HomeMy WebLinkAbout2004 REPUBLIC AVE - Building Permits / 1 I i
CITY OF COSTA MESA
^5`" Sst BUILDING DIVISION
Fµ;Vi' 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
11)-" PERMIT NUMBER: E09-00255
PERMIT TYPE ELEC STATUS: ISSUED
APN: 42248117 DATE ISSUED: 10/06/2009
--.-- , , .ISSUED BY: RMD
JOB ADDRESS: 2004 REPUBLIC CM -Sate/Unit
Vicinity: •
•
SCOPE OF WORK: ELECTRICAL'PERMIT TO,REPLACE•A SERVICE PANEL-200 A. e,
OWNER: MEYERS,DEBORAH ` . Address: 2004 REPUBLIC AVE- Unit
PHONE: 562-810-2553 -'City/State/Zip: , COSTA MESA, CA7
APPLICANT: MEYERS,.DEBORAH } - Address:" ' 2004 REPUBLIC AVE Uniti,'
PHONE: 562-810-2553 - • City/State/zZip: COSTA MESA,CA •
CONTRACTOR: OWNER-BUILDER License No. 000000
Address: Unit: . . ' -; ' PHONE:. - - "
City/State: ZipCode:
•
ELECTRICAL PERMIT FEES . :
Electrical Plan Check Fee: - $0.00 '
Electrical Permit Fee: • • $54.00
Reinspection Fee $0.00 .
TOTAL FEES $54.00 '.
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord. No.92-28,§1, 12-21-92)
EXPIRATION: 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 A INSPECTION TYPE DATE INTITIALS CODEA 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 0 I
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
1 \ • c Nit
WORKERS'COMPENSATION DECLARATION: Owner ID verified by driv-
Er piert
❑ I have and will maintain a certificate of consent to self-Insure for workers' 7!•""� Er
fres.:,
as provided for by section 3700 of the Labor Code, for the enfication of by(type of document,i.e.-property tax II deed):
performance of the work for which this permit is issued.
0 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 ❑ 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
by this permit,and that no building structure,scaffolding,falsework,or demolition
Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
(This section need not be completed d the permit is valued at one hundred dollars(5100)or less.)
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
1 .7I 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
sued, 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.
t the workers' compensation laws of California, and agree that if should
beco r- ubject to the . - c.• sation provisions of S-ction 700
Applicant's Signature Date
the •r dr!,I shall I. hwit 'th these .rovisio . /I
i� e / / Division of Industrial Safety Permit Number:
iliM.4 /
111111r —Rail :req/• , a',/
'W !_ s- HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SE R •'KERS' COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SU:.ECT 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
($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? ❑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
Contractor's 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
•
L'ender's Name: hazardous materials)? 0 Yes CINo
(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 ❑ 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? ❑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 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 ndred dollars($500).): of the California Health and Safety Code).
del, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Duality 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? ❑Yes ❑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",es", 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 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.
UCENSED 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
1:1• Iam 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 ode for this reason: the City of Costa Mesa to enter upon the above-described property for
inspect'•], p rposes. I agr r . occupy or allow occupancy of any building
th. y his per .t u + Ins eclion.
is, A_ ,/✓ g.: 7
3057-48(3/07) And/or Authorized Applicant Date
T
PROJECT ADDRESS: UNIT:
OWNER'S NAME: 2004 REPUBLIC AV CITY OF COSTA MESA - BUILDING PERMIT PERM NO: E 065754
ADDRESS: RAPOZA, DENNIS
2004 REPUBLIC AVE PERMIT NO: E 065751 PLAN CHECK NO: N GOVT: N SUPP : N
COSTA MESA, CA 92627
1.1`.
CONSTRUCTION TYPE; PERMIT TYPE: ELE PURPOSE: 0TH
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION ; UPGRADE METER
ADDRESS: UNIT: SQ FT:
PERMITTEE: CLAIM VALUE: CALC-VALUE; GROUP OCC; /
ADDRESS: DENNIS RAPOZA ( 714 ) 642-5855
20040M � REPUBLIC AV 7 COMMENTS : INSTAL CONDUIT FOR PORTABLE JACCUZI
'LICENSED CONTRACTOR OEL[1(flaTIDN: (hereby affirm lhatlam licensed underCprAvisi92o Ap(er9(cammencing with Section ****************************************************************'****'**** '*'N'****
7000)of Division 3 of the Business and Professions Code.and my license is in full farce and effect. Z ON ING R EQU I R EMENT S
CITY LIC.: STATE LIC.: CLASS: SE TB ACK S
Dale: Signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a cenificale of consent to self-insure ora cenificale of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT; FT IN RGHT: FT IN LEFTFT
POLICY NO.: EXP.DATE: : IN RGHT: FT I N
'DMPANY: PARKING REQ• PROV; PARCEL: 42248117 ZNE: REF NO:
J Certified copy is hereby furnished. D Certified copy is filed with the city Building Division. PLANNING NOTES>
r
Date: Applicant: ********************************jkiEik*****3fiFlEiFiflEifiEiFi ****ffififitifiEiElEiEjEififiEjkiE9FeE****'JE***
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (j is section need not be completed if the permit is for one hundred(5100)or less). DEVELOPMENT ''S--E- 'R V ICES REQUIR EMENTS
I certify that in the performance of the work for which this perms is issued.I shall 1 e y any person in any manner so as to become i
subject to the Workers'Compensation Laws of California. 4'"
(j/p ZONING APPROVED BY !' ' DATE;
Dale: I " ) J--14-1 you should
//>~ ( �-
NOTICE:If,after making this declaration,you should become subject to the work Co pensation provisions of the labor BUILDING APPROVED BY : r j
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. DATE
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for r �A
which This permit is issued(Section 3097,Civ.Cl. APPLICATION ISSUED B Y; / DATE: , `B �'
* ************************* ****** ***
LENDER:
ADDRESS: *******************************************************************************
LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SM I P/RES GRADING
Section 7031.5 Business and Professional Code: Any city of 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/she is licensed PERMIT 3 0 25
pursuant to the provisions of the Contractors'Slate License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 5 0% SM I P/NON-RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). ISSUE FEE 15 . 00
I, as owner of the properly or my employees with wages as their sole compensation, will do the work, and the BUILD ING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 3 0 . 2 5 15 , 0 0 0 . 00 4 5 . 2 5 4 5 . 2 5
does not apply to an owner of a property who builds or improves thereon.and who does such work himself/herself or through . 00
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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED : 45 . 25 OVER/SHORT• . 00
for the purpose ol sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
I,as owner of the properly,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 45 . 25
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such protects with a contractor(s)license pursuant to the Contractors'Slate License Law). I am aware ****,*********************************************************************
that proof of their Worker's Compensation insurance should be provided to me. *'*'***
❑ I am exempt under Section: B.s P.C. IND IV IDUAL F E E BREAKDOWN
for reason. / r: /1./1-1e ��
TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
y Date: / -1 Y• i Owne /1./1-1 -
I do hereby certify that l am aware of and understand the requirements of California Health and Safety Cod echons 25505,25533,and EL E 1 REC EP T/OUTLET 1 ST 20 EA. . 75 75
25534 and that l or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a ELE 1 SERVICES BELOW 600 V & BELOW 201 AMP 18 . 50 18 , 50
permit for construction or modification from the An Duality Management District.Residential construction applications are exempt from ELE 1 M I SC CONDUIT NOT LISTED REQ PERMIT 11 . 00 11 . 00
these provisions. END OF FEES
Dale: Applicant: /
I hereby certify that I have read this application and state that the ove information is correct.I agree to comply with all city and county 01 0015391 ft-001`3916 E�13th
ordinances and stale laws relating to building construction and hereb authorize representative yot this city to enter upon the above-mentioned 45._2,1
property for inspection purposes. r � DATE: 01/13/94 TIME: 15:03
7 Dale'. /' " f V Signature: y `i �—\
Driver's License or Social Security
1641.46 White—Budding:Green—Code Enlorcemenl:Canary—Applicant:Pink-Revenue:Goldenrod—Assessor
1111111111111111111. . _ .
' PC & SPA
CONSTRUCTION AND PLANNING -
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53, Steel Reinforcement
-E3: ElectricalConduiti.Jtility•Undrgrnd. - 54. Forms
4, Electrical Conduit-Undrgrnd. - 55. Electrical Bonding
-•5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
1
I 6. Electr'.ca: UFERGrnd, 57. APPROVAL TO COVE R-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
T 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. I 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
I 12. Sewer Cap t
63. Heater & Vent-Final -
13. Roof Drains - 64. Plumbing System - Final -•
14. Rough Plumbing 65, Electrical-Final - -
15. Rough Electrical-Conduit 66. Solar System-Final • •
16. Rough Electric Wiring 67. Fencing& Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19 Rough Heating& Air Conditioning . FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace _ APPROVALS Permit #
21. Ducts, in Structure - 3 70. Underground Hydro
22. Ducts, Ventilating - _ - . '}1. Product Piping 0 Gas Obil
23. Gas Pipe-Rouge& Test - - .. 72. Underground Flush
• 24. Roof Framing' - 73. Undergrnd:Storage Tank 0 Gas G Oil '
• 25. Roof Sheathing - _ 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & ttonbtoat ,. 75. Dry Chemical - ' '
i -
27..Frame and Flashing r r 76. Dry Standpipe - '-
-28. Lathing Sr Siding - 77. .FIXED SYSTEM FINAL - '
•• -•
29. Insulation - . 78. _FIRE PREV. FINAL
33. Drywall Nailing HEALTH DEPT..REQUIREMENT
31. Plaster Bro.vn Coat __ _ 79. FINAL INSPECTION -�
32 Electrical Power [1.eter'Final �' a,ji 1. '80. :F•OOD CERTIFICATE ISSUED
33. final Electric I _7 ` •dotes:
34. Final Heating& A;r Conditioning _
35. Final Gas Pipe-Test -
I 36. Hood or CanOPY _ - -
37. Final Factory Fireplace
- _ •
38. Final Plumbing - ,
39. Water Service-Final
I 40. Gas Service-Final _
111 . .
41. Solar Domestic-Final - _
' , 42. Backflow Preventer - V - -
43. Backflow Irrigation -. -
44. Landscape Irrigation System ., ,. - • - -
45. Sound Attenuation _ •
i'46. Handicap Regulations -
' 47. FINAL STRUCTURE & BUILDING - -
48 FINAL PLANNING - {
49. Electric Release to Edison !
50. Gas Release to Southern California Gas Co . -
51. CERTIFICATE OF OCCUPANCY ' - - .
No. Date
ORANGE COUNTY BUILDING DEPARTMENT APPLICATION FOR PERMIT
•
' 636 Korth Broadway Q ® ®
SANTA ANA, CALIFORNIA' ' ' `• v_•__BU_ a.® N, 11_- _•_�
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY 1
RECEIPT NO. PERMIT NO.
BUILDING I , 2-8.6 - _ L3 / :S3, /,
ADDRESS 2004 Republic Ave. _ i c..r1
SCHOOL DIST. C Mesa RECEIVED SYS DATE OF APPL. DATE ISSUED I
OR TOWN Costa I III ]EAREST �7 (� -�J -�� OCTl, 2 I.I. �3J3;
CROSS ST. Grove Place �\ /_ / / [L p // mayp
OWNER MOH I CAN HOMES, INC. ADD EISSG Z D/yl 1. /F'C-�j.G✓VLL- 24/.4
ADDRESS 9363 WILSH I RE BLVD.MAILSCHOOL DIST` / �� _ .( 1(2.4t
_ I
OR TOWN • L/u�(!{- �//�Q�i
TEL. /, //
CITY BEVERLY HILLS NO. CR. 54361 NEAREST -Vri _ G//
CROSS ST. �Vr(/V / C_
A RCHITEweyAR TEL. p ZON O� OF TtP=� I GROUP;
ENGINEER LAIN Si MCKERRAC HER NO. SY. 64891 //7/ I ,PCANS
ADDRESS 2110 E. WALNUT ST. , PASADENA SETBACK LINE Unlit CENTER OF ST. 15$1]' I
REAR;YARD ` "`.--ISIDE YARD 9 .-.1:2""
CONTRACTOR NEWPORT VISTA CO NO. CR. 54361 ,
ADDRESS
9363 WILSH I RE BLVD. BEV.HI LLS APPROVED �% � i DATE�G {�j
LEGAL ' U CORRECTIONS ' I
DESCRIPTION I LOT NO. 162 I BLOCK 1 712 I I I
(ATTACH METES & BOUNDS) _ _
TRACT . ---
- . - _ '. .
PLUS NO.OF SLOGS., . 'I' ' 1
SIZE OF LOT7200 SO.FT. I NOW ON LOT I -
USE OF I NO. OF I NO. OF
EXISTING BLDG. FAMILIES ROOMS _ _ —_ __ - -__ _—J
DESCRIPTION OF WORK
NEW I X I ALTERATION I I ADDITION
D
REPAIR I I MOVING I I DEMOLISH I Z
BUILDINGNO. OF V F
SIZE 1034 SO.FTROOMS 5 STORIES 1
WALL I ROOF COMPO
COVERING STUCCO COVERING SH I NGLES '
USE OF NEW
BUILDING RESIDENCE,A tt_Carport
APPROVALS
FOUNDATION: LOCATION I PECTOR DATE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS UNDER-PINNING RM , IALS /1 A /��
APPLICATION AND STATE THAT THE ABOVE IS CORRECT ��() P
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FRAME: FIRE STOPS. -(
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. BRACING. BOLTS ��(/ J2-/(/'� v
LATH. INT. ...Sr
SIGNATURE OF NEWPORT VISTA CO. LATH. EXT. /f/� / a�•i;..7
ei
PERMITTEF c^V
PLASTER. INT. I /�
AUTHORIZED AGT. e3 /-n�J'
o PLASTER. EXT. r � �
$ 4830.00 P. C• $ /✓ -•---- MASONRY REINFORCED
/
FEE L BOND BEAM /
sM VALUATION _FEE // 1)�3 FINAL `t
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