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HomeMy WebLinkAbout2922 ELLESMERE AVE - Building PermitsCITY OF COSTA MESA � MFs'q BlIILDING D/V/S/ON '`�� 77 FAIR DRIVE. COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us � FOR INSPECTIONS CALL: (714) 754-5626 h�pA' PERMIT NUMBER: BC10-00265 PERMIT TYPE: B COMBO STATUS: ISSUED Sub Type: RES_ALT DATE ISSUED: 06118I2010 ISSUED BY: KJB Jos aooRESS: 2922 ELLESMERE AV CM APN: 13927218 Zoning:R1, , Vicinity: Const Type: V-B SQ. FT: 0 Suite/Unit: Primary Occ: Valuation: $7,000.00 SCOPE OF WORK: REMODEL ONE BATHROOM. SCOPE OF WORK TO INCLUDE: TILE, DRYWALL REPAIR/PATCH, 1 TOILET, 1 WASH BASIN, 1 SHOWER, 4 LIGHT FIXTURES, 2 OUTLETS AND 2 SWITCHES. ALL NEW LIGHTING SHALL COMPLY WITH MANDATORY MEASURES. NO MECHANICAL WORK. OWNER: MILLER, RICHARD A TR Phone: APPLICANT: GRINBAUM, RAZ Phone: 818d45-4439 CON7RACTOR: LIBERTY CONSTRUCTION Phone: 818-045-0439 Cell: ARCHITECT: ENGINEER: COMBINATION PERMIT FEE SUMMARY Building Plan Check: Building Fees: Electrical Fees: Mechanical Fees: Plumbing Fees: SMIP Residential: SMIP Commercial: Bldg Std Admin Fund TOTAL FEES: Address: 2922 ELLESMERE AVE City/State/Zip: COSTA MESA, CA Address: 427 N CITRUS AV City/State/zZip: LOS ANGELES, CA License No. 640562 Address: 427 N CITRUS AVUnit: City/State: LOS ANGELES, CA License No. License No. $0.00 $139.25 $32.30 $0.00 $52.90 $0.70 $0.00 $1.00 $226.15 Unit: Unit: ZipCode 90036 PHONE: PHONE: "Refer to fee recei ts for all fees ald for ro'ect HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/78/2070 - PER CMMC Sec. 13-279 Monday thru Frlday-7:o0 am thru 7:0o pm. Saturdays-9:oo am thru s:oo pm. Prohibited all hours - Sundays and lhe following Federal holidays: New YeafS Dav. Memorial Dav. Indeoendence Dav. La6or Dav. Thanksaivina �av and Christmae nav NOTICE: The work authorized by this permit shall comply with all applicable hantlicap access requirements under Cali(ornia statutes and relaled regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPEC710NS: In order for the work authonzetl 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 inspeclions and final approval will result in the expiration of lhis permit. COOE �. INSPEC110N T1PE 7816 Fixed System Final Fire Prevemion 12fi6 Pool Spa Final 200 Final Re-Roof 20t Final8locWRetaining Wall 202 Final Factory Fire Place 203 204 Final Sign Final Demolition Dp1E INTIiIpLS CO�E/ INSPELiIONTYPE 208 Final Mechanical 208 Final Plum�ing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Appmval 222 Final Site 250 FinalBuilding/Occupancy UAIE INi171AL '1-ao- 1� bx y„+ (t+�) -i �� NmC/�� �-an��a b, HM Cr�s�) WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one o( the following declarations: ❑ I have antl will maintain a certifcate of consent to self-Insure for vrorkers' compensation, as provided tor by sec�ion 3700 of the Labor Code, for the peAormance o( Ihe work (or which Ihis permit is issued. ❑ I have and will maintain workers' compensa[ion insurance, as required by section 3700 of lhe Labor Code, (a the peAortnance o( the vrork for which Ihis pertnit is issued. My workers' compensation Insurance carrier and policy number are: '^ Garrier�i� `/K� (Tnis sect need rwl Ee mmpletetl Alne pe�mrt is valuedat one nundmtl Alllars (St00) orlessJ olicy Number:_ s�f.JC J 2-8 ��� 2i ? r� \ ❑ I certify that in the performance of [he vrork for which this permit is issued, I shall not employ any person in any manner so as to become subject lo the workers' compensation lavrs o( Califomia, and agree that if I should become subjed ro the workers' compensation provisions of Seclion 3700 of lhe Labor Code, I shall lorth � compty with these pmvision .�^� � � O ��p� !1^l-�SFfy�(LI� � iPdle� "_T> WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE IS UNLAWFUL AND SHALL SUBJECT AN EMPIOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLL4RS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND AlTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereDy aKrm that I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, antl my licens is in full force and eHect. � �i #''�� yOs�_ •�•;�Glass # 'on c IgMHdtF.., :o ' -�o5te `.� CONSTRUCTION LENDING AGENCY: ❑ I hereby a(frm that Ihere is a consWcl'an lending agency for Ihe peAortnance of the wurk for which this pertnit is issued (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Signature Date OWNER-BUILDER DECLARATIONS: I hereby aKrm that under penalry of perjury lhat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business and Pro(essions Code: Any ciry or county which requires a permit to construcl, alter, improve, tlemolish, or repair any structure, prior to its issuance, also requires the applitant for such permit to file a signed statemenl Ihal he or 5he is licensetl pursuant lo the provisions of Ihe Coniractors License Law (Chapter 9(commencing with Seclion 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and Ihe basis for Ihe alleged exemption. Any violation of Section 703L5 by any applicant br a permit subjects the applicant to a civil penalty of not more Ihan five hundred dollars (5500).): ❑ I, as owner of the property. or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is no[ intended or oBered for sale (Sec. 7044, Business and Professions Code: The CoMrectors License Law does not apply to an owner of property who builtls or improves thereon, and who does such vrork himself or herself or through his or her ovm employees, providetl that such improvements are not intended or oHered 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 builtl or improve for purpose o! sale.). ❑ I, as ovmer o( lhe property, am El(CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to constmct the prqect (SecJ044, Business and Professbns Code: The cont2ctors License Law dces not apply to an ovmer of property who builtls or impmves thereon, and who contracts for such project with a contractor(s) license pursuaN tothe Cont2ctors License Laws.�. ❑ I am exempt under sec. Business and Protessions Code for this reason: SgnaWre 305]-A6 pl0]) Owner ID verified by tlriver's license. ❑ Yes ❑ No Driver's License No. Expires: Verification o( Ownership by (rype of tlocument, i.e. - pmpetly tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cetldy that no excavation frve (5) or more feet in depth into which a person is requiretl to tlescend, will be matle in connectbn with work authorized by this permit, and that no builtling sirucWre, scaffdding, falsework, or demoli[ion or dismantling Ihereo(, will be more Ihan thirty-six (36) feet high. (Chap. 32, Grp 2. Ad 2, Sec. 341, Ttle 8, California Administ2tive Code�. ❑ As owner-builder, I will not employ anyone to do work which vroultl require a permit fmm the Division o( IndusMal Safery, as noted a6ove, unless such person has a permit to do such wnrk from the division. Appli�anlb Signalure Date Division o� Intlustrial Safety Pertnit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or fuWre building occupanl need to file antl certify a Business Plan for emergency response to release or threatened release of a hazartlous material? ❑ Yes ❑ No (Section 25505 of the Califomia Health antl Safery Code requires, with some exceptions, lhat a Business Plan be fled with Ihe Costa Mesa Fire Department by every business which has at any one time during a reporled year a quantiry of hazardous matenals equal lo 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 fle a regisValion form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the Calilornia Healih antl Safety Code, with some ezceptions, requires registration vnth 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 o( 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standartl �emperalure and pressure�. . 3. Does or will Ihe appliwnt or present or luture builtling occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)7 ❑ Yes ❑ No (Section 25534 of Ihe Califomia Health antl Safely Code�provides thal lhe Costa Mesa Fire Department may require the preparalion, certifica[ion and fling with the Fire Depatlment of an RMPP by businesses which are required to register acutely hazardous matenals with the Fire Department. 4. If an RMPP is presently required, has Section 25534 0! lhe Cali(omia Health and Safe[y Code been fully complied with? ❑ Yes ❑ No . 5. Does or vdll the apPlicant or presem orluWre builtling occupant require tor the work which is the suDject of this application a permit for such cons[ruction or modi(cation trom the South Coast Air Qualiry Management District or Irom any other aii pollution control tlisMct or agency? ❑ Yes ❑ No (Section 658502 of the Califomia Govemment Code requires [hat the requestetl information be Fumis�etl on applications for noo-resitlential buildinq permits). 6. Will any part o( the laciliry to be conswcted under this permit be within 1000 feel from the outer boundanes o( a school? ❑ Yes ❑ No (If "yes". the facility must meel the requirement of Sections 25534 and 42303 o( Ihe California Heallh and Safery Code�. 7. If a pertnit from the South Coast Air �ualily Management District or other air pollution control distdcl or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by Califomia Health and Sa(ety Code Section 42303 been made? ❑ Yes ❑ No 8. (If yes", attach certificate ot compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is cortect. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. 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 correcL I agree to comply vnth all state laws and city ortlinances relating to building wnstruction, and authonze representaiives o( the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree nol to occupy or allow occupancy of any builtling aWhorized by this permit until fnal inspeclion. Signaw aie \ � ? y J " �Q(Q'�A�I�o_izetl AOClicant 1'� al �'"�� �-�'"� 11.��� COSTA MESA BUILDING-SAFETY DEPARTMENT . P.O. BOX 31] COSTA MESA. GALIFORNIA fOR APPUCANT TO F/[C /N COMPLETELY TYPE OR PRINT BUILDING 2922 Ellesmere Avenue ADDRESS COSTA MESA. CALIFORNIA Placentia rt Beach K. W, Koll �� �tE REC�i�IED euJ �� ,�-�..o FINAIVCE DEPT. cirr or- cosTFl m�sa APPLICATION FOR PERMIT BUILDING faR officE usF aNcy PEGEIPT NO. PERMIT NO. � `� � 2�� IVED BV OATE RECEIVEU "DATE'ISSIIE[ �fi'- I _'7._/�-L+� FFR 9 u BUILDING COSTA MESA. CALIFORNIA . FIRE I/ ZONE TYPE '✓ " GROUP d ADDRESS ZONING LEGqL I LOT I I��(] ZONE NO.OF U9E OF NEW , (� oEscqlPilov NO. �� 6LOGK T 7 I PLANS �]II BUIIDING� � �. APPROVED A.P. NO. BV �� SIZE 9ox1o6 i�rreg I NO.OF e�ocs. O YARDS OF LOT Now oH �oi REOUIRED USE OF none (LENTER LINE HT.) EXISTING BLOG. FRONT SETBRCK LINE FROM � ' CENTER OF STREET O REAR YARO Z� R. SIDE SIDE YARD I LEFT J' r I RIGHT � L SIDE DESCRIPTION OF WORK - REAR NEW I� II ALTERATION I II ADpITION I ftEPAIR I IIMOVING I IIDEMOLISH I SZIEDING 1C'4,0 sf' ftOOMSD /1� STORIES 1 EXTERIOR WAL1�. ROOF L1OCl] COVERING JtUCCO COVERING ' ' USE OF BUILDING AND WORK TO BE PERFORMED Sin�le-Familv Aesidenee a �i�i 1 HEREBY ACKNOWLEDGE THAT I/ �HAVE READ THIS APPLICPTION BUILOING COLSTR C ONNANCIE� {�N��ATEND�(�LREGUOLATIO G � � � � i AUTHORIZEO AGENT r FT. TNE AMOfINT SHOWN UN�ER VNLUATION IS FOR THE PUFPOSE OF ESTABlI8HIN6 q PERMIT FEE ONLY. VALUATION � J� PERMIT FEE $ �.J �� � �� �//'� PLAN CHECK S � y.� � TOTAL FEE $ � %— � "` � � ���� COSTA MESA BUILDING-SAFETY DEPARTMENT _-P. O. BOX 317 C06TA MEBA. CALIFORNIA For Applicanf fo Fill In Compleiely ' TYPE OR PRINT COSTA MESA. CALIFORNIA �'; �/�.�rrn �/ /��i,(/. � �i MAIL AOORF6S �� cin �/�i!1�/. STATE / ii 9/ LIC. NO. ♦ C�lJ 5� SIZE ic� /_ USE OF EXISTING BIDG. 98TBAGK LINB PROM FEE RECE1vED �MAY 17 13fi1 FlNANCE DEPi• �IiV Of COSiI� MESA APPLICATIO FOR PERMIT BUILDING For Offiee Use Only ReC81R NO. P�8¢MIT NO../ R8LE1 �D. 9/Y DA H8C8/1V-/lO DA 189UHO L/ � � / . . —�7�.i 7EL. BUILDING 1�IG/.�.�J �/�iI ,��7E/�? NO. ADDRE65 7� x '�� ;E�' COSTA MESA. CALIFORNIA � � FIRE � ii� � �i � �/4�H ZONE�r TEL. .f ' � /O l Leae� NO. [ DEBCRIPTI� � I NO. OP BLD69. DESCRIPTION OF WORK BUILDING NO. OF SIZH ftOOM6 EXTERIOR WALL IROOF COVHRING COVERII US8 OF BUILDING AND WORK TO BE ZONING NO. OF U8B OP NHW�% ]LAN6 ?/ 9IIILD�NO V OQ ` �'/L 3.S,,L �1 <v �--�z i�--FY3 -�s YARDS EVES APPROVED 1c¢rmx uMe 9'r.) � �/6- 1 HepEBY ACKNOWL8D08 THAT 1 HAVE ReAO THIB MPtJGT10N AND 9TATH THAT THE ABOVB IB CORRECT—�kNNDD�� ORlE TO CON- TN¢ AMOUNT BHOWN IINDER VALU�TION �� POR THH PLV WITX ALL C(TY ORD AN N¢' BTATE LAVI� q8 GLATINO PURP08C OP HBTABLIBHINO A PBRMIT FE8 ONLY. BIIILDINO cONGradcr� n 1 ���� VALUATION � BIGNATURE OP'_ 1 PERMIT FEE $ G�'— PERMITT� (j� '/ - . $ "I��D° e � PLAN CHECK $ �T ' �t AUTHORIZED AGEN _ �� � i" - +' d`}'.�:;�.;'.>, ,..} '., , ., �. .:i •. : � , �# .:' �:� ' . f �`:'t�t .:i�:�i1'ii'ii�-t � �,ti'r, t�tt.i�.t :�'' �ij}`0 � _. ' '� ' 12'��'7 COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 9f7 COSTA MEBA. CALIPORNIA For Appilean+ fo Fill in Complefely ' TYPE OR PRINT COSTA MESA CALIFORNIA ...-----��—_ 1 6TATE TEL. ■ BETBACK LINB FEE RECEIVED -� SEP 8 1960 '. APPLI��N��O��1 BUILDING For Office Use Only RECEIPT NO. FERMIT NO��_ 0Y BUILDING AODRESS COSTA MESA. CALIFORNIA FIRE ZONE APPROVED BY e ZONE � LE6AL OE9CRIPTION oF BILGB. ' oei LOT q, p, NO. YARDS APPROVED (CHNTER LINE DESCRIPTION OF WORK REPAIR I I mov�nG I II uemoue BUILOING NO. OF BIZE ROOM6 STOF EXTERIOR WALL ROOF COVERINC COVERING USH OF BUILDING AND WORK TO BE PERFORMED 'i!",/� /SG �� G��� %. %. %Ji 1 H8H6BY ACKNOWIPPGe TNAT I XAVE ftBAp TH16 APPUGTION NNU 6TAT8 THAT TH0 ABOVe 19 CORPECT ANO AGRHE TO COM- PLY WITry ALL CIiY O�1 C88 AND 6TATH LAWB fl60lILATINO BUILGINO CONOTRUCTIC . BIGNATUR6 OP /� //� PERMITTHa ��{, AUTHORIZED AGEN7 ZONING NO.OF I U6E OP NEW PLANB � BUILDINO REAR � APPROVEO �� j _ I _J_{ J TXG AMOUNT BHOWN UNDEH VqLUAiION IB POR THH PUfIPOBH OP E9TABL�BH�NG A PHRMIT FEE ONLY. VALUATION �` � � PERMIT FEE $ N S / � PLAN CHECK $ — _ 2 TOTAL FEE ��� 4 0 MAIN OFFICE 1695 WEST GAV�ORD ST., — P.O. BOF 9085 LONG OEACH )q CALIFOANIA HEMLOCR 3-]d93 SFPUCE 5-2001 '��rini�t� Laborato�ies Esamination No. Yro.jcci Sample trom Architect Contr.ictor �fix \Vciter, gal./sk. cement Size Uatc cast Datc tested BflANCH OFFICE Il14�0 NORTH H�RPER ST. � SANTA /�N1.CFLIFORNIA JEiGEflSON 1.20a] JEFFERSON 1�2006 of eSouE�Ze �n �a�i f ovua, �ne. June 23, 1961 GUNITE REPORT OPx�c TGST CYLINDER SC61-3134 JUN 27 19G? City of Costa Me� • Building Dey:. For - Tahitian Pools � 1622 E. 17th, Santa Ana, Calif, � h1ILLE[t RESIDLNCE - 2922 Ellesmere;/Costa biesa Gunite Swim Pool 6 x 12-3/$ 5-26-61 6-2-61 Cti•linder IVo. 1 COtiIPRGSSfON TGS7' 7 Days Total ]oacl to desu-uccion, lbs. $5,000 Pounds per square inch 3,005 C��linder made by Ct�liuder dclivered by C�'linder mceieed ou cF: Tahitian Pools Resident CoSta D1esa 61dg, Dept. SA Lab Gunihe Crew Saecat 5-29-61 63/6x 12 6-23-61 2 28 Days t25.000 3.9�7 ��� � ��� wLL PEpORTS ARE Sl15MITTEp w5 TME CONFIOENTII�L PROPEPTY OF CLIENiS, .�UTMORIZ�TlON FOF PUBLICATION OF OUF REPORTS, CONCLUSIONS, Op EI(� TN�CTS FROM OR flEGARDING THEM IS RESERVEO pENOING OUR WFRTEN APPROVGI FS .� MUtUAL PROTCCTIOR TO CLIENTS, TNE PUBLIC ANO OURSELVES.