HomeMy WebLinkAbout2323 RUTGERS DR - Building Permits N r CITY OF COSTA MESA
4BUILDING DIVISION ,
;1-a0 0- - DEVELOPMENT SERVICES DEPARTMENT P RMIT NUMBER
H I '/" I PERMIT
`I. fl . v B06-00174
S oRmts 44+
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.BUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 2323 RUTGERS DR Status: ISSUED
Suite: Applied: 02/02/2006
Vicinity: RESIDENCE AND ATTACHED GARAGE Issued: 02/02/2006
Primary Occ: R-3 Dwellings/Cong Res<10 Type of Construction: V-N
Parcel Number 14147314 Zoning:
Applicant: VRSKA, MARTIN A a
Address: 2323 RUTGERS DR
Phone: 213-359-1024 CELL ISSUED BY:
COSTA MESA,CA Zip: 92626
Owner VRSKA, MARTIN A
Address 2323 RUTGERS DR ,
Phone:
COSTA MESA,CA _ Zip: 92626
Contractor: . OWNER-BUILDER
Address:
' Phone:
Zip: License: 000000
Arch : Eng:
Address: Address:
Phone:• ' x Phone:
Zip: 'License: .. License:
SCOPE OF PERMIT
REROOF RESIDENCE AND ATTACHED GARAGE:DO EXISTING ROCK ROOF,APPLY 1/2"CDX,FELT PER MFGR'S SPECS,APPLY 30-YEAR
COMP SHINGLES.2700 SQ FT
' -. i FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $6,000.00
Permit $125.25 Claim Valuation: $6,000.00
SMIP Res: $0.60
SMIP Com: $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
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
244646(6100)
DECLARATIONS • •
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 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.)
C � 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'
TTTT���` 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 provisi s.
nitre aM.Signeure: � 'V` -1"CDalee: 4/1/ i
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE TIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706OF 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.N Class u
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 tor the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
su jests the applicant to a civil 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 ec. -' Business and Professions Code for this reason: y/�/O`
Sratenature:4' - -��
lExpire—s""//L//II
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,California Administrative Code).
❑ 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:
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 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 ❑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.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification
from the South Coast Air(Duality Management District or from any other air pollution control district or agency? Yes l�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? ❑Yes ❑No
(If'Yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 It a permit from the South Coast Air Quality Management District or other air pollution control district ar 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 ❑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 stale 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 pr arty for'nspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
SlgtiaWre.Of Leggl.Owner(s) ��-J
And/Or Authorized Applicant Date
QgQEL INSPECTION TYPE PAIS INTmAIa CODEr INSPECTION TYPE DATE IfRInALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Root (p-6-0.0 - 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
• OWNER PRINCETON, Inc. DATE 11-13-57
JOB ADDRESS 2323 Rutgers Drive BUILDING PERMIT NO. 6001
GENERAL CONTRACTOR Dike & Colegrove VALUE $ 3413.46.,00
AP. No. LOT 47 TRACT P9553 FIRE ZONE DESCRIPTION OF WORK Residence w/att gar.
GROUP I & J TYPE V ZONE Rh PLAN NO. 6035 _
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
DATE NUMBER
Trenches ac } rForms Steel '- 12-3-S7
Floor Sys eCm
Steel Reinforce Chimney Re-Rod
Bond Beam
Frame and Flashing .//-
Lathing, In C Out Z-7
Plaster, brown c k�}7J�-. Y-C$
��3.r r7 2-s/
Underground soi �.,,r G W/G Pipe Test', /ry/9
( -/S7
Top Out a, y���
Furnace /-13 S8 - - ..frai t- -n sr..V .l •
Gas Vents 2.. Off. , Air . Jr /
Rough Plumbing - AIMS /-7_2
2.-se 7""i^C .. - tNOV 1 3195 12055 i .
Cesspool Septic Tank
Prop. Swr. Line House Con./J//{St. Swr. /-20 Scre 1/a...)- 1 6,...4-Cs.... /-/e Sr 14(09
Sprinkling System O
Heating Final Miler H 2-A si ali
Plumbing Fixtures, Final /MALI Ate,.,-5Y U
Final Gas Test /S /J9/fc L/-y-.st I,
Construction Pole 42.4 4. r- I.�e./,�,. {��r� //-If y.7 S 71/ ✓ 47 .
Underground Power _ --1 --.W joi
Rough Wiring _2/ v sr, i_ --Ce 11. R • R 5r0 ,4 (
Fixtures, Final T ,
,�"'/f-
OCCUPANCY—NCY "4I SLS L{-z/-s P
Form 210.—SM-1-57
✓ ;
•
COSTA MESA BUILDING DEPARTMENT FINANCE DEPT. Y' LA
P.G. BOX 3 n
COSTA MESA. CALIFORNIA CITY OF COSTA MESA
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
BUILDING BUILDING
ADDRESS 23 3 RTI'g n Drive
4JJ JJCOSTAMESA. CALIFORNIA FOR OFFICE USE ONLY
/1�r'/l�j'j
RECEIPT NO. P MW VZ
OWNER Princeton, Inc.
MAIL
RECEIVED BY DATE RECEIVED DATE ISSUED
ADDRESS /19 Fast 17th Street ,..--7o //-tea -7NOv 1 a 1957
CITY Costa Mesa TN
OO. Li 8-1159 ADD L. BUILDING ESS
ARCHITECT CarleO LIC.
OR ENGINEER '<'}iddlebrook NO. COSTA MESA. CALIFORNIA
FIRE
ADDRESS Garden Grove ZONE
207NO.OF TYPE GROl1P
T''11'' CITY LIC. �j PLANS // H
CONTRACTOR, Dike and Colegrove NO. 7333 V V d�
ADDR19 East 17th Street In&FEL. APPROVED CCC
n4tR MAaa NO. TA R-1159 BY DATE
LEGAL LOT I CORRECTIONS
DESCRIPTION NO. 47 BLOCK TRACT 2953
A.P.NO.
SIZE NO.OF BLOCS.
OF LOT 72^ x 102 NOW ON LOT none
USE OF
EXISTING BLDG. nn" I.
SETBACK LINE FROM �
CENTER OF STREET y{�S^ 50I REAR YARD 26 I'
SIDE YARD RIGHT 61 ' LEFT 61
DESCRIPTION OF WORK .
NEW x ALTERATION ADDITION
REPAIR MOVING DEMOLISH
BUILDING NO.OF
SIZE 1658 Sq. Ft.._ROOMS 7 STORIES 1
EXTERIOR WALL ROOF
COVERING Stucco COVERING Comp.
USE OF NEW
BUILDING Single family residence
attached garage
Plan 760B
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
CITY ORDINANCES AN ATE LAWS REGULATING BUILDING
TION. VALUATION
SIGNATURE OF PERMIT FEE $ 'l Jl_'.�
PERMITTEE -4 A A� ��
$• 14,146.00 PLAN CHECK $ 17.00
TOTAL FEE S 51.00 'MT
AUTHORIZED AGENT Dike and ColegroveA Tac.