HomeMy WebLinkAbout2257 RUTGERS DR - Building Permits t` F CITY OF COSTA MESA
BUILDING DIVISION
> • ,1 DEVELOPMENT SERVICES DEPARTMENT PERM! UMBER
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4 PERMIT
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(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
MECHANICAL PERMIT
Job Address: 2257 RUTGERS DR Status: ISSUED
Suite No Applied: 01/10/2003
Issued: 01/10/2003
Vicinity: CLOSET
Parcel Number: 41905409 ISSUED BY: �%/
Applicant: DINE, JOE
Address: 6015 STATE ST
Phone: 323-582-7942 .
HUNTINGTON PARK,CA Zip: 90255
Owner: ROBERTS, JOHN MICHAEL ,
Address: 2257 RUTGERS;DR -
Phone:
COSTA MESA,CA Zip: 92626
Contractor: B &W FURNACE SERVICE
Address: 6015 STATE ST •
-"Phone: 323-582-7942 "
HUNTINGTON PARK CA Zip: 90255 . -
License:762451
SCOPE OF PERMIT
CHANGE-OUT OF AN EXISTING 75,000 BTU FAU IN AN EXISTING SFD. 1 INST FAU<100K
BTU - _ _ _
NO OTHER WORK AUTHORIZED WITH THIS PERMIT. / _.
FEE SUMMARY - ,
' Quantity , Quantity
ISSUE FEE $23.50 _ Repair/Alt Absorbtion Unit $0.00 0
Inst FAU<100 k BTU $14.80 1 Repair/Alt Refrigeration Unit $0.00 0
Inst FAU>100 k BTU $0.00 0 Ventillation System $0.00 0
Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler '" $0.00 0
Inst/Rep.Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0
Refrig Sys<100 k BTU $0.00 0Domestic Incinerator , $0.00 0
Refrig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems
Gas Piping $0.00 0 , , • Up to 3 hp/100 k BTU $0.00 0
Factory Fireplace $0.00 0 3 To 15 hp/500 k BTU $0.00 0
Hood w/Mech Exhaust $0.00 0 15 To 30 hp/1,000 k BTU ' . $0.00 0
VAV Box $0.00 0 30 To 50 hp/1,750 k BTU $0.00 0
Vent Fan/Single Duct $0.00 0 Over 50 hp/Over 1,750 BTU' $0.00 0
Appliance $0.00 0 Boilers
Fire Dampers $0.00 0 Up to 3 hp $0.00 0
Smoke Dampers $0.00 0 3 To 15 hp , $0.00 0
Inst or Relocate Appl Vent $0.00 0 15 to 30 hp $0.00 0
Air Handlers< 10000cfm $0.00 0 30 to 50 hp - $0.00 0
Air Handlers> 10000cfm $0.00 0 Over 50 hp $0.00 0
Floor Furnace $0.00 0 Other Mechanical Fee '
Floor or Suspend Heater $0.00 0 Investigation Fee $0.00
Plan Check Fee $0.00
Reinspection Fee $0.00
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: 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 1
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
O 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.
y My workers'compensati n Insuranye carrier and policy number are:
Cartier: l'n n9 ``compensation
N C{ Policy Number: 0 916 `O OO (0 f; ?
(This sect need not be completed if a permit Is valued at one hundred dollars($100)or less.)
❑ I certify that in the performance of the work . -which this permit is Issued,I shall not employ any person In any manner so as t become subject to the workers
compensation laws of California,and at ,e that If I should become subject to the workers'compensation provisions of Sectio 3700 of a Labor Code,I shall forthwith
comply with th::•prow ions.
Applicant Signet, —a-=� Date: C)/ d® d_
WARNING:FAILURE TO SE• -E WORKell COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMIN PENAL ES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE(Slit..t),IN ADDIT/ TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3708 OF TH R DE,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.Uc.a 7,4e- y, ( .'" Class A -ZO
Contractors Signature: Date: O / -/0 ' O 3
CONSTRUCTION L INC AGENC :
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lenders Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to Its issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I,as owner Of the properly,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such Improvements are not Intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). •
O 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. 0 Yes 0 No Drivers License No. Expires:
Verification of Ownership by(type of document,i.e.-properly tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth Into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding.falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
•
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 Will the appint 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 et 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 p No
(Section 25534 of the California Health and Safety Cale provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification
from the South Coast Air Duality Management District or from any other air pollution control district or agency? 0 Yes LI 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.
Signature Ol i • ner(s) Date
�enea�� a /0 C)
And/'• •uthorized Applicant •- e
CODE r
1616 / , ItQIDeLS E r ixed System Final Fire Prevention 206Final DAM MTf/l9
Mechanical cal
)- IS -o3 an/
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 _
(55- X7300 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
-
CITY.OF,COS •�a MESA CONS U(r�TION PER I PERMIT NO. /'� TRACT NO. LOT NO. UNIT NO. 6496 I /25/d5 , 15.iC IL
a- Project-Addran ' z'2r 7 .<GZ4eAS' C. Pat�a 0V - .
Applicant's Mailin Add ess i u - TYPE OF CONSTRUCTION ❑ NEW Li ADD U ON EPAIR ALTERATIR '
� O CI CONVERSION CI DEMOLISH CI OTHER A,P• Zone
Owner's Name a �`C��' Phon•:
CONSTRUCTION AND PLANNING PO y SPA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
•
i4. Temporary Electrical Service or Pole 52. Pool & Equipment Location
Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
' 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 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 • 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
i.4
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas O Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing •, , - 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing jl1:I�!I HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat - 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED r ^/
33. Final Electric ,• . Notes:
/7445
'7J9c -J / � IOkCf
34. Final Heating & Air Conditioning 3 / p / !9
I z"
7Fiy L - %d/ Zs ye-.Cr/
35. Final Gas Pipe-Test
36. Hood or Canopy pOfsMAS irulerM CafilenkoM -
37. Final Factory Fireplace • /„
38. Final Plumbing • trig
c'ca-IAk:71.- s jet) V7/CA* 05.5
39. Water Service-Final alsre)(4wy-ts! a., :€cp: .y*
40. Gas Service-Final Cg./9/w�'- .St7��/77e, 7244/..SV*Q,"r
41. Solar Domestic-Final is Grfa-,2=. Tom£ boa
42. Backflow Preventer Vo ///
43. Backflow Irrigation •••• , •
44. Landscape Irrigation System
45. Sound Attenuation .
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison I.
50. Gas Release to Southern California Gas Co
51: CERTIFICATE OF OCCUPANCY
No. _ Date
I
REPORT OF INVESTIGATION
Variances: Assigned to: Case No.: (NIB Ss'9
❑ Building Division
C.U.P.'s: ❑ Planning Division Assigned to:
❑ Joint Investigation
Date: 3///S,.
Received by: - W • C�a of • 022' .c2 • &Tee/ZS
Complaint Address
Complalntant Name of Tenant (if applicable)
Tel,v M• Pi CIZarS 19,—0524
Address Name of Property Owner Telephone
Telephone/' Number /-/ Owner's Residential Address
Nature of Complaint: Wend— To C 5vhd-ecT 4c/c rocs 7 fait 5tf4cL --TAr 77oA/(
Of OI 1-1,1 b,,v�- 4-1,cf N/L-ec7k,r v< #pt - X 73 d-Yo , -L T # ,0-P//It e ,S 7%.v
to GA-24 f)�-t SCI-e-PM( (°ONd-eKT•rc/ //f// O /R /f..47-4[7/✓ /200^-7
Investigation by: Time of Day (if applicable)
Inspector
Building Permit Files Reviewed: Zoning Files Reviewed:
Initial and Date Initial and Date
Assessor's Parcel No. Map No.
Violation of C.M.M.C. Section Cs):
Findings:
NOTICES:
1st Given: Time Allotted for Correction
Date
2nd Notice: 5-day maximum time
Date
Certified letter advising that if violations are not corrected, the complaint and all supporting data will be forwarded
to the City Attorney's office with request for prosecution.
Date Mailed Date Received 7-day recheck of site
Files forwarded to City Attorney's office with request:
Initial and Date
CMF 0829-30 rev.4/83
OWNER SHERWOOD FOREST -DEVELOPERS IOJ - ••fl t_ 7-23-57
JOB ADDRESS 2257 Rutgers Drive BUILDING PERMIT NO. #5107
GENERAL CONTRACTOR Lido Constr. Corp. VALUE $ 113884.00
LOT 27 BLOCK TRACT 2845 Res. w/att. gar.
GROUP I & J TYPE V ZONE Rh FIRE DISTRICT 5092
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
C r " DATE _ NUMBER
Footing Trench 5-y • 2,$'-"E 7
Foundation Forms and Grade to GarageGC
Rough Framing _ -- -
Plumbing, Rough to Slab r ,, w. - `?tt to
Plumbing,Rough Complete}16-/3. S ¢9, S?
Temporary Pole 773 1 C,
Wiring, Rough it 0 -1fr—)7z2,k"-o,___I .e.Qaat et 3 33-57 Vt. 9/ ✓
Heating,Rough )L""/pi - i'- 30-C, /O /�^ %,Heating, Final inGc 03/--t7 '.al-Wi F . 6 - 7—s 7
Sewer, House Q/,- Sewer,St.)t4I� 9-IL S7 - . / p- /0-57 It 777
Septic Tank or Cesspool
Lathing, In Out b,---s-5
[//�+r-y 7 //
Plastering trij P -30 j
Plumbing,Final,Fixtures CompletekwS O-3/-S7 7 — / Al
Plumbing, Final Gas Test J6 }&c S D-3/SJ `/ te.�( IL i EMI �. //� -
Wiring,Final 1I) 0-31-.a // /./he' y: / - /— ( (/
Occupancy ,
�/ i .
FORM 210 3M 10-55