The URL can be used to link to this page

Home My WebLink About1102 SAN JOSE AVE - Building Permits • 9-Y+ \--1.c Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - ' ..11 ' V ^ er- .;OSTA MESA CONSTRUCTION PERMIT - P NO TRACT NO. LOT NO. UNIT NO. • , �4'7s 1027s 37 ' `. •ddress _,/O� C.10!✓ VP SS - - - LJ REPAIR . SE :24 1a8b ' I'. ':.ant's Mailing Address T 'TYPE OF CONSTRUCTION - L I NEW ADD LJ ALTERATION , ..er's Name- r .5 teE9,O.V Phone rot 37/J ❑ CONVERSION CI DEMOLISH ❑ OTHER A.P.# 4/D— ex.13 raA Li ._--- zone-me W DESCRIPTION OF WORK/USE OF BLDG. , ' Address //D 7( S a ti The- 7- ' S Main Bui '- ' Accessory Buildirig`i IVIWH• Arch/Eng. A License No. . TYPE OF PERMIT ❑ GRADING H FOUNDATION LJ STRUCTURAL T Front. 0Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N ` \ Contractor's Name /✓Ow.�1< Jr Phone 3-iesrrl2'7' ❑ OTHER A I PROJECT DESCRIPTION SQ. FT. OCCUPANCY - C Right • N Address(mailing) nsa H/3 ' • on.A,. 5'LLD 1+/2 ' CONST RUCTION TYPE VALUATION $ /2,016%. s Left R City License No. 37�%9/7J 2/Z� ZONE GRADING CU.YDS. ACRES Ping. Ref.# Parking Req./Provided E LICENSED CONTRACTOR DECLARATION e•� L f Q I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: S k.t` 1 •' ! Tr S ` 3 Planning Notes: UGIT--7 S with section 7000) of Division 3 of the Business and Professions Code, and 1 h lr H J • NI T Licelnsense is Cllass in full force and effect. N� 3 f/7� - �l� Q�/') .- S �— License No. 1 (9 Irl Date . Signature PLUMBING .FEES f WORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL I hereby affirm that I have a certificate of consent to self-insure or a certificate - FEES . of Workers' Compensation Insurance, or a certified copy thereof (Section - Backflow Preventer - Service Sink - '3800, Labs) - - Automatic Washer - Transformer 0 15-50 KW Policy No.b rah ii In S�Company • S7`�TE fUN0 Backflow Irrigation • 'Sewer Cap Construction Pole Sub. 0 50+ KW ❑ Certified copy is hereby furnished.. . . - (J-Certifie copy is filed with the city BuilDiv on / Jr • Bathtubs Sewer Connection Cooking'Unit • Meter Due to 100 amps Date � Oi'`1 Applicant �/ E`%i,/ (t74O • EXEMP ION FROM WORKERS'C NSATION DECLARATION Clarifiers . -Solar Collector Dishwasher Meter Dover 100 am • (This section need not be completed I the permit is for one hundred($100) or less). Dishwasher • Solar Pipi Dryers ❑Gas ❑Electric Sub Panel 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 Drinking Fountains 'Sola ank • Fan Motors 0 HP 01%-8 Workers' Compensation Laws of California. Date - Signature Floor Drains imming Pool w/SpaF:A.U. - NOTICE: If,after making this declaration,you should become-subject to the . Inc. ar 09.15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal - Fixtures comply with such provisions or this permit shall be deemed.revoked. icrowave • - CONSTRUCTION LENDING' AGENCY 4Gas Service Outlets Water Closet Device Boxes I hereby affirm-that there is a construction lending agency for the performance - _ P• ole Light • ' of the work for which this permit Is Issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Lender's Name - Range ' Lender's Address• ' - - Kitchen Sink Water Service Switches _ Sign • OWNER BUILDER DECLARATION ' ' I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories - Auto-Wash • Garbo a Disposal - ' following reason (Section 7031.5 Business and Professional Code: Any city or. • - 9 P Standing Sections county which requires a permit to construct,alter,-improve,demolish or repair P-Trap Laundry Trays Generator ❑0- W ❑5-15 KW - • • any structure, prior to its issuance, also requires the applicant for such permit - "Trash Compactor ' to file a signed statement that he/she is licensed pursuant to the provisions ofRoof .Drai - - the Contractor's License Law (Chapter 9(commencing with Section 7000) of _ - Division 3 of the Business and Professions Code) or that he/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, - Reinspection Fee, I $15 Issue Fee $ 3• , t compensation, will do the work, and the structure is not intended or offered - - Reinspection Fee • for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL -FEES • p I $15 .Issue Fee • $ 3 License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own - DEVELOPMENT SERVICES REQUIREMENT 9-24- 12/J_� l employees, provided that such improvements are not intended or offered for Boiler • Hood or Type I ❑ r i 7— sale. If, however;the building or improvement is sold within one year of com- - Canopy Type II 0 Zoning Approved By Date pletion,the owner will have the burden of proving he/she did not build or Im- Duct-Under-Ground; Building Approved By - • Date prove for the purpose of sale). 0 I) as owner of the property, am exclusively'contracting with licensed con- Duct-Structural Refri tion System ApplicatioljtIssued By_ - Date r- %7 /Je tractors to construct the project (Section 7044,Business and Professions Code:- —f The Contractor's License Law does not apply'to an owner of property who Duct-Ventilating -100,00 BTU ❑100,000 BTU $UM V F EES • builds or improves thereon,and who contracts for such projects with a'con- - - - - - - (..,/'� tractor(s) license pursuant to the Contractor's License Law). Cam aware that Exhaust System ❑ Multiple System Re air/Alteration • BUILDING PERMIT $ ---�� SMTP - - $ / ✓L/ • proof oftheir Worker's Compensation insurance should be provided to me. t /( I (t PLAN CHECK $ • PERMIT '• 0 I am exempt under'Section B.& P.C.for this reason Firepl/Fact.Blt. ICBO# Fire Dampers fLl f1S ISSUANCE $ Date T !/ Owne iHeating System& D In Registers IilC0111Niti �Il;l` PLUMBING $ ice- `n . .// 9PLAN CHECK 25% $ ENERGY P.C. $ i I hereby certify that I have Ade and state that the above . 0o-100,000 BT 100,000 BTI, .� - GRADING $ information is correct. I ogre: comply with all city and county ordinances �g —'P'LECTR'CAL $ and state laws relating to bu dingconstruction,and hereby authorize repre- Date PLAN CHECK • 50% $ MICROFILM $ sentatives of this city to enter upon the above-mentioned property for inspection p / 9 •�� MECHANICAL i SigoattireC�: - --Applicant; Pink -Accounting; Goldenrod -Assessor 7 - UCTION AND PLANNING y POOL&SPA VALS Permit# Date Inspector APPROVALS Permit# Dater Inspector .Temporary Electrical Service or Pole 52. Pool & Equipment Location r 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4.5Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5`"Steei Reinforcement 56. Rough Plumbing & Pressure Test - c • •6: Electrical UFER Gond.' , 57. APPROVAL TO COVER-GUNITE - - 7:'Footinys • 58. Electrical Conduit-Undrgrnd. , ' ••f; 8.T•Foundation �f 59. Gas Pipe, 0 Undrgrnd.,Test • '/ y' 9:"Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line,& House Connection - 62. Backwash & Receptor-Final 12. Sewer Cap . ,. '' 63. Heater & Vent-Final 2.;-, ' • 13. Roof'Drains64. Plumbing System - Final 14. Rough Plumbing: - - • 65. Electrical-Final 15. Rough Electrical:Conduit _ 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing& Access Approval . 17t Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace • APPROVALS Permit# _ - 21. Ducts,in Structure I 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test .. 72. Underground Flush . 24. Roof Framing • (D/1 4 Dt+ 73. Undergrnd.StorageTank DGas ❑Oil p 25. Roof Sheathing e, t,A/2 Ct ,�0 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat _ 75. Dry Chemical 27. Frame and Flashing • 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat .i79. FINAL INSPECTION ' 32. Electrical Power Meter-Final • 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: to/Z3/86 f P e - of 34. Final Heating & Air Conditioning / _ 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace -' 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final ' 41. SolayDomestic-Final • py, l, 42. Backflow Preventer f 43. Backflow Irrigation EXPIRED Incompl/te nspections • 44. Landscape Irrigation System 45. Sound Attenuation Date 7 46. Handicap Regulations • 1 47. FINAL STRUCTURE & BUILDING i r 48. Special Requirements Completed 49. Electric Release to Edison , 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY - No. Date ' ( 41t1r CITY OF COSTA MESA ;+. �� BUILDING DIVISION • ' t' "r ' DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER �• PERMIT (99-008411 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COESA,CA 92626 BUILDING PERMIT Job Address: 1102 SAN JOSE AV Status: ISSUED Suite: Applied: 06/10/1999 Vicinity: HOUSE&GARAGE Issued: 06/10/1999 Parcel Nunmber: 41204321 Zoning: R1 R1 „„^ ISSUED BY: / /) Applicant: HEARN, DORAN Address: Phone: Zip: Owner: DANIELS, JOHN W Address 1102 SAN JOSE AVE Phone: COSTA MESA,CA Zip: 92626 Contractor HOWARD ROOFING CO. INC. Address: 139 E COMMERCIAL STREET Phone: (909)622-5598 POMONA,CA Zip: 91767 License: 475568 Arch : Eng: • Address: Address: Phone: Phone: Zip License: Zip: License: SCOPE OF PERMIT REROOF-T/0,INSTALL 1/2"CDX SHEATING, 1 LAYER OF SBS MODIFIED TILEGUARD UNDERLAYMENT&CEDARLITE (ICBO#2093)TILE ROOF. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $14,263.00 Permit: $224.75 Claim Valuation: $14,263.00 SMIP Res: $1.43 SMIP Com: $0.00 • Other: $0.00 Inspection: $0.00 Total: $226.18 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 160 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 WORKERS'COMPENSATION DECLARATION: `• I hereby affirm under penalty of perjury one of the following declarations: O I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the ork 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, Myrs'c•mpen ti n!nun rice - : :nd policy number are: Carrier: 1 ' r• Policy Number: (This section need at be •mp a d' the permit Is slued at one hundred dollars($100)or less.) ❑ I certify at In the pe orman e of the work or w ich this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compe -ation law of aliforn • and agree t at f I should become subject to the workers'compensation provisions of Secti n 3700 f the Labor Code,I shall forthwith comp) with these prov Applicant SI.nature: ' Date: / /99/ WARNING:FAIL'.- • : RE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMI PENALTIE D VIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,•.•, 1 ODITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE R CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTR- TORS r CLAR• ON: I hereby affirm that am liven a r•ro To . N apter 9(commencing with Section 7000)of Division 3 of the Businn an o Bions Code,and my license is in full force and effect. .# SAW r /��•r1 Class# Contractor's Sig :tura: AY/M111y�S z!i • Date: CONSTRUCTION LENDING AGENCY: O 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,end 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: Date: Owner ID verified by drivers license. 0 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: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,wit be made In connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). O As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: • Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 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 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? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas 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 Iithe Fire Department. .- -- —. 4 en RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application agermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes LU No (Section 85850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have at of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No B (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: • C- • FI••TE OF CO ' ANC:AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is orrect. I :gree to co, ply with : state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-des ribed pr.•arty for Ins.action purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final Inspection. /,F+ /wL Of Legal OwneAriaS .) / nd/Or Authorized Applicant D e 000E 1 INSPECTION mg 26I1 !EMU CODE! INSPECIWNTYPg QAIE INTITAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final //�� 208 Final Plumbing 200 Final Re-Roof i�� /o�*'� 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 2446-46 COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FO Rtt 't}4 LPERMCQ32.35 TU P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 - "` ,. -.. RECEIVED V PERMIT For Applicant to Fill in Completely — Use Ink Only (14 N2 4 7 7 4 6- BUILDING BUILDING A.P. NO. -jL/.9--\'0'ya-s6 ADDRESS 1102 San Jose Ave. BUILDING OWNER OR ADDRESS 1102 San Jose Ave. TENANT Wimbledon Assoc. UNIT OR MAILING 1470 Jamboree Rd SPACE N036 ADDRESS TR.NO. LOT BLK. CITY Newport Beach N01640-6800 10275 36 NEW ADD ALTER REPAIR MOVING DEMOLISH CONSTRUCTION mperial Savings & Loan LENDER X BRANCH Pasadena — OWNER Wimbledon Assoc . ADDRESS 61 S. Lake Ave. VALUE��f3 ARCHITECT Corbin/Yamafuji W549-7124 USE PRD i OR ENGINEER NO. (� JJ ,^ `' ADDRESS 17992 Mitchell So. , Irvine ZONEPDR YP -[y GROUP 111- 3 APPROVED CONTRACTOR McLain Dev. Co. BY rpm( DATE ( 12o%i� ADDRESS 1470 Jamboree Rd CITY Newport Beach NOL640-6800 Fl APPROVED SETBACKS CITY LIC. NO. 273875 LIC. NO. 18873 SIZE NO.OF BLCXSS. (FROM-CDC-STRKTIn- 1 OF LOT I NOW ON LOT 0 FRONT o?O FT. Q USE OF o. EXISTING BLDG. _R.SIOF S FT. to i-. Separate permits are required for L.SIDE tT FT. d electric,plumbing and heating work. REARH/8 FT. F USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION Q c PRD - New ConstructionG r / DATE Z -78 -3- APPROVED a-a7 /98(J > Single-family dwelling APPROVED DATE t `$1 wr' HOLD FOR SPECIAL REQ IREMENT; N QI hereby acknowledge that I have read this application and state N N. [C that the above information is correct and agree to comply with O. all laws regulating building construction, and I shall not employ i Z any person in violation of the workman's compensation laws of 'WS the State of California. r / �/ m I hereby certifythat I am /tch 9 SQ. FT. ` -o N properly licensed as a contractor under the State of California Business and Professions Code, Division 3, THE AMOUNT S WN UNDER VALUATION IS FOR al Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY; �1 am exempt from the provisions of the State of California Business VALUATION a a�[t n 5 and Professions Code, Division 3 Ch pte 9. PERMIT FEE $ Signature of rr+��1 / PLAN CHECK $ 2 �. Permittee a L' dC/ $�l (3� TAX $ 41- �U Authorized Agent Data TOTAL PAID $ IIr1 �1 (�