HomeMy WebLinkAbout3160 COLLEGE AVE - Building Permits, . \
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CITY OF COSTA MESA
4 �'�p~Fs'q BUILDING DIVISION
i� � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
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" g FOR INSPECTIONS CALL: (714) 754-5626
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PERMIT NUMBER: BX10-00282
PERMIT TYPE � MISC STATUS: ISSUED
APN: TPN01029 DATE ISSUED: 12/13/2010
Zoning: , ISSUED BY: RMD
.--.+.--�.�+w....�.�i ss«—n�. ..�::w'�9
JOB ADDRESS: �`3160°COL'L•'EGEA1/_CM�'!1 Suite/Unit:
Vicinity: ALONG CHEMIN DE FER WY Primary Occ: Const Type :??
SQ. FT: 0 Valuation: E27,400.00
SCOPE OF WORK:
REPLACE AN EXISTING BLOCK WALL WITH A 158 LF 8' HIGH BLOCK WALL FOR "FRENCH QUARTER" ALONG CHEMIN DE
FER
WAY DUE TO VEHICLE ACCIDENT. CITY STANDARDS ATTACHED TO JOB CARD. �
OWNER: FRENCH QUARTERS HOA
City/State: SANTA ANA, CA
Phone: 92626
APPLICANT: LOVE, S7EPHANIE
City/State:
Phone: 714-679-2256
CONTRACTOR:
Address:
City/State:
Zip Code:
ARCHITECT:
Phone
ENGINEER:
Phone
OWNER-BUILDER
FEESUMMARY
Builtling Plan Check:
Builtling Permit:
Electrical Permit
SMIp Residential
SMIp Commercial
Bldg Std Admin Fund
Address:: 2020 E FIRST ST
Zip Code:
Address:
Zip Cade:
License No. 000000
Phone Cell:
License No.
License No.
$0.00
$34925
$0.00
$2.14
$0.00
$1.00
Unit
Unit:
Unit:
TOTAL FEES $352.39
HOUR$ FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3HBI2010 - PER CMMC Sec. 13•279
Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays -9:00 am thru 6:00 pm. Prohibited all hours - Sundays and the following Fetlerel Holidays:
NOTICE: The work authOnzed by this permit shall comply with all applicable handicap access requirements under California statutes and relaled
regulations. (Ord. No. 92-28, § 7, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order (or the work aulhorized 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 oblain inspections and fnal approval will result in the expiretion of this permit.
LODEN. INSPECTIONTYPE UATE INIITIRLS COOEp INSPECTIONTVPE OAiE INTITIRlS
1816 Fiaed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Elecirical
201 Final Block/Retaining Wail 2�2 Final Fire Prevention
202 Final Factory Fire PIaCe 220 Final Planning Approval
203 Final Sign 222 Final Site �
204 Final Demoli�ion 250 Final Building/Occupancy ; �� m�
•
WORKERS' COMPENSA710N DECLARATION:
I hereby affrm under penalty oi perjury one of the following declarations:
❑ I have and will maintain a certifiwte of wnseN to sel4lnsure for workers'
compensation, as provided for by section 3700 of the Labor Cotle, for the
performance of the work for which this permit is issuetl.
❑ I have and will maintain Horkers' compensa�ion insurance, as required by
sectbn 3700 of Ihe Labor Code, for Ihe pertortnance of the v✓ork for which this
permi� is issued. My workers' compensation Insurance carrier and policy
number are:
Carrier
(This seclun neetl �ml De cOmpleletld fhe perm� is vaWed uf one �undrctl0�llars (S100J a less )
Policy Number
�)I certify that in the peAormance of the work (or which this permit is
�s3ued, I shall not employ any person in any manner so as to become subject
to the workers' compensation laws of Calilornia, and agree that if I should
beco ne subject to the workers' compensation provisions of Section 3700 of
the or Code, I shall forthwith comply with lhese provisions.
ia`�3-'U
APP ta� S:Slgiu�ure ie
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS �ECLARATION:
I hereby afLrm that I am licensed under provisions o( Chapter 9(commencing
with Section 7000) of Division 3 of the Business and Pro(essions Code, and
my license is in full force and effect.
Lic. # Class #
Canlratlor's SignaNre
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby aKrtn lha[ there is a consWction lending agency for [he
perfortnance of the work (or v.hich this permit is issued. (Sec. 3097, Civit Code).
Lender's Name:
Lender's Address:
Daie
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW lor the (ollowing reason (Sec. 7037.5,
Business antl Professions Code: Any city or counry which requires a permit to
constmct, alter, impmve, demolish, or repair any structure, prior to its
issuance, also requires the applicant for such permit to fle a signed staiement
ihat he or she is licensetl pursuant lo the provisions of the Contractors
License law (Chapfer 9(commencing with Section 7000) of Division 3 of Ihe
Business and Professions Code) or Ihat he or she is exempt theretrom and
the basis (or the alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit subjects the applicant to a civil penally of not more than
five hundred dollars ($500).):
I,. as owner o/ the property, or my employees with wages as their sole
compensalion, WILL DO TME WORK, and the slructure is not intended or
oRered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an owner o( property who builtls or improves
thereon, and, who does such work himself or herself or through his or her ovm
employees, provided Ihat such impiovements are not intentled or offered for
sale. If, however, Ihe building or improvement is sold wilhin one year of
completion, the ovmer-builder will have the 6urden ot proving [hat he or she
ditl not build or improve for purpose ot sale.).
❑ I, as owner of Ihe property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRAC70RS to consWct the project (Sec. 7044, Business antl
Professions Code: The contractors License Law dces not appty to an owner of
property who builds or improves thereon, and who cont2cts (w such project with
a cont2ctor(s) license pursuant to the Cont2ctors license Laws.�.
❑ I am exempt under sec.
Business and Professions Cotle for this reason:
� } -�3-.0
SigreW�e •�'oate
3051�46 (3rol) �
,
Ovmer ID verified by drXi er s license. ❑ Yes ❑ No
Driver's.LicenseNo. / � Expires:� 3'.��
.�--
� eiifcalion of Ownership by (type of tlocument, i.e. - property tax bill or tleetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation frve (5) or more feet in depth into wfiich a
person is required to tlescend, will be matle in connectbn with work aulhonzed
by �his pertniC and �hat no building sWCWre, scaF(dding, (alsev.ork, or tlemolition
or dismantling �hereo(, will he more �han Ihirty-si� (36) feet high. (Chap. 3.2, Grp
2, M 2. Sec. 341, Ttle e, Cali(ornia Administrative Cotle�.
❑ As owner-builder, 1 will not employ anyone to do work which would
require a permit from the Division of Industrial Satety, as noted above, unless
such person has a permit to do such vrork from the division.
Applicanfs SignaWre Dale
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicaM or present or tuture building occupaN need to !le and
certify a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 oi the Califomia Health and Safely Code requires, with some
exceptions, that a Business Plan be filed with the Costa Mesa Fire
Depariment by every business which has at any one time during a reported
year a quantiry o( 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 ihe applicant or present or tuture building occupant need to file
a regislration form for acutely hazartlous materials? ❑ Yes ❑ No
(Section 25533 of the Califomia Health antl Safery Code, with some
exceptions, requires registration with Ihe Costa Mesa Fire DepanmeM 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 fee[ of compressetl gas at standard
temperaWre and pressure).
3. Does or will the applicant or present or future building occupam need to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the California Health antl Sa(ety Code provides that the
Costa Mesa Fire Department may require [he preparation, certification and
filing with the Fire Department of an RMPP by businesses which are required
to register acutely hazartlous materials with the Fire Department.
4. If an RMPP is presently required, has Section 25534 of the Cali(ornia
Health and Satery Code been tully complied with? ❑ Ves ❑ No
5. Does or win me applicant or present or fuWre building cecupant require for
lhe work which is the subject of this application a permit for such construction
or modification from the Soulh Coasl Air Quality Management DisMct or (rom
any other air pollulion conlrol Oistrict or agency? ❑ Yes ❑ No
(Section 658502 of the Califomia Govemment Cotle requires that the requested
infortnation be (umished on applications for nornresidential building permits).
6. Will any part of Ihe facility to be constructetl under Ihis permit be vnthin
1000 feet from �he outer boundaries of a school? � Yes ❑ No
Qf'yes", the (acility must meel lhe requirement o( Sections 25534 antl 42303
of Ihe Calilornia Healih antl Sa/ery Cotle).
7. I( a permit lrom the South Coast Air Quality Management District or other
air pollution control disMct or agency is required tor the work which is the
subject of this application, have all o� the disclosures prescnbed by Califomia
Health and Safely Code Section 42303 been matle? ❑ Yes ❑ No
8. Qf 'yes", attach certificate ot compliance from the appropriate air pollution
control oKcer).
CERTIFICATE OF COMPLIANCE: I certify that untler penalty of perjury Ihe
information given above is correct. I aqree to comply with all state lavrs and
city ordinances regarding Hazardous Materials and Emissions.
SignaWre �ate
CERTIFICATE OF COMPLIANCE AND AUTMORIZATION OF ENTRY: I
certify under penalry of perjury that I have reatl this application and state that
the information given is correcL I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
the City of Cpsta Mesa to enter upon the above-described property tor
inspection pur,poses. I agree not to occupy or allow occupancy of any building
authonzed b khis permit un' final inspection.
�a-,3_,0
(Jl��'01���OB�.QWf1¢f�6��� r=,%.
Analor Aumonrea Apphont
, j-=-'� --�
.�. _�1
Costa Mesa
City of Costa .9l�lesa �ui�ding �ivision
77 Fair Drive, Costa Mesa, CA 92626
714-754-5273/Fax 714-754-4856
OWNER BUILDER VERIFICATION
�• - :_ � i � ,�
Disclosures 8 Forms for Owner- Builders Applying for Construction Permits
IMPORTANT! NOTICE TO PROPERTY OWNER
Dear Property Owner:
An application for a building permit has been sub iSt in yQur ame listin,Q�y�ourse�lf as the builder of the
property improvements specifed at I�0� ( Ci� v<-� (/U1.C��/
We are providing you with an Owner-Builder Acknowledgment and In rmation Verification Form to make you
aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the
Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of
each provision, signed, and returned this form to us at our official address indicated. An agent of the
owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permiiting
authority.
OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION
DIRECTIONS: Read and initial each statement below to signify you understand or verify this information.
�1_,I-understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-
Builder" building permit that erroneously implies that the property owner is providing his or her own labor and
material personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any
injuries sustained by an unlicensed person and his or her employees while working on my property. My
homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder
and am aware of the limits of my insurance coverage for injuries to workers on my property.
xo✓1. I understand building permits are not required to be signed by property owners unless they are
responsible tor ihe construction and are not hiring a licensed Contractor to assume this responsibility.
�3. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that
I may,protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his
or her name instead of my own.
Gll�/4. I understand Contractors are required by law to be licensed and bonded in California and to list their
license�numbers on permits and contracts.
Cy 5. I understand if i employ or otherv,�ise engage any persons, other than California ficensed Contractors,
and:the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may
be considered an "employer" under state and federal law.
�6. I understand if I am considered an "employer" under state and federal law, I must register with the state
and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and
contribute to unemployment compensation for each "employee." I also understand my failure to abide by these
laws may subject me to serious financial risk.
�"�- 7--I.understand under California Contractors' State License Law, an Owner-Builder who builds single-family
residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed
by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of
the work is performed under contract with a licensed general building Contractor.
3148-30 CALBO Jan 1, 2009 OB Packet template 1 of 2
�i�-8 I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable
for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent
construction defects in the workmanship or materials.
�9•,I understand I may obtain more information regarding my obligations as an "employer" from the Internal
Revenue Service, the United States Small Business Administration, the California Department of Benefit
Payments, and the California Division of Industrial Accidents. I also understand I may contact the California
Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information
about licensed contractors.
"I_�10.7am aware of and consent to an Owner-Builder building permit applied for in my name, and understand
that�l am the party legally and financially responsible for proposed construction activity at the following address:
"U�1-1�'I agree that, as the party legally and financially responsible for this proposed construction activity, I will
abide by all applicable laws and requirements that govern Owner-Builders as well as employers.
��12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the
information I have provided on this form. Licensed contractors are regulated by laws designed to protect the
public. If you contract with someone who does not have a license, the Contractors' State License Board may be
unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against
unlicensed Contractors may be in civil court. It is also impoRant for you to understand that if an unlicensed
Contractor or employee of that individual or firm is injured while working on your property, you may be held
liable for damages. If you obtain a permit as Owner-Builder and wish to hire Contractors, you will be responsible
for verifying whether or not those Contractors are properly licensed and the status of their workers'
compensation insurance coverage.
Before a building permit can be issued, this form must be completed and signed by the property owner
and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's
driver's license, form notarization, or other verification acceptable to the agency is required to be
presented when the permit is is,sued to verify the property owner's signature.
Sic,�natu`re.-of:property owner
i�-•/3-ip
Note: The following Authorization Form is required to be completed by the property owner only when
designating an agent of the property owner to apply for a construction permit for the Owner-Builder.
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I
hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents
necessary to obtain an Owner-Builder Permit for my project.
Scope of Construction Project (or Description of Work):
Project Location or Address:
Name of Authorized Agent:
Address of Authorized Agent:
Tel No
I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled
out the above information and ceRify its accuracy. Note: A copy of the owner's driver's license, form
notarization, or other verification acceptable to the agency is required to be presented when the permit is issued
to verify the property owner's signature.
Property Owner's Signature:
Date:
3148-30 CALBO Jan 1, 2009 OB Packet template 2 Of 2
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^O:OfOEuree�i•ennelenle�
Y
e
Cament Coping Optlon6l
Chonnel block wllh one 5I8
Hodzonlal lop of all Fences
Fa fences B' hlgh �
Ved, Bors 5/B' 0 at 16' O.C,
All Cetls Solid Groouled
Relnloicing Sleel SMII
Contoim lo Sec. A�15•39 A.S.1.M.
All Steel to bo Lappod
2A• or lo Code
�)loriz Ilars 5/8 qi al 32" O.C.
NATUR�L GR�bE
�
iwo 5/8' � Bais '
Continuous iop —►I
ond Bottom
Hotlt. SIe01 must be Iled In place
at time ol hench Inspecflon
TYPICAL 8" CONCRETE BLOCK FENCE
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0
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Widlh
see cnart
Below
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FOOTING REQUIREMENTS CHART
Wotl I fefghl . . . . . . . . . . . . . . . b' i0 8'
YNdllt ......................16'
fhlckness . . . . . . . . . . . . . . . . . . . 12'
Deplh O� Eailhlooth . . . . . . . . . . . 36'
Spacing ol F.adh�oolh. . . . . . '. . . . . 8'
Dlomelei of Eodhloolh. . . . . . . . . 1 T .
BUILDING DIVISION
GENERAL - NOTES
Mortai: One Port PlasMc Coment,
and Rvee PaAs Sand
Giou1: . One PoA Cemenl. Tivee
and Ono Hall PaAs Sorx1
Copinp: One Part CemenL and
mrea Parls Sanc1
Conciefo: WeA Mixed 12 - 1/2:3�1/2
Max ol 7-112 Ganons al �
Wafer Per Sack ol Cemenl
G�out moy be poured from the
1op ol lhe lence.
Cells and orc�s o1 halzontal
ielntoicemenl shaA be clern,
cleon ond hee o( aIl modar
debdq ela
NOTE
woll In excess ol 6 leet In helght
iequlre dlscietlanary revlew antl
oppiovol proCess thrOVgh ihe
Plonning DMslon and ae nol
oulomalkallY aPP�oved. Dlease
constnl N1th me PlorvW�g DMslon.
vos.e
(