HomeMy WebLinkAbout2976 REDWOOD AVE - Building Permits •
` CITY OF COSTA MESA
40-iii'4.. BUILDING DIVISION
1.1 '% 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • w.vw.ci.costa-mesa.ca.us '
i. FOR INSPECTIONS CALL: (714)754-5626 1
PERMIT NUMBER:1'B08-00211
PERMIT TYPE B_ROOF2 STATUS: ISSUED
APN: 13921503DATE ISSUED: 07/14/2008
ISSUED BY: RMD
•
JOB ADDRESS: 2976 REDWOOD AV CM 1 - S'uite/Unit
Vicinity: HOUSE AND GARAGE ROOF r
ct
Squares: 2600 =, • - Valuation $6;100.00
SCOPE OF WORK: TEAR OFF(E) ROOF MATERIALS, INSTALL 1 LAYER OF 30#FELT ON A'4:12 PITCHED ROOF, REROOF . ,
WITH30 YEAR COMP SHINGLES,ON AN ATTACHED HOUSE AND GARAGE,APPROX 2600 SF. REPAIR AND REPLACE '
SHEATHING AS NEEDED. `
OWNER: BROWN,JAMES:WILLIAM :Address: 2767 ALBATROSS,DR r `-.+ Unit:
PHONE: 714-241-1455 -City/State/Zip: COSTA MESA,CA - - .
APPLICANT: AKIL,ABDO - Address: 2737 S CRODDY WAY 11,„
Unit : ,
PHONE: 714-641-1440 ' - - City/State/Zip: SANTA'ANA,CA
CONTRACTOR: DKAM,ROOFING - License No. 641611
Address: 2737 S CRODDY WAYUnit: 1. - PHONE: , .714-641-1440
City/State/Zip: SANTA ANA;CA ; • 92704 • • _ CELL:
ARCHITECT: - License No. PHONE_
l _
ENGINEER: License No. _erPHONEY
FEE SUMMARY
Reroof Plan Check: ;„$0.00 -" - '
Reroof Permit Fee: $139.25 '--'.:[ ; - - -'
•
Reinspection Fee: $0.00 - -
TOTAL FEES $139.25
•
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 S. INSPECTION TYPE DATE INITIALS CODED INSPECTION TYPE DAT INTTALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical . .
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof -4-05' 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
r
WORKERS'COMPENSATION DECLARATION: • - Owner IQ verified by drive. -ense. 0 Yes 0 No ' \
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: -
❑ I have and will maintain a certificate of consent to self-Insure for workers' ''Verification of Ownership by(type of document,i.e.-property tax bill or deed):
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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: . . :
permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth'into which a
number are: • person is required to descend,will be made in connection with work authorized
�Carrierl A ( -- 11 , by this permit,and that no building structure,scaffolding,falsework,a demolition
phis section need not be completed(the penitis va/ed at one hundred dollars($100)or less) 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). •
Policy Number: k �1�t7 H. 7 `7. O0-1-
� ❑ As owner-builder, I will not employ anyone to do work which would
❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued,I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
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 Lab Code,I shall forth th comply with these provisions. Applicant's Signature Dale
Division of Industrial Safety Permit Number:
Applipnt's'Signalue Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEYS FEES. 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
LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons.or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No
Le CP ((CA ( 1.-Class# 3 (Section 25533 of the California Health and Safety Code, with some
` t i, exceptions, requires registration with the Costa Mesa Fire Department by
�� — - -1/41_ d"A _ each business which at any one time has on hand a quantity of acutely
I _confractas Signaw (....---"Date 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
CONSTRUCTION L G AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097.Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? 0 Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: 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.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes 0 No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes ❑No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits).
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 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No
applicant for a permit subjects the applicant to a civil penalty of not more than (If yes", the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec. 7044,Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes ❑No
'thereon,and who does such work himself or herself or through his or her own 8If es
employees, provided that such improvements are not intended or offered for • ( y attach certificate of cothpliance fromthe a ppropriate air pollution
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she .CERTIFICATE OF.COMPLIANCE: l'certify'that under penalty of perjury the
did not build or improve for purpose of sale.). . -information given above is correct. I agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions,- ' `
o I, as owner of the property, am-EXCLUSIVELY CONTRACTING WITH . ,
UCENSED CONTRACTORS to construct the project(Sec.7044,Business and
Professions Code: The contractors License Law does not apply to an owner of Signature Dale .
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION -OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). .certify under penalty of perjury that I have read this application and state that
❑ I am exempt under sec. the information given is correct. I agree to comply with all stale laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: 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. -
• Sigi s Q'.al Owner(s) j Date
Signature Date rL/, q� �• I I lil ((J
005]-06(310])
`----- And/or Author ed Applicant 1 L__Dat)
CITY OF COSTA MESA
4 BUILDING DIVISION
). "„a,r,,,e , a DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
:4i !al •, PERMIT
e•o BOO-01584
•
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca usNG PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDIJob Address: 2976 REDWOOD AV Status: ISSUED
Suite: Applied: 10/03/2000
Vicinity: BEDROOM Issued: 12/05/2000
Parcel Number: 13921503 Zoning: R1 R1
Applicant: BROWN, JOAN ISSUED BY: 426.=____
Address: 2976 REDWOOD
Phone: 714-241-1455
COSTA MESA,CA Zip: 92626
Owner: BROWN, JAMES WILLIAM &JOAN CHRISTINE
Address 2767 ALBATROSS DR
Phone:
COSTA MESA,CA T rI Zip: 92626
Contractor: � 7uti
ld —, a-
Address:
Phone:
Zip: License:
Arch : - Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
278 SQ. FT ROOM ADDITION/CONVERSION OF EXISTING BEDROOM TO CREATE A NEWMASTER BEDROOM AND
ADDITIONAL CLOSET SPACE IN AN EXISTING SINGLE FAMILY RESIDENCE.SINGLE STORY RESIDENCE. NO NEW
PLUMBING PROPOSED.
300 SQ.FT. REAR YARD COVERAGE ALLOWED; 162.5 SQ.FT. PROPOSED.
FEE SUMMARY
Plan Check: $267.77 Calc Valuation: $26,769.00
Permit: $411.95 Claim Valuation: $0.00
SMIP Res: $2.68
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00
Total: $682.40
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 10-0 Left 5-0 Right 39-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 2 Required: 2 Proposed: 2
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
2446-46(6/00)
DECLARATIONS
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 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:
Carrier: Policy Number:
(This section need not be completed it 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:
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 DOLURE($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 7010)of Division 3 of the Business and Professions Code,and my license is In full
force and effect.Uc.# Class If
Contractor's Signature: _ _ 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:
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 properly,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.).
❑ I am exem t under s Business and Professions Code for this reason:
Signature: Date: /l —
Owner ID v ted by drivers license. Yes 0 No Driver's License No. Expires: C —O 3
Verification of Ownership by(type of doc rment,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 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? 0 Yes 0 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? 0 Yes 0 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 et 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 Califomia Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes U 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? 0 Yes 0 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 prescnbed by California Health and Safety Code Section 42303 been made? 0 Yes 0 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 pury ses.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Signature Of Legalal Owner(s) Date
And/Or Authorized Applicant Date
;ODE U INSPECTION TYPE PAII INTDULS CODE! INSPECTION TYPE DATE HOLMLE
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 Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site o p
204 Final Demolition 250 Final Building/Occupancy ^�—
CITY OF CESTA MESA PROPERTY DETAILS.PORT . • • -
2976 Redwood Av
•
Costa Mesa, CA 92626-3741
Owner: Brown James William Brown Joan Christine Phone:
Resident: Phone:
Site Address: 2976 Redwood Av Tax Address: 2767 Albatross Dr
City/Zip: Costa Mesa/92626-3741 City/Zip: Costa Mesa/92626
Parcel Id: 139-215-03 Own. Occ.:
Location: Costa Mesa City School District: Newport-Mesa Unified
Neighborhood: Unknown Census Tract: 063802
Legal Desc.: N Tr 2822 Lot 249
Usage: 122: Single Family Residential
Style: Unknown
Construction: Unknown
Year Built: 1959 Tot.Rms.: 5 Blktop Paving: Unk.
Stories: 1 Bsmt. Type: Unknown Concrt Paving: Unk.
Bdrms: 3 Bsmt. Fin.: Unknown Carport: No
Baths: 2 Full Gar. Type: Attached Garage Deck: Unk.
Heating: Unknown Gar.Sq.Ft.: Patio: Unk.
Cooling: Unknown Roof Mater.: Unknown Pole Barn: Unk.
Irr. Lot: Unknown Roof Style: Unknown Pool: No
Terrain: Unknown Attic Type: Unknown Fireplace:
Water: Unknown Condition: Unknown Gas: Unk.
Sewer: Unknown Lot Dim: Electric: Unk.
Sqft 1st: Lot Size: .145 acres
Sqft Total: 1451
Market Value: $209,596 Gross Tax Semi Ann.: $1,216.86
Assessed Land: $143,776 HB920 Credit Semi.:
Assessed Bldg.: $65,820 RB Credit Semi Ann.:
Assessed Total: $209,596 RBA Credit Semi.:
Tax Semi Ann.: $1,216.86 Homestead Exemption:
Spec.Assmt. Semi.:
Sale Date: Oct-23-1990 Mortgage Date:
Sale Amt.: Mortgage Amt.:
Deed Type: Other Mortgage Type:
Volume&Page: Volume&Page:
Seller: Lender:
Title Company: Unknown Mortgage Term:
Multi-Parcel: N Mortgage Rate:
The information is deemed reliable but is not guaranteed. 2001-2002 Tax Year Copyright 2002 Haines Printed Aug-14-02
p ' I'S 9 CITY OF COSTA MESA
BUILDING DIVISION
>:f l �. DEVELOPMENT SERVICES DEPARTMENT P IT NUMBER
I. -1E".17.1 I PERMIT
� "' ' E00-01148
fi
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
ELECTRICAL PERMIT
Job Address: 2976 REDWOOD AV Status: ISSUED
•
Suite No Applied: 12/04/2000
Vicinity: BEDROOM ADDITION Issued: 04/04/2001
Parcel Nunmber: 13921503
Applicant: BROWN, JOAN , _ - ISSUED BY: f!/
Address: 2976 REDWOOD AV - -, , . .. •-•
- -
• Phone: 71'4-241-1455' •- - /
< A.
COSTA MESA,CA Zip:- 92626
/:
Owner. 'BROWN, JAMES WILLIAM &JOAN CHRISTINE'
Address ,2767 ALBATROSS DR
Phone: "
COSTA MESA,CA Zip: 92626 .
Contractor: ) OWNER-BUILDER -`,`' A� \�\,
•
Address: - ,
•
Phone: •
V\
- _ - 'L}.
. • - Zip: - . -
•
License: 0
•
Vi
' • -, :• SCOPE OP PERMIT / " •
• " ELECTRICAL PERMILFOR'AN ADDITION TO A SFR., ._r -- . - .. . 1 •,
' .,11 LIGHTING FIXTURES, 11 OUTLETS, 8 SWITCHES. - - - - -- !
, - ' • REF: B00-01584. _. !1 ' _ , ;
r , , ,•-;--
- C� ;
-- FEE SUMMARY /' ;r- •• - relry i /f, /.
Quantity ,/ Quantity///•/ �� r �
ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0 J' - ri
/
Temp service test - '
$0.00 Busway7100 ft ' - $0.00 0 f ( V♦/ (} j
Res..a/c package . , $0.00 .7-,Standing Section $0.00 f0/ /"CJ / 1//
New Res(1-2 units), ' $0.00 0 -•_,1 Misc Electrical Equipment $0.00 „',i0 / , e •
7.
New Res,(3+units)' ; .$0.00 0 ' - Transformers up,to 1 kva/kw $0.00 '/O �' ry
Pool/Spa., `� $0.00 0 v ` up to'10 kva/kw . $0 00//' 0 \--._ 1/%
Lighting Fixts.' $12:10 ;.--c,11 - - 'up to 50 kva/kw'zi,7J7$0.00/ 0 Z-\)"" '
Recept Outlets '\ x'$1210* A 11 " - - up to 100 kva/kw -$0:00 0 1
Switches ` ',`,,. /.x`• $8.80 �.VB c_ , ''?7, •over 100.kva/kwv;-��$000yf�0} AY
Non Res Appl A� / $0.00, /O\ 'LOW Voltage Equipment -/� $0:00 v/70/ rl
Res \\\-\\`.. MOO
- �- `Low,Volt Wiring.Syste�.Ckt ).,---$0.00°)"/0��
Service to 200a $0-00 0 _ - Misc.Conduit- - $0 00� 0�
Service to 1000a v�<>\ $0.00 / 0 Misc.Conductor A' -$0 00 �0'/
Service over 1000a =- $0.00 //'0- Circus(gen or ride) , A A -1`$0.00,/,'„,/,' '�0
Motors to 1 hp $0.00 0 - Circus'(meth ride or lights) $0.0 .- 0
Motors to 10hp $0.00 0- - . ' , Christmas Tree Stand-/ $0.00' 0
Motors to 5Ohp $0.00'',., 0- . i `v. Fireworks'Stand r --11/-C-/$0- -00 0
Motors to 100hp $0.00 •-, 0 Other Electrical Feed K/',, $0.00 •
Motors over 100hp $0.00 0 _ '_
Communicationdrops $0.00 0 -- - Investigation`Fee $0.00
Sub panel to 200a $0.00 0 Plan Check Fee $0.00
Pole Light Pkg $0.00 0 Reinspection Fee $0.00
Sign Circuits $0.00 0
Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $56.50
Intermed Pole $0.00 .0
COMMENTS I SPECIAL CONDITIONS
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
2446-46(6/00)
DECLARATIONS l ') l :
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 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:
Carrier: Policy Number:
(This section need not be completed if 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:
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 DOLLARE($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 in full
force and effect.Lic.# Class#
Contractor's Signature: 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).
Lenders 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 Mat 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 Mil 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.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: C Date: 4470;/ Y —0/
Owner ID ve• y driver's license. 0 Yes 0 No Drivers 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:
I 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
materiel? 0 Yes 0 No
(Section 25505 of the Calitomia 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? 0 Yes 0 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 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application akEermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ 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 pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 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? 0 Yes 0 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.
91211 e _ tee,/ Y -o/
Signature I Legal Owner(s) Date
And/Or Authorized Applicant Date
BODE r INSPECTION TYPE QATE' INTRIAI$ BODE 1 INSPECTION TYPE 129g INTtUAL4
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical S 9.c 1ic
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
•
OWNER H0 _VALT,EY4 DATE 7_9_59
JOB ADDRESS 2976 Redwood Ave. BUILDING PERMIT NO. 9829
GENERAL CONTRACTOR Dike & Colegrove, Inc. VALUE $ 14.552.00 _
AP. No. LOT 249 TRACT 2822 FIRE ZONE DESCRIPTION OF WORK Res. watt.. gar
INSPECTIONS »S-S9 DATE I GROUP I & J TYPE V ZONE Jfl
Underground Soil 441-5 U.G. Water44-/37-/6 all _PERMITS ISSUED _
Underground Gas SUBCONTRACTOR DATE NUMBER
Overhead Water and Gas �-y f _
Rough Heating /44-5'/44-5' 9 9-/P--SP 7. , o7 ' ,z,_pa� 9 s_ _c22 // a/
Rough Plumbing ,4 *},S >/I- 9-1,"1/1/21), limse . 7 -/C<S-`7 1 i y5/01--' V/
Miscellaneous __
Prop. Swr. Lino Hoate&n. St. Swr. 'Ola(/cr. /!7-K4 ,�{
.. -cesji-- -- _7/9b6i f Lr/2 -
Sprinkling System _
Heating, Final _ il°
Plumbing Fixtures _ —
Final Gas Test /S r G>/ 7 -
•
Construction Pole '
Underground Power .
Rough Wiring t1/14, ft.(i... e4 V/th b.90/z/ .., XIV) 41_///-c-9 /Q/ 'N2) r/
Trenches/1t3'lJ-Forms 4,9).} Steel 61 8/.4- .7-,r-i•i
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam 1
Sheathing /k r W
Frame and Flashing /(fi q -i6-5'
Lathing, In A Out 8-u q.-go_'
Plaster, brown coat / cY .* '(•-,w-5"tf
Plumbing Fixtures, Final
at--Ca� I ;7•y�
Electric Fixtures, Final .2. lig 1
Building, Final j w/t•Q.591
OCCUPANCY I
Form 210-3M-4-59 9829
9829 1=EE RECEIVED.
COSTA MESA BUILDING-SAFETY DEPARTMENT • JULx 1959
R O.BOX 317 COSTA MESA, CALIFORNIA FINANCE DPI.
CSA
FOR APPLICANT TO fill IN COMPLETELY APPLICATIONF FORQPERMIT
TYPE OR PRINT BUILDING
AB 1(5)
DDLRESS DING 97
2 6 Redwood Avenue
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
RECEIPT NO. 1 PERMIT NO.
OWNER Homes Valley, Inc. :�IcS �
MAIL 419 E. try UL, St. REG I ED BY DIE7E1VeE _PATJF�ISSUED
ADDRESS I Il q / T`t',�7 / ,'--
CITY Costa Mesa TND.L1g11-59 ADDRE ' , '/
ARCHITECT Carlson& LIC. •
OR ENGINEER No. COSTA MESA. CALIFORNIA
A1ddlcLnDok 1
' ADDRESS Garden Grove FIRE 1/ V.
��tt�� ZONE y�-✓
CONTRACTOR ORe & Colegrove, In".L SCT NPO, 167293 APPROVEDI DATE
ADDRESS 419 E. 17th St., Costa Mesa^� ZONING
LEGAL LOT 2822 ZONE NO.OF UEE OF NEW
DESCRIPTION I NO. 249 BLOCK I TRACT R r PLANS I BUILDING p,
. p, 1.112-I."t+/
A.P.NO. APPROVED r1 A_ J ) DATE S7
SIZE 60 x 105 NO,of BLDGS YARDS !'(/ L/ EVES _
OF LOT NOW ory Loi hone REQUIRED ALLOWED
USE OF (CENTER LINE ST.)
EXISTING BLDG. FRONT CO FT. IN.
SETBACK LINE FROM ! 27!
CENTER OF STREET 55-- REAR YARD 7. R.SIDE S' FT. IN.
SIDE YARD'(LEFT 5! I RIGHT 5' L.SIDE 6- FT. IN.
DESCRIPTION OF WORK .. /)
REAR ''I FT. IN.
NEW I X II ALTERATION I II ADDITION I
REPAIR 1 . II MOVING I II DEMOLISH
SIZE BUILDING 1450 NO.OF
ROOMS 6 STORIES • 1
EXTERIOR WAtlDb
COVERING OICCO (COVERING rock
USE OF BUILDING AND WORK TO BE PERFORMED
Single family residence with
attached garage.
Plan 146AR
1
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- THE AMOUNT SHOWN UNDER VALUATIINN IS FOR THE
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
•
BUILDING CONSTRUCTIO /pq VALUATION
SIGNATURE OF PERMIT FEE $ 34.00
PERMITTEE V
Dike
]1,,,552 PLAN CHECK $ 17.00
AUTHORIZED AGENT Dike & olegrove, Inc. 1.00
TOTAL FEE S 5