The URL can be used to link to this page

Home My WebLink About1027 CONCORD ST - Building Permits�r,Tp MF �l 4 O i• _ u (714) 754-5273 • Fax (714) 754-4856 CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT PLUMBING PERMIT .lob Address: 1027 CONCORD ST Suite No Vicinity: Parcel Nunmber: 14165220 Applicant: NOCK,RON Address: 11612 KNOTT ST Phone: 714 895-1246 GARDEN GROVE, CA Zip: 92841 Owner: SRAVROS,JEANNE Address 1027 CONCORD ST Phone: COSTA MESA,CA Zip: 92626 Contractor: NOCK PLUMBING Address: 11612 KNOTT ST Arch/Eng: Address: Phone: 714 895-1246 GARDEN GROVE, CA Zip: 92841 License: 707775 DISH WASHER. Phone: Zip: License: SCOPE OF PERMIT PERPER T�� P98-00896 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 12/16/1998 Issued: 12/16/1998 QTY AMT FEE SUMMARY 0 AMT QTY 0 AMT ISSUE FEE $22.00 0 Laundry Tub / Washer $0.00 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 Backflow Preventer $0.00 0 P -Trap $0.00 Bathtub $0.00 0 Pressure Regulator $0.00 Clarifier System $0.00 0 Process Piping (per 10 N) $0.00 Connect (Ice,Soda,etc) $0.00 0 Receptors $0.00 Dental Units $0.00 0 Septic Tank $0.00 Dishwasher $8.75 1 Sewer Cap for Demo $0.00 Drain, Floor $0.00 0 Sewer Connect $0.00 Drain, Rainwater $0.00 0 Sewer Private Line $0.00 Drain, Roof $0.00 0 Shower $0.00 Drinking Fountain $0.00 0 Sink, bar $0.00 Expansion Tank $0.00 0 Sink, commercial $0.00 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 Gas (1-4 outlets) $0.00 0 Sink, kitchen $0.00 Gas (Over 4 outlets) $0.00 0 Sink, service/mop $0.00 Gas Repipe $0.00 0 Spa (private) $0.00 Gas Service $0.00 0 Spa (public) $0.00 PERPER T�� P98-00896 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 12/16/1998 Issued: 12/16/1998 QTY AMT QTY 0 Sump Pump $0.00 0 0 Swimming Pool $0.00 0 0 Trap Primer $0.00 0 0 Urinal $0.00 0 0 Vacuum Brkr Bkflow(1-4) $0.00 0 0 Vacuum Brkr Bkflow(5+) $0.00 0 0 Wash Basin $0.00 0 0 Wash Basin Set $0.00 0 0 Waste and Vent System $0.00 0 0 Water Closet (Toilet) $0.00 0 0 Water Heater/ vent $0.00 0 0 Water Piping (Inst or Rep.) $0.00 0 0 Water Re -pipe $0.00 0 0 Water Service $0.00 0 0 Water Softener $0.00 0 0 OTHER $0.00 0 VIOLATION $0.00 0 PLAN CHECK $0.00 EXPIRATION: 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 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 obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the Fork for which This permit is issued. have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compens�ationnlnsuran a Carrier e d policy number ' 1 1 , ` r� n t� Carder: . �L–/,/� Policy Number: NGvC-T / / 3 T' l�d Z (This section need not be completed if the permit is valued at one hundred dollars ($100) or less.) ❑ 1 certify that In the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these provisions. �-}� Applicant Signature: I �,� Y--�� Date: / Z WARNING: FAILURE TO SECURE WORKER COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBIEGT AA'EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($101,000), IN ADDITION TO THE COST OF OOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chap{er9 (commencing with Section 7000) of Division 3 of the Business a%Prgtyss'uns Code, and my license is in full force and effect. Uc. M —] ) % % 1 Class x E 7 Contractor's Signature: Date: CONSTRUCTION LENDING LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Coda) 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 of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not 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 thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not Intended or offered 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 build or improve for purpose of sale.). ❑ 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend will be made in connection with work authorized by this permit, and that no building structure, scaffolding, talsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: 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 cartily a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ONO (Section 25505 of the Celifomia Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of 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 the applicant or present or future building occupant need to file a registration forth for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department 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 2DO cubic feet of compressed gas at standard temperature and pressure). .................................................................................................................................................................................................................................................................................... 3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ................................................................................................................................................................................................................................................................................. 4 II en RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully compiled with? ❑ Yes ❑ No .................................................................................................................................................................................................................................................................................... 5 Does ar will the applicant or present or future building occupant require for the work which is the subject of this a plication aemit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 8 No (Section 65850.2 of the Celifomia Government Code requires that the requested information be furnished on applications for non-residential building penults). ................................................................................................................................................................................................................................................................................. 6 will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (It yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). .................................................................................................................................................................................................................................................................................. 7 If a Permit from the South Coast Air Ouality Management District or other air pollution control district or agency Is required for the work which Is the subject of this application, have all of the disclosures prescribed by California Health and Safety Cade Section 42303 been made? ❑ Yes ❑ No .............................................................................................................................................................................................................................................................................. e (11 yes", attach cartificate of compliance from the appropriate air Pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: _ Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and slate that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. 1 agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. rj natur^ Of Legal Owners) / Date / Anc r Authorized Applicant �— Date' 6y QQU-L INSPECTIONTYPE DATE RiMAL5 CODE I INSPECTION TYPE GATE INTIMALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site _ 204 Final Demolition 250 Final Building/Occupancy 244646 OWNER KEITH G. BARKER DATE 10-2-75 ,JOB ADDRESS 1027 Concord St. BUILDING PERMIT NO. 40641 141 -652 - INSPECTIONS Signature Date TYPE V GROUP J ZONE R1 JOIL SUBCONTRACTOR PERMITS ISS ED GAS Date Number Si nature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND POWER ❑ ROUGH WIRING Heating and Vent. TRENCHES ❑ FORMS ❑ STEEL REINF. FLOOR SYSTEM BOND BEAM STEEL REINFORCE SHEATHING FRAME AND FLASHING LATHING — IN OUT PLASTER, BROWN COAT STRUCTURAL, FINAL trig;_ HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST ELECTRIC, FINAL BUILDING. FINAL O1 - �i- '1 4n641 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA, CALIFORNIA 92626 F r Applicantgqtos�Fill in Completely — Use Ink Only BUILDRESS IC:.rl ! LO Q`: CO �� C'T C,.F( E ER � RESS CO CITY CASTpk HES q NO. , CONSTRUCTION LENDER BRANCH ADDRESS ARCHITECT TEL. OR ENGINEER ADDRESS CONTRACTOR ADDRESS se �A CITY STATE LIC. NO. TEL. NO. CITY LIC. NO. BLDGS. V LOT USE OF EXISTING BLDG. PR%VATF RESl�E1,ICE Separate permits are required for electric, plumbing and heating work, USE OF BUILDING AND WORK TO BE PERFORMED 2 I hereby acknowledge that I have read this application and state that the above Information Is correct and agree to comply with all laws regulating building construction, and I shall not employ ony person in violation of the workman's compensation laws of PAIL OCT-2-75cM.00 AP¢LIgATI/ON FOR STRUCTURAL PERMIT OWNER r /%1 %' r,. 13A 2.CL�sL/ S L c4qu �� 110 VALUE y / FIRE DATE RECEIVED DATE ISSUED o - 2-7� ffADDRESS �7 PERMIT NO. APPROVE 7 T�C1 LOT�� BLOCK W AREPAIR NO.OF PLANS USE OF NE 'B BUILDING YARDS APPROVED YARDS APPROVED MAIN BUILDING OWNER r /%1 %' r,. 13A 2.CL�sL/ S L c4qu �� 110 VALUE y / FIRE ZONE TYPE :fLGROUP APPROVE 7 BY �r%� DATE r (_21F • II N ZO NO.OF PLANS USE OF NE 'B BUILDING YARDS APPROVED YARDS APPROVED MAIN BUILDING ACCESSORY BUILDING (FROM C/LST T) FRONT FT. FT. SIDE 3 5� F T. L. SIDE ' FT. FT. DISTANCE BET, BET. MAIN BLDGS. ACCEI VAR.+ DATE the State of California. I hereby certify that I am properly licensed as a contractor underrVALUATION O. FT. the State of California Business and Professions Code, Division 3,NT SHOWN UNDE VALU. Chapter 9, and that such licenses are In full force and affect, or IE OF ESTAB S IN ERn am exempt from the provisions of the State of California Businessand Professions CodeDI ision 3, Chapter 9. Signature o S`r / FLAN CHECK E permittee I///i��/ TAX $ Authorized Authorized Agent I TOTAL PAID sE I FT. F;. n m i 0 m N IS FOR m ONLY: m t.— a J� m m 0 U V. �ss�s COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 817 COSTA MESA, CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT COSTA MESA. CALIFORNIA I 1 MAIL ADDRESS 9/i S �. /"'/ N `—V X/ FEE RECEIVED duNIe, iS APPLICATIO i FOR PERMIT FINANii 460T. C1*r0?fUm1R59V1P:wy DESCRIPTION OF WORK ■ BUILDING SIZE EXTERIOR COVERING USE OF BU II HEREBY ACKNO AND STATE THAT PLT WITH ALL CI BUILDING CONSTF 0 AUTHORIZED AGENT VAR. * -7-Nd- 11-6y R\i- Z APPLICATION IEE TO COM. ZONING S REGULATING VALUATION i A� ZONE R_1 no. DP Pune .2 uG¢oP NEw Su1LO1Na RL'. AIIde ACTOR Construct I II 9 L - oeacnlrtlon Lot 4 Tract. 46o8 rADDRESS m A. P. NO. none TEL. T 90T TO SIDE 8 REAR p, E: NO EAVE LNG SHALL BE LESS THAN NEAVES (U. B. C. REQUIREMENT. ALLOWED / NO. OF SLOGS. C7 NOWONLOTYARDS APPROVED YARDS APPROVED G BLDG. MAIN BUILDING ACCESSORY BUILDING e ETBACK LINE FROM CENTER OF STREET � 7I REAR YARD J (FROM C/L STREET) FRONT S FT. FT. I � I � e minv C et yr DESCRIPTION OF WORK ■ BUILDING SIZE EXTERIOR COVERING USE OF BU II HEREBY ACKNO AND STATE THAT PLT WITH ALL CI BUILDING CONSTF 0 AUTHORIZED AGENT VAR. * -7-Nd- 11-6y R\i- 11—O 0 SQ. FT. Z�151 m APPLICATION IEE TO COM. THE AMOUNT SHOWN UNDERVALUATION PURPOSE OR BSTABLISHINO A PERMIT le FOR THE F FEE ONLY. O REGULATING VALUATION i A� PERMITFEEj m 0 PLAN CHECK S j9'.5-6 z _ . _ E