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Home My WebLink About1042 SEA BREEZE DR - Building Permits CITY OF COSTA MESA t BUILDING DIVISION >:l, -„ ..sr DEVELOPMENT SERVICES DEPARTMENT RMIT NUMBER M 4 P • PERMIT M05-00560 elbobtarroffr* (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 1042 SEA BREEZE DR Status: ISSUED Suite No - Applied: 09/28/2005 Issued: 09/28/2005 Vicinity: Parcel Number: 93529001 ISSUED BY: Applicant: RONALD LANE Address: 204 WAKE FOREST RD",44^' - - Phone: 743-1776 `" ` COSTA MESA,CA Zip: , 92626 Owner CARPENTIERI,'PINA: Address ,,.,1042,SEABREEZE DR - ` "' -"' Phone: COSTA MESA,CA Zip: 92627-487 P ... . . . . Contractor. R . .. `Address: , , . Phone: Zip. - - ' " License: SCOPE OF PERMIT REPLACE DUCTS IN ATTIC. FEE SUMMARY Quantity t . Quantity ",' ISSUE FEE : $23.50 ' w " ;-*Repair/Alt Absorbtion'Unit „ z$0.00 - 0 Inst FAU<100 k BTU , $0.00 0 - 'Repair/Alt Refrigeration Unit"' -fi'$0.00 0-- - Inst FAU>100 k BTU_ - $0.00 0_ `_ • - - Ventillation System' ' $0.00 - 0, Repair T ; Alt Cooling/Heat- $13.70 1 = - W Evaporative Cooler •.: '^ $0.00 -0- Inst,/Rep:.Recess Wall Htr - $0.00 0 Commercial Incinerator - ' $0M0 . 0- Refrig Sys'_<100 k BTU --: $0.00 0 • Domestic Incinerator " ^x':$0.00 0 Refrig Sys>100 k BTU $0.00" 0 - Compressors'/Absorption Systems GasPiping _ $0.00 0 - Up to 3 hp/.100 k BTU - $0.00 0' Factory Fireplace - -$0.00 0 3 To 15 hp/500 k BTU - $0.00 - 0 ' Hood w/Meth Exhaust'; "3.... A :. - $0.00 0 15 To 30 hp/1,000 k BTU $0.00. 0 VAV Box 'ti!' ; " , $0.00 0 3010 50 hp/1,750 k BTU $0 00, 0 Vent Fan/Single Duct - -$0.00 0 Over 50 hp/Over 1,750 BTU '$q:00.1 0". Appliance • ' $0.00 0Boilers - Fire Dampers $0:00 0 .. Up to 3 hp $0 00 0' Smoke Dangers . $0.00 0 3 To 15 hp $0.00 0. Inst or Relocate Appl Vent $0.00 0 15 to 30 hp, : $0.00 . 0 Air Handlers< 10000cfm $0.00 0 - 30 to 50 hp - • - $0.00,' 0 Air Handlers> 10000cfm -$000' : 0 :"Over 50hp - $0.00 0 Floor Furnace - '$000 0'- - - " ' Other Mechanical Fee-, - - - FloororSuspend:Heater $0.00< 0 .`Investigation Fee ' '$0.00' Plan Check Fee - $0.00 fReinspection.Fee ; $0.00 _ - • -. ' • TOTAL CALCULATED FEES $37.20 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 2448-46(6/00) • DECLARATIONS C ) ( '\l 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. ❑ 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'compensation Insurance canier and policy number are: Carrier: Policy Number: (This sect/on 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 provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED THOUSAND COLLARE(5100,000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3708 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.Lic.M Class it Contractor's Signature: 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: 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 .,.i.,,: •r 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 pen:;yr• ore th. dive hundred dollars($500).): . Vd,'�.' ,. ❑ I,as owner of the property,or !§i'.yees 1 ages as Mali sole comps WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec. 7044,Business and Professions C•....7, The COAOactors License Law does pply:to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own em ajoyees,provided that such im nts 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,ouf,.,.} ''ritg'that he or she did not build or improve for purpose of sale.). ' ❑ I,as owner of the . •.arty,am EXCLUSIVELY CONTRACTING WITH LICENSEObONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The con -clots (cense Law does not apply to an owner property who builds or improves thereon,and who contracts for such project with a contractor(s) license purs :nt to the,ontractors „yg.e La s.). r ❑ I am exem•t un.- � ,/� ness an. •rofessions Code for this reaso c3 Signature: lef4rAA tt/�_W agd . .� Expires: _Si Verification of Ownership by(type of document,i.e.-property lax 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 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 the Fire Department. 4 If an 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 appermit 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 LJ 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 pan 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 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 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 ..ree 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 a.. : - .•property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Ig aur-OI • a 0 er(s)Al Date - An+. hord r:•�� Da e gODEb INSPECTION TYPE - PATE INTRIALE CODEr INSPECTION TYPE /D. 3241L 11111.1616 Fixed System Final Fire Prevention 206 Final Mechanical r'1/ e E 414A4.,t,r 1266 Pool Spa Final • 208 Final Plumbing P' 200 Final Re-Roof 210 Final Electrical 201 Final BIock/Reteining 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 7-1 PROTECT ADDRESS: 1040 SEA BREEZE DR UNIT CITY OF COSTA MESA — BUILDING PERMIT ' PERM NO;. B ; 054088 OWNER'S NAME: PACIFIC TERRACE H.O.A. ADDRESS: 1500 ADAMS AV PERMIT NO: B 054088 PLAN CHECK NO: N GOVT; N SUPP ; N . i COSTA MESA,CA 92626 - CONSTRUCTION TYPE; 5—N PERMIT TYPE: STR PURPOSE: ALT ; $H/ENGINEER: REG.NO.: UNIT: JOB DESCRIPTION : REROOF DUPLEX W/3—TAB ASPHALT SHINGLES SQFT: 2, 156 - ` ADDRESS: CLAIM VALUE: 2 156. 4 , CALC—VALUE: 2, 156.00 ' GROUP OC : R-3 / II: • PERMITTEE: ELLIOTT ROOF MAINTENANCE ( 714)997-4938 ADDRESS: 324 S EARLHAM COMMENTS: INCLUDES OF " 04SEA BREEZE" ALSO �}+� �E " ORANGE CA 92669 ********************** ** . ******************************* LJ 1 �/n* . i iii LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z I N G R E Q U I R E M E N T S ` Tit'" 70001 of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS CITY u4: 03 965 STATE LIG.: '65344 CLASS: C-39 I ,��C- -,. Date: G' if, •?�tia..� - �•� MAIN BUILDING ACCESSORY BUI7iNG�— '3-i—�-- r I WORKERS' MPENSA ION DECLARATION: Ihereby afhr I I have a certificate of consent to self-insure or acertificate 01Workers' FRNT: FT IN REAR: FT IN FRNT: ; FT IN REAR: FT IN ' Compensation Insurance.on a cerotted copy thereof(section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN I POLICY NO.: 571785 EXP.DATE: 07/01 /92 l COMPANY: STATE FUND / PARKING REQ: PROV: PARCEL; 93529006 ZNE; REF NO: ❑ Certified/copy is hereby furnished. EX rtified copy is filed with the city Building Division. PLANNING NOTES> Date. / 9/ Applicant. '✓Y>1 flr/� ` Xjf_LLvV ********************************************************************iEj('********* 6 EXEMPTION F OM WORKEpSs COMPENSATION DECUMT : (This section need not be completed it the pemm is for one hundred($l%)or less). DEVELOPMENT SERVICES R E Q U I R E M E N.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:If.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. . CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: DATE: ': 1 which this permit is issued(Section 3O97,Gv.Ci. �E****.*.****.***{p*********.**.**.***..)E*****.*.*.*.*.*** *. ***.***.***.*.***.*.*.*.*. • ** LENDER: "DUPLEX" STRUCTURE ******************************************************************************* - ADDRESS: "DUPLEX" STRUCTURE LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT:Y• _ _ OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SHIP/RES GRADING ' (Section 7031.5 Business and Professional Code: Any city of 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/she is licensed PERMIT S 4 , OO O pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Oivision 3 o1 the Business 1 SHIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption Any 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($500). ISSUE FEE g I. as owner of the property 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----> 54 . 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.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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED; 54 . 50 OVER/SHORT; 00 0 mrthepurposeolsale6 BLDG G9PMT 00 PLUMBING ELECTRIC MECHANIC FIRE ' SMIP/TOOT GRADING PLAN—CHECK I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business❑ 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 the Contractors'State License Law).l am aware *************************************.****************************.*********.***,** that proof o1 their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section. 6 &P.C for this reason: TYPE QTY DESCRIPTIO N . UNIT COST TOTAL COST Dale: Owner: SFR 2156 ' REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 2, 156.00 Ida hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25517.and END OF FEES 25534 and that I or any lunate building occupant wtlVwill not(circle one)need to comply with said state codes and the requirements for a Permit Tor construction or modification from the An Duality Management District.Residential construction applications are exempt from • these provisions. I Dale: Applicant: • I hereby certify that I have read this application d state that the above information is correct.I agree to comply with all city and county ordinances and slate laws relating to building cr motion and hereby authorize representatives of this city to enter upon the above'menlfOned - .. I _ v property for inspection purposes. CJ ^ J , -' . It'- Date: / Signature v IDriver's icense or Social Security u.- - (' s Yi1 r -S 1 k x ( :n.UC, I. 16,4i-46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor - - ' - :ry = Witt./�'; ,!' • : � i 4 •5. - — --�