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Home My WebLink About1024 SEA BREEZE DR - Building Permits CITY OF COSTA MESA 4( PoeT • BUILDING DIVISION F r ]; ' DEVELOPMENT SERVICES DEPARTMENT AI�uNUMBER • * • PERMIT 00374 +ro•�D fi, P00 00376 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT • Job Address: 1024 SEA BREEZE DR Status: ISSUED Suite No Applied: 07/17/2000 Issued: 07/17/2000 Vicinity: ISSUED BY: Parcel Nunmber: 93529014 Applicant: NOCK, RON Address: 11612 KNOTT ST Phone: (714)895-1246 GARDEN GROVE, CA Zip: 92841 Owner: LIEFFERS, HENRY J Address 1024 SEA BREEZE DR Phone: COSTA MESA, CA Zip: 92627 Contractor: NOCK PLUMBING Address: 11612 KNOTT ST Phone: (714)895-1246 GARDEN GROVE,CA Zip: 92841 • License: 707775 • • Arch / Eng : Address: Phone: Zip: License: SCOPE OF PERMIT 1 WATER HEATER CHANGE-OUT. FEE SUMMARY AMT QTY AMT QTY AMT 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 Preventer $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 Basin Set $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 I 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 DECLARATIONS (`} WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the rk for which this permit is issued. I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My wrkers'compensationInsurrance carrier and policy number are: Carrier: ,oQ1_41CaJ enG Policy NumberA)W0T79 3 ` troy"Oy" (This section need not be completed If the permit Is valued 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 California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provi � / Applicant Signature: Date: �r/I / / WARNING:FAILURE TO SECURE W RKERS'COMPENSATION COVERAGE AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($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 p'rs7 vissi�o s Rhlapter 9(commencing with Section 7000)of Division 3 of the Business d Irons Code,and my license is in full force and effect.Lic.# "70 / / ? Class# Contractor's Signature: _ Date: tlt_sr CONSTRUCTION LENDING AG NCY: ❑ 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 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 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,end 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 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,ore 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 0 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 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 apermit 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 U 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? 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 all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 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 this permit until final inspection. Signature Of Legal7 —!i17p, _ �1.,. dDate /Or Authorized Applicant , tel �/�} CODE I INSPECTION TYPE PATE INTRIAL$ CODES INSPECTION TYPE pqF INTIMAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical /�r� /�� 1266 Pool Spa Final 208 Final Plumbing /—p(�7 - 'fl ,° /Y 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 2448-46 I PROJECT ADDRESS: 1024 SEA BREEZE DR - UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B O59090 •MILER'S NAME: PACIFIC TERRACE H.O.A, ADDRESS: 1500 ADAMS AV PERMIT NO; B 054090 • PLAN CHECK NO; N GOVT: N SUPP: N 4 COSTA MESA, CA 92626. • CONSTRUCTION TYPE; 5—N PERMIT TYPE: STR PURPOSE; ALT ARCH/ENGINEER; REG.NO.: SOB- SQ DESCRIPTION : REROOF DUPLEX W/3—TAB ASPHALT SHINGLES - FT; 2, 156 ADDRESS: UNIT: PERMITTEE: CLAIM VALUE: 2, 156 . 00 CALC—VALUE; - - 2, 156. 00 GROUP OCC; R-3 / ADDRESS: ELLIOTT ROOF MAINTENANCE ( 714 ) 997-4938 324 S EARLHAM • COMMENTS• INCLUDES OF "107.4 SEA BREEZE" ALSO ORANGE CA 92669 ***************** **********************TE****Tk*********** I*'******.)******** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENT E( 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect , ` 7-�••� CITY LIC.: 03996 STATE LIC 465344 CLASS: C_39 / SETBACKS O DETECTOR Date: 972-s q/ Signature:_ dz9� _ - � MAIN BUILDING ACCESSORY Bl7l C ' WORKERS'C MPENSA ION DECLARATION: Ihereby affirrnt�atI have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR; FT IN FRNT; FT IN REAR, IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: FT ' IN RGHT: FT ' IN LEFT; FT IN RGHT: FT IN POLICY NO.: 571785 EXP.DATE: O7/O1 /92 • COMPANY; STATE FUND PARKING REQ: PROV: PARCEL: 93529006 ZNE: REF NO: Certified copy is hereby furnished. 11 C itied copy is filed with the city Building Division. , PLANNING NOTES> Late: 1��•��y/ Applicant: �/— ��"""F'Jrr ( **************************************************************************%'**** . EXEMPTION ROM WORK RS'COMPENSATION DECLARATION: his section need not be completed if the permit is for one hundred($110)or less). DEVELOPMENT . SERVICES R E Q U I R E M E /C'T S 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. ZONING APPROVED BY DATE: _- Date: Signature: NOTICE:It,after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. - 1 I �y CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• S 1'l A ' DATE• 5Jz 3097. • issued(Section *********************iE*)E**************,**k***•*********************,1F* * * ***, LENDER: "DUPLEX" STRUCTURE *****************Rr************************************************************* ADDRESS: "DUPLEX" STRUCTURE LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 54 . 00 50 repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMI P/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis tor the alleged exemption.Arty violation of Section 7031.5 by PLAN ' any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE • I. as owner of the properly or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code, The Contractors'State License Law , TOTALS-,---> 5 4 . 50 0. 00 0 . 00 54 . 50 54 . 50 . 00 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 employees, prowled 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 will have the burden of proving he/she did not build or improve REVENUE .DIVISION TOTALS——> COLLECTED: 54 . 50 OVER/SHORT: , 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK . I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business •• 5 4 . 00 . 5 0 • ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon • ' and who contracts for such projects with a contractor(s)license pursuant to theContractors'State License Law).I am aware ***.*.*.**.****.***.***.*.**.*****.******************.***************.*.********************. that pmol of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.8 P.C. for this reason: TYPE QTY D E S C R I P T I O' N UNIT COST TOTAL COST Date: Owner SFR 2156 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 2, 156 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions.' Date: Applicant: I hereby certify that I have read this applicati�i nand state that the above information is correct.I agree to comply with all city and cou y • ordinances and state laws relating to building onslruction and hereby authorize representatives of this city to enter upon the above.mentio ed property for inspection purposes. �I ` Date: , 5/7 9,/97 Signature: 4t 4 /49 4�� , 01 00043063-00098064 1.01- 54.,4A Driver's License or Social Security e: M419453DATE: 09/25/91 TUU1E: 13:14 164146 While—Building;Green—Code Enforcement;Canary—Applicant;Pink—Revenue:Goldenrod—Assessor .. ~w-•"., .CQN«TRUCTION AND PLANNING POOL .- SPA I- APPROVALS Permit# - Date Inspector APPROVALS Permit # Date Inspector 1:Temporary Electrical Service or Pole 52. Pool & Equipment Location - •. 2. Soil Pipe-Undrgrnd. �. _ 53. Steel Reinforcement cat_Electrical Conduit Utility-Undrgrnd:' - - -54. Forms 4. Electrical Conduit-Undrgrnd. - - 55. Electrical Bonding • - 1 ••5. tS14el Reinforcement ` _ . Rough Plumbing & Pressure Test • "6.iElectrical UFEitOind. - ,57. APPROVAL TO COVER-GUNITE , 7.;Fobtings - ?, _56. Electrical Condui%•Undrgrnd. • ;