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Home My WebLink About2302 COLUMBIA DR - Building Permitsd , � CITY OF COSTA MESA � � BUILDING DIVISION 77 FqIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: BC09-00204 PERMIT TYPE: B COMBO STATUS: PC Sub Type: RES_ALT DATE ISSUED: 07/07/2009 ISSUED BY: RMD �06 A��ResS: 2302 COLUMBIA DR,CM ; Suite/Unit:. APN: a1s08507 � , - Zoning:.� �. , � � ,.' ' . Viciniry: REAR OP HOUSE Primary Occ: R3 Const Type: V-B - � SQ: FT: �484 � - . .Valuation: $44,721.60 SCOPE OF WORK; 484 SF 1-STORY SFD ADDITION. WORK TO INCLUDE ADDITION OF P, NEW DEN WITH 1 REPAIR/ALTER COOLING/HEAT, 13 LIGHT FIXTS, 11 OUTLETS, 6 SWITCHES, RELOCATE AND UPGRADE SVC TO 200 A. 3 BED/1.5 BATH TO REMAIN. - ��, - .. . � , OWNER: LAKO7A, WALTER -" �. � Address: - 2302 COLUMBIA DR �- - Unit: Phone: 949-646-5231 . " . . �- City/Stafe/Zip: -COSTA MESA-,-CA - - APPLICANT: HEAL�Y,PAUL � � Phone: 951-707-8769 - ' � CONTRAC70R: OW NER-BU I LDER Phone: Cell: ARCHITECT: . � .., ENGINEER: � Address: � � City/State/zZip: Address: Unit: - City/State:-- � License No. . License No. COMBINATION PERMIT FEE SUMMARY Building Plan Check: � . �.-- $385.94 Building Fees: ^ $59375 Electrical Fees: $87.00 Mechanical Fees: . � � .,$37.20 Plumbing Fees: $0.00 SMIP Residential: . - � $4.47 . SMIP Commercial: � . -- $0.00 Bldg Std Admin Fund $2.00 TOTAL FEES: $1,110.36 - ' "Re(er to (ee receipts fqr all fees paid for project �� - Unit: License No. 000000 ZipCode PHONE: PHONE: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In ortler for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval musl be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permit. COOEF. INSPECiIONTYPE OATE IN7ITIRLS LOOEC INSPEG110NTYPE �� DA INnTWI$ � 1 /'_. 1616 Fixed System Finel Fire Prevention 206 Final Mechanical �J �W�l 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roo( p10 Final Eleclncal � � 201 Final Block/Retaiqing Wall 212 Final Fire Prevention 202 Final FaCtory Fire place 220 Final Planning Approval 203 Final Sign 222 Final Site ��l. 204 Final Demolition ' 250 Final Building/Occupancy WORKERS' COMPENSATION DECLARATION: I hereby aKrm untler penal�y of perjury one of Ihe following declarations: . ❑ I have and will maintain a certifcate of consent to selt-Insure for vrorkers' compensation, as provided for by section 3700 0( the Labor Code, for the pertormance of Ihe vrork for which Ihis permit is issued. ❑ I have and will mainlain workers' compensation insurance, as required by sec[ion 3700 of �he Labor Code, (or Ihe pertormance o( ihe vrork for which this permi[ is issued. My workers' compensation Insurance carrier and policy number are: Carriec (This section needlwt be comdelM d(he pe�mn is valoed a1 one hundre0 [bllars (St00) a IessJ Policy Number: ��, I�•certify that in the peAormance of the vrork for which this permi[ is issued, I shall not employ any person in any manner so as to become subjecl to the workers' compensation laws of Califomia, and agree that if I should become subjec[ to [he vrorkers' compensation provisions of Section 3700 0( the Lab e, I shall fy hwith comply with these provisions. / n_ y�� / '/ sSignaWre Dale , WARNING: ILURE TO SECURE WORKERS' COMPENSATION COVER4GE IS UNLAWFUL AND SHALI SUBJECT AN EMPLOYER TO CRIMINA� 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, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm Ihat I am licensed under pmvisions of Chapter 9(commencing wi�h Sec�ion 7000) o( Division 3 of [he Business and Professions Code, and my license is in full force and effect. Lic. # Class # Convacmr's Signawre Da�e CONSTRUCTION LENUING AGENCY: ❑ I hereby affrm that Ihere is a construction lending agency for [he pedormance of the wurk fOr wfiich this pertnit is issued. (Sec. 3097, Civil Code). Lender's Name: Lentler's Adtlress: SgnaWre OWNER-BUILDER DECLARATIONS: I hereby affrm that under penalty Of perjury Ihat I am EXEMPT FROM TME CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to conslruct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires Ihe applicant for such permit to fle a signed statement that he or she is licensed pursuant to �he provisions of the Contractors License Law (Chapter 9(commencing vrith 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 o( not more than five hundred dollars ($500).): � I, as �owner of the property, or my employees with wages as their sole compensalion, WILL DO THE WORK, and the structure is not intended or oKered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an ovmer of property who builds or improves ihereon, and who does such vrork himself or hersel( or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, ihe builtling or improvement is sold within one year of completion, the owner-builder will have the burden of pmving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WI7H LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business antl Professions Code: The contractors License Law dces nol apply to an owner o� propeAy who builds oi improves thereon, and who contracts for such project with a cont2ctor(s) license pursuant to the Cont2ctors License Lavrs.). Owner ID verifed by driver's license. es ❑ No , Driver'sLicenseNo. Expires:.�3 Verifcation of Ownership by (type of document, i.e. - property lax bill or deed): DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: ❑ I hereby certify [hat no excavation fve (5) or more (eet in depih into wfiich a person is requiretl to descentl, will be made in connec[ion with vrork authonzed by ihis permit, and Iha[ no building strucWre, scaffdding, falsework, or demolition or dismantling thereof, will be more Ihan Ihirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle 8, Cali(omia Atlministrative Code). ❑ As owner-builder, I will no[ employ anyone to do work which would require a permit fmm the Division ot Industrial Safety, as noted above, unless such person has a permit �o do such work from Ihe division. /+OOliwnfs Signawre Date Division of Industrial Safety Permit Number HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will Ihe applicant or present or future building occupant need to fle and certify a Business Plan for emergency response to release or threatened release ot a hazardous malerial? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Cotle requires, with some exceptions, thal a Business Plan be fled with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantiry of hazardous materials equal to or greater ihan a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic (ee[ of compressed gas at standard temperature and pressure). 2. Does or will the applicant or presen[ or future building occupant need to fle a regis[ra[ion (orm for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the Califomia Health and Safety Code, wilh some exceptions, requires registration wi[h the Costa Mesa Fire Department by each business which at any one time has on hand a quantiry of acutely hazardous materials equal m or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressetl gas at standard temperalure antl pressure). 3. Does or will the applicant or present or WWre building occupant need to prepare an RMPP (Risk Management antl Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 0( ihe California Health and Safely Code provitles that the Costa Mesa Fire Department may require the preparation, certification and fling 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 0( the California Health and Safely Code been fully complietl with? ❑ Yes ❑ No 5. Does or will the applicanl or present or fuwre Duilding occupant require for ihe work which is the subject of Ihis application a permit for such constmction or modifcation from the South Coast Air Quality ManagemeN District or from any other air polWtion control district or agency? ❑ Yes ❑ No (Section 658502 of the California Govemment Code requires that the requestetl information be fumished on applications for non-residenlial building pertnits). 6. Will any part of the faciliry lo be constructed under this permit be within 1000 (eet from the outer boundaries of a school? ❑ Yes ❑ No Qf'yes", the facility must meet the requirement of Sections 25534 antl 42303 of [he Cali(omia Health and Safery Cotle). 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 Ihis application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. Qf'yes", attach certifcate of compliance from the appropriate air polWtion control offcer): CERTIFICATE OF COMPLIANCE: I certify that under penalry o! perjury the information given above is wrrect. I agree to comply with all state laws and city ordinances regarding Hazardous Materials antl Emissions. Signature �ate CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. lhe information given is correcL I agree to comply with all state laws and city ordinances relating ro building construction, and authorize representatives of Business and Professions Code for [his reason: ihe Ciry of Costa Mesa ro enter upon ihe above-described property for mspechon purposes. I agree not to occupy or allow occupancy of any building authorized by lhis permit until fnal inspection. �� ( Date , ienaWre . � Dale -✓ /J Q� <6(3/ � ' . � �-�/ plw onzetl Ap0licanl " Dal¢ . �-:- ,� --�---_�-�-� �osta Mesa �'ity of Costa �YLesa Building �1�ivision 77 Fair Drive, Costa Mesa, CA 92626 714-754-5273/Fax 714-754-4856 OWNER BUILDER VERIFICATION Permit # Disclosures & Forms for Owner- Builders Apptying for Construction Permifs IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the propertyimprovementsspecifiedat �30� CO�-uNnL��iA D2 Cos:AY�nb"SK1 9a(,a� We are providing you with an Owner-Buitder Acknowledgment and Information 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 �ead, initialed your understanding of each provision, signed, and retumed this form to us at our offcial address indicated. An agent of the owner cannot execute ihis notice unless you, the property owner, obtain the prior approval of the permitting authority_ 4WNER'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 f�equent practice of unlicensed persons is to have the property owner obtain an "Owner- ui e�' building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner-Buiider, 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. \ J,�12. I understand building permits are not required to be signed by property owners unless they are `Fes}sbnsible for the 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. . . \G •. I understand Cont�actors are required by law to be licensed and bonded in California antl to list their iic e numbers on permits and contracts. , a�I understand if I employ or othervvise engage any persons, other than Califorrtia licensed Contractors, e total vaiue of my consVuction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employe�' under state and federal law. �� 6. I understand if 1 am considered an "empioye�' under state and federal law, I must register with the state an federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "empioyee." I also understand my failure to abide by these la may subject me to serious financial risk. 7. I understand under Califomia Contractors' State License Law, an Owner-Builder who builds singie-family i ential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by I ensed subcontractors and the number of structures does not exceed four within any calendar year, or ali of the ork is pertormed under contract with a licensed general building Contractor. 3148-30 CALBO Jan t, 2009 OB Packet template 9 Of 2 �I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable �or a financial or personal injuries sustained by any subsequent owner(s) that result from any latent con uction defects in the workmanship or materials. � � 9. I understand I may obtain more information regarding my obligations as an "employer' from the Internal Re nue Service, the United States Small Business Administration, the Califomia Department of Benefit Payments;'and the California Division of Industrial Accidents. I.also understand I may contact the California Contractors' State License Board (CSLB) aY1-800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractor5, �. 10. I am aware of and consent to an Owner-Builder bui�ding permit applied for in my name, and understa�d t I am the party legally and financially responsible for proposed construction activity at the following address: I agree that, as the party legally and financially responsible for this proposed construction activity, I will all applicable laws and requirements that govern Owner-Builders as well as employers. �. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the i orm tion I have provided on this form. Licensed contractors are regulated by.laws designed to protect the p lic 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 important 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 Contrectors are properly licensed, and the status of their workers' compensation insurance coverage. Before a building pertnit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing th pertnit. Note: A copy of the. properry owner's driver's license, form hotarizatio or other erific ' accep ble to e agency is required to be presented when the permit is iss ed ve pro owne s i e. Signature of property owner. ,`. -. . �. Date: � �� "'�%9 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. �/ c� Scope of Construction Project (or DescriPtion of Work): Y B 7 S Z? FT R f�l �4001T1vN ProjectLocationorAddress: �0�. CI�IUM[3lA OR- C?.M. �9.(o�.Co NameofAuthorizedAgeqt: �RU �- H�I�tlbi TeINo `�SI-7�7'E��9 AddressofAuthorizedAgent' ! BBSo �� RU� (1W�c1LSiOG— QaISO�/ � � I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled . out the above informa6on and certify its accuracy. Note: A copy of he owners driver's license, form notarization, br other ve�cation acceptable to the is requi to be presented when the permit is issued to verify the property owner's sig Property Owner's Signature: :. Date: � r �� 3148-30 CALBO Jan 1, 20Q9 OB Packet templ;N� � . . 2 Of 2 OWNER KENDON HO�t�S INC. JOB ADDRESS p302 Colwnbia GENERAL CONTRACTOR K, W. GROUP I P; J. INSPECTIONS Final Gas Test TYPE FIRE ZONE ZONE DATE DATE 'j_l�_�8_ B[IILDING PERR3IT NO. VALUE $ 12�790.00 DESCRIPTION OF WORK S1Il Fam, � Res. & A $UBCONTRACTOR PERMITSI$$UED � n � „� _ _, .. '7��0 COSTA MESA BUILDING DEPARTMENT P. O. BOX 31] . COSTA MESA. CALIFORNIA FOR APPLICANT TO FILL IN BUILDING _ _ . - _ _ _ OWNER MAIL ADORE55 cirv II_\�] I:T�F� COSTA MESA. CALIFORNIA TEL. suoort Beach, Cal �o. S 47 Koll Const Co �,'a; noopess Go� LEGAL LOT �ESCRIPTION NO. A.P. NO. �'ZE 63.6; OF LOT USE OF EXISTING BLOG. SET6ACN LINE FeOM CENTER OF STREET i ITY LIC. �y Y O NO. p' Blvd• TNO.OR NO.OF B�DGS NOW ON LOT �n8 ftEAR YARD DESCRIPTION OF WORK NEW x ALTERATION ADOITION REPAIft qMI�OVING DEMOLISH BUILDING l�µ�. SF NO.OF SIZE ROOMS STORIES EXTERIOR WALL ROOF f.[lvcainin 3'f.11CC0 ' COVERING r ock � tE ��.C�.iV �y ` FINANCE DEPT. CIiY 0� COST.A P�IESA APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY s 6LlILfJING ADORE55 COSTA MESA. CALIFORNIA FIRE � ZONE ZONE NO.OF TYpE / PLRN$ ^ . 7 A�PPROVED ��Y �` �ATE � / CORRECTIONS � � �� — I NEPEBY ACKNOWLEOGE TMRT I HRVE RERD TMIS APPLICATION FND �f STPTE TH4T THE PBOVE IS CORREQ ANO TGREE TO COMPLV WITH ALL ✓/ CITY OROINFNCES ANO STATE LAWS REGUIRTING BUILDING CONSTRVC� � norv. VALUATION SIGNATURE OF KB��=] Homes Iric. PE MIT FEE $ 3Q �' PERMITTEE � 1 AUTHORIZED $ /� � ^� PLAN CHECK $ �� / � TOTAL FEE $ {C.(Y �eMi �;