HomeMy WebLinkAbout2127 REPUBLIC AVE - Building Permits 51111 MF CITY OF COSTA MESA
49@@ BUILDING DIVISION
(41•PhirffnEr DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
1:1w.-"r PERMIT
�• B01-00698
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.caUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 2127 REPUBLIC AV Status: ISSUED
Suite: Applied: 05/15/2001
Vicinity: Issued: 05/16/2001
Parcel Number: 42244109 Zoning:
Applicant: REDMON, KELVIN ISSUED BY:
Address:
Phone: 949-548-3305
Zip:
Owner: REDMON, SHIRLEY J TR
Address 2127 REPUBLIC AVE
Phone:
COSTA MESA,CA Zip: 92627
Contractor:
Address:
Phone:
Zip: License:
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
CONSTRUCT 6 FOOT HIGH BLOCK WALL ALONG REAR PROPERTY LINE. 70 L. f. /mac a- Ga-sty aid.
FEE SUMMARY
Plan Check: $27.17 _ Calc Valuation: $1,096.20
Permit: $41.80 Claim Valuation: so.00
SMIP Res: $0.00
SMIP Corn: $0.00
Other $0.00
Inspection: $0.00
Total: $68.97
. PLANNING &ZONING
SETBACKS - 7 /
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
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PARKING Existing: 0 Required: 0 Proposed: 0
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: r
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 f California,a a a th t it I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these r I ons.
Applicant
Applicant Signature: a l d 4111 1 Date: i� 0 I
WARNING:FAILURE TO CURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND MU-ARE($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.If Class 4
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).):
O I,as owner of the property,or my employees with wages as their sole compensation,WILLDO 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 Atelier se� _ Business and Professions Code for this reason:
Signature: (,�/'{Fp�pY,44. Date: S//t.0/ 0)
Owner ID v ified by driver's license. 0 Yes 0 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 8,Califomia Administrative Code).
O 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
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 Califomia 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.
ii
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 apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? DI 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 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 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.
• Alf 7•nature Of Legal Owner(s) 5—//cet to
V ..And/Or Authorized Applicant i Date
CODE s. INSPECTION TYPE PATE INTITIALS CODE[ INSPECTION TYPE DATE INTITIALS
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 Wail S® 212 Final Fire Prevention E---
202 Final Factory Fire Place - 220 Final Planning Approval
203 Final Sign 222 - Final Site _
204 Final Demolition 250 Final Building/Occupancy
I \
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•THIS SKETCH IS FOR INFORMATIONAL PURPOSES •SOLID WALLS/FENCES BETWEEN 7-6•&0 IN HEIGHT SHALL
4)NLY. APPLICANT IS RESPONSIBLE FOR PROVIDING BE SE 1 SACK AT LEAST 10' FROM FRONT PROPERTY LINE.
AN ACCURATE REPRESENTATION OF THEIR PROPERTY
IN CASE THE SHAPE AND SIZE DO NOT CORRESPOND •SOLID WALLS/FENCES SHALL NOT EC®2'b•IN HEIGHT
WITH THE INFORMATION PROVIDED ON THIS SHEET. WITHIN 10'OF THE FRONT PROPERTY 1RNE(NOT CURB LINE).
• •VERIFY DISTANCE FROM CURB TO PROPERTY LINE
AND SHOW ON PLAN. VERIFICATION FROM THE CITY'S
ENGINEERING DIVISION IS REQUIRED. CALL(714)7544313
FOR INFORMATION.
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RE9QNQ 1152:oENQ x S •
7a' APPROVED
• CITY 0 COSTA MESA
• PLA NTNG DIV.
Z 2-1 21/ SUBJECT T BLDG. DEPT. REG.
Q BY DATE
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• DIVISION OF BUILDING SAFETY ,
CITY OF COSTA MESA
BbierWAL ffOUT FOR BUILDING PERMIT
:v _Dimlis set of plans and sot . :afore MUST oe kept on Ith job at all tknes and It is unlawful to 1
eakS any mangos er acorafon on Same without written palmetto from the Melon of Sukdng • I,
uni 2 faty,City of Coma Mast
he stamping of this plan and specification SNAIL NOT he hek to porn*or to bean approvrl �+
If the vi„taticn of any vmvlsior;of any City of C:ota tdt rdi n DIVISION
7hei 0,4,4,...,4,4%07,-y n Iimildynr(dna 4000AC u'tfr I R R itl!,..Ii_i..
1'._.�n1intl.n
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DECLARATION OF AUTHORITY Bldg.Permit f BO( '00(09e
FOR AGENTS OF PROPERTY OWNER 'This Remit;Ea a _Z)Q('p 9 43
TO APPLY FOR PERMITS
Street Address: C--217)1 r p LA-- 0 { f, C AP Number:
1. I (we), (t ,<.0 p'L 01-43\--N , declare that I am the Owner of Title of the above
referenced real property,^ and that I(we)hereby authorize:
Name: A4� V lAu 6. Rel nix) ~A Telephone Number.
Street Address: 9►2- 12-99lA43 ( 1 c
City: CQn o1/4— State: CA— Zip: ciOCael
to obtain permits in my behalf,as owner/builder,for b( 0 CIC., w
at the above referenced property.
2. Should any person become an employee engaged in the improvement of the property, I (we)shall immediately provide Worker's
Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa
Mesa,as required by State of California laws.
3. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other person, company or
corporation.
4. I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or
personal injury to myself or any other parties as a result of work authorized by the permits from the City of Costa Mesa.
5. I declare under the penalty of perjury that the foregoing is true and correct. p
Executed this'- day of ay 20 0-) ,at ceOS 6—PS ,California.
Print Name: /5( .6-11, ). Rcb Move
Signature: / 9�}
Date: cal ay a 5- /LTD l
Nota: This authorization does not grant authorization to perform the work as owner,
it solely provides for limited power of attorney to secure this permit in any behalf.
OWNER FARBER� BOB R. DATE JUL 1964
' JOB ADDRESS 2127 He.11b11C AVE. BUILDING PERMIT NO. • 22561
r GENERAL CONTRACTOR Owner-Builder VALUE $ 0.00
"AP No. 115-412-9 LOT TRACT FIRE ZONE 3 DESCRIPTION OF WORT dd Frpl.toRes.
INSPECTIONS Signature DATE GROUP J TYPE III ZONE R1
Soil PERMITS ISSUED
Gas SUBCONTRACTOR DATE NUMBER
Water -\
Rough Corn. Refrig. 0 Air Cond. ❑
Rough Heating
Rough Plumbing
Miscellaneous
Prop. Swr. Line 0 House Con. 0 St. Swr. I
Sprinkling System
Construction Pole
Underground 0 Power
Rough Wiring
Trenches ❑ Forms 0 Steel Reinf. 0 _ "f"-
4 y./O4y
Floor System _ `/
Bond Beam 0 Steel Reinforce 0 _
Sheathing _
Frame and Flashing
Lathing — In ❑ Out 0 _
Plaster, brown coat
Refrig. 0 Air Con. ,❑ Final
Heating, Final
Plumbing Fixtures, Final
Final Gas Test
Electric Fixtures, Final _ B
Building, Final ref p--/-4V
OCCUPANCY
Form HU4—SMS-63—S-H P •
22S -1
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' 22561 FEE RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT FI MIkE 70�P14
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 -
CITY OF COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
•
TYPE OR PRINT BUILDING
tfi For Office Use Only
Du1LDINa ..•TI •��I '^ 0
ADDRESS .( ),9i RePUSJ lin ag
RECEIPT NO. PERMIT NO
COSTA MESA. CALIFORNIA Zai .
•. EEC!, •• SY DA ,�rED 10 UED
OWNER i )l7 C! Il c0. I k e e p6
MAIL.I. BUILDI G
ADDR. � - t - A • I ADORE'S - 47 I �•�
4 TEL FIRE
TE ✓ lin /
ZONE L £ GROUP I
CITY ♦ - S NO. • .- .Y[, s„f- ARCHITECT TEL �_ B PRI!.1.4( £It "C3A/t'. `
r. OR ENGINEER NO.
WIl Z. ING , —
:� ADDRESS _
N NO.OF BUILDING
�1 CONTRACTOR l 0-1.3 Y\t:''e^ \6I1I IdP `CLEGAL Lim �`r �j �('2 0�7''] —
.1
Y ADDREDS 1 DESCRIPTIO �/ ✓ 1 I , `l l/J //
1CITY A.P.NO. VVV// 'Cry L//�— 7
I. NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
,.. STATE _ TEL -/ SO'TO SIDE B REAR r.L
• LIG.NO. NO.
EXISTING
T/ O 4 O I NO.OF BLOTS,
NOW ON LOT AL
OPLOT / LOWED (U.B.C.REQUIREMENT)
YARDS APPROVED YARDS APPROVED
, USE OF MAIN BUILDING ACCESSORY BUILDING
, EXISTING BLDG. _
(FROM C/L STREET)
SETBACK UNE FROM FRONT . .. fO pr.' CENTER OP STREET
3-0REAR YARD ./
TR
a_ SIDE YARD I LEST ----- RIGHT R.SIDE FT, v FT.
DESCRIPTION OF WORK L HIDE PT. •,t. FT.
— I REAR PT. /// Fr.
NEW ALTERATION 1/ ADDITION
t. DISTANCE BET. BET.MAIN&
,. REPAIR MOVING DEMOLISH
MAIN BLOCS. ACCESS.SLOGS.
BUILDING NO.OF VAR.fj DATE
I. SIZE ROOMS STORIES//• ,� C.U.P.
# J�J\ APPROVED / t/
. EXTERIOR WAL4��.1,^ I COVERING \Al(CLh�ROOF
P W•E V DATE - -lp`J 0.
COVERING �✓IV`V I
USE OF BUILDING AND WORK TO BE PERFORMED
m
SQ.FT.
I HEREBY ACKNOWLEDGE THAT.1 NAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE 10 CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT PEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCT° . VALUATION OG cap
SIGNATURE OF ///y/� �,,///� ,^ 1 PERMIT FEE $ 3 CI
'•'' PERMITTEF / / /•od/71Lc1C .4Qn,�).yA • ' / E
i.
S y0e9 PLAN CHECK E L� W
AUTHORIZED AGENT 'G/ 3
TOTAL PEE $
ORANGE COUNTY BUILDING DEPARTMENT ' APPLICATION FOR PERMIT
636 North Broadway
SANTA ANA, CALIFORNIA B U 9 L D ' N G
•
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
RECEIPT NO. PERMIT NO.
BUILDING 7336 567 C
ADDRESS 2127 RepublicflAve.
SCHOOL DIST.
OR TOWN Costa Mesa
RECEIVED
�EC/EI VaED BY DATE RECD. DATE ISSUED
NEARES4-8/ —52(
/i-9f�i
CROSS ST. VictoriaT� Ave. (BUILDING . // -� 1 T O /J
OWNER Crow Homes Inc. ADDRESS i i 4_�/_Oli -/ N��
MAIL
ADDRESS 9363 Wilshire Blvd. SCHOOL DIST. ��_ ! �" '�
L,,. OR TOWN L.� J.(�'
CITY Beverly Hills N0.CR 54361 NEAREST �/
CROSS ST. (/j�jf�
ARCHITECT R IC. ZONE NO. OF TYPE I GROUP
ENGINEER GPain—tdc0araa cheo. I I PLANS
ADDRESS 2110 E.Walnut-Pasadena `/ �l
APPROVED
CONTRACTOR Balboa Vista 1 (143231 BY DATE
ADDRESS
9363 Wilshire-Beverly Hills CORRECTIONS
LEGALLOT n p
DESCRIPTION I NO. 215 BLOCK I TRACT1872
(ATTACH METES a BOUNDS/
I NO.OF SLOGS.
SIZE OF LOT 70 x 103 NOW ON LOT 0
USE OF I NO. OF I NO. OF
EXISTING BLDG. I FAMILIES ROOM
SCENTER OFI STREETM o 50 l t• SIDE YARDD 6-).
DESCRIPTION OF WORK .
NEW I ][ I ALTERATION I I ADDITION I O
Z
REPAIR I I MOVING I I DEMOLISH I >
5 1 r
SIZE DING
SE 1034 sq. SND OMSSTORIES
EXTERIOR WALL ROOF Compo
COVERING Rtunrn I COVERING Stvi np
USE OF NEW ngl
�
BUILDING Residence-Att.Carport
APPROVALS
FOUNDATION: LOCATION INSPECTOR DATE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS UNDER-PINNING RM , MATERIALS, .ry/
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FRAME:BRACING, TOPS,
_.-et't �r)) i'V '/�_2�'
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
LATH. INT. /
SIGNATURE OF LATH. EXT. 4 P •'�Sr
PERMITTEE Ba�boa Vista Co.
AUTHORIZED AGT `/ //I / _ PLASTER, INT. ./ /J / /j J /
( /• y . rrr ; PLASTER, EXT. !If/(//��•7Jj _�0/
p
PERMIT FEE $ / MASONRY REINFORCED
VALUATION $ 4830.00 PLAN CHECK S
BOND BEAM
TOTAL /� 7%-#1 7-.521.,. _ .. . ., FEE $I!o FINAL
5M 9-90-99
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PLOT PLAN
Show location and distances from
property line and between buildings. _
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