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2201 SANTA ANA AVE - Building Permits (2)
r1-1 • CITY OF COSTA MESA Agin%eBUILDING 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 154Po ^fi PERMIT NUMBER: BC11-00419 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: DEMO ALL DATE ISSUED: 08/30/2011 ISSUED BY: • - JOB ADDRESS:;: 2201 SAN. TA ANA AV CM-7 Suite/Unit: APN: 42608111 ' —Zoning: , , Vicinity: Primary Occ: • Const Type: V-B SQ. FT: 1450 Valuation: $20,600.00 SCOPE OF WORK: DEMO OF AN EXISTING 1,450 SF SFD AMD DETACHED GARGE WITH UTILITY CAPS. . .. . . .._ APPLICANT TO CONTACT AQMD. OWNER: PATTERSON,VELMA C Address: 2201 SANTA ANA AVE Unit:. . '. • Phone: City/State/Zip: COSTA MESA,CA APPLICANT: HENDRYX, DAVID Address: Unit: : Phone: 949-270-3620 City/State/zZip: CONTRACTOR: • BASCOM LOWELL MELLON III License No. 774746 Phone: 909-428-0320 Address: 14998 WASHINGTON,DRUnit: Cell: City/State: FONTANA,CA ZipCode 92335 • ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: COMBINATION PERMIT FEE SUMMARY Building Plan Check: $217.91 Building Fees: $335.25 Electrical Fees: $41.70 Mechanical Fees: $0.00 Plumbing Fees: $43.10 - - — SMIP Residential: $2.06 SMIP Commercial: $0.00 . Bldg Std Admin Fund $1.00 - . TOTAL FEES: $641.02 "Refer to fee receipts for all fees paid for project HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010- PER CMMC Sec. 13-279 Monday thru Friday•7:00 am thru 7:00 pm. Saturdays-9:0D 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 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 p. INSPEC11ON TYPE DATE INTITIALS CODEC INSPECTION TYPE DATE INTmALS 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/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site -" • 204 Final Demolition — v,'-'t.( . 250 Final Building/Occupancy X lb .41411 WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver a license. ❑Yes .❑No I hereby affirm under penalty of perjury one of the following declarations: ' privet's cense No. Expires: 0 I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-properly tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the perfor ance of the work for which this permit is issued. . I have and will maintain workers'compensation insurance, as required by s tion 3700 of the Labor Code, for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: rmit is issued. My workers' compensation Insurance carrier and policy 0 hereby certify that no excavation five(5)or more feet in depth into which a er are � ,,rry� person is required to descend, will be made in connection with work authorized 0 T� � /v� by this permit,and that no building structure,scaffolding,falsework,a demolition Carrier: or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Grp (This section need not be completed if the permit is valued al ne hu 7ddollars(3100 or less) 2,Art 2,Sec.341,Title 8,California Administrative Code). Policy/Numb . 7/3 2-7 7 ❑ As owner-builder, I will not employ anyone to do work which would ❑ certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any pers in any manner so as to become subject such person has a permit to do such work from the division. to the w. -rs' compensation law of California, and agree that if I should beco : subj-ct to the workers' c mpensatio�rr ions of Section 3700 of Applicants Signature Date the a for Co.- I shallcforth/wvfth ply w ovisio i - ,� / Division of Industrial Safety Permit Number: / A.plicanrs Signal Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAIL - TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires.with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full for - and[eeffe . _ a registration form for acutely hazardous materials? 0 Yes 0 No Li C lass • (Section 25533 of the California Health and Safety Code, with some / /] exceptions, requires registration with the Costa Mesa Fire Department by �// �ifw (�1- v � � each business which at any one time has on hand a quantity of acutely C actors slnawre Date hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to dr modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications for non-residential building permits). License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). O I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No thereon,and who does such work himself or herself or through his or her own 8. (If"yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that 0 am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to o upy or allow occupancy of any building authorized by this permit until final in-.ection.1: iiiiir .-9 �1 9„.. r £Dat !/•ill Signature Date 005]-06(10]) And/or Aut•sized Appi© r`r ) �. Date CITY OF COSTA MESA c^os'°uMFsp BUILDING DIVISION `a `() 77 FAIR DRIVE, COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • w'w.costamesaca.00v F v ° FOR INSPECTIONS CALL:(714)754-5626 4`a+funnn0 d•' PERMIT NUMBER: G11-00020 PERMIT TYPE GRADE STATUS: ISSUED DATE ISSUED: 01/13/2012 ISSUED BY: ?? JOB ADDRESS: 2201 SANTA ANA AV CM Suite/Unit: . Vicinity: , Cubic Yards: Valuation: ?? SCOPE OF WORK: PRECISE GRADING FOR TWO NEW SINGLE FAMILY DWELLINGS. PM-2011-120. PARCEL 1 AND 2. ON SITE IMPROVEMENTS: DRAINAGE. NO OFF SITE IMPROVEMENTS AUTHORIZED UNDER THIS PERMIT. CY CUT:2,164 CY FILL: 2,321 INCLUDES 2201 AND 2203 SANTA ANA. • OWNER: SCEL PROPERTIES, LLC Address:620 NEWPORT CENTER 12TH FLOOR PHONE: 949-270-3620 City/State/Zip: NEWPORT BEACH, CA APPLICANT: HENDRYX,DAVID Address: t: . PHONE: 949-270-3620 City/State/zZip: CONTRACTOR: BASCOM LOWELL MELLON III License No. 774746 Address: FONTANA, CA PHONE: 909-428-0320 City/State: FONTANA,CA ZipCode: 92335 CELL: ARCHITECT: License No. PHONE: ENGINEER: ADAMS STREETER CIVIL ENGINEERING License No.70862 PHONE:714-474-2330 GRADING PERMIT FEE SUMMARY Grading Plan Check: $78.73 Site Improvement Plan Check: $18.08 Total PC Fee: $96.81 Grading Permit Fee: $484.50 Site Improvement Permit Fee: $111.25 TOTAL FEES: $366.44 HOURS���ra.� FORy� nCONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 -PER CMMC Sec. 13-279 Nd�Of ?ythf&w ciptthii®Pai 8y9as0offlit§l3ullstamply91,WhaklnyrSpdab@nhaRr0pdryted9ikkGwkrir&RGft9 8@dh4afR itritP9tfiAfl@PI i@/i d -egulatinns !Ord NrNe9"-YF;a§s1Ocy.jMeEjprial Day, Independence Day,labor Day, Thanksgiving Day and Christmas Day I 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. COOS t INSPECTION TYPE PATE IN1InAl5 CODE! INSPECTION TYPE peg INTTnALs 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/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval �1 /7.�1 /� 203 Final Sign 222 Final Site d-a —I a K" 113 204 Final Demolition . 250 Final Building/Occupancy WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's license. ❑Yes ❑No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. _ --EApires: 0 I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are .0 J person is reqand to no descend,will btr made in connection Lal with work authorizedm by this permit,and that no building structure,scaffolding,falsework,a demolition Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This secton need not be completed the�/per1me a valuedvaat one hundred Mears($100)a less.) 2,An 2,Sec.341,Title 6,California Administrative Code). Policy Number: 7 3 'V vJ Zfl 2 Z Li ❑ As owner-builder, I will not employ anyone to do work which would 0 I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California. and agree that if I should become subject to the workers'compensation provisions of Section 3700 of th L Code,I shall rthwith comply with these provisions. Applicant's Signature Dale U.---- t, E.. r)...0.b0.0 I —t' -L-L Division of Industrial Safety Permit Number: Applicant's Signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑ No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons.or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in fulltforce��l���ce�1111and effect, �/� a registration form for acutely hazardous materials? ❑Yes ❑ No Lic Class# • °` (Section 25533 of the California Health and Safety Code, with some Li/c0.30......)1 '3 —ZC�Z exceptions, requires registration with the Costa Mesa Fireof Department by % 1 ���� each business which at any one time has on hand a quantity of acutely CCLntracmr's signature Date • hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3, Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department, Signature Dale 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications for non-residential building permits). License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044,Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑No thereon,and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for 6. (If"yes",attach certificate of compliance from the appropriate air pollution sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I. as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code: The contractors License Law does not apply to an owner of Signature Dale property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I a-,ree not to occupy or allow occupancy of any building authorized .y this permit ntil final inspection. • eqs) Da e Signature Dale n� ii1 / t1, 3057.46(3/07) A And/or Authonze?Applicant Dale • JOB NO.11-1828 ADAMS • STREETER IRVINE • RIVERSIDE CIVIL ENGINEERS INC. Jan A. Adams • Randal L. Streeter February 9, 2012 City Building Inspector City of Costa Mesa Development Services Department 77 Fair Drive Costa Mesa, California 92628-1200 Subject: Civil Engineer's Certification of Rough Graded Pad Project: 2201 and 2203 Santa Ana Avenue Reference: Grading Permit Number: G11-00020 Address: 2201 and 2203 Santa Ana Avenue, Costa Mesa, CA Owner: SCEL Properties, LLC General Contractor: RSI Construction In accordance with the City of Costa Mesa Grading and Excavation Code and the requirements of the Building Code, I certify approval of this project as outlined above, to rough grade. Rough grading of the building pads has been completed substantially in conformance with the approved grading plan and in full compliance with said codes. Certification includes horizontal and vertical control for building pads as listed above. This approval does not include placement or compaction of soil, which is under the purview of the soil engineer. 00F~ 8lESS/O ig 'VA By: AL Date: February 9, 2012 w a s m Nicholas A. Streeter, RCE#70862 * Project Manager * Adams Streeter Civil Engineers Inc. OCAO CALICO' 15 CORPORATE PARK • IRVINE, CA 92606 • Tel: (949) 474-2330 • Fax: (949) 474-2362 2900 ADAMS STREET, SUITE A-400 • RIVERSIDE, CA 92504 • Tel: (951) 352-4100 • Fax: (951) 352-6200 ilb 1 PETRA S • PAGE OF FIELD MEMO JOB NO. CLIENT/PROJECT TECHNICIAN DATE&DAY /6 7- // -T/ l- c U ///4 /�il/✓1 /I I- LOCATIIOON PROJECT ENGINEER R`/GEOLOGIST CONTRACTOR FOREMAN OWNERS REPRESENTATIVE OBSERVATIONS // 6/ rao?U / / rap 03 ���-r,G.. (24, Com! �p..y.� �.r_�,// A A.�-.s _. // I/ .ctrl �.J �- ^"t'! '' . -19—t f -CI-4(,/d a. ..-- So 20 L'T/4e/I.Lm-AA-1 00-7'.t-ed_t i -o-h ii+ lir rre 1 I f� 4 s q 7t ' , _+ 1,. � zz.. 4���s-u//'j � ,1 � .may-1------. 1-1... 1c4 id Li" ._n 'r1 ter/ i_77 ,t. a RECOMMENDATIONS T `.../ • ACTIVITY HOURS CODE (Portal to Portal) TECH (signs1----"----------- /A14 lure) -REGIEWED BY(signature) DATE RECEIVED BY (print) (signature) TOTAL / / CWMac\Petra\FormsW40-as OFFACE: Costa Mesa Santa Clarita Murrieta OV WHITE-OFFICE YELLOW-FIELD PINK-CLIENT