HomeMy WebLinkAbout2746 SAN JUAN LN - Building Permits CITY OF COSTA MESA
O at r BUILDING bIVISION
f ural 77 FAIR DRIVE,COSTA MESA, CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
sc •'
FOR INSPECTIONS CALL: (714)754-5626
• "' PERMIT NUMBER: M10-00093
•
PERMIT TYPE MECH STATUS: ISSUED
APN: 14164225 DATE ISSUED: 10/0512010
ISSUED BY: RMD
•
JOB ADDRESS: 2746 SAN JUAN+LN;CM :-Pfa ' Suite/Unit:.
Vicinity: SIDE •.Nowts 4�`a'''
SQ. FT: 0 •
SCOPE OF WORK: MECHANICAL PERMIT.TO CHANGE OUT A 3 TON CONDENSING UNIT LOCATED IN SAME LOCATION,
SIDE YARD. REF#: E10-00234
OWNER: SNOW, NORMAN E.TR - • Address: • 2746 SAN JUAN LN .Unit:
PHONE: 714-549-0572 ' - _ . City/State/Zip: COSTA MESA-, CA •
APPLICANT: JACOBY, ERIC • - - - Address: Unit
PHONE: 714-549-0572 City/State/zZip: •
•
CONTRACTOR: SERVICE CHAMPIONS License No. 799170 •
Address: 22911 SAVI RANCH PKWYUnit: .-- PHONE: 714-777-7777 •
City/State: YORBA LINDA,CA ZipCode: 92887 CELL:
•
MECHANICAL PERMIT FEE SUMMARY
MECH ITEM FEE: • $38.30 _ •
PLAN CHECK FEE: $0.00 - •
INVESTIGATION FEE: $0.00 •
REINSPECTION FEE: • $0.00 •
•
•
•
TOTAL FEES: $38.30 -•
-
•
•
•
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#. INSPECTION TYPE DATE INTITIALS CODE# INSPECTION TYPE DATE INTITIALSS
1616 Fixed System Final Fire Prevention 206 Final Mechanical x II—I-7- 10 PL'r\�T/
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
WORKERS'COMPENSATION DECLARATION: Owner ID verified by drivel a license. ❑Yes ❑No
I hereby affirm under penalty of perjury one of the following declarations: ' • Driver's License No. Expires:
El I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the
perform ce 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 carrier and policy CIhereby certify that no excavation five(5)or more feet in depth into which a
number are: pp person is required to descend, will be made in connection with work authorized
LC.] 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
�7TM1:flea un need not be mrmMeted I the permit is valued at one hundred dollars($100)or less)
2,Art 2,Sec.341,Title B.California Administrative Code).
•P_oligy Number: N>CPdj C /D 7/70/ 0
�.. ❑ 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 workers' compensation provisions of Section 3700 of
the Labor Code,I all fort with comply with these provisions. ////// Applicant's Signature Date
/O/S //O Division of Industrial Safety Permit Number:
'Itcahts etdrt^ l ate / 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 ❑ 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 ❑ No
#---- —
- "70 Cla`--a G ZO (Section 25533 of the California Health and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Department by
"}.•• i0W�//lJ each business which at any one time has on hand a quantity of acutely
"----Contractor s Signal 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)? ❑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 furnished 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 8If"yes",attachcertificate ofrom the
f
employees, provided that such improvements are not intended or offered for ( complianceappropriate 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.
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
❑ 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 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.
Y
$Ignatur (Legal er(s) Date
Signature Date , l
( _ 1 _ AO/D �!/
305]<6 3b]) _
]GMltluw.ntir' -earn
•
Simplified Prescriptive Certific f Compliance: 2008 Residential HVAC f. ions CF-1R-ALT-HVAC
Climate Zones 1 and 3-7
Site Address: Enforcement Agency: Date: Permit it:
27'l' 5'I“ .?v i I--A. r ssq .. £f,1' e—& ze/c/io n/8-0.093
Conditioned Duct irisulano
Equipment Type' List Minimum Efficiency Floor Area requireme J'p T ostat
❑Packaged Unit 1 �r'
' ❑Furnace OAF ❑COP Over 40 f fduc
Served by system added rel p Setback
•
• ❑lnd otl ER ❑HSPF (If nor already preserve must be
el
Unit ❑EER ❑Resistance S �U sf nc ndmo a pace insioned)
❑Other R 6 (CZ 1,3-5) •
I. Equipment Type:Choose the equipment being installed;if more than one system,use another CF-IR-ALT-HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER,78%AFUE,7.7HSPF for typical residential systems.
Contractor(Documentation Author's(Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this
Certificate of Compliance.
• I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24,Parts I and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable
compliance forms,worksheets,calculations,plans and specifications submitted to the enforcement agency for approval with the permit
_ application.
Name:gL r G c 04 7 Signature:
Company: Date:
S 40 F G/c/-/i- tt4 P/DNS ?;(2)/t%
Address: License:
// 9-tY/ oe/(7/C /11 )(1,0 799/799/ 7o
City/State/Zip: '/h,< rh4 _ 2-> ./ cA_ c-)2 S. Phone: elf —7 777777
•
•
•
•
•
2008 Residential Compliance Fomes March 2010
•
(ENE ORCEMENT•A GEN CY
CAN CUSTOMIZE:WITH LEZ77ERBEAD/SEAL) •
2008 Building Energy Efficiency Standards Residential HVAC Alterations
Climate Zones 1 and 3 through 7 CZ-6 c GOST73 •
BUSINESS AND PROFESSIONS CODE,SECTION 7110
Willful Or deliberate disregard and violation of the building laws,including the California Building Code,and
local permit requirements constitutes a cause for disciplinary action from the Contractors State License Board
working in conjunction with the local building department. This action may consist of fines up to$5,000 per
violation or suspension/revocation of a contractor's license.
WHEN IS A PERMIT REQUIRED?
A written construction permit shall be obtained from the enforcement agency prior to the erection,construction,
reconstruction,installation,relocation,or alteration of any mechanical system,except as permitted in Appendix
Chapter 1,Section 112.2 of the 2007 California Mechanical Code. Projects requiring permits include,but are not
limited to:
• New HVAC installation
• HVAC Changeout •
• Replacement of furnace,coil,FAU,or condenser •
Relocation of an existing HVAC unit
Adding or replacing more than 40ft ducting in unconditioned space
•
2008 BUILDING ENERGY EFFICIENCY STANDARDS (Title 24,Part 61 REOUIREMENTSINCLUDE:
1. Heating equipment must have a minimum 78%AFUE(Exception:Wall &floor furnaces;room heaters).
2. Central air conditioners&heat pumps less than 65,000 Btu/hr must have a minimum 13 SEER.
3. Newly installed or replaced ducts must have a minimum insulation value of R-4.2.
4. A setback type thermostat(24 hr clock with four set points)is required for all alterations.
5. New or replacement ducts must meet the mandatory requirements of Section 150(m):
-• All joints and openings in the in the HVAC system must be sealed.
•• Only UL 181,UL 181A,or UL 181B approved tapes or mastic shall be used to seal duct openings.
• Connections of metals ducts and the inner core of flex ducts shall be mechanically fastened. Flex ducts
must be connected using a metal sleeve/coupling.
• Flex ducts that are suspended must be supported every 4ft.max for horizontal runs with no more than 2"
of sag between supports and 6 ft.max for vertical runs.
6. The CF-6R-MECH-04 must be completed and signed by the installing contractor. The Inspector will collect
this form and verify that the model numbers are the same as the installed equipment.
CITY OF COSTA MESA '
oy9%� BUILDING DIVISION
>•"'„, .. 77 FAIR DRIVE,COS MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
=I w�kt - !
S. 11.4.� FOR INSPECTIONS CALL: (714)754-5626
*`°"° ' PERMIT NUMBER: E10-00234
PERMIT TYPE ELEC STATUS: ISSUED
APN: 14164225 DATE ISSUED: 10/05/2010
ISSUED BY: RMD
JOB ADDRESS: T.¢6SAN3JUAN LN•G Al Suite/Unit:;
Vicinity: - -
SCOPE OF WORK: ELECTRICAL PERMIT FOR DISCONNECT TO CHANGE OUT CONDENSING UNIT LOCATED AT SAME LOCATION,SIDE
OF HOUSE. REF#: M10-00093 . .
•
OWNER: SNOW, NORMAN E TR Address: 2746 SAN JUAN LN . Unit:
PHONE: 714-549-0572 r - City/State/Zip: COSTA MESA, CA
APPLICANT: JACOBY,ERIC - Address: - ' Unit:
PHONE: 818735-7876 ' ' City/State/zZip:
CONTRACTOR: SERVICE.CHAMPIONS .. . License No. 799170.
Address: 22911 SAVI RANCH PKWYUnit: PHONE: 714.777-7777 •
City/State: YORBA LINDA, CA ZipCode: 92887 CELL: - •'
ELECTRICAL PERMIT FEES -
•
Electrical Plan Check Fee: $0.00 •
Electrical Permit Fee: . $41.70
Reinspection Fee $0.00 _
TOTAL FEES $41.70 .
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.
CODES. INSPECTION TYPE DATE INTRIALS CODE* 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 X 1I—1 1— Ib IonP o.Q
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
WORKERS'COMPENSATION DECLARATION:- Owner ID verified by drivel a license. ❑Yes ❑ No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document.i.e.-property tax bill or deed):
compensate , as provided for by section 3700 of the Labor Code, for the
perfor ce 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 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
D LV by this permit,and that no building structure,scaffolding,falsework,or demolition
arzl
Cerr or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Grp
(Tho sedan need not be completed a the permit a valued at one hundred dollars(5100)or less)
2,Arta Sec.341,Title S,California Administrative Code).
PoG�cyY Number:
11../C/94 L /7j ZKO/
❑ 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 workers'compensation provisions of Section 3700 of Applicant's Signature Dale
the Labor Code I shall forthwith comply with these provisions.
i 74/.-/o Division of Industrial Safety Permit Number:
AOplirant'Sature
r ICES- HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE • 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 ❑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? El Yes 0 No
Class-#- 'an (Section 25533 of the California Health and Safety Code, with some
/,0� �/ exceptions, requires registration with the Costa Mesa Fire Department by
4 /V each business which at any one time has on hand a quantity of acutely
c mr g nalure teA iflSe•• 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 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 Califomia Govemment Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be furnished 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 Dale
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.
Signa. e of Leg.I Ownegs) Date
Signature Date .�
7057-46(3/07) m
eA .or Aho. dA limit Date
pp
---1 CITY OF COSTA MESA
4 BUILDING DIVISION
> t 14, DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
�. Vii; . PERMIT
�' "i. P01-00481
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
PLUMBING PERMIT
Job Address: 2746 SAN JUAN LN Status: ISSUED
Suite No Applied: 08/09/2001
Issued: 08/09/2001
Vicinity:
ISSUED BY: .
Parcel Nunmber: 14164225
Applicant: GLOVER, LORIE> f'' ' / .
Address: /' . 7 ,. _ r '•< ���
- Phone: 714-241-1414 - - \
Zip: - _ ,- �\
Owner:, SNOW, NORMAN E TR -
Address '2746 SAN-JUAN LN- 'C .- -
Phone: -1,
•
• ' - COSTA MESA,CA Zip:' 92626
9
ContractorCOAST ROOTER PLUMING HEATING &AIR CONDITIONING.
- Address: 2737 S CRODDY STE D< '
- " Phone: (714)241-1414
,
"SANTA"ANA;CA' Zip: 92704 License: 529127
Arch / Eng:
Address:
Phone:
• . Zip:. - "
License: - - -
�i
SCOPE OF PERMIT -
• WATER HEATER CHANGE OUT. - ,
_ ;.FEE SUMMARY .
AMT QTY AMT - OTYAMT QTY
ISSUE FEE _ $23.50.. . (_• -.,..'Laundry Tub/Washer ' $0.00.; ° 0, 'Sump-Pump ' - $0.00 0
Backflow irrigation " $0.00 0 ., Landscape Irrigation .$0.00 0 Swimming Pool •$0.00 0
Backflow PreJentei- /$0.00 ' 0-,'
P-Trap ' $0.00 0 Trap Primer ' $0.00 0
Bathtub $0.00' - 0 '• - , - Pressure Regulator $0.00 0 Urinal '- - - $0.00 0
Clarifier System , $0.00- 0 . Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0
Connect(Ice,Soda,etc) $0.00' 0 Receptors - : $0.00 0 • Vacuum Brkr Bkflow(5+) $0.00 0
Dental Units : $0.00 ' ' 0 Septic Tank. $0.00 0 • 'Wash Basin. /
$0.00 0
Dishwasher -$0.00: 0 Sewer Cap for Demo $0.00 :0 Wash BasinSet $0.00 0
Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0
Drain, Rainwater $0.00 0:' '•-Sewer Private Line • $0.00 0 Water Closet(Toilet) $0.00 0
Drain, Roof $0.00 0 Shower $0.00 0 . Water Heater/vent $12.30 1
Drinking Fountain $0.00 0 Sink,bar $0.00. 0' - Water Piping(Inst or Rep.) $0.00 0
Expansion Tank $0.00 0 ' Sink, commercial . $0:00' 0 Water Re-pipe $0.00 0
Gas Earthquake Valve $0.00 0 Sink,Floor $0.00 0 Water-Service $0.00 0
Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0
Gas(Over 4 outlets) $0.00 0 Sink, service/mop $0.00 0 OTHER $0.00
Gas Repipe $0.00 0 Spa(private) ' $0.00 0 VIOLATION $0.00
Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00
Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0
Interceptors(Sand Auto) $0.00 0
TOTAL CALCULATED FEES: $35.80
COMMENTS/SPECIAL CONDITIONS
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(6/00)
DECLARATIONS ' f
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.
(40 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'c`9Qhpen�satiQnpInsur e'carrier
—a1pd policy number are:
Cartier: \\ r ! ' C�r-�y\( yk Policy Number: I 30^- 0
(This section need n t to completed if the permi v toed at one hundred dollars($100)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 Califomia,and agree that if I should become subject to the workers'compensation provisions of Section 3J970
the Lr Code,I shall forthwith
comply with these provisions.
BI
Applicant Signature � Date:WARNING:FAILURE SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALD CIVIL FINES UP TO ONE HUNDRED
THOUSAND IXXLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licenseitunder provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business suid Professions Code,and my license is in full
force and effect.Lk.a R)9/.� '7 Class a 'l Cr /9^ (//
Contractor's Signature: Date: 6 (J O I
CONSTRUCTION LENDING AGENCY:
❑ 1 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 pontiff
subjects the applicant to a civil penally 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 appy 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 sac. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. 0 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:
❑ 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? 0 Yes 0 No
(Section 25505 of the Califomia 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).
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 Califomia 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 then 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 0 N
(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 businesseswhich are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the Califomia Health and Safely Code been fully complied with? 0 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 koermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? j�Yes LJ No
(Section 65850.2 of the Califomia 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
(II"yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia 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 ❑Nc
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.
ectal Owner(s) 90.7, 0 /
An. Or Authorized Applicant D to
CODE It INSPFCTION TYPE BASE RITUALS CODE INSPECTION TYPE D� ItlIIDALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing 3-.� -09 (�n 1J
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
STA
"AR -6.6'PACO 1- 1 032 ****94:50
.895
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 COSTA MESA. CALIFORNIA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING
ADDRESS 2746 San Juan Ln.
•COSTA MESA..CALIFORNIA For Office Use Only
T �e
RECEIPT NO. ?MIRI3 5
OWNER Mesa Del Mar Development Co. yL-I RV.:]
MAILRECeI gD�Y DATE RECEIVED DATE ISSUED
ADDRESS-3800 E. Coatt Hwy. �, /� —/0.3 'MAR 6 1963
CITY Corona De] rear
TEL 9!1220 ADDRESS
ARCHITECT TEL. COSTA MESA. CALIFORNIA
OR ENGINEER
CCO Realty CO, NO.OR
M$
34220ADDRESS 3800 E. Coast Hwy, FIRE (/(�y -
ZONE TYPE - 11y`/GROUP
CONTRACTOR PIacca Realty Co. APPROVED
BY DATE
ADDRESS 3800 E. Coast Hwy. ZONING r.-. y/�
ZO-�7�7 NO.OF. USE OP N[ j -` 4'
CITY Corona DelfMar V J I PLANS 7,..,'"-i BUILDING a 4 t STA
LIC.TE TEL.NO. 20 3'I3-A-SB-1 NO. OR 3220 LEGAL
DESCRIPTION Lot 33 Tract 11808
SIZENO. OF BLOTS
OFFLOT 6696 S.F. NO. ON LOT done A.P.NO.
USE OF YARDS EVES
EXISTING BLDG. 'Non P APPROVED ALLOWED
SETBACK LINE FROM[ (CENTER LINE ST.) r„,...., �/
CENTER OP STREET 501 REAR YARD 22 I—211 FRONT 'j / FT. Tom' IN.
SIDE YARD I LEFT 61 I RIGHT 61 s R.SIDE 6r FT. IN.
DESCRIPTION OF WORK- C' FT. ' IN.
L.SIDE
NEW X I IIALTERATIONI II ADDITION I REAR n 2 ZFT. i-- IN.
APPROVED �y`,�] ' ,(� n .-( / J
REPAIR' [[ MOVING DEMOLISH BY L�, rt�1 vVL 4 DATE p -b �l
SIZE�ITO tx50 -loll ROOMS 6 STORIES 1 J 000 `��
EXTERIOR WALL StUCCO I ROOIIIOOd shake & Rock
COVERING c11 Wood'' COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
Single family res. watt. gar. Living Area: 1780 S.F.
Plan # 450-B Garage Area: 1160 S.F.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS POR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OP ESTABLISHING A PERMIT PEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
reit BUILDING CONSTRUCTION. VALUATION //``??
PERMAITTEF OF Mesa Del Mar Development Co. PERMIT FEE $ y J n
By. _ / i $19,065.00 PLAN CHECK $ 3��d lit
AUTHORIZED AGENT _ 2(- - . �� - / c
TOTAL FEE 0