HomeMy WebLinkAbout185 ADMIRAL WAY - Building PermitsCity of Costa Mesa p
Building Safety Department CERTIFICATE O F O'C'C.0 P A N`C'Y
e _ P.O. Box 1200. , r - 3587
esa„-1 -
Costa NI -� 1 -
The Building located at iii4. neirmi ral_ TFlnrr
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for, a Group1<-7 r M-1 Occupancy:
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i
Use of.Building. r^ ri(1.. rrararrc 7 r+arrv,rF f-ral1irx
Legal D'escrlption y D 111'IQ-nrl QA7 R Tr,* F TpA(-WP 1nQF7' �
(See reverse .side forMetes and Bounds)
Building P.erm,it No, 49R41 Electrical Perm it.No; 4R42R 'Plumbing Perm,it'No. 7RG7R
Number of apartments —0— and/or guest rooms —fl—
ISSUED TO: Building Official
byl
P. I. & I.., INCURPORATZ) Victor C. Newton -Director Building'Divisicd
11 Date October 26, 1981
This Certificate of Occupancy'SHALL BE posted in cIl
onspicuous place on'the premises and SHALL NOT.BE removed except by. the
Building Official of-theiCity of Costa Mesa under Sec. 306 (e) U.B.C.
'Form SU 34 nev.•11'/70 4 - it
E3
3704 3/19/80 106e57
COSTA MESA DING -SAFETY DEPARTMENT APF`- CATION FOR STRUCTURAL PERMI
P.O. BOX 1200 'LSTA MESA, CALIFORNIA 92626
'
REC V PERMIT /�
Q�
For Applicant to F' pljlely - USe Ink
BUILDING
ADDRESS' nue
A.P. NO.
- -
BUILDING
OWNER OR
P. I. & I., Inc.
ADDRESS34,
TENANT
MAILING
13919 Struikman
UNIT OR SPACE
SPACE NO.
ADDRESS Road
TR.NO. LOT i BLK.
TEL.
rI
CITY.prritnR NO.
_
CONSTRUCTION
NEW ADD ALTER REPAIR MOVING DEMOLISH
LENDER
X
BRANCH
OWNER P. I. & I. Inc.
ADDRESS
VALUE ,70
ARCHITECT TEL.
USE S.F. residence $53�63ff
OR ENGINEER Lee & Sakahara No.
ADDRESS3184-B Airway, Costa Mesa 92626
ZONE TYPE -� GROUP
APPROVED
CONTRACTOR
BY. DATE
ADDRESS
TEL.
CITY NO.
STATE CITY
APPROVED SETBACKS
LIC. NO. LIC. NO.
SIZE NO. OF BLCXS. -
(FROM C/L STREET)
OF LOT 1.606 acres NOW ON LOT 2
FRONT FT.
USE OF
EXISTING BLDG. S.F. residence
S /r/✓
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
onstruction of 2 -story single family
residential condominium unit arae &
�%
APPROVED �O
carport trellis.
APPROVED`i�
it
QATFCl
I hereby acknowledge that I have read this application and state
OLD FOR rw7ritAll Rr;G(IIR,r
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 certify that I am properly licensed as a contractor under
the State of California Business and Professions Code, Division 3,
THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and that such orce and effect, or I
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the California Business
VALUATION PERMIT FEE $
and Profession
Wof
PLAN CHECK
Signat
Perm
/+ ^
TAX $ • O
0
Authorized Agent t a
/ TOTAL PAID $/DG•
6 CITY OF COSTA MESA
BUILDING DIVISION
F DEVELOPMENT SERVICES DEPARTMENT
PERMIT
(714)754.5273 • Fax(714)754-4856
BUILDING PERMIT
Job Address: 185 ADMIRAL VVY
Suite:
Vicinity: UNITS 185 THRU 189
Parcel Number: 43929314 Zoning:
PERMIT NUMBER
99-01890
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 11/29/1999
Issued: 11/29/1999
Applicant: LUKE, GARY ISSUED BY:
Address: 448 S. MONTGOMERY
Phone: (714) 633-8798
ORANGE, CA Zip: 92667
owner: VILLAGE IN COSTA MESA _
Address P 0 BOX 579
Phone:
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:
- ,Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
REROOF EXISTING 3 -UNIT CONDOMINIUM - EXCLUDES GARAGE AREA (33 SO OF PITCHED & 16 SO 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 185, 187,&-189 ADMIRAL WAY.
Plan Check:
$0.00
Permit:
$181.25
SMIP Res:
$1.00
SMTP Com:
$0.00
Other:
$0.00
Inspection:
$0.00
Total:
$182.25
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0
ACCESSORY
Front 0-0 Rear 0-0
PARKING
Existing: 0 Required: 0
FEE SUMMARY
Calc Valuation: $10,000.00
Claim Valuation: $10,000.00
PLANNING & ZONING
Left 0-0 Right 0-0
Left 0-0 Right 0-0
Proposed: 0
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
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 Cotle, 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 or which this permit is issued.
My workers' compens n urance LcaTp0.r andel olicy number are:
Carrier: ' �+�7 ./ Policy Number: 0�0
(This section need not be completed i/ 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 afire 'f I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with these provisio�ns/�/
Applicant Signs
iSi nature: Date:
WARNING: FAILURE TO SECURE WORKERS'COMPC
ENSOVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE ($100,00)), IN ADDITION TO 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 Uader provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions ode, and my license is in full
force and effect. Lic. N 06 .3 Class k C - /n
Contractor's Signature: Date: //• 7-37 _ 5'9
I '
CONSTRUCTION LENDING AGENCY:
❑ I hereby all inn 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. 703 t.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 inteplded 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 sple.).
❑ 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.).
❑ 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 connectionwith 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 WIII 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 M a 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 jorm 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 bullding occupant need to prepare anRMPP (Risk Management and Prevention Program for cutely hazardous materials)?
❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation certif ation 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 requiretl has Section 25534 of the California Health and Safety Code been fully complied with? Yes ❑Not
..— .__....................._ ...._ -
..__ _..... _..__ __ --. .....
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication a.LPermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes U No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential I wilding 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? [I Yes ❑ NS
(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
e (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:
i
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.
Signature O g r(s) Date
7rJx^
nd/OtAuffior;pd1lipplicant Date
CODE.. INSPECTION TYPE DATE INTITALS CODE N INSPEOTIONTYPE DATE INTRIALa
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof—�� _ 60 210 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
2446-46