HomeMy WebLinkAbout175 CABRILLO ST - Building Permitsf - e
CITY OF COSTA MESA 1
BUILDING DIVISION
iA 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754.4856 • www.ci.costa-mesa.ca. s
r
�. FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER. B07-00982
PERMIT TYPE B_ROOF2 STATUS: ISSUED
DATE ISSUED: 10/17/2007
ISSUED BY: RMD
JOB ADDRESS: 175 CABRILLO ST CM Suite/Unit: .
Vicinity: HOUSE AND GARAGE
Squares: 1800 Valuation: $5,330.00
SCOPE OF WORK: REROOF OF COMMERCIALBLDG "SCHAEFER AMBULANCE". TEAR OFF (E) ROOF MATERIALS, INSTALL 1 LAYER
OF 30# FELT ON 5:12 PITCHED ROOF AND REROOF W 30 YEAR GAF COMP SHINGLES ON A DETACHED HOUSE
AND GARAGE, APPROX 1800 SF. REPAIR AND REPLACE SHEATHING AS NEEDED. REROOF OF HOUSE AND
GARAGE TO BE DONE CONCURRENTLY.
OWNER: SCHAEFER AMBULANCE
ANGELES, CA
PHONE:
APPLICANT: ALLEN, MIKE
PHONE: 714-731-3911
CONTRACTOR: ABOVE [TALL ROOFING
Address: 3943 IRVINE BLVDUnit:
City/State/Zip: IRVINE, CA 9260:
ARCHITECT
ENGINEER:
FEE SUMMARY
Reroof Plan Check:
$0.00
Reroof Permit Fee:
$125.25
Reinspection Fee:
$0.00
TOTAL FEES
$125.25
Address: SERVICE INC
City/State/Zip: P O BOX 74697
Address: 3943 IRVINE BLVD
Cdy/State/Zip: IRVINE, CA
License No. 765842
UNIT 297 - PHONE: 949-673-9222
CELL:
License No. PHONE:
License No. PHONE:
Unit: LOS
Unit: :UNIT 297
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California 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 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.
CODE I. INSPECTION TYPE DATE INTMALS CODE I INSPECTION TYPE DATE INTRIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final �J 208 Final Plumbing
200 Final Re -Roof OILY IL 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
S �
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 sell -Insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued. .
❑ I 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' compensation Insurance carrier and policy
number are: � �_ `
Carder: QL(C. ('/T�I '�>
(This sedbn nSed rare& ro(;mpeted d the perm<e waived of we hundred W9ats (S 100) a less )
Policy.Numbei: ) l —(
❑ 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 rkers' compensation provisionsofSection 3700 of
the Labor CodI 1t with comply with (hese provsi
�Appi nt's Stgmdture �_ Date
-
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 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 affirm that I am licensed under provisions of Chapter 9 (commencing
with Section 7000) of Division 3 of the Business and Professions Code, and
my license is iL7, full f pe rid effect.
lass
#7
C mre Sigruture Date _
CONSTRUCTION LENDING AGENCY:
❑ I 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).
Lender's Name:
Lender's Address:
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 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 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.).
❑ I, 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.).
❑ lam exempt under sec.
Business and Professions Code for this reason:
Owner ID verified by drive. - e. ❑ Yes []No
Driver's 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, falsework, or demolition
or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp
2, An 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.
Apphwnl's Signature
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 material? ❑ Yes ❑ No
(Section 25505 of the California 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 200 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 California 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. If an RMPP is presently required, has Section 25534 of the California
Health and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or future building occupant require for
the work which is the subject of this application a permit for such construction
or modification from the South Coast Air Quality Management District or from
any other air pollution control district or agency? ❑ Yes ❑ No
(Section 65850.2 of the California Government Code requires that the requested
information be furnished on applications for ran -residential building permits).
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
(If "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 Quality 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 Code Section 42303 been made? ❑ Yes ❑ No
8. (If "yes". attach certificate 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 stale 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. I agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection.
Sjgna( re f gal Ovmegs) t
Signature Date 1J1V/_ "
305746 (9W )
Md/gr AuthbefteltAppl¢ent (_ _'Dal.,—
ADDREss ap 9uLaNc: 175 CABRIjLLO
MEWS NAME IF IO1OAIN: SCHAEFER AMBUL,
ADosEss:SERVICE INC
P 0 BOX 74697
LOS ANGELES,CA
ApL. YNUNG AOD11Ess:
A11CHITECT OR ENGINEER:
ARCH. OR ENQ'S ADDRESS:
UNIT:
90004
uc. NO.:
UNIT:
COMACTOR'SWE:COVER RIGHT ROOFING (714)832-0113
CONUUCTOASMAIUNO14262 ALLMAN PL
ADDRESS, S.A. CA mw: 615852
92705 UNIT:
LICENSED CONTRACTORS DECLARATION: I hereby affirm under penalty d Fernery that I am licammol uMer Wovioiu d Chapter 9
loommemiep with Section ]OWI of Divbon 3 of the Bmioesa end PMmseaa Code. aed my license is in lull knee and effect.
CITY LIC.NO.O 0868 uc.CLASS: C-39 LIC. NO.;615852 EXP: 03/96
cl, AI e Caarador:
R BUILDER DECLARATION: 1 hereby Affirm ueMer Penalty d perjury I I mempl from the Conump. License law for the
'Jbxiq ranm ISedion ]W 1.5 Busvnsa sed PMaariroa Cada: AM ckY won At nguim a prof to aomhuN, Mer, imPrwe.
onofish. or repair any sVudae. pro, tp at issuance, ebo re armee the ceen 1 such pmts to fls s sgwd ewerwm tlW he a ahs
. Iiouroed p .1 1p the gwisi. a the COared. license Lew (C (canmmo, wile Sgion ]000) d Dison 3 a the
Beevoem end Prdasaons Cade) a that he a aM b uemq therehan a besb for Na AfleOed mamgion. Any vidatkm d Sedon
7W1.5 by any applicant for a peril mbpda the apdecant to a civil penalty of no, more Ihan five hundred Eollers tSSOOf).
❑ I, m owner of the Properly or my wpkwaea weir wagm m thek sole compensaton, enl Bathe work, ami the sidm is not inteMed
m offered for sale (Section ]011. BUAfrwsa end Professions Code: The Correctors License Lew does not apply to an it oe dpoppy
who Wida or knprwm themon, Aral who does such work Nmsaff or hena5 or Woregh hat or her ow emplo mea, provided lhar van
impeovem wee are red Wended or offered for cab. K. hmetner, the Wilding or knpmwnem is sotl within one year d completion, the
o.._kxnlder wig love the Wrden of p ww he or she did not build or impro a fur the purpwe d sale).
❑ I. as owoer d the praprty, am mdemvMy mmradkp wiIh licersed ronh to ronsueed the project (Semon ]011, B ninmProf.ira s an
PrCode: The Commolon License Law Law does nal appb ilde pwm y an owner of Properly who Wor imlemon areal who
contracts for rude pmiecs with a marrsor(e) licensed pnmnt to the Coraredon Liwrna Law).
❑ I rn mempi uMar Sacton: B. d P.C., ler Ub melon:
Date: Owner:
I do hereby cant, that I am aware of anal ordrenrd the eaRukemems of CaGgnua fieeffh and Safety Code Sections Y55O5. Y55QT, end
p5531. end that I or any Mon bAMkq ocaepent will / wD not (circle me) need to campy with mid sate codes end the repanmerm for
a permit for mnsufxucn or moddrelion horn the At 0 yeeF1%enegemme Direnq. RmidW®I mrutrWion appkatiorm en ammq from these
prmiaip
Data: Apy1iani:
WORKER'S COMPENSATION DECLARATION: I hereby affirm order penally of perjury one of the Iolowmg deaWatons:
❑ I hew and W mainnn o of fun d consent h Wier per it Ia wanken mmpawatim, m Provided fa by 6ectbn 3]W d the labor
Code, for the pMomurca d Os work for wfich Nb oenrat b imuatl.
_ ❑ I nava and win maWan wrk.W mngrroap. irou.. ea npuired by Section 3700 d the labor Code. for the Pedormaews a the
XO work for which q pr is imued. My waken' canprumon inwrmw loner eM poW number era:
Carrier: STATE FT7MD EXPIRES
Policy Number: 01/01/97
(This motion need nor be panpetrl if tM permg he for one hundmd dollaw ISI W/ or Ice)
❑ I wally 1har in the pdomunrw d Ia work lar leme of Aril b i" I shell nal aI aho arty panni M any manner o m e'
become wbyed to the workers' n 37W of the laws C .AfI &I, sad ahem Uw 1 I ehouM chrome wbjsd to the woM1en'
caCnp/qn/��tfeon f+mv+/eJ��!^� d Section 3TW d the labor Cods. I I Imhwilh canon with Ueose prwisone.
)'.a : / / ! / ! L Applkm:
a
m/np: F.H. ro secure woAsn'romperuatlon roverepe 1=1= lcf an scop/oyar to cdm'nsl peruMu and
o10 Nem rpt N ons hlndM fhousanof ddb. ($1000W), M eWltloa pnsatlon damepm m prov/dod for In
Section 37M of fire Lebo, Cods, Interest, and AMMO, s fms.
CONSTRUCTION LENDING AGENCY: I hereby affirm under pneRy e condeudon being agency for the
part..
art. ce of the work for whits Hne pard he
bared (Section 3097, CN. C).
LENDER'S NAME:
LENDER'S ADORESS:
1 cenilY that I have reed Ihie mpoaron and pate Wait the abom Wormabon b caned. I egret to campy, with al any and manly ordlnmws
and state laws Meting to WIM'op cmatrWon anal hereby auUarae nprsmnMim of fhb city to enter upon the above-memoned pmpery
V impaction purposes.
MARK BILLINGS
Print Nemo
_ _ Date:
(5151i60P) Waa-Buildkp A Safely: Grmo-Fle:
Pink -Revenue: Golders d Aesmwr
------------ MAIN BUILDING
CITY OF
COSTA MESA - BUILDING PERMIT
ACCESSORY BUILDING---------
FRNT: FT IN REAR:
FT IN
FRNT:
PERM NO: H 07747.7
PERMIT NO: B
077417
PLAN CHECK NO: N
GOVT: N SUPP: N
CONSTRUCTION
TYPE: V -N
PERMIT TYPE: STR
PURPOSE: OTH
JOB DESCRIPTION T/OFF 3
LAYERS COMP. & REROOF W/COMP.
SQ FT: 2,397
CLAIM VALUE:
2,397.00
CALC-VALUE: 2,397.00
GROUP OCC: B /
COMMENTS: X.
>
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Z 0 N
I N G R E Q U I R E M E N T
S
C E S
R E Q
S E T B A C K S
ZONING APPROVED'BY
------------ MAIN BUILDING
----------
---------
ACCESSORY BUILDING---------
FRNT: FT IN REAR:
FT IN
FRNT:
FT
IN REAR: FT IN
LEFT: FT IN RGHT:
FT IN
LEFT:
FT
IN RGHT: FT IN
PARKING REQ: PROV:
PARCEL:
42541204
ZNE:
REF NO: -,
PLANNING NOTES>
>
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1E 1E lE iF iE iE 1E if iE 1E if iE iE if fE iE IE dE iE iE iEiF ib IF if if 1k fE SE IE
D E V E -L 0 P M E N
T S E R V I
C E S
R E Q
U I R E M E N T S
ZONING APPROVED'BY
DATE:
BUILDING APPROVED BY
I
DATE:
�C7
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APPLICATION ISSUED BY:
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LEGALIZATION:N
F E E S U
M M A R
Y
STRUCTURALAL SE MENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 74.75
SMIP/NON-RES
PLAN .50
ISSUE FEE
BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE
TOTALS ---- > 75.25 0.00 0.00 75.25 75.25 .00
REVENUE DIVISION TOTALS--> COLLECTED: 75.25 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK
74.75 .50
i6 TE irk ♦E * iF if * * * ♦E * di iE * iE i51E N: iF iH 1E iF dE iE iF iE iE dE iE dF 1E fF 1E dE dF dE 1f iE if )f * * RE if irk ii if * * iE )k ♦E * dE ♦E IE 9E IE 4 HE iE fF iF ♦E iF if 1E iE IE iE 1E * 1E fE dE IE 1E IE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFC 2397 REROOF BY VALUE COMMERCIAL NOZONE 1.00 2,397.00
END OF FEES
6
CONSTRUCTION AND PLANNING
APPROVALS Permit# Date
:1
Inspector
POL y SPA
APPROVALS Permit#
Date
Inspector
1. Temporary Electrical Service or Pole
52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd.
53. Steel Reinforcement
3. Electrical Conduit Utility•Undrgrnd.
54. Forms
4. Electrical Conduit-Undrgrnd.
55. Electrical Bonding
5. Steel Reinforcement
56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd.
57. APPROVAL TO COVER-GUNITE
7. Footings
58. Electrical Conduit-Undrgrnd.
8. Foundation
59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd.
60, Backwash Lines, P -Trap, V .Undrgrnd.
10. Structural Floor System
61. APPROVAL TO DECK
11. Property Sewer Line & House Connection
62. Backwash & Receptor -Final '
12. Sewer Cap
63. Heater & Vent -Final
13. Roof Drains
64. Plumbing System - Final
14. Rough Plumbing
65. Electrical -Final
15. Rough Electrical -Conduit
66. Solar System -Final
16, Rough Electric Wiring
67. Fencing & Access Approval
17. Rough Wiring Sign
68. APPROVED FOR PLASTERING
18. Rough Electrical -T Bar Ceiling
69, POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
20. Rough Factory Fireplace -
21. Ducts, in Structure
70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping ❑Gas ❑Oil
23. Gas Pipe -Rough & Test
72. Underground Flush
24. Roof Framing
73. Undergrnd. Storage Tank ❑Gas ❑Oil
25. Roof-Sheathing-qb
6a4l
74. Overhead Hydro
26. T -Bar Ceiling (Structural) & Monocoat
75. Dry Chemical
27. Frame and Flashing
76. Dry Standpipe
28. Lathing & Siding
77. FIXED SYSTEM FINAL
29. Insulation
78. FIRE PREY. FINAL
30. Drywall Nailing
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat
79. FINAL INSPECTION
32, Electrical Power Meter -Final
80. FOOD CERTIFICATE ISSUED
33. Final Electric
Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe -Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service -Final
40. Gas Service -Final
41. Solar Domestic -Final
42. Backflow Preventer
43, Backflow Irrigation
44. Landscape Irrigation System
-
45. Sound Attenuation
46, Handicap Regulations
47. FINAL STRUCTURE & BUILDING
N
48. FINAL PLANNING
49, Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date
CITY OF COSTA MESA
BUILDING DIVISION
ROOF COVERING CERTIFICATION
Permit No.
Property Address
' ) (� S En /+116
t�
Owner JC�'I��Ci�� MAUil6;ne_e,
Contractor VGA Qty (~+ POO ,'IC,
State Contractor License Number & K k <;Z. Classification G- 3�
I hereby certify that I have installed, or caused to be installed, a minimum Class C roof covering at the
above address in conformance with Chapter 32, and Section 1704 of the latest adopted edition of the Uniform Building
Code, as amended in Section 5-17 Title 5 Costa Mesa Municipal Code, and the installation instructions of the
manufacturer.
❑ I further certify that I am the owner of the property. (Owner -Builder permittee only).
�further certify that I am:
Owner of sole proprietorship company
❑ Full partner of the company
❑ Limited partner of the company
❑ Officer of the corporation
I certify that as an authorized officer or agent of the company or corporation, I am empowered to make
this certification, which shall be binding on all successors or assigns of the company or corporation.
I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building
Division for acceptance.
Received by Building Division
By: n /
J 7 b
ni al ate
0990-46 While -Building Div, Canary Contractor, Pink -Owner
(foue'/
Company or Corporates Name
10162, Q1(t'Z P
Address
SGn k /)4 /
Signa y� p Date
Printed or typed name