.;�, n
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirtn that there is a constmctbn lending agency for the
performance o( the vrork fa which lhis permit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Atltlress:
SlgnaWre
OWNER-BUILDER DECLARATIONS:
I hereby aKrm Ihal under penalty of perjury lhat I am EXEMPT FROM 7HE
CONTRACTORS LICENSE LAW for lhe (ollowing rea5on (Sec. 7031.5,
Business and Professions Code: Any ciry or county which requires a permit to
constmct, alter, improve, tlemolish, or repair any stmcture, prior to its
issuance, also requires Ne applicaM for such permit to fle a signed statemen[
�hat he or she is licensed pursuant to the provisions of Ihe Contrac�ors
License Law (Chapter 9(commencing with Seaion 7000) of Division 3 ot the
Business antl Professions Code) or that he or she is exempt [herefrom and
ihe basis !or the allegetl exemption. Any violation of Section 7037.5 by any
applicant for a permit subjects the applicant to a civil penalry of not more than
five hundretl dollars ($500).):
❑ I, as ovmer of the propeny, or my employees with wages as their sole
compensation, WILL DO THE WORK, an0 the struclure is nol 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
Ihereon, and who does such vrork himself or herself or through his or her own
employees, provided that such improvements are not intended or oftered 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 builtl or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTR4CTING WITH
LICENSED CONTRACTORS ro construct the project (Sec. 7044, Business and
Professions Code: The conlraclors License Law dces not apply to an ovmer of
property who builtls or impmves thereon, and who contracts for such pmject with
a contractw�s) license pursuant to the Contractors License Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
Slgnalure
JOS)-A6�J10]�
l
Ovmer ID verifietl by drive� e iicense. ❑ Ves ❑ No
Driver's License No. Expire�:
Venfication o( Ownership by (type of document, i.e. - property tax bill or Ceed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby cetlify that no excavation five (5) or more feet in tlepth into which a
person is required to descend, will be made in connection with work authonzed
by ihis permit, and that no building sWcture, scaffdding, falsework, or demolition
or dismantling thereof, will be more Ihan [hirty-six (36) feel high. (Chap. 32, Grp
2, Art 2, Sec. 341, Title 8, Califomia Administrative Code).
❑ As owner-builder, I will not employ anyone to do vrork which would
require a permii from the Division o/ Industrial Sa(ety, as no�ed a6ove, unless
such person has a permit to do such work from the division.
Appliwn[s Si9naWre oale
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 matenal? ❑ Yes ❑ No
(Sec[ion 25505 of the Calitomia Health antl Safery Code requires, with some
exceptions, that a Business Plan be filed with the Costa Mesa Fire
Department by every business vmich has at any one time dunng a reportetl
year a quaniity of hazardous matedals equal to or greater than a weight ot
S00 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at standard temperature and pressure).
2. Does or vrill the applicant or presenl or future building occupant need to file
a regis[retion fortn for acutely hazardous malerials? ❑ Yes ❑ No
(Section 25533 of the Califomia Health and Safety Code, wit� some
exceptions, requires registration wiih the Costa Mesa Fire Depanment by
each business which at any one time has on hantl a quantity of acutely
hazardous materials equal to or greater than a weight of 500 pountls, or a
volume of 55 gallons, or 200 cubic teet of compressetl gas at standard
temperaWre and pressure).
3. Does or will the appliwnt or pre5ent or fuWre building occupant need to
prepare an RMPP (Risk Management and Prevenlion Program lor acutely
hazardous matenals)? ❑ Yes ❑ No
(Sec[ion 25534 of the Cali(omia Healih and Safety Code provides �hat Ihe
Costa Mesa Fire DepartmeN may require the preparetion, certification and
fling with the Fire Department of an RMPP by businesses which are requiretl
to register acWely hazardous materials with the Fire Department.
4. If an RMPP is presently requiretl, has Seclion 25534 0! the California
Heallh and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or vrill the applicant or present or future Duiltling occupant require for
the work which is lhe SUbjeCt of this appliCalion a permi[ for such constmction
or modifcation from me Soum Coast Air Qualiry ManagemeN Disvict or from
any other air pollulion contml district or agency? ❑ Yes ❑ No
(Secfron 658502 0( the Califomia Govemment Code requires mat the requested
infortnation be fumished on applications (or non-residential building permits).
6. Will any part o( Ihe faciliry to be constmcted under Ihis permit be within
7000 feet (rom the outer boundaries of a school4 ❑ Yes ❑ No
p('yes", the faciliry must meet the requirement of Sections 25534 and 42303
of the California Health and Safery Code).
7. If a permit from the SoWh Coast Air Quality Management DisMct or oiher
air pollution contml tlistrict or agency is required for the work which is the
subject of this application, have all of the disclosures prescribetl by Califomia
Health and Satety Code Section 42303 been made? ❑ Ves ❑ No
8. Qf'yes", attach certiflcate of compliance trom the appropriate air pollution
contml officer).
CERTIFICATE OF COMPLIANCE: I certify Ihat under penalty of perjury the
intormation given above is covecl I agree to comply with all slate laws and
city ordinances regarding Hazartlous Materials and Emissions.
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalry of perjury that I have read this application and state that
the information given is correcL I agree to comply with all state laws and city
ordinances relating ro building construction, and authodze representatives ol
the City of Costa Mesa ro enrer upon the above-describetl property for
inspection purposes. I agree not to occupy or allow occupancy of any builtling
authorized b his permit uNil f ' spection.
gnature ol Legal Ovme ` Daf�le 1
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City of Costa Mes(a� Building De/j7t.
BY..__C��_!.U.__�,__._GU.��- DATE/�/_.._.� .19�
THESE FlANS hIUST �: CFl JOB AT ALL TIMES
MA((C NO C;�I.�N3E5 \VITHOUi PItISR APPROVAL
Of DEPT.
THE ISSU�N�'E Ofi GR'f:Ti':3 Of A PERSIIT OR �PARO4Al
OF PLfbS '� S t��FIC-.TIJ:;S ��".Ll t:i7 BE CON3TRUE0
TO BC A f, ;.7( f0�;, QR �; ."rr,L."L CF, :IV� 410lhTIQY
OF i,.':� ;' i PPL���C!O.S G'F (h'� CCJE. 1!0 MERt11T PRE•
SUGIIitC i0 eIJE .iUi �0.;�7� T7 OAL'.TE DR CANCE� THE
FCC•,alC.'_ �F �Yi3 ^�LE Jh,LL Gi ': . 9. E%C[Pi !N SO
v�
FAR AS 1HE IYORI: Od LSc t'l,.I,.H li AU'�A�.. ZLS IS LAIYFUI.
THE ISSU=�:C. C�F A r'c !:tl gASED U,'0:7 PL1R3 AND
SPECIfICATIUPlS SHALL i,J; rd_lt��T TYE BU�LUIN^u OFFICIdI.
FROM THEREAFTER FEQUIRINC Illt COnRLL'TION OF ERRORS
IN SAID PIANS F(ID StEC1FICAuUt+S OR fR0!d AftEVENTiNR
BUILDING UPERATIONS BEING CAHNIED UY THEREUNOER WHEN
IN VIOLATION OF TMIS CODE OR OF ANY OTHER ORUINANCF
Of TNE CiSY, ,
�
� PLANNIh�G D�pT. `
SUBIECT O BLDC. OEPT, REG.
BY������DA7E��(�
��RKTGR F PLAkNINO
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`�e_�„� `,��'`'�Qir�
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CQUNI'Y OF ORANGE
BUILDING DEPT.
636 No. $roadway
5anta Ma� Califomia
Phone: KI 2-6211
App�ication for Building Permit
AND FOR A
Certificate of Use and Occupancy
1. OWNER'S NAME_.._.......__.AIiSE_&.-�9LEGRQYE
Permit No...�L.��l�'�.
D�te —D�Qk�M.BN�..1Q.�...19$I - ----
PHONE:BEA'---722-�---.----
MAILING ADDRESS--------.15Lh.._&..IRVIflTE_ST3.------------------------- ............. CITY----NEWPDRT..$EAGH..------....---
I '
NameRILEY-�-L�rYtINF.S.�...&.9Ii.....G.O.._.AliAk1.I1QG_.5�. Name ----------.--.I?IKE.&.CQj�EGRUV�i.._ ...................----------
(Architect or Engineer) (Contractoc)
Addres�...810._CAA$T--H41Y.....------------------------------._.-------- Addrees ..------.1Sth.._&...7.AYIN�..STB.-----------....---...------
City _HEWc�RT_SEACH
State
Lic. No...._.......----�--------
City _......NEWPQRT_HEACHr--GfILIF----------------- ----------
Statc �
Lic No._.._.12�2�2_.-- ............... Phone-----Bs,N.�--7225 ------
PROPOSED USE---------------_RESIA�NC�.-&--.ATT.EI9HED...GABEI�E...._-------.}......._...----.._..-----.._---------.....-----------------,.--------.
2. J013 LOCATION_- .._.2E221......-- - -- CLUS.. r�SA.. P�A.G.E_... J ' --- - -..._- - CQSTA_.MESA....._ .............. . ..
(House No.) (Namc of Street) (Town or Sthool Dis[ric[)
3. LEGAL DESCRIPTION: Loc- La' - ..... -' - - -- - - Block ... - - - -- -- -- - - Tract - �14 ---__...... _
(Metes and Bounds De=cription—Use reverse side of form)
4. CORNER LOT ( ) INTERIOR LOT ( X ) THROUGH LOT ( ) SLOPE OF LOT ( )
i. SIZE OF BLDG.:.--�--i�--�iZ----.--_-_AREA:--_ZQSID_..--__-.-.---.SIZE OF LOT:---.fi0_X-124......._-_.AREA:_-720A--...-------..—.-.
G. HEIGHT OF BLDG.:_-_.--15.�-_-..-.-_.....-__....CEILING HEICHT:-----S�Q^_--__.-._.--.---NO. OF STORIES----._.y---------------------
7. NO. FAMILIES--..---..Q`��'. ...............____._Sizc of Smallest Bedroom:---1QJ-fi."_.%--9-!-$"._--__ Size of Kitchen..._..],0-.$-..1$---------�
6. EXTERIOR WALL CONSTRUCTION:...k'R?�r4E...8s...S�'UCCO__.__INTERIORWALLCOVERING..__P�15Trit._.._.
(Frame, Smtto, Ete) (Plaster-Drywall, Etc.)
9. SETBACKS: Front Yard From Center Line of Street-.--_---_.SO�___.----,-_-_-.-_-__--.'--._-----------____-_.---------__'_........_....
Nearest Side Yard......5!..._.__..._Reaz Yard_.1r0�------�--Distance in Feet Betv.�cen Bldgs. on Same Lot......Tjpiyg.....__..._ ................
10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH.
11. For (a) Foocing: Width..-------'g.".---- j.`.�1.---------Depth in Ground------�1t°- ..............Width of Wa1L,-----b°....----...-----
Accessory
Bldgs. and n „
Similar
(b) Size of Studs:-_.----2_7�---�+-.------Spacing._-_-----�f2--_-----_ CC Material of Floor--.._.--.1!IOOD_,_-----------------------
Structure=_:
n.,
(c) Size of Floor Toists:-------'�--i�--"---.__..------Spacing.-------------.�.�2'-------------- CC
(d) Size of Rafters.... - - -2-X -6-... -- --__...Spacing ........-- -- �*n- -:'CC
12. VALUATION�OF PROPOSED WORK: Including all labor, plumbing, elecvical wiring, heating, fire sprinkler=_, paioting and
sewage disposal $---- 8(J00..00----......----------'. '
13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS
APPLICATION IS CORRECT AND THAT THE CONSTRUCTION bVORK WILL CONFORM TO ALL LAWS OF
THE COUNTY OF Oi2ANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO.
—Signed:---- ._...--Y:`�..r.l� -�-e�-=�Lt�..: -- --- --- ......__.
/.. �'�� �i/ � . ner)
Plan� Filcd :..............-{ ---..._ - B 9'�
j �-"----j Cl c -
-- Y�-----------'---------- � - � ��-- .............-------------.._---�--.....----'
" """ "'�'(Authorized Agent)
Bldg. Permic
Plan Check
Tota] - -
Receipt No.
Paid to •
Date -----...._.
FEES:
�.... -/��.. �J.
FOR DEPARTMENTAL USE ONLY
GROUP- - � - -....
TYPE - --.. � ...._ - -- -
DIST. ..
MAP------�-, -��� -�--
SHEET NO.....=5 --- - - ...
PERMIT
DATE..... - - AF �-1-2 .1951--........ -
'Hh;C:KJ�N(i t1Y �
J � '
APPLICATIOI�' �JL.��HEALTH ............................
v FIRE
ZONING--------------
-
PLANS AND MARSHAL ....................._..
SPEC'S --- - - : _�� STATE- - - - -
CORRECTIONS ENGINEER
VERIFIED.... - - - - CAL.. - -- -- -- - ..
CiJ� �� Y :�
1� COUNTY BUILDING
�--� INSPECTOR
5 M-g-51 � � .�y�/ ��
v `_�l
Ci r�'
OWNER Wpgg�N peter
106 ADDRESS 2 71 Club Mesa
AP No119-123-32
INSPECTIONS
SOIL
GAS
WATER
ROUGH PLUMBING
PROP. SWR. LINE � H01
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AN� AIR
UNDERGROUNO U POWER �
ROUGH WIRING
TRENCHES � FORMS � STEEL REINF.
FLOOR SVSTEM
BONO BEAM � STEEL REINFORCE n
SMEATHING
FRAME AN� FLASMING
LATHING - IN �J OUT [�
PLASTER,BftOWN COAT
HEATING.
PLUMBING
BUIL�ING. FINAL
A.L. FINAL
T
DATE
DESCRIPTII
FIRE ZONE
�UP J TYPE
SUBCONTRACTOR
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COSTA MESA BU�LDING-SAFETY DEPARTMENT
P.0.60X 1200 COSTA MESA.CALIFOf2N1A 92626
�FC 14-70�Pn��OO 676 u***+�+�
cnsn S.OG
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
REC V D BV DATE RECEIVED DAT ISS E
BUILDING �� //� � 2.— —`,O ��y�7
ADDRESS C '
r C PEqMRf.7�IQ�
OWNER / '—( � �'. . N A.P. NO. / � �
MA I L BUI LDING
ADDRESS �/(/ �� /�.DDRESS��'J
TEL. TRACT LOT BLOCK
CITV Q � JGT NO.
CONSTRUCTION W ADD ALTER PA
�ENDEfi
BRANCH � �
OWNER
A DD R ESS VALUE
ARCHITECT TEL SE $
OR ENGINEER NO.
FIFE
ADDRESS ZONE TVPE GFOUP
O �NG� APPROVED
CONTRACTOR ' BV DATE
ADDRESS
TEL. ZON NO.OF USE OF NE
CITV NO. � P�� BUILDI G c.
STATE CITY �'�+RDSAPPROVED VARDSAP ROVED
I.IC. NO. LIC. NO. MAIN BUILDING ACCESSORV BUILDING
SIZE / NO.OF BLDGS. (FROM C/ REET)
OF LOT �I �I x aQ, 0 NOW ON LOT ftONT FT. FT.
USE OF
EXISTING BLDG. IDE T. FT.
SIZE OF NO. OF
NEWBL�G. ROOMS STORIES L.SIDE FT.
EXTERIOft WALL ROOF
COVERING COVERING REAR FT. FT.
USE OF BUI�DING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN &
MAIN BLDGS. ACCESS. BLDGS.
G VAfl. # DATE
rerUq - Nee S QN 'v, // G Qt^ C.U.P.# APPRpVED
T �7O '�F!f +.� / � APPROVE " ' .J�
L J L G 10 I!
1 hereby acknowledge chat I have reatl this application antl state
that the above information is correct antl aBree to comply with
all laws regulating builtling consttuction, antl I shall not employ .
any person in violation ot the workman's compensation laws of
the State ot C tornia. �
ali
m
I hereby certiFy that I am p�operly licensetl as a contracto� untler
SQ. FT. o
the State ot California Business antl P�ofessions Cotle, Divisicn 3, THE AMOUNT SHOWN UNOER VALUATION IS FOR '
Chapter 9, antl that such licenses are in full force antl effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: m
am ezampt from the provisions of ffie State ot Calitornia Business � ¢
VALUATIONI y
antl Profeszions Code, Division 3, Chapter 9. PERMIT FEE $ r �
J
Sig^atura of �� m
Permittee .� $ �OD PLAN CHECK $ E
`o
Autharizetl Agent �� LL
TOTAL FEE $