HomeMy WebLinkAbout1101 DANIELLE DR - Building Permits(714) 754-5273 • Fax (714) 754-4856
CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
BUILDING PERMIT
Job Address: 1101 DANIELLE DR
Suite:
Vicinity:
Parcel Number: 41207433 Zoning: R1 R1
Applicant: BONAZZA, MARION
Address:
Phone:
Zip:
Owner: ' BONAZZA, BLAZE O & MARION R
Address 1101 DANIELLE DR
Contractor:
Address:
Phone:
COSTA MESA, CA Zip: 92626
Phone:
Zip: License:
Arch Eng:
Address: Address:
250SF PATIO.
PERMIT NUMBER
B99-01694
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 10/19/1999
Issued: 10/20/1999
ISSUED BY:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
LEGALIZE PATIO COVER BEHIND AN EXISTING SFD IN A PDR -LD ZONE.
FEE SUMMARY
Plan Check: $72.31 Calc Valuation: $4,030.00
Permit: $111.25 Claim Valuation: $0.00
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $184.06
PLANNING & ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 5-0 Left 25-0 Right 5-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
NOTES:
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: 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
rr
lk,
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 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
work for which this permit is issued.
❑ 1 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:
Carrier: Policy Number:
(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 it 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: Date:
WARNING: FAILURE TO SECURE WORKERS' OOMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 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 in full
force and effect. Lic. It Class #
Contractor's Signature: Date:
CONSTRUCTION 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).
Lender's Name: Lender's 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 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
su jects 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.
044, 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 contractors)
license pursuant to the Contractors License Laws.).
❑ xem t under sec. Business and Professions Code for this reason:
,Sjatur ate:
er ID verified by driver's license.❑ No ver's License plres
Venfication of Ownership by (type of document, i.e.. property tax bill or defd):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I 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, 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 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 budding occupant need to file a registration form 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 a plication aermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes a No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-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 It 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 state 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 inspecti n purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until Inal Inspection.
,J 4:::: tea--- Ib /ae 5
Sig ure Of eget Ow arS6 oat
And/Or Authorized Applicant Date
COOE_L INSPECTION TYPE DATE INTRIALS CODEX INSPECTION TYPE DATE INTITIAL
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 Nock/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
2446-46
NOTE: SHOW AND DIMENSION PROPOSED
PATIO COVER AND YARD AREAS
'�25' 5)aA�et wo
P -y _
//0/ This se
make <
and S
?he 66
of the
Jq/%— 0/(1911(74
1�.. FT�tr� ��T�v�
1 jL WO .FLJ1 ,1
aTY OF COSTA MESA
PUNN[NG DIV.
SUwEC'C 3® BLDG. DEPS RE
STREET
J) co -11, e.i l e
NOTE
DITIONS DELETIONS, OR CORRECTIONS SHALJN
BE APPI OVED BY THE PLANNING DIVISION
SEE DETAREVERSE SIDE
/ROOF SHEATHING
1
I
V.ISION OF 8'CITY OFAPPR
J'I
dansroo,
speMUST N
g alterat on on same w N
citycstamesa.
Ig of n s plan and spBrif catlom `.
:ica if Ln '( PwAsians of any C
s an perrA shall expire bit mil
TO
011 SIE AND
OVERHANG
_X—RAFTERS
RY_ D.C.
V F„1)
_X_ BEAM
0
li ZV C
T- STRAP EA. SIDE
FOR POST- BEAM -
NPy I I6WG a'd A'S tmlawhll to a
N7lflan p,, Um C3 DIV5�tn .ing CONNECTION, o .O
a H U
J a Z Z
1LLNOT tghBl permit or tobBanappmvd m o _Z
of Ccsta*as ' dnance 4 ehr "mate lav:. a N v m a
J = a s cr Z
,n end iwel) I and v id',. a bU;2ng c: n t _
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DROP PATIO W LL Z X Z O
FLOOR 2' o i \ O
=p
U a
SLOPE TO DRAIN PLATE 1"
ABOVE SLAB
• W NSPGA. G. I. FLASHING IWOOD
VALCONS RUCT ONR PIERS 12" SQ J o
a
a
LL
SIDE ELEVATION
.,
I PLOT PLAN I CONSTRUCTION DETAILS
20tM.ROOF
DETAILS
CONT,
LEDGER
CONNECTION
SOLID BLOCK
RAFTER
DEVEIOPr7rrP
SERVICES DEPAR'IMEW
DUILDDIG SAFETY DIVISION
2"x4"
PATIO COVER
T Y P. PLANS
u-zzo, MAKzloi A E BLA-2
OWNER: Ksa
DATE: ID -"-In
9'-0"
16"
ADDRESS: 1101 D4�,1L�Ll >= D2.
PHONE:C�ILgr c54
v2" DIA. X 5" LAG SCR.
CONTRACTOR: 0Wi1�2 Its i CL��
LIC. NO.
AT 32 G.0
" .
ADDRESS:
PHONE'
2"x6"
DETAIL I
5'-0"
RAFTERS
RAFTERS
16'-6"
APPROVED FOR
16"
CARPORT, PORCH OR PATIO
LIGHT WEIGHT ROOF COVER OF
BUILDING PERMIT
1By
24"
12'-0"
NOT SUPPORTING CEILING
LATH, FIBERGLASS,
ALUM.
10'-6"
48"
.8'-0"
Date
CONT.
LEDGE
CR a CL"TECO
GRIPS OR JOIST
HANGER
3/8" DIA. X 5" LAG SCR.
AT 16" 0. C.
DETAIL 2
IOimOR LIGHT WEIGHT ROOFS
ONLY CONNECTION DETAILS
2"X FACIA -MIN. REO.
�I:l RAFTER
APPROVED METAL
HANGER
DETAIL 3
SIZE
SPACING
SPAN
2"x4"
12'D.C.
9'-6"
4x6
9'-0"
16"
8'-0"
12'-0"
24"
6'-6"
32"
6'-0"
2"x6"
48"
5'-0"
2"x6"
12"
16'-6"
16"
14'-6"
24"
12'-0"
2"x8"
32"
10'-6"
48"
.8'-0"
2"x8"
24"
15'-6"
32"
13'-6"
48"
ll'
-6"
4"x6"
24"
17'-0"
32"
15'-0"
36"
14'-0"
4"x8"
24"
21'-0"
32"
19'-0"
36"
18'-0"
48"
16'-0"
4"xlO"
32"
22'-0"
36"
21'-0"
48"
20'-0"
72"
17'-0"
SIZE
SPACING
SPAN
2"x4"
16"O. C.
9'-6"
4x6
9'-0"
24"
8'-0"
12'-0"
32"
6'-6"
48"
5'-6"
2"x6"
16"
16'-6"
24"
14'-6"
32"
12'-0"
48"
10'-0"
2"x8"
24"
19'-0"
32"
15'-6"
48"
13'-6"
HEADERS
LICHT WEIGHT ROOF ONLY
SIZE
POST
SPACING
4x4
6'-0"
4x6
9'-0"
4x8
12'-0"
4x10
15'-0"
CARPORT, PORCH OR PATIO
SIZE
POST
SPACING
4x4
5'-0"
4x6
8'-0"
4x8
10'-0"
4x10
12'-6"
GENERAL NOTES:
1, These plans must be
kept on the job at
all time during
construction.
2. All framing to be
Douglas Fir N9 2
grade minimum.
3. Rafters may not
attach to facia ex-
cept for 1016sroofs
as shown on details;
201b5roofs must use
a continuous ledger
attached as shown
on details #1Q 42.
4. Light weight roofs
may attach to facia_
for 14' span max.,
spans over 14' must
use a continuous
ledger as shown in
detail #3.
S pc5 O1:7 2X(o"?\
DIVISION OF;01BUIILDI GS AFFTY
CITY = COSTA ME
APPROVED
Date
{ -61 Tans 2 MUST be kept on ;lhis �e Oivis'an o s and A is %�9
p �to@
make any changes or aleralan on same v+#nut ddon pe+..
and Safely, City of Costa tdesa. permit or to be an approval
The stamping o1 this p'an and spec.'gcau°� ALL NOT be held to
o} the violal+cn °1 any Ft°vis ons of any City ct Costa Mesa Crd',nance andbr Slate law
These P rti �ha:l expire Sy 1'!mila icn znd bccome�ull z vlttLa 9
lans&ndpe,;.- d Y...
i
it li or
9Tl L
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CITY OF COSTA MESA REQUEST FOR OCCUPANCY
—` TRACT NO. DATE e(2 ` /3 —J 9
R
LOT N0. (�COSTA—
nn _n/1 PLANNING DEPT.
ADDRESS / l y' IS/a w. ct��. "O� . I
Aid PM
718000010211120 14t516
The developer of the above entitled tract desires to s111 the above set forth
lot prior to the time that the tract has been completed and its streets
accepted by the City of Costa Mesa.
The undersigned, by executing this agreement, acknowledges that (he -she -they)
(was or were) �G� advised that this tract has
not been given final inspection nor has it been accepted by the City of Costa
Mesa as having complied with the conditions of approval which were imposed by
the city at the time the final tract map was approved.
The city assumes no liability for the enforcement of the conditions necessary
for approval other than those conditions protected by surety bond.
The undersigned agrees to indemnify and hold the city harmless from any claim
resulting in damage or personal injury to the undersigned by reason of the
aforementioned uncompleted condition.
By Vl�
Purchaser
BY
Developer and/or authorized
representat' e 9
BY LLQ
(714)754-5273 • Fax(714)754-4656
CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
BUILDING PERMIT
Job Address: 1101 DANIELLEDR
Suite:
Vicinity:
C-7 1 -
PERMIT NUMBER /
B98-01298 1,"
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 07/20/1998
Issued: 07/20/1998
ParcelNunmber: 41207433
Zoning: R1 R1
Applicant: MIRANDA,FRANK
Address:
-
- Phone: 714-557-6516
Zip:
Owner: KANG; DON D'TR"
_
Address 3001 COUNTRY CLUB DR
-
//�
/ COSTA MESA,CA '.
Zip: 92626
Contractor:' ISLAND'PACIFICGROOFING
'
Address: 17762 CAMERON ST-
'
Phone
H.B. CA=
Zip: 92647
License 631472
-
Amh/Eng:
" Address:
--
-i1
Phone: - -
Zip:
" < -
License:
-
SCOPE OF PERMIT
. T/O EXIST AND REROOF W7,1/2
PLYWOOD; #30 ASTM FELT INST EAGLELITE TILE ICBO 4660.
\
FEE SUMMARY
'Plan Check: $0.00
- - -
Calc Valuation: $8,000.00
Permit: $137.25
Claim Valuation:. $8,000.00
�SMIP Res: $0.80
/
SMIP.Com: .$0.00
Other:'v .-$0.00
-
Inspection:: ',$0.00
,Total: $138.05
PLANNING & ZONING
SETBACKS
MAIN STRUCTURE Front, 0-,0 - - - Rear
0- 0 Left " 0-0
Right 0-0
ACCESSORY Front 0-0 - • Rear
0-0 Left 0-0
Right 0-0 .
PARKING Existing: 0 - Required:
0 Proposed: 0
NOTES:
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
ca
DECILARATIONS
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations: If
❑ 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
w -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 pennit is issued.
My workers/'Jj?pensation InstlTaace carti e/p�d poll number are: /�
Cartier. L &J7,N Policy Number:
(This section need not be completed the permit is valued at one hund— re d00) 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'
co nsetl these
laws re Celifomia, ogres the should become �subject to the workers' compensationDate:
of Section 3700 of ther C�, I shell forthwith
mply. these rov ons"C�// '/ 7 8
plicant net �1/
LURE TO SE URE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOULARE (5100,000), 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 1 am licensed and vysien; ptar 9 (commencing with Section 7000) of Division 3 of the Business annAProfessions Code, and my license is in full
force and ett i. Lia a ( i` Class q
ontractor's SigneDate:
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:
Signature: Date:
OWNER -BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that 1 am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Cade: 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 contractors)
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 lax 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, Art 2, Sac.
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 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 Cade 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 feat of compressed gas at standard temperature and pressure).
....................................................................................................................................................................................................................................................................................
2 Does er will the applicant or present or future building acwpant 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 5DO 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 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'o.......................................................................................................................................................................................
4 It an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully compiled with? ]Yes ❑ No
......................... illt....appl.............................. future
buil..........................quir..........................hich.................ject.. f thi.......plic.tion.................................nstructi ............ modification 5 Does or will the applicant u present or future builtling occupant require for the work which is she subject c this a Byes
epertnit for such construction or modificoilon
from the South Coast Air Quality Management District or from any other air pollution control district or agency? � Ves ❑ Na
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building penmils).
....................................................................................................................................................................................................................................................................................
6 Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Ves ❑ 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 ❑Ves ❑ No
....................................................................................................................................................................................................................................................................................
B (It 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 state 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.
e L gel Ow r ) ,.Daly- _ ((
AnaQOrAuthorized-ApDll nt .• /�—Date j)
CO2E-L INSPECTION TYPE BATE INTMALfi CODE l INSPECTIONTYPE gA¢ INTITAI$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re -Roof /'"l ( 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
246646
I
i
4499a
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDING 11/ll nAAli �lIf_ flit
hUV 10 77c
PA`°00 529= ****95.37
nSA
FOR STRUCTURAL PERMIT
rr vYct ulcer rrc5 i, LC VtllUjJmCRL T"4f1Wr•
OWNER Cor A.P. MO.
`O
BUILDING G
ADDRESS 508 29th Street ADDRESS 110' D IEI.1..E
CITyNewport Beach, Ca, No`675_y.91 TRACT 866 LOT 26
CONSTRUCTION NEW ADD 81190 11116111 1119111111, -
LENDER /
BRANCH V roper leSfees
OWNER Uh
ADDRESS VALUE
ARCHITECT .. _ TEL._ _ _ _ __ USE Res.Atd. Gar. $
ADDRESS 2240 Newport
Blvd.
CONTRACTOR Owner
ADDRESS
CITY
TEL.
NO.
STATE
LIC. NO.
CITV
LIC. NO.
SIZE
OF LOT
NO. OF BLOGS.
NOW ON LOT
USE OF
NO.OF /J USE OF N l
PLANS L BUILDING
YARDS APPROVED YARDS APPROVED
MAIN BUILDING ACCESSORY BUILDING
Separate permits are required for L SIDE FT FT.
electric, plumbing and heating work.4
REAR I FT CT
USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. on _ BET. MAIN & /a1_
Construct s7nwle family_ 9 Ylpfl_ IVA. 11CURP..yst���1��J(/j[I APPROVED I/ OLI L /
1 hereby acknowledge that I have rd.A this applliation and state
that the above Information Is cbrrjoTand agree to comply with
all laws regulating building construction, and I shall not employ
any person in violation of the workman's compensation laws of
the State of California.
I hereby certify that I am properly licensed as a contractor under
the State of California Business end Professions Code, Division 3,
Chapter 9, and that such licenses are In full force and effect, or I
em exempt from the provisions of the State of California Business
end Professions
�C,00d/a,91visloonn 3, Chapter 9.
Signature of''2'.GA.�'z-! r•.G�/
Permittee 9
Authorized Agent
N
0
i
r "PERAENTS
o
AU EJ L
m
SO. FT. i 7ALL N
THE AMOUNT SHOWN UNDER VALUATION IS FOR
m
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:—
VALUATION PERMIT FEE E O
N
'r PLAN CHECK E 92.00 c
S 48,200TAX $
IL
7 U
TOTAL PAID E q J;_. -1
^EC—9-77P1s;00 476 d*.r 184.00
COSTA MESA BUILDING -SAF TY DEPARTMENT
P O BOX 1200 COSTA MESA CALIFORNIA 92626
0
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to F' in Completely — Use Ink Only
RECEIVED BV I DATE
RECEIVED DATdEE
BUILDING
ADDRESS /OI
PER
OWNER Af
P. NO.
BUILDING Q
ADDRESS
MAIL
ADDRESS
TEL.
CITY NO.
TRACT
LOT
CONSTRUCTION
W
ADD
ALTER
PA
MOVING nFMOI tSH
LENDER
BRANCH
OWNER
ADDRESSV
wig
UE
$
ARCHITECT TEL•
OR ENGINEER
FIRE
ADDRESS
ZONE TYPE GROUP
APPROVED
CONTRACTOR
BY
DATE
ADDRESS
TEL.
20NE
NO. OF
USE OF NEW
CITY NO.
PLANS
BUILDING
STATE CITY
YARDS APPROVED
YARDS APPROVED
LIC. NO. LIC. NO.
MAIN BUILDING
ACCESSORY BUILDING
SIZE
NO. OF BLDCS.
(FROM C/L STREET)
OF LOT
NOW ON LOT
FRONT FT.
FT.
USE OF
EXISTING BLDG.
T
FT
Separate permits are required for
L. SIDE FT.
FT.
electric, plumbing and heating work.
REAR FT.
FT.
USE OF BUILDING AND WORK TO BE PERFORMED
DISTANCE BET.
BET. MAIN &
MAIN BLDGS.
ACCESS BLDGS.
VAR.*
DATE
C.U.P.$
APPROVED
APPROVED
DATE
I hereby acknowledge that 1 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
any person In violation of the workman's compensation laws of
the State of California.
I hereby cenify that I am properly licensed as a contractor under
SO. FT.
THE AMOUNT SHOWN UNDER VALUATION IS FOR
the State of California Business and Professions Code, Division 3,
Chapter 9, and that such licenses are In full force and effect, or i
THE PURPOSE OF
BLISHJNG A PERMIT FEE ONLY:
am exempt from the provisions of the State of Callfornia Business
and
end Professions Code, Division 3, Chapter 9.
VALUATION
MIT FEE E s
P LAN CHECK $
Signature of
TAX E
Permittee
$
Authorized Agent
TOTAL PAID S
0
COSTA MESA BUILDING—SAFETY DEPARTMENT
+ P.O. BOX 1200
Costa Mesa, California
klks s s s
TRACT 10. l •I� � �`J t
Z 1 Permit ��
Contractor `� �U�\ � V �\� �� " LOT N0, 4•
Address ' N1. �� r� — BUILDING USE DATE ISSUED
F•„� "t Zip Code.J� I/ r
City _�V
State License
No. L 1�1s
Class.
(- t
BUILDING \ \
ADDRESS ��(1 )• `�?'
City License
No.
Tel. No.
✓� 4
Ducts Ventilating
COSTA MESA, CALIFORNI�\\���
NO.
ITEM
EACH
FEES
Refrigeration Lines
Plan Check
Pressure Test
FAD, Wall, or Gray.
Air-Cond. Final
�+ Y�J
LU
Furn. Incl. Ducts andY
Sub -Total
OWNER `%1 \•v
,�
Heating Final
Refrigeration Final
Processing Fee '
-� Final Gas Test
Vents
CMF 0449-46
BLDG. PERMIT NO. /t /.�
r4-�`�.,eC (j i�. A. \ �Jf 1
MAIL l-_
Q
to 100,000 BTU
AODR ESS _1Oti % (
J
over 100,000 BTU
\ q
CITY 1\1 �C. TEL. N0.
Vent (if not incl. above)
,
Heater
Y
,•(\
I hereby acknowledge that I have read this application
J
Suspended
\+
and sta[c)[ha[ the above is correct and agree to comply
Alter Replace
or
n p
allyCity Ordinances and State Laws regulating Heat-
W
Appliance
�wt`h
Refrigeration and Air -Conditioning.
Over feet a
gas piping
'o8Ventilating•
•{jl t
Ix
1 certify that I possess the above valid State of Calif-
BOILE RS O R
`,r Y
s
COMPRESSORS
ornia classification or I am the legal owner of the single
Z
W
3 H.P. or less
family residential property described above.
\
=
Over 3 H.P. to
` U-
Signature of
15 H.P.
Permittee ;� 11 ^. Ck
Bathroom h\ '
-
H
f
( ,
�
Vent Fan—Sin Ie,Duct
Kitchen
REMARKS: l •�
(f ,J -
W
Ventilating Hood
APPROVALS INSPECTOR DATE
Misc,
Ducts Underground
Ducts in Structure
Ducts Ventilating
Heating — Rough
Hoods
Refrigeration Lines
Plan Check
Pressure Test
Reinspection Fee
Air-Cond. Final
Ventilating Final
Sub -Total
Heating Final
Refrigeration Final
Processing Fee '
-� Final Gas Test
TOTAL FEES i 0 J Utility Co. Notified
CMF 0449-46
BLDG. PERMIT NO. /t /.�