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Home My WebLink About171 ADMIRAL WAY - Building PermitsCity of Costa Mese Building Safety Department CERTIFICATE OF OCCUPANCY P.O. Box 1200 Costa Mesa, California The Building located at has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group Occupancy. Use of Building ur'rn ri- :: atiau} 3- '.rcre Legal Description 1J.':• J- ei—^�a 13. :��L-r 11� ."I (See reverse aide for Metes and Bounds) Building Permit No Electrical Permit No. Plumbing Permit No. Number of apartments and/or guest rooms ISSUED TO: Building Official c by 1n CO Imo ': �U vncco_ Ncn*rton-1)2xe for l u.z.r nr _ Dare `� This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 lei U.B.C. Form BU 34 Rev. 11/70 OF COSTA MA Ef"' �sING-SAFETY DEPARTMENT P.O. BOX JS 200 GiSTA MESA, CALIFORNIA 92626 5i 371 3(19(80 �JhQAkfi7 TL API"' TION FOR STRUCTURAL PERMIT RECEI(rr PERMIT For Applicant to Fill in Com letel se Ink 0 V i BUILDING a ADDRESS A.P.NO. 119-061-27,28 BUILDING OWNER OR P • I. & I. InC. ADDRESS N , MAILING UNIT OR Q NO. �\ 13919 Struikman Road SPACE ADDRESS 213 TR.NO. OT BLK. CITY Cerritos, CA 90701 NOL 926-4407 10957 13 NEW ADD ALTER REPAIR MOVING DEMOLISH CONSTRUCTION LENDER BRANCH OWNER P. I. & I., Inc. ADDRESS VALUE ,.� USE S.F. residence _ _' ARCHITECT TEL. Lee & Sakahara 979-6283 OR EN INEER ADDRESS 3184-B Airway, Costa Mesa 92626 `'7]' T% ZONE � TYPE -.IG GROUP i " / APPROVED CONTRACTOR BY DATE ADDRESS TEL. CITY NO, STATE CITY APPROVED SETBACKS ' LIC. NO. LIC. NO. 512E 1.606 acres NO.OF BLDGS. 2 (FROM C/L STREET) OF LOT NOW ON LOT ROM FT. USE OF S.F. residence EXISTING BLDG.R. SIOQe�i4 Separate permits are required for L. SIDE FT. electric, plumbing and heating work: REAR FT. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION Constructionof 2 -story sin le famil residential condominium unit arae APPROVED/ ( �� & car ort trellis i 1 APPROVED By E t/ I hereby acknowledge that I have read this application and state 1/3 that the above Information is correct and agree to comply with all laws regulating building construction, and I shall not employT/. ��fN� any person in violation of the workman's compensation laws of C Ai4 ; the State of California. �� O ctor under I hereby certify that I am or erly lie tle..d SO. FT. the State of California Bu - ofDiisio3 THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that a i effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from t of ifornia Business VALUATION PERMIT FEE $ antl Professions 9. J PLAN CHECK $,Qj`ss� Signature Permittee ,meq ,/r $/r y L d/a TAX $ IZ17 @e // �+ or Authorized Agent Date TOTAL PAID $ /Q L7 (714) 754-5273 • Fax (714) 754-4856 Job Address: 171 ADMIRAL WY Suite: Vicinity: UNITS 171 THRU 175 Parcel Number: 43929314 Applicant: LUKE, GARY Address: 448 S. MONTGOMERY ORANGE,CA CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT BUILDING PERMIT Zoning: Phone: (714)633-8798 Zip: 92667 owner: VILLAGE IN COSTA MESA Plan Check: $0.00 Calc Valuation: Address P 0 BOX 579 SMIP Res: $1.00 SMIP Com: $0.00 Phone: $0.00 Inspection: DANA POINT, CA Zip: 92629 Contractor: LUKE ROOFING Address: 448 S. MONTGOMERY - - Phone: (714) 633-8798 ORANGE,CA Zip: 92667 - License. 672569 Arch : . . Eng: Address: Address: PERMIT NUMBER B99-01888 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Status: ISSUED Applied: 11/29/1999 Issued: 11/29/1999 Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF EXISTING 3 -UNIT CONDOMINIUM - EXCLUDES GARAGE AREA (30 SO. SQ OF PITCHED & 18 SQ. OF FLAT). TEAR OFF EXISTING WOOD SHAKES & INSTALL 1/2 INCH OSB PLYWOOD SHEATHING, 1 -LAYER OF 15# FELT UNDERLAYMENT, & 30 YEAR CLASS -A- COMPOSITION SHINGLES ON PITCHED AREA. ON FLAT AREA, INSTALL 4 -PLY BUILT UP ROOFING WITH GRAVEL SURFACE. '3 -UNIT CONDOMINIUM INCLUDES UNITS 171, 173, & 175 ADMIRAL WAY Total: $182.25 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 $10,000.00 $10,000.00 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 FEE SUMMARY Plan Check: $0.00 Calc Valuation: Permit: $181.25 Claim Valuation: SMIP Res: $1.00 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $182.25 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 $10,000.00 $10,000.00 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 WORKERSCOMPENSATION 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 ^ 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. M workers' com ens on..Iurance carr) and otic number are: Carrier: y 7 �/ C"/2 y Policy Number: (This section need not be completed i/ the permit is valued at one hundred dollars ($100) or less.) ❑ I 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: �// �� Date: �� -2 3; �S S WARNING: FAILURE TO SECURE WORKE COMPEN COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE 1$100,00(0), INADDITION TO T1 RT 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 in full # � force and effect. Lie. �i 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 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.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑ 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: ❑ 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 B, 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 building 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 It an RMPP is presently required, has Section 25534 of the Callfornla 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 8 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 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 [I 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 inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Si ur al Owners)/ — � sate SS r Auth d Applicant 6 Date CODE M. INSPECTION TYPE gM IINTMAL$ CODE? INSPECTION TYPE DATE INTMAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Raaf i- 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 Buildmg/Occupancy 244646