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235 18th St - Building Permits
PERMIT NUMBER: BC14-00381 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: RES—ALT DATE ISSUED: 06/02/2014 ISSUED BY: KJB JOB ADDRESS: 235 E 18TH ST CM Suite/Unit: APN: 42539226 Zoning: Vicinity: Primary Occ: Const Type: V -B SQ. FT: 0 Valuation: $3,000.00 SCOPE OF WORK: SHOWER ENCLOSURE IN 3 UNITS OF AN EXISTING TRIPLEX. REF: P14-00089 OWNER: FAEC HOLDINGS 419649 LLC Address: 235 E 18TH ST Unit: Phone: City/State/Zip: COSTA MESA, CA APPLICANT: FERREIRA, OTONIEL BROOKHURST ST Phone: 714-842-8242 CONTRACTOR: ALPHA CONTRACTOR Phone: 714-842-8242 Cell: ARCHITECT: ENGINEER: COMBINATION PERMIT FEE SUMMARY Building Plan Check: Building Fees: Electrical Fees: Mechanical Fees: Plumbing Fees: SMIP Residential: SMIP Commercial: Bldg Std Admin Fund TOTAL FEES: "Refer to fee receipts for all fees paid for project Unit: :CUITE C-304 City/State/zZip: HUNTINGTON BEACH, CA License No. 882746 Address: 19881 BROOKHURST STUnit: City/State: HUNTINGTON BEACH, CA License No. License No. $0.00 $83.25 $0.00 $0.00 $0.00 $0.00 $0.00 $1.00 $84.25 Address: 19881 CUITE C-304 ZipCode 92646 PHONE: PHONE: HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279 Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays- 9:00 am thru 6:00 pm. Prohibited all hours - Sundays and the following Federal holidays: New Years Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day and Christmas Day PERMIT TYPE B_ROOF2 APN: 42539226 JOB ADDRESS: 235 E 18TH ST CM Vicinity: Squares: 31 PERMIT NUMBER: B14-00043 STATUS: ISSUED DATE ISSUED: 03/10/2014 ISSUED BY: RM Suite/Unit: Valuation: $10,000.00 SCOPE OF WORK: REROOF EXISTING TRIPLEX. TEAR OFF EXISTING ROOF, INSTALL 1 LAYER OF 30# FELT PAPER, AND REROOF WITH GAF 30 YEAR DIMENSIONAL COMPOSITION SHINGLES. 31 SQUARES. NOTEAESIDENTIAL RE -ROOF: For projects exceeding $1,000 in valuation final approval of permit shall not be granted until access to dwellina unit(s) is provided for verification of the installation of smoke and carbon monoxide alarms by the Citv Inspector. See Attachment w/Inspection Card OWNER: FAEC HOLDINGS 419649 LLC Address:235 E 18TH ST Unit: PHONE: City/State/Zip: COSTA MESA, CA APPLICANT: BUCKLIN, JIM PHONE: 949-207-3468 CONTRACTOR: OZONE ROOFING INC 866911 Address: 63 VIA PICO PLAZAUnit: STE 433 City/State/Zip: SAN CLEMENTE, CA 92672 ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $181.25 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 Address: Unit: City/State/Zip: PHONE: 949-366-6597 CELL: License No. License No. License No. PHONE: PHONE: OTAL FEES $182.25 HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279 Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays - 9:00 am thru 6:00 pm. Prohibitied all hours - Sundays and the following Federal holiday! New Years Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day and Christmas Day PERMIT TYPE ELEC APN: 42539226 JOB ADDRESS: 235 E 18TH ST CM Vicinity: PERMIT NUMBER: E14-00076 STATUS: FINALED DATE ISSUED: 03/24/2014 ISSUED BY: KJB Suite/Unit: SCOPE OF WORK:UPGRADE ELECTRICAL SERVICE TO 200 AMP. REPLACE 60 AMP SUBPANELS IN EACH UNIT OF AN EXISTING TRIPLEX. REPLACE 3 LIGHT FIXTURES PER UNIT, 6 OUTLETS PER UNIT. 3 NEW CIRCUITS PER UNIT FOR DISHWASHER, GARBAGE DISPOSAL, AND REFRIGERATOR. REVISED: 4/16/14 ADD 3 CIRCUITS FOR STACKABLE LAUNDRY UNITS. ADD 3 OUTLETS. STACKABLE UNITS TO BE INSTALLED IN EXISTING CLOSET. OWNER: FAEC HOLDINGS 419649 LLC 235 E 18TH ST Unit: PHONE: APPLICANT: GUTIERREZ, OSCAR Unit: PHONE: 562-688-3992 CONTRACTOR: MAXIMUM LIGHTING ELECTRIC 936461 Address: 10930 RATLIFFE STUnit: City/State: NORWALK, CA ZipCode: 90650 ELECTRICAL PERMIT FEES Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $245.15 Reinspection Fee $0.00 TOTAL FEES $245.15 Address: City/State/Zip: COSTA MESA, CA Address: City/State/Zip: License No. PHONE: 562-688-3992 CELL: PERMIT TYPE PLUM APN: 42539226 JOB ADDRESS: 235 E 18TH ST CM Vicinity: PERMIT NUMBER: P14-00089 STATUS: FINALED DATE ISSUED: 05/20/2014 ISSUED BY: CAC Suite/Unit: SCOPE OF WORK: MISC PLUMBING FOR UNITS A, BAND C OF AN EXISTING TRIPLEX. UNIT A: NEW SHOWER VALVE AND 10' OF 1/2" GAS PIPE. UNIT B: REPIPE 1 BATH UNIT AND 1 KITCHEN. UNIT C: REPIPE 1 BATH AND KITCHEN. REPLACE PERMIT TO INCLUDE RELOCATION OF LAUNDRY FACILITIES INTO EXISTING HALLWAY CLOSETS. 3 WASHERS, 3 GAS OUTLETS, AND 3 WATER PIPINGS. 05/23/14 REPLACE 3 SHOWERS OWNER: FAEC HOLDINGS 419649 LLC 235 E 18TH ST PHONE: APPLICANT: JOHN MICHALSKI 4195 CHINO HILLS PARKWAY PHONE: 714-719-9976 CONTRACTOR: CHAMPION PLUMBING Address:4195 CHINO HILLS PARKWAY PHONE: 714-719-9976 City/State:CHINO HILLS, CAZipCode:91709 CELL: ARCHITECT: ENGINEER: Address: City/State/Zip: COSTA MESA, CA Address: City/State/Zip: CHINO HILLS, CA License No. PHONE: License No. PHONE: PLUMBING PERMIT FEE SUMMARY PLAN CHECK FEE: $0.00 PERMIT FEE: $170.50 TOTAL FEES: $170.50 License No.:730334 PERMIT NUMBER: BX12-00501 PERMIT TYPE B_MISC STATUS: FINALED APN: 42539226 DATE ISSUED: 12/17/2012 Zoning: , ISSUED BY: RMD JOB ADDRESS: 235 E 18TH ST CM Suite/Unit: Vicinity: GARAGE Primary Occ: Const Type: ?? SQ. FT: 0 Valuation: $1,250.00 SCOPE OF WORK: INSTALLATION OF 6 OUTLETS, 1 LIGHT FIXT, DRYWALL AT GARAGE. NOTE: FINAL APPROVAL OF PERMIT SHALL NOT BE GRANTED UNTIL ACCESS TO DWELLING UNIT(S) IS PROVIDED FOR VERIFICATION OF SMOKE AND CARBON MONOXIDE ALARMS BY THE CITY INSPECTOR. SEE ATTACHMENT W/INSPECTION CARD OWNER: SNYDER, E NICHOLAS III City/State: NEWPORT BEACH, CA Zip Code:92663 Phone: APPLICANT: JAGLOWSKI, EDWARD City/State: Zip Code: Phone: 714-478-6662 CONTRACTOR: JAGLOWSKI CONSTRUCTION License No.962084 Address: 2828 W CAMDEN PLUnit: City/State: SANTA ANA, CAZip Code: 92704 Phone 714-478-6662 Cell: ARCHITECT: Phone ENGINEER: Phone FEE SUMMARY Building Plan Check: $0.00 Building Permit: $47.90 Electrical Permit: $30.60 SMIP Residential $0.50 SMIP Commercial $0.00 Bldg Std Admin Fund $1.00 Address:: 2322 MARGARET Unit License No. License No. Address: Unit: TOTAL FEES $80.00 HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279 Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays -9:00 am thru 6:00 pm. Prohibited all hours - Sundays and the following Federal Holidays: New Years Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day and Christmas Day CITY OF COSTA MESA BUILDING DIVISION 4 F77 FAIR DRIVE, COSTA MESA, CA 92626 - (714) 754-5273 - Fax (714) 754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: BX09-00100 PERMIT TYPE B_MISC STATUS: ISSUED APN: 42539226 DATE ISSUED: 06/18/2009 Zoning: r ISSUED BY: BJK JOB ADDRESS: 235 E 18TH ST CM Suite/Unit: Vicinity: UNITS A B AND C Primary Occ: Const Type :?? SO. FT: 0 - Valuation: $5,000.00 SCOPE OF WORK: RETROFIT INTERIOR PARTY WALLS FOR ONE HOUR FIRE RATED ASSEMBLY BETWEEN EXISTING UNITS A, B AND C IN ORDER TO CONVERT INTO A DRUG AND ALCOHOL REHAB CENTER. REPLACE 1 SWITCH. OWNER: SNYDER, E NICHOLAS III City/State: NEWPORT BEACH, CA Phone: APPLICANT: STUBBS, CRAIG City/State: Phone: 714-390-2728 CONTRACTOR: CRAIG H STUBBS Address: 17150 NEWHOPE ST 1106 City/State: FOUNTAIN VALLEY, CA Zip Code: 92708 ARCHITECT: Phone ENGINEER: SAMIR Y GOSHEN, PE Phone 949-364-0744 FEE SUMMARY Building Plan Check: Building Permit: Electrical Permit: SMTP Residential SMIP Commercial Bldg Std Admin Fund TOTALFEES Address:: 2322 MARGARET Zip Code: 92663 Address: Zip Code: 'License No. 370303 Phone 714-390-2728 Cell: License No. License No. C042152 $72.31 $111.25 $24.60 $0.50 $0.00 $1.00 $209.66 Unit Unit: Unit: UNIT 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 t, INSPECTION TYPE DATENI imALS CODES INSPECTION TYPE D4TF, INTMAL 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final Block/Relaining 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: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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 workem' 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: Carder: (This section need not be completed ff the perm4 is valued al one hundred dollars ($100) or less.) ,,Policy Number: 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 sub'ect to the workers' compensation provisions of Section 3700 of the Lab de, I shat ort ith ly with these provision . ica� n Date. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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 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. ZJ Class it. aclo( iDA ale—� 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 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 contraclods) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: 3057-46(3/ 7) Owner ID verified by driver's license. []Yes ❑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, a 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. Applicant's Signature Division of Industrial Safety Permit Number: Date 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 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). 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ Yes ❑ 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. 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 ❑ 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_tbis permit until final inspection. I�%moi �l CITY OF COSTA MESA BUILDING DIVISION > 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: E09-00039 PERMIT TYPE ELEC STATUS: ISSUED APN: 42539226 DATE ISSUED: 02/1212009 ISSUED BY: BJK JOB ADDRESS: 235 E 18TH ST CM Vicinity: TREATMENT HOME Suite/Unit: SCOPE OF WORK: UNITS A, B, C HARD WIRE 12 SMOKE ALARMS IN A TREATMENT CENTER HOME, NATIONAL THERAPEUTIC SERVICES, INC. OWNER: SNYDER, E NICHOLAS 111 PHONE: APPLICANT: SULLIVAN, RICK PHONE: 949.515-5147 CONTRACTOR: 1 SUPERIOR ELECTRIC INC Address: 1048 IRVINE AVUnit: PHONE: 949-515-5147 City/State: NEWPORT BEACH, CA ZipCode: 92660 ELECTRICAL PERMIT FEES Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $36.70 Reinspection Fee $0.00 TOTAL FEES $36.70 Address: 2322 MARGARET Unit: City/State/Zip: NEWPORT BEACH, CA Address: 10481RVINE AV Unit: City/State/zZip: NEWPORT BEACH, CA License No. 883400 CELL: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODEI INSPECTION TYPE DATE INUITALS CODEC INSPECTION TYPE DATE INMALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 206 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. have and will maintain workers' compensation insurance, as required by sec Ion 3700 of the Labor Code, for the performance of the work for which this permit is issuetl. My workers' compensation Insurance carrier and policy number /,p-�,, Carrier. W"MQ ejit's rd0 �S (Thasecrion needncl be completed neperrnngs vamedaajZe nunrbbdollamf$t00J or less) Policy Number: 1 �/, 6 19 2do u o a ( ❑ 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 qe workers' compensation provisions of Section 3700 of the L or Cod I s a I forthwith comply with these provisions. 7� Iz-� y plica is Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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 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. A Lic. # q0 C7 Class # 6 - itO 7 -(Z_-0 C1 Con rad r s e 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: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that 1 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 (hat 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 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 W5746 (a 7) Date Owner ID verified by drivers license. ❑ Yes []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, falsew7ork, a 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. Appticanrs Signature Division of Industrial Safety Permit Number: Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will (he 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ Yes ❑ 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. 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 ❑ 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. 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. Sipnatu or legal Ovmer(s) Date Anntor Kuthonzed Applicant Date (714) 754-5273 • Fax (714) 754-4856 Job Address: 235 E 18TH ST Suite: Vicinity: CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT BUILDING PERMIT Parcel Nunmber: 42539226 Zoning: Applicant: ACADEMY ROOFING CO Calc Valuation: 54,734.00 Address: 1070 N BATAVIA #502 Claim Valuation: $4,734.00 SMIP Res: $0.50 Phone: (714)997-0038 SMIP Com: ORANGE, CA Zip: 92667 Owner: SNYDER, E NICHOLAS III Address 2322 MARGARET Total: $100.25 Phone: NEWPORT BEACH, CA Zip: 92663 Contractor: ACADEMY ROOFING CO . Address: 1070 N BATAVIA #502 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Phone: (714)997-0038 Existing: 0 ORANGE, CA Zip: 92667 _ s ' . License: 648959 Arch : Address: Eng: Address: PERMIT NUMBER 7 /B,99-01129/ 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Status: ISSUED Applied: 07/19/1999 Issued: 07/19/1999 Phone: Phone: Zip License: Zip: License: SCOPE OF PERMIT REROOF - T/O, USING EXISTING SHEATING, 2 LAYERS OF 15# FELT & NEW 20 YEAR COMPOSITION SHINGLE ROOF. FEESUMMARY Plan Check: $0.00 Calc Valuation: 54,734.00 Permit: $99.75 Claim Valuation: $4,734.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $100.25 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, § 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) 754-6626 WORKERS' COMPENSATION DECLARATION: ' hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to sell -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. ❑ 1 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 workefs' compensation Insurence carrier and policy number are: Carrier: l i,/ /GI 1I A/Cl A/'P 6O Policy Number: ICC — C25`ii—CQ'20 C� (This section need not be completed /f the permit is valued of one hundred dollars ($100) or less.) ❑ I certify that in the performance of the work for which this permit is issued, I shell not employ any person in any manner so as to become subject to the workers' compensation laws of California, and that If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these provision Applicant Signature: Date: WARNING: FAILURE TO SECUR RKERS' C 1PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLAR E (5100, , IN ADDITION TO THE COST OF COMPENSATION, 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 Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Lic. N Class N 4 —__? Contractors Signature: Date: 7 / ter —GZG/ 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). Lenders Name: Lender's Address: Signature: Data 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 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 Cade: 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.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 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) feel 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? ❑Ves ❑ No 5 Does or will the applicant or present or future building occupant require for the work which is the subject ofthis application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes � 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 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 ❑ 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 1 have read this application and state that the informatio]givon correct. I agree to comply with all state laws and city ordinances relating to builtling construction, antl authorize representatives of the City of Costa Mesa to enter above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final Inspection. egal Owner(s) Date �- /`Z-4 c7 d/Or Authorized Applicant Date CODE I INSPECTION TYPE RATE INTITALS CODE. INSPECTION TYPE pAg INITIAL 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 7 210 Final Electrical 201 Final Block/Retaining Well 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 2446-46 7 OWNER TOWNE ESTATES, INC. DATE 10-3-56 JOBADDRESS 235 (b) 18th Street BUILDINGPERMIT NO. #3778 (b) GENERAL CONTRACTOR K. W. Koll Const. CO. VALUE 111 15.265.00 H BLOCK TRACT 225.E Triplex wZgar. GROUP H TYPE V ZONE R4 FIRE DISTRICT 3775 INSPECTIONS DATE , i SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Footing Trench 199V Foundation Foundation Forms and Grade to Garagt Rough Framing b pp Plumbing, Rough to Slarb /�yf //;//; x)—e/'.SG %O U p Plumbing, Rough Co _ plete Temporary Pole Wiring, Rough-3o—sb 339 Heating, Rough /6i� /O Heating, Final $elder, House Sewer, St. Septic Tank or Cess ooI Lt1tiing, In Out I :ring 2-2/ Plumbing, Final, Fixtures Complet Plumbing, Final Gas Test Wiring, Final JAN 119 Occuoancv C I—i9 FORM 210 3M 10.05 I OWNER TOWNE ESTATES, INC. DATE 10-3-56 JOBADDRESS BU I LD ING PERMIT NO. #3778 (C) GENERAL CONTRACTOR K. W. K011 Confit. Co, VALUE $ 15,265.00 B BLOCK TRACT GROUP H TYPE Q ZONE k4 FIRE DISTRICT 3775 %fewer, PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER / • Footing Trench Foundation Forms and Grade to Garag Rough Framing Plumbing, Rough to Slab /Q 700 9 Plumbing, Rough C�e 9� Temporary Pole c �3 394 Wiring, Rough Heating, Rough Heating, Final House Sewer, St. ��•� (� e„ _ . _s ya 6 ^ Septic Tank or Cesspo I In Out 7 _Lashing, I !ring Plumbing, Final, Fixtures Complete Plumbing, Final Gas Test Wiring, Final JAI 11 19 nnel,nannv RJ) h FORM 210 3M 10:55 v 3778 (C) F0wrvER TOiTIE ESTATES, INC. DATE 10-3-56 J JOBADDRESS 235 (B) 18th Street. BUILDINGPERMIT NO. #3778 (a) GENERAL CONTRACTOR K. W. x011 Const. CO. VALUE $ 15,265.00 B BLOCK TRACT 2251 Triplex V/gar. GROUP B TYPEy ZONE +V1 FIRE DISTRICT 3775 INSPECTIONS 'BLwer, DATE / ! SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Footing Trench Foundation Forms and Grade to Garage?' Rough Framing Plumbing, Rough to Sl B,c, "' Plumbing, Rough Complete !!CTfoo t1/✓ i./�.C_l�w ,t:. ,.e_/6 -y'S6 700y Temporary Pole Oe—IV Wiring, Rough 1i Heating, Rough ,6 _ 0 30 ,�.339 /p L/ -s 7007 --- Heating, Final ,n,.� House t.y r�?r' Sewer, St. ,'jam ��# , �0 S'r/ CP6 Septic Tank or Cesspool Lathing, In ChIr, Out 1 zring Plumbing, Final, Fixtures Complete Plumbing, Final Gas Test ` /��(���(i,.�J �/ J' Wiring, Final JAN11 19 57VC8 hOccupancy —/�f FORM 210 3M 10.95 3778 B) Costa Mesa Building veparV-_ , 1. PLICATION FOR FERM T 171 EAST 20th STREET . BUILDING COSTA MESA, CALIFORNIA FORM 204 S -BP 2M 6-55 FOR OFFICE USE ONLY FOR APPLICANT TO FILL IN Receipt No. Permit No. Buildin Address Tract 7122572iiftl & Ie4 roster Costa Mesa, California Received by Date Recd. (/— Date Issued_ O ^a1—S /© Nearest �" " 3 Cross St. Orange Building Address owner To-.;ne Estates, Inc. Costa Mesa, California Mail Address 2826 Newport Blvd Nearest City Newocrt Beach, Cali.Nol; Ha 5201 Zone St.No. of Type Group Plans A rch'te�t o Ljc. Engineer �arlson & Middlebrow, C 1673 Approved oy Date Address Garden Grove, Calif. CORRECTIONS tractor K. W. Koll Const C;yL10611n5 Address 2826 Newport Blvd Legal Lot Description I No. B Block I Tract 225 (Attach Metes and Bounds) 75 0 Nof Bldgs Size of Lot' (�_ 50 I Noo. l on Lot O Use of No.of I No.of Existing Bldg. A Famflies3 Rooms12 _ L7 Setback Line from Rear Yard Z Center of Street 50 ft Side Yard y DESCRIPTION OF WORKi New I X I Alteration I I Addition Repair I I Moving I I Demolish Building No. of Size 23.5 X 86 Rooms 12 Stories 1 r� �. EY*erior Wall I Roof CO,rt ring StUCCO Covering p APPROVALS ,1 New ,����� I Building Residert'i aI ancome� Foundation Location Inspector Date Forms, Materials, and 3 Ear garage Under -Pinning Frame: Fire Stops, N Bracing, Bolts I hereby acknowledge that I -ha a read this Application and state that the above is co ct and agree to comp y Lath. Int �Jr o --A� with all City Ordina s State laws regula ' g building constructi0 Lath. Ext. Signature of Permittee Plaster, Int. Authorize Alit. Plaster, Ext. .p. Valuation Permit Fee $ 3.5 — Masonry Reinforced15. �'•'fj:_ `2 i Plan Check $ / S !J Bond Beam $ rQ69 00 Total o 2115 C Fee $ .S , O FINAL o FORM 204 S -BP 2M 6-55 PLOT PLAN Show location and distances from property line and between buildings c' U a N H ri 0 IA a c u J S J n a Street PLOT PLAN Show location and distances from property line and between buildings c' U a N H ri 0 IA a