HomeMy WebLinkAbout249 ROBIN HOOD LN - Building Permits CITY OF COSTA MESA
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� S BUILDING DIVISION
Ff' #4%2 77 FAIR DRIVE, COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.costamesaca.gov
°. ." FOR INSPECTIONS CALL: (714)754-5626
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PERMIT NUMBER: E12-00004
PERMIT TYPE ELEC STATUS: ISSUED
APN: 42620253 DATE ISSUED: 01/04/2012 •
ISSUED BY: KJB
JOB ADDRESS: 249 ROBIN HOOD PL CM Suite/Unit:
Vicinity: •
SCOPE OF WORK: RELOCATE FAU TO ATTIC,CHANGE OUT COIL, INSTALL TANKLESS WATER HEATER IN THE ATTIC. DUCT WORK. 1
LIGHT FIXTURE,2 OUTLETS,2 MOTORS TO 1 HP FOR TANKLESS WATER HEATER. 1 GAS OUTLET, 1 WATER HEATER(TANKLESS).
OWNER: SITZMAN, MATTHEW Address: 249 ROBIN HOOD PL Unit:
PHONE: 949-200-9627 City/State/Zip: COSTA MESA, CA
APPLICANT: IBANEZ,ADOLFO B Address: Unit:
PHONE: City/State/zZip:
CONTRACTOR: ECONO AIR License No. 445220
Address: 4915 E HUNTER AVEUnit: PHONE: 800-503-2666
Ciky/State: ANAHEIM,CA ZipCode: 92807 CELL:
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ELECTRICAL PERMIT FEES
Electrical Plan Check Fee: . $0.00
Electrical Permit Fee: $54.50
Reinspection Fee $0.00
TOTAL FEES $54.50
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NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, 9 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF.ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
CODE O. INSPECTION TYPE DATE INTmAL$ CODEg INSPECTION TYPE INTITIAL$
-1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing / %/�
200 Final Re-Roof 210 Final Electrical X } - -t(3__o tc
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
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WORKERS'COMPENSATION DECLARATION: Owner ID verified by drivers license. ❑Yes ❑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 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
perfor nce 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 carni 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
by this permit,and that no building structure,scaffolding,falsework,or demolition
Carrier R�lir.•-v /1.-074 or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Gm
(Thin ;on need not be comp'
the perm isved at one hundred dollars(St00)or less.)
2,Art 2,Sec.341,Title 8,California Administrative Code).
Policy Number: / '"7 -
❑ 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 mpensation provisions of Section 3700 of
Applicant's Signature Date
the Labor Code,I shall ply wjtp th*ee provisions.
c �/ /' / — 51
/ Z Division of Industrial Safely Permit Number:
tricant's sgnawre 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? ❑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 ininfull force and effect. a registration form for acutely hazardous materials? DI Yes ❑ No
Lic.# �7 rS -2—° Class#G/' ' 7-0 ' (-a (Section 25533 of the California Health and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Department by
/ f / each business which at any one time has on hand a quantity of acutely
tractor lure Dale 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 ❑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 ❑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 ❑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? ❑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: 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 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.
Signature of L ner(s) Date
Signature Dale
3057-4613/07)
9 for Authorized Applicant Date
'70- , t, CITY OF COSTA MESA
,4;(4011r::,,
BUILDING DIVISION /
r i �: P MIT NUMBER
Ki . DEVELOPMENT SERVICES DEPARTMENT
• PERMIT BOO-00930
'1••'GINil00'' *
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 249 ROBIN HOOD PL Status: ISSUED
Suite: Applied: 06/22/2000
Vicinity: Issued: 06/22/2000
Parcel Number: 42620253 Zoning:
Applicant: MIGUEL ENRIQUEZ ISSUED BY: 3 v
Address:
Phone: 714-542-5222
Zip:
Owner: NININGER, JERRY
Address 411 15TH ST
Phone:
NEWPORT BEACH,CA Zip: 92663
Contractor: BEST VALUE ROOFING
Address: 1420 E. EDINGER AV#111
Phone: 714-542-5222
SANTA ANA,CA
. Zip: 92705 License: 715903
Arch : Eng: .
Address: Address:
Phone: Phone:
Zip: License: License: •
SCOPE OF PERMIT
T/OFF,SHEATH AND REROOF 2500SF RESIDENCE W/COMP SHINGLES,SMOKE DETECTORS REQ.PER 97UBC.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: 56,000.00
Permit: $125.25 Claim Valuation: 56.000.00
SMIP Res: $0.60
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00 .
Total: $125.85
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
NOTES:
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord.No.92-28,§ I, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180.days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
•
DECLAPATIgws •
_ U
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance Of the
work for which this permit Is Issued.
I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workers'compensation Insurance carder and policy number are: .yam n�
Carrier: 'C'"^Cl'teem., Z�-r rl F• • / Policy Number: aQ— 71 —30 pct
(This section need not be Completed/f the permit is valued at one hundred dollars($f Ob)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 prOwsi / CQ
Applicant Signature: y / Date: (-0O'Q Q i�
WARNING:FAILURE TO SE E WORKERS' 22N COVERAGE IS UNLAWFUL AND SWILL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND OVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE(Sl ODD).IN ADD TO THE COST OF C0MPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST.AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Sectiopl000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Lie.# 7� q o 3 Class a —
Contractor's Signature: / Dale: (p—as—(9(7 /
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 CMI 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: Date: •
Owner ID verified by driver's license. ❑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:
❑ 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,latsework,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,l 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? ❑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 end 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 end 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 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 0 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? ❑Yes 0 No
6 (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.
r Si. :lure S.Legal Owner(s) Date
CO— aa--cO
`y. And/0 o Tr..plicant Date
CODE f INSPECTION TYPE PAM UIIIIIALS CODE• INSPECTION TYPE DAME INTmAL5
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof (/2.-G0 210 Final Electrical
201 Final BIocldRetaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
2446-48
•
• losircig FEE RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT �
P.O.BOX 317 COSTA MESA. CALIFORNIA -�GC9 // y -J 7-
FINANCE DEPT.
TOR APPLICANT TO FILL IN COMPLETELY APPLicenIp FTBR,I M iT
,2517 TYPE OR PRINT BUILDING
ADD BUILESNSrWv'6r2f�' Robin Hood Lane
COSTA MESA, CALIFORNIA TOR Off/CE USE ONLY
E�Stmomt pgvelo»lent Corporation I RECEIPT NO. I PERM IT j.
OWNER U 6(% {/1//�'
MAIL / t+ RECEIVED BY DATE RECEIVED�B DATE ISSUED"
ADDRESS 419 E. 17th Street _ A , j - I f/—/}..3/I y/•�
CITY Costa Mesa, Calif. TEL.LI 0115( ADDRESS INI��
ARCHITECT Carlson & LIC. COSTA MESA. CALIFORNIA -
OR ENGINEER Middlebrook NO. FIRE
_ / 4� (((���
ADDD_RE'SS Garden Grove, Ca73fornia ZONE TYPE // GROUP p /PL?e.
CONTRACTOR CTOR Colegrove, Inc. STATE LIC.NO. 167293 BY DATE DATE V//j
419 E. 17th Street, Costa Mesa ZONING
ADDRESS
LEGAL 3378 ZONE NO.OF USE OF NEW
DESCRIPTION I NOT I BLOCK I TRACT /OO/yy\ ./,JPLA/N/S// 2/I BUJ LDIN GQQ�I
APS A.P.NO. BVPR/A/ D`� , lY DATEfA C/ .e -S
SIZE NO.OF BLOGS t ��EVES
V
OF LOT 77' x 91 I NOW ON LOT None REQUIRED ALLOWED
USE OF (CENTER LINE ST.) //
EXISTING BLDG. None FRONT .J'CFF. IN.
SETBACK LINE FROM
CENTER OF STREET 45' REAR YARD 22' R.SIDE I _FT. IN.
SIDE YARD I LEFT 121 RIGHT 51 L.SIDE / FT. IN.
DESCRIPTION OF WORK •
X REAR 0., �FT. IN.
NEW I II ALTERATIIONI II ADDITION I
i REPAIR I II MOVING q I II DEMOLISH I
`
SIZEBNO.OF
IGING 1601 ROOMS 6 STORIES 1
EXTERIOR WALL ROOF
COVERING stucco I COVERING shake
USE OF BUILDING AND WORK TO BE PERFORMED
Single family residence with
•
attached garage
750L
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BUILDING CONSTRUCTION. VALUATION
PSIGNATURE ERMITTEE 0 ,' i PERMIT FEE $ 36.00
$ 16,424 PLAN CHECK $ 10.000
AUTHORIZED AGENT. Dike & Colegrove. Inc. TOTAL FEE 5 54.00