HomeMy WebLinkAbout847 SAINT CLAIR ST - Building Permits� CITY OF COSTA MESA
BYILDING DIVIS/ON
F � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www ci.wsta-mesa.ca.us
� FOR INSPECTIONS CALL: (714) 754•5626
�m'�
PERMIT NUMBER: P08-00133
PERMIT TYPE PI.UM STATUS: ISSUED
APN: 14154122 DATE ISSUED: 0512312008
ISSUED BY:
JOB ADDRESS: 847 SAINT CLAIR ST CM SuitelUnit: �
vicinity: � � � � � -
SCOPE OF WORK: INS7AL NEW WHIRLPOOL BATHTUB @ 2ND FLOOR BATHROOM.
SEE E08-00173 FOR ELECT. MOTOR.
OWNER: MCCORMICK,DONALD
PHONE: 714 436-190fl
APPLICANT: MCCORMICK,DONALD
PHONE: . 714 436-190$
CONTRACTOR:
Address:
CirylState:
ARCHITECT:
ENGINEER:
ZipCode:
Address:
CiryBlate2ip:
Address:
Ciry/State/zZip:
License No.
License No.
847 ST CLAIR ST
COSTA MESA, CA
847 ST CLAIR ST :
COSTA MESA, CA
Licensa No.
PHONE:
CEI.L:
PLUMBING PERMIT FEE SUMMARY.
PLAN CHECK FEE:
PERMIT FEE:
TOTAL FEES:
$0.00
$33.30
$33.30
PHONE:
PHONE:
NOTICE: The work authorized by this permit shall comply with all appliwble handicap access requirements under Califomia statutes and related
regulatlons. (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 wnsidered legal, such work must comply with all applicable codes, and all
required Inspections and flnal approval must be obtained. Failure to obtain inspeclions and final approval will result in the expiration of this permit.
40nE t. INSVEC710N TYPE �R�F Ixnn��s $�d INSPEC710N ME Q�g ixnnus
1616 Fixed System Final Fire PrevenGm ZOB Final Mechanical ,�p
7268 PootSpaFinal " 208 FinalPlumbing �O-.�,�-�:O _�
200 Final Re-Roof 210 Final Elecincal
201 Final BIocWRelaining Wall 272 Final Fire Prevention
202 Final Factory Fira Place T20 Final Planning Apprpval
203 Final Sign 222 Final Sile
204 Final Dertalition 250 Final BuilAing/Occupanc.y
WORKERS' COMPENSATION DECLARATION:
I hereby affirtn under penalry o( perjury one o( the tw.,,.ring declarations:
❑ I have and will maintain a cenificate of wnsent to self-Insure tor v.orkers'
compensation, as provided for by seclion 3700 of the Labor Coda, (or the
peAormance of the work for which lhis permit is issued.
❑ I have antl will maintain workers' wmpensation insuranca. as required by
section 3700 of the labor Code, for the pedwmance of Iha v.ork for wfiich Ihis
permit is issued. My workers' compensation Insurance cartier antl policy
number are:
Cartier.
(Th55ecfm neGtl M Ep mr�plelM I Ne pamf a vdWetl al aro �ui@M ab�Wrs (S IOp) wkss )
Policy Number:
❑ I certify lhat in Ihe peAormance of the vrork lor which this permit is
issued, I shall not employ any person in any manner so as to become subject
to the workers' compensation lav5 of Califomia, antl agree Ihat if I s�ould
become subject to the workers' wmpensation provisions of Seclion 3700 ot
the Labor Cotle, I shall lorthvnth comply wilh Ihese provisions.
Applifdnl'S $iB��ure
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLIARS
($700,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that I am licensed under provisions of Chapter 9(wmmencing
with Section 7000) of Division 3 ot the Business and Prolessions Code, and
my license is in (ull force and eflect.
Lic. # CIa55 #
Conl2dor's SignaWre �aie
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirtn that there is a wnstrucCan lentling agency for the
peAormance ot the v.ork ta wfiich this pertnit is asued. (Sec. 3097, Civil Cotle).
Lender s Name:
Lender's Atltlress:
OW NER•BUILDER DECLARATIONS:
I hereby aKrm tha[ under penalry o( perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for lhe following rea5on (Sec. 7031.5,
Business anA Professions Code: Any city or tounty which requires a permit ro
conSWct, alter, improve, tlemolish, or repair any strucWre. prior to its
issuance, also requires Ihe aDD�iwnt for such pertnit to file a signed statemenl
that he or she is licensetl pursuant to the provisions of �he Contractors
License Law (Chapter 9(commencing vnth Section 7000) of Division 3 of the
Business antl Professions Code) or that �e or she is exempl Nerefrom and
the basis for the alleged exemption. Any violation of Section 7031.5 by any
applicant tor a permit subjects the applicaN to a civil penalty ol nol more than
fve h retl dollars ($500�.�:
I, as owner of the propeny, or my employees with wages as their sole
compensation, WILL DO 7HE WORK, and Ihe struclure is not inten0etl or
oflered lor sale (Sec. 7044. Business and Professions Cade: The Contractors
License Law doas not apply to an owner of property who builtls or improves
thereon, and who dces such work himself or herself or lhrough his or her own
ertiployees, provided thal such improvaments are not intended or offeretl for
sale. 11, hovrever, the builtling or improvement is sold within one year of
completion, the awner-builtler will have the burdan o( proving that he w she
ditl not build or improve for purpose of sale.). �
❑ I, as owner of the property. am EXCIUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to canstrucl the projecl (Sec. 7044, Business and
Professbns Code: The cmt2ctors License Law dces not appty to an ovmer ot
property who Duilds or improves thereon, antl vfio contracts for such project vrith
a contracta(s) license pursuant to the Contraclors License Laws.).
❑ 1 am exempt under sec.
Business and Professions Code for this rea
r
/
B��
305]-<fi�310))
Owner ID vanfied by dmt ise. ❑ Yes ❑ No
Driver's License No. Expires:
Verification�of Ovmership by (rype of document, i.e. - pmperty tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavatbn frve (5) or more (eet e� depth into wfiich a
person is requiretl to tlescend, will be made in conr�ction with Morlc authorrzed
by this pertnit, and thal no building stmcture, scaffdding, falsework, a demdition
or dismantfing thereof, will be more Ihan Ihiny-s& (36) feet high. (Chap. 3.2, Grp
2, fvl 2, Set. 341, Title 8, Califomia Administrative Code).
❑ As owner-builder, 1 will not employ anyone to do work which woulC
require a permit from the Division of Industrial Safery, as notetl above, unless
such person has a permit to tlo such work fmm the division.
Applidnl's SB�alure Date
Division o! Intlusirial Safety Permit Number.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will Ihe applicant or present or tuture building occupant need lo file antl
certify a Business Plan for emergency response to release or threatened
release of a hazartlous material7 � Yes ❑ No
(Seclion 25505 0! the California Health and Safety Code requires, wit� some
exceptions, that a Business Plan be filetl vrith the Costa Mesa Fire
Department by avery business which has at any one time tlunnq a reported
year a quantily of hazardous materials equal to or greater than a weight of
500 pounds, or a volume o� 55 gallons. or 200 cuDic feet of compressed gas
at standard temperature and pressure).
2. Does or vrill the applicant or present or fuWre building occupam neetl to file
a registration form (or acutely hazardous matenalsl ❑ Yes ❑ No
(Section 25533 ot the Califomia Health and Safe[y Cotle, with some
exceptions, requires registration with the Costa Mesa Fire Department by
each business which at any one time has on hantl a quantiry o( acutely
hazardous matenals equal to or greater Nan a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standara
temperature and pressure).
3. Does or will the applicant or present or fu[ure builtling occupant need to
prepare an RMPP (Risk Managemen[ and Prevention Program for acu[ely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of Ihe Califomia Health and Safery Code provides that the
Costa Mesa Fire DepaAment may require the preparatlon, certifiwtion antl
filing with tha Fire Departmen[ of an RMPP by businesses which are required
to register acutely hazardous matenals wiM the Fire Department.
4. If an RMPP is presently required, has Section 25534 of Ne Califomia
Health and Sa(ety Code been fully complied with? ❑ Yes ❑ No
5. Does or vnll the applicant or present or fulure building occupanl require for
Ihe work whic� is the subject of [his application a pertnit for such consWction
or motlifiwtion (rom me South Coast Air Ouality Management District or Irom
any other air polWtion control district or agency? ❑ Yes ❑ No
(Section 65850.2 of the Califomia Govemment Cotle requiies that the requestea
infortnalion be lumishetl on applicatbns for ron-residential builtling pertnits).
6. Will any part of the tacility to be constructed under Ihis permit be within
7000 feet from Ihe outer boundanes of a school? ❑ Yes ❑ No
(II'yes", me facility musl meet the requiremeN ot SecUons 25534 antl 42303
of Ihe Califomia Health and Safely Code).
7. If a permit from the South Coast Air Qualiry Managemenl Distric� or other
air polWtion control tlisMct or agency is required for lhe work whic� is Ihe
subject o( this application, have all ot the disclosures prescribetl by Califomia
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No _
B. (11 yes', attach cenifcate of compliance from the appropriate air pollution
control oKcer). . . �
CERTIFICATE OF COMPLIANCE: I certi(y that under penalry of perjury the
information given above is correcL I agree to comply with all state lavrs and
city ordinances re9arding Hazartlous Materials and Emissions.
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: 1
CeAify under penalty o( perjury thal 1 have read this appliwtion and state lhat
the informalion given is correcL I agree to comply wilh all State laws antl ciry
ordinances relating to building construction, and authorize representatives ot
the Ciry of Costa Mesa to enter upon the abovedescribed pmperty for
inspeclion purposes. I agree not lo occupy or allow occupancy of any building
authorized by this permit until final inspection.
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CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
BUILDING PERMIT
PERMIT NUMBER
77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 847 SAINT CLAIR ST Status: ISSUED
Suite: Applied: 08/20/1999
Vicinity: Issued: 08I20/1999
Parcel Nunmber: 14154122 Zoning: M�
App�icant: JOHN SMITH ISSUED BY: �/ '— "
Address: 3410 LA SIERRA - . � � . ,� ., , ��
F149 - , , .r� � ,Phone: 909-657-5600� ' �
,i
RIEVERSIDE, CA� ' + � �' Zip: 92503 � '.
Owner: BROWN,FRANK�J- ` , � � � . �� -�
Address 847.ST�CLAIR ST "" ' � .. � � , . � � � ' �' �
/, r,/, � �� ` - . Phone[ � � � \• _ � - _ . . .: � �
,� �COSTA�MESA, CA Zip: 92626 � � - ' -
/ - �
, - ��� j "� = � _ ,' `� _
Contractoc - JOHN'SMITH ROOFING � �� ��
.'Ad'dress: �3410 LA�SIERR4 . _ " '
, � � �.' F149 ; .�/ Phone:- 909-657-5600 �. ' - � '
. RIEVERSIDE, CA � � .
� Zipi - 92503 License:, 443878 ; , �
Arch : " ' �-�� � � � - Eng: . , .
Address: . ' � � — � Address: _ , •
- � ,.' � Phane: . _ . � - _ � - _ , Phone: , .
, ,
- Zip: � � , Llcense: � � License: ,
.
� ' � � SGOPE OF PERMIT ,
TEAR OFF WOOD SHAKE INSTALL 1/2"PLYWOOD AND 30 YEAR COMP: SHINGLES. � - '
� � FEE SUMMARY ' `" .
, Plan Check: $0.00 _ _ , � ,� � Calc Valuation: � Se,iso.00
, Permit: , $139.25 = _ - Glaim Valuation: $s,ieo.00
SMIP Res: $0.62 — -- � � �
SMIP Com: $0.00 _ j�
Other: � $0.00 — � �
Inspection: , $0.00 . -. � 1 . �
�.
` TotaL•� $139:87 � . � �
` PLANNING & ZONING �
SETBACKS' � �- ' - � , •-
MAIN STRUCTURE Front 0- 0, Rear 0- 0 LeR . 0- 0- Righl 0- 0
ACCESSORY � Front 0-0 Rear. 0-0 LeR 0-0 Right 0-0
PARKING Existinq: o Required: o Proposed: o
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 i( work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 1 BO days.
INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inspectlons and final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 754-5626
WORKERS' COMPENSATION DECLARATION:
I hereby eHirm under penaly of perjury one of the following tleclaretions:
❑ I have and will maintain e certificate ot consent to self-Insure for workers' compensation, as provitled For by section 3700 of the Lebor Cotle, for the pertormance of the
Jwork foi which ihis permit is issued.
u I have antl will maintain workers' compensation insurance, as required by section 3700 of the Lebor Code, for the performance of the work for which this permit is issuetl.
Myworkars'compen i n�uranc{�rrjeran�policynumberare: /
Carner. � � v W policy Number: � l�V a�
(This section need not be comp/ered i! fhe Oermif is valuetl et one hundred tlollars ($100) or less.)
❑ I certity ihat in the ped rmanceqf the work for hich this permit is issued, I shall not employ any person in any manner so as to become subject to ihe workers'
compensation laws of lifomi !�nd a ree t '/I should become subject to the workere' compensation provisions of Sectlon 3700 oi the La6or Code, I shall forthwith
comply with these pr is on . ,,/ / �y3
ApplicantSignaNre: GC � � Date: �'Z�—z�
WARNING:FAILURETOSECU WORKERS'COMPENSATIONCAVEPAGEISUNLAWFULANDSHALLSUBIECTANEMPLOYERTOCRIMINALPENALTIESANDCIVILFINESUPTOONEHUNDRED
THOUSANDDOLLARE�S100 ),INADDITIOfJTOTHECOSTOFCOMPENSATIIXJ,�AN.AGE5A5PROVIDEDWRINSECilON3]O60FTHELABORCODE,IMEREST,ANDATTORNEV'SFEES.
LICENSED CON7RAC70RS DECLARATION:
I hereby aHirm Ihat I am licensed untler r�sion ot Ch pter 9(commencing with Section 7000) of Division 3 of ihe Business,�ntl P,�qf�sions Code, antl my license is in full
force antl ettect Lic, p Class k 6 �i
ConiractoYs Signature: Date: —.� —
CONSTRUCTION LENDING GENCY:
❑ I hereby aHirm that there is a construction lending agency for Ihe pertortnance ot Ihe work for which ihis permit is issued. (Sec. 3097, Civil Code).
Lender's Name: Lender's Address:
Signature:
oate:
OWNER-BUILDER DECLARATIONS:
I hereby attirm ihat under penalry of perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (SecJ031.5, Business and Professions
Code: Any city or county which requires a permit to construcl, alter, improve, demolish, or repair any stmcture, pnor to its issuence, elso requires Ihe applicaN tor such permit
to tile a signed statemen� Ihet he or she is licensed pursuan� to ihe provisions of Ihe Coniractors Licanse Law (Chap�er 9(wmmencing wiih Section 7000) ot Division 3 oF Ihe
Business and Professions Code) or that he or she is evempt Iherefrom antl the besis for the alleged exemption. Any violation ot Section 7037.5 by any applicant for a permit
sub�ects Ihe applicanl to e civil penalry ot not more ihan five huntlretl tlollars ($500).):
❑ I, as owner of iha propehy, or my employees with wages as �heir sole compensation, WILL DO TME WORK, and the s�ructure is not intended or oHeretl for sale (Sec.
7044, Business antl Professions Code: The Contractors License Law does no� apply to an owner of propetly who buiitls or improves ihereon, antl who does such work
himseN or hersel} or through his or her own employees, provided that such improvements are not intended or oHered for sale. If, however, the building or improvement is
sold within one year of completion, the owner-builder will have �he burden of proving tha[ he or she did not build or improve for purpose of sale.).
❑ I, es owner of the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to constmd Ihe project (Sec. 7044, Business antl Professions
Code: The coniractors License Law does not appty to an owner of property who builds or improves thereon, antl who contrects for such project with a contracmr(s)
license pursuant to ihe Contractors License Lews.).
❑ I am exempt under sec. Business end Protessions Code for this reason:
Signawre: �ate:
Owner ID venfietl by tlnver's license. ❑ Yes ❑ No Driver's License No.
Verification of Ownership by (type of document, i.e. - property tax 6ill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICA710N:
Expires:
❑ I hereby certify t�at no excavation five (5) or more teet in tlepth into which a person is required to tlescenQ will 6e matle in connection with work authorized by Ihis
pertnit, and ihat no building stmcture, scattoltling, falsework, or demolition or dismantling thereot, will he more Ihan ihirty-six (36) feet high. (Chap. 32, Grp 2, An 2, Sec.
341, Ttle B, California Adminisiretive Cotle).
❑ As owner-builder, I will not employ anyona to do work which woultl require a permit irom ihe Division of Intlustrial Safery, as noted above, unless such person has a
permit to do such work from ihe division.
Signawre: Date:
Division ot Industrial Sefety Permit Number:
CERTFICATE OF COMPLIANCE AND AUiHORIZATION OP ENTAY: I cartiry under penalry of perjury that I have read this appliwtion and siate that the information given is
correct I agree to comply with all state laws and ciry ordinances relatinq m building construction, antl authorize representatives of the Ciry ot Costa Mesa to enter upon ihe
ebove-tlescribed property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by ihis permlt until final inspection.
COOE �,
1616
7266
200
201
202
203
Fixetl System Finel Fire Prevention
Pool Spe Final
Final Re-Roof
Final Block/Retaining Wall
Final Factory Fire Place
Final Sign
204 Final Demolition
2446-46
u
���:,� �
400E� INSPELTIONTYPE
206 Final Mechanical
208 Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 FinalPlanning Approval
222 Final Site
250 Final Building/Occupancy
Date
— � �
Date
DpTE INTRIr1L5
JOB ADDR�SSt547 St. Cl�
GENEI2AL CONTRACTOR ]
AP No. LOT
INSPECTIONS
,.as
OCCUPANCY
0
TRACT 4260 FIRE ZONE
� Signature � DATE GROUP
BUILDING PERMIT NO.
var.u� s 18,768.00
DESCRTPTION OF WORHes
TYPE V 70NE
SUI3CONTRACCOR
8tt
,, 16693 FEE REu��`F���
COSTA MESA BUILDING-SAFETY DEPARTMENT �!M1� ���p2� �t 9S - Tract 1�260
P. O. BOX 817 C08TA MHHA. C��FORNIA � FINf�,I:C� DEP�lan �SO-A
CITY OF COS[A k1cSA
For Applicanf fo Fill In Complefely APPLICATION f-OR PERMIT
TYPE OR PRINY BUILDING
BUILOING
ADDRESS 8 C a' �P+
COSTA MESA CALIFORNIA F0� Offiee �i$@ �Ii�jl
NHCeIPT NO. � Y!l#W;
E
■ STATE
Olsten
NO, OR
,88TBAG�K^LINmcRRM IiA/
C�11 �� APPROVED
I LEFf 6� I RfGHT �
DESCRIPTION OF WORK
BIZE � X < <� ROOMB
PxTERIOR WALL S't CO ROOF
COVERING COVHRR
U6E OR BUILDIN AND WORK TO BE
;,,oi a.•i �;
w/attached garaee
I XEHEBY ACKNOWLEOG6 iHAT 1 XAVB PlA� TM�9 MPYGTION
AND BTATE THAT THE ABOVB IB CORABR AMC AGREB TO COM-
vLY WRH ALL CITY ORDINAN�B AND 8TA'B 1+�W8 H6OULATIN6
BUILDINO CONBTRUCTION.
BIGNATURE OF y ' r .�o� mnr�+ (`
PERMITTE � Q -
AUTHOR I � :�:'�^�'�2��!/(/C�
�
DATE IBSUED
COSTA MESA, CALIFORNIA
ZONING
ZONE I NO. OP I U8! OP NeY/ �+�
� � � PLANB Z BIIILOINO �J�
��a"e`�o.�.,.� �of 9'f i R v z 60
(�NlER lJN6 8T.1 � �
FRONT
R. SIDE �
L. SIDE `�
REAR 2 /
APPROVED �B n ,.
BY .
a
`— IN.
IN.
—� IN.
� IN.
�erF 2�t��6Z
1739 S
TME AMOUM BXOWN UNOlN VALUAT�ON IB POR TXE
PURP09E OP ¢HTABLJBHINO A PERMIT FEE ONLY.
$ 18,768�Q� IPLAN
0
4
COiTA MESA BUILDING—SAFETY OEPAHTMENT
"' P.O. BOX 1200
Costa Mesa, Calilornia
CONTRACTOR �
Address � f
Ciy Tel.
State License No / ��la�.
� City License No.
F-
Q nunuaek rvi�r or' r'izrues oa �rr�i
-.
N'ater Closet (Tuileq
8ath 'Cub
; $hoµ'er
l.avaWry (A'ash Qusin)
JAitchcn Sink
� LaunJp� Tub or 'Pray
W Scrvire Sink
a Floor Sink
O
� Floor Drain
a Dishwasher
z Drinkin F'ountain
W Urinal
= Garbage Din0osal '
�
AuWmatic Woshin Alach.
~ N'arer Snftener. �
� «'ater Neatei &�Vent
wRecc tor
1 Swim Pool Filter Sycmm
� Gas Sysrem . . . Outlets
� Laa'n c�rinAlers
Ins[nilation or �Vtcration
Vt'ater Pi in
� Back Floa Peeven[er
y Pro . Szwcr_
2 1 , . �
� Cess ooi Sepuc Tank
�
l�Y � JY:IAyDl�I
rortw eu.a+
eer:
�
TRACT NO._
L07 NO._
';!1G 15-74�ASa��1282 v*�*�*3.50
RECD. BY V� t+V�JL
� OATE 166U6D
BUILDING USE
GOSTA MESA. GALIFORNIA
I hereby acknowledge that I have read this applicatio¢
and state that tLe above is correct and agree to comply
with all City Ordinances and State Laws regulating
p]umbing.
� I certify that I possess the above valid state of Cali-
fornia classificatlon or I am t6e lega owner of the resi-
dential property des 'bed ab e.
Signalur¢ O/
Permittee
INSPECTION RECORD
APPROVALS
BtDO. PERINIT