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HomeMy WebLinkAbout2119 UNION ST - Building Permits ,1 • CITY OF COSTA MESA lee BUILDING DIVISION F a ,) 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 PERMIT NUMBER: BC1O-00494 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: RES ALT DATE ISSUED: 11/08/2010 ISSUED BY: RMD JOB ADDRESS: 2119 UNION AV CM Suite/Unit: APN: 42244211 Zoning: , , Vicinity: BATHROOMS Primary Occ: Const Type: V-B SQ. FT: 0 Valuation: $10,000.00 SCOPE OF WORK: DEMO EXISITNG BATHROOM,ADD 2 NEW BATHROOMS. RE-LOCATE LAUNDRY TO EXTERIOR COVERED PATIO. REPLACE EXISTING WINDOWS SAME SIZE OPENINGS.WINDOWS TO MEET EGRESS REQUIREMENTS. PLUMBING TO INLCUDE TANKLESS WATER HEATER,LAUNDRY,1 BATHTUB,1 SHOWER,2 LAVS, 2 WATER CLOSETS. ELECTRICAL TO INCLUDE 2 LIGHTS 2,RECEPTACLES,2 SWITCHES. MECHNICAL TO INCLUDE 2 BATH EXHAUST FANS. OWNER: JEFF HARRISION Address: 933 CEDAR PL Unit: Phone: 949-422-0190 City/State/Zip: COSTA MESA APPLICANT: JEFF HARRISION Address: 933 CEDAR PL Unit: : Phone: 949-422-0190 City/State/zZip: COSTA MESA CONTRACTOR: OWNER-BUILDER License No. 000000 Phone: Address: Unit: Cell: City/State: ZipCode ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: COMBINATION PERMIT FEE SUMMARY Building Plan Check: $117.81 Building Fees: $181.25 Electrical Fees: $30.10 Mechanical Fees: $38.00 Plumbing Fees: $127.65 SMIP Residential: $1.00 SMIP Commercial: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES: $496.81 --Refer to fee receipts for all fees paid for project HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279 Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibited all hours-Sundays and the following Federal holidays: New Years Day, Memorial Day,Independence Day,Labor Day,Thanksgiving Day and Christmas Day 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 lN1mALE CODE INSPECTION TYPE DATE INIIIIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing vX 2-2-I) /17P 200 Final Re-Roof _ 210 Final Electrical )t 2- 2 -/I e L,.Aa 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 �( 2-�" -/I `i;/ 6 y; I, - r WORKERS'COMPENSATION DECLARA:t rvN: Owner ID verified b, .,ver's license. clidfCr. ❑No I hereby affirm under penalty of perjury one of the following declarations: Dmer.'s.License No. /✓ .,pines: )12 l2 ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-properly 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: 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 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend.wit be made in connection with work authorized by this permit,and that no building structure,scaffdding,falsework,or demolition Carrier: or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Gm (This sedpn need not be Completed rfthe perm(is valued at one hundred dollars($100)or less) 2,Art 2Sec.341,Title 8,California Administrative Code). P.i y Number: 0 As owner-builder, I will not employ anyone to do work which would RI'— ertify 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 / i!rued. 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 Applicant's Signature Date the Labo C.r: I sh.I •rthwith comply,with these provisions. ,. ' ' I t g( l J Division of Industrial Safety Permit Number: 'f '..•-, 'P.^,!tu CjeTh HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: F•!LURE 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? ❑Yes ❑No (5100,000), 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 ATTORNEY'S 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 Lic.# Class# (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 Contractors Signature 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 LENDING 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 0 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. Signawre 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? 0 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 0 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 License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be furnished on applications for non-residential building permits). 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 ❑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 fihundred dollars($500).): of the California Health and Safety Code). Q as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast AirQuality Management District or other pensation. 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 0 No thereon,and who does such work himself or herself or through his or her own 8. (If"yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for 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: I 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 0 I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date 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 EDI exempt under sec. the information given is correct. I agree to comply with all state 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 r lg authorize. .. t per until final inspection. z--il f. 1//�/Ay/I1 ser{s <.l.i(/j.l0-lit: FFS '--�__7J '1J -- toil wrea e I wen sl �e 3057-46/32 And/or Authorized Applicant Date 0iI111111il lI4 ItI , i , lil , l8 111 it , l , l1h 2J , L , i1I11 i 1611l1l1l11 i1201i1 i_ ti Ii1 , X24111 iii 111 II281 : :�Kf6�?5 ?�: �iiA1A! -:1- .. l{ e. ;S, 9j . . . . . . : : TQr.I.:Y� . lam/N "� . . . . . : •: J• . . . . . . . . . . . . . . . . . . . J CJ. . - - _ li . . . . . . ._. . . . I! l T �� 11 - . ti,uS�ul b e3' —/ . . . . . . . . ' A. . . . . . . . . . . . . . . . . . . . . . . . . . 0 4\ 1 E p�„.....ro.„40 'a': :44' .� `. . ._. tasm•pshipbei 5sol �509nsle"W •e qi. pue=O ' - c1�3 ID Aug lu su w;nado_ pus siu buicoeeAu u 6u�dmel9 @LL ` . . . . . . . . . . . . . . _moms los ue spotop7Q'eeeW slip e37,,-adS pa adtii . . . . . . . . . . . • . lepadeuseCelm2iu3dap egegIONTP{ esey;4s.60io45'Nel?SP� ' . , m uassrauaduatUmtna:. °`losualetsuelo-sa6ue4iWe � MNING 64"IDuelswG84/ e� �lc31,.)odspuekUeUllu a APPROVAL IMmelen sl U Pue sewq Ile le qd SP u�71°''.Q, SI'� . " is City of Cosh)Mesa t Ire g Dar. Convert I bathroom and utility room to�2 -athrooms 2119 Union2b27 tdWO:) V(lOO Reauhsdth�rtot3-..aPProved Final VS3W V1SOJ �O 1110 .ES ONO Zqd�t LflAVS �J[`ll4 Ilflfl d0 f�IOISIAIU OYES ego cznin Park " r Fees -L-.±_nate: 147/0 Neil) bit*/I ani$ €747 alt X111.44,/ 11-41/69D--'C/4 .144-nt rim_ Now CITY OF COSTA MESA 05`11/4C,p BUILDING DIVISION F77 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 PERMIT NUMBER: E10-00269 PERMIT TYPE ELEC STATUS: ISSUED APN: 41221233 DATE ISSUED: 11/08/2010 ISSUED BY: RMD JOB ADDRESS: 929 CARNATION AV CM Suite/Unit: Vicinity: SCOPE OF WORK: ELECTRICAL PERMIT FOR A DISCONNECT TO CHANGE OUT AN EXISTING A/C UNIT. REF#:M10-00116 OWNER: MARGOLIS,CARL J Address: 929 CARNATION AVE Unit: PHONE: City/State/Zip: COSTA MESA,CA APPLICANT: MILLER, DUSTIN Address: Unit PHONE: 714-826-5113 City/State/zZip: CONTRACTOR: SONSHINE PLUMBING INC -DIAL ONE License No. 550716 Address: 10537 DALE AVEUnit: PHONE: 714-523-9219 City/State: STANTON,CA ZipCode: 92626 CELL: ELECTRICAL PERMIT FEES Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $24.60 Reinspection Fee $0.00 TOTAL FEES $24.60 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 I. INSPECnON TYPE DATE INTRIRLS CODES INSPECfON TYPE DATE INTMALS 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 204 Final Demolition 250 Final Building/Occupancy Mr NW WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's license. 0 Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ovmership 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 Wan.. 7 vtSl.VvFCV /w5:-r✓A Vt Zorn/Fa "+ by this permit,and that no building structure,scaffolding,falserk,cr demolition (This section need not be completed if the permit is valued at one hundred dollars(it 00)or less) or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.341,Ttle 8,California Administrative Code). CifblIcy:Numbec (A)&GOO 10`1710 0 0 As owner-builder, I will not employ anyone to do work which would O 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' compensationryprovisions of Section 3700 of Applicant's Signature Dale the La Code,I shall forthwith o ply with these provision tl t//S td Division of Industrial Safety Permit Number: gppll ants Sign 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 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS , (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No Licr—:72135crl-.<4,#:(-56-tiye. L,/rid £10 (Section 25533 of the California Health and Safety Code, with some 3�6. ,.,!,_..t"--- -4 "- exceptions, requires registration with the Costa Mesa Fire Department by /,%/_."�--� %/�$ �/O each business which at any one time has on hand a quantityof acutely Contractor ignature t- —Dale hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feel of compressed gas at standard CONSTRUCTION LENDING 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)? ❑Yes 0 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? 0 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 Govemment Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be fumished 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 0 No 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 8. (If"yes", attach certificate of compliance from the appropriate 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: I certify that under penalty of perjury the did not build or improve for purpose of sate.). information given above is correct. I agree to comply with all state laws and LI I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date 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 0 I am exempt under sec. the information given is correct. I agree to comply with all state 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. (2-‘17-- � Sign we of Legal Owner ) Date Signature Date ? q' YY% `//g'Signature /!� 305]-0e(3107) \// // - 7-- nc/oAu p pdacant cSa 0� 5/8"X 10'AB W/2-3/8"X 2-318"SO.WASHERS @ 4'O C, e�3�'r .BX�6X W'STEEL MEBHI / ��L} 15'-0' Iti, I VA 3H 0 / 5 9 9 3 / z $�� �' o \ ' \ 04 LINE OF ADDITION • \ e \/\\i\\i\i\ \\/\�//�\/ T 4'-0'x 3'-4' 14-0'x 3-N 6'-p•x g-0 0 - - L - - \/ /�� tt4 REBAR OONT. u I SHELF«POLE ; \ a • A /'• \�//3 Y 2'OF SAND W/6 MIL.VISOUEEN ` " N/\\ '.° �T,N' \\//\ 2"OF SAND OVER VISOUEEN - x jMASTER NJ / - EDROOM-= 1 BEDROOM #2 ;`c. SHFLF+POLE g ��/�yy / — BEDROOM . .;., G� j, „' SCALE:314"=1'-0• 0 r ++ MAS—ER i 3 )OTING DETAIL __�_ c HALL ` CAMs-in � , ! ! N ' BATH IIri 0 s'-o" I� EXiSTI .G w 14 UTILITY Q , \SHALETWOCK THIS v vash4 f r'4111.1 j;` RESID' NCE m ✓1 0.. I N m 1 SEL -CLOSING, �--- IJ ryeIn SOLID ORE DOOR a / u — \HD-z ,�TQnIGIC 4,2't2 n N • W.lu 5 VW X 1'T--' PARALLAM BM.OVER SIDENCE ah t JFK KITCHEN LI IfNG \ / 0 r; I I I ROOM ... IN I 2X6 J.@16'O.C. �$`y GARA E 6-0” — 0 DINIING ROOM / 2 X 6AARAGE WALL TIES @48\O C. Ni n I /y \ \ _ 14'.0"rt-0"I I 6'-0"x 4'0" o *sal 9'-p••x -. !S.7 G / 2 X 8 RAFTERS @24'0.C. \ .7-----------------.20'LONG BARS OF STEEL @24'O.0. _ - - [ 5'IMBEDDED IN EXISTING FOUNDATION i7 • / �s in LINE OF ADDITION r ' y ... / '` t - - - - F� - - - - - - E '' ;: ' �' e a.w 4"CONCRETE .0 Z... N 10'-0' 4'-0' I6'-0" 1'-0' 14...' 2P-0" T HD-2 / cr_n• ...ale , 1111 41. It Y CITY OF COSTA MESA fradon Aft a BUILDING DIVISION F4 ��I 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us o FOR INSPECTIONS CALL:(714)754-5626 SIztPeniarto PERMIT NUMBER: B09-00287 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 42244211 DATE ISSUED: 11/2012009 ISSUED BY: RMD JOB ADDRESS: 2119 UNION AV CM Suite/Unit: . Vicinity: HOUSE AND GARAGE ROOF Squares: 1400 Valuation: $4,100.00 SCOPE OF WORK: TEAR OFF(E)ROOF MATERIALS, INSTALL 1 LAYER OF 30#FELT ON A 4:12 PITCHED ROOF AND REROOF WITH 30 YEAR COMP SHINGLES ON AN ATTACHED HOUSE AND GARAGE,APPROX 1400 SF. REPAIR AND REPLACE SHEATHING AS NEEDED. OWNER: SMILEY,W A TR Address: 2408 MARGARET DR Unit: PHONE: City/State/Zip: NEWPORT BEACH,CA APPLICANT: LEHMAN,JEFF Address: 2415 MARGARET DR Unit: : PHONE: 949-646-3571 City/State/Zip: NEWPORT BEACH,CA CONTRACTOR: J S L ROOFING INC License No. 747706 Address: 2415 MARGARET DRUnit: PHONE: 949-646-3571 City/State/Zip: NEWPORT BEACH, CA 92663 CELL: ARCHITECT: • License No. PHONE: ENGINEER: License No. PHONE: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $111.25 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES $112.25 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#. INSPECTION TYPE DATE INnnAL3 CODE# INSPECTION TYPE DATE INITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof Ia'/-CJS] ' (]U 1 w�) 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 • IIIIP WORKERS'COMPENSATION DECLARATION: Owner ID verified by drivere. ❑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 In��1111rance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: 1 person is required to descend,will be made in connection with work authorized Carrier: 5 ri 4 5,4,C./ by this permit,and that no building structure,scaffolding,falsework,or demolition r�"a"(rnls sectronneed n�emmpleted Atheperml is valued ato e hundred dollars($100)or Dr dismantling thereof,will be more than thirty-six(36)feet high.(Chap. 3.2,Grp 3 Doo r} 2,Art 2,Sec.341,Title 8,California Administrative Code). Policy Number: �� 0 As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the perf.rmance 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 an person in any manner so as to become subject such person has a permit to do such work from the division. to the worker compensat.n laws of California, and agree that if I should become subjs• t to the . ers'compensation provisions of Section 3700 of Applicant's Signature Date the Labor .e,I sh '. hwith comply with these provisions. 1 ,/ ' SL• /1 2©- 0 r! Division of Industrial Safety Permit Number: / /' ppllcaa Signa ure Gloats>= HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WA"NI . FAILU" 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 fled with the Costa Mesa Fire ATTORNEY'S 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 a registration form for acutely hazardous materials? 0 Yes ❑ No ai-C-# tl-I 779 celas5#—.t 39 (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by 2 �� //— ZD' �? each business which at any one time has on hand a quantity of acutely Y rs si- ure Loate •. 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 CONSN LE LNG 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 0 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? 0 Yes ❑ 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 Govemment 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? 0 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 8 (If"yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for 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: I 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 ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: a contractors)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that LI I am exempt under Sec. the information given is correct. I agree to comply with all state 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 upo the above-described property for inspection purposes. I ag ee not to Dc• py or allow occupancy of any building authorized by this p-r until final section. S • Date d--202-4-7 Signature Date i f — )0 57-46 13107) �7�0447///...111 ✓ "—i if d.'•Jf h. d'A:pliranlr?ri y�„ r_Deta�.