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Home My WebLink About2535 SANTA ANA AVE - Building Permits h1 T��3, • y yn ` CITY OF COSTA MESA 1, BUILDING DIVISION PER NUMBER +t� , . F' ' DEVELOPMENT SERVICES DEPARTMENT 4 PERMIT F99-00110 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 FIRE SUPRESSION PERMIT Job Address: 2535 SANTA ANA AV Status: ISSUED Suite: A Applied: 05/11/1999 Vicinity: Issued: 05/24/1999 Parcel Nunmber: TPN98097 Zoning: ISSUED BY: Applicant: MORSETT, JOCELYN Address: - Phone: (800)915-3473 . ' Zip: Owner:/ MESA BUNGALOWS,,LLC - Address,, 3535E COAST HWY . . ` • 155„ - Phone: 949-722-8120 . .% -,CORONA DEL MAR Zip: 92625 ' , / " / .Contractor: FIRESPRINKLER SYSTEMS i ;-Address: 155 ENTERPRISE COURT - Phone: 800-915-3473 ' ' CORONA,CA • : • Zip: : 91720 ' •, License: 684600 • �' ' SCOPE OF PERMIT 22 RESIDENTIAL FIRE SPRINKLER HEADS FOR NEW SFD. ' B98-01825. N ' / FEE SUMMARY . Plan Check: $40.46 Calc Valuation: $2,000.00 ' Permit: $62.25 - Claimed Valuation: $2,000.00 , Other: ' $0.00 • . - - i / Total: ' ' $102.71 - 1 , N �. , - - . .... 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 fora 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 CD DECLARATIONS WORKERS'COMPENSATION DECLARATION: _ I hereby affirm under penalty of perjury one of the following declarations:,. Y: ', ' r. • _ - ❑ 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 wo c pensatio Insures r and policy umber are: �l ,,__� `' Carrier: ' Qa --�`r'�J CN Policy Number:t�- .Y J& (� 1 (This section need not be completed i1 the permit Is valued et 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 se ovisions. c. ^ Applicant Sig eture: 1 Q Date: l�'t 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 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 Ii enserp.pder g(ai sions of Chapter 9(commencing with Section 7000)of Division 3 of the Busine.en4 P ofl essions Code,and my license is in lull force and effect.I,r # v D`F v Class ` , V �� Contractor's Sig tura: _ \ Date: •ckU 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: Lenders 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 drivers license. ❑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,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,Califomia 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 W III 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). will heappca_.t.opeent ofut_...r.. oa_----h'-_____.._ Ater..____. 3 Does or the applicant or present or Futuro 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. . _ _R..__._ _ _.- ui_ _ _, 4 If an RMPP is presently requireq 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 ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 0 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 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? ❑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 this permit until final inspection. n Signature gal Owner(s) 7Th- C� — ate — OTh And/Or Authorized Applicant 1 Date CODE t INSPECTION TYPE PAIS '\WTITIALS CODE N INSPECTION TYPE DATE INTRIALS 1616 Fixed System Final Fire Prevention 1 -n 111 'Z'Y-/ '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 /43 -S7 Cob 202 Final Factory Fire Place • 220 Final Planning Approval 203 Final Sign 222 Final Site • 204 Final Demolition 250 Final Building/Occupancy 2446-46 -�v �.,, CITY OF COSTA MESA :0-; '! BUILDING DIVISION IDEVELOPMENT SERVICES DEPARTMENT 4. grkikia. PERMIT PERMIT NUMBER / E99-00122 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 2535 SANTA ANA AV Status: ISSUED Of) Suite No A Applied: 02/22/1999 Vicinity: Issued: 02/22/1999 Parcel Nunmber: TPN98096 Applicant: CERNICH, ERIC Address: Phone: • - Zip: 7 Owner: MESA-BUNGALOWS, LLC . ' " „ Address 9535 E.COAST HWY.,#155 , - , , , _ Phone: 949 722-8120 ` , CORONA DEL MAR,CA- Zip: 92625 Contractor: Address: ;� • - • Phone it I . . Zip: - --license: ' "" • SCOPE OF PERMIT ELECTRICAL FOR NEW SFR, REF: B98-01825: 1962 SQ FT, 1 REC., 1 8W.,\1 OUTLET,& 1 200 AMP METER. FEE SUMMARY - , Quantity -_- - ---.-- i :-'_' • 1,„ Quantity • ISSUE FEE $22.00 - -- Temp Dist System/Lighting $0.00 0 , Temp service test $0.00 - -- " Busway/100'f i $0.00 0 Res,a/c package $0.00 Standing Section $0.00 0 , New Res(1-2 units) $98.10 •1962 Misc Electrical Equipment $0.00 0 • New Res(3+units) • $0.00 0 Transformers up.to 1 kva/kw $0.00 ' 0 • } Pool/Spa $0.00 0 up to 10 kva/kw $0.00 ," 0 - , Lighting Fixts " ' $1.00 1 ,. up to 50 kva/kw $0.00 • 0 Recept Outlets " $1.00 1 up to 100 kva/kw $0.00 0 " Switches $1.00 1 over 100 kva/kw $0.00 0 Non Res Appl " _ $0.00 0 , ' Low Voltage Equipment $0.00 0 Res Appl $0.00" --• 0- , Low Volt Wiring System/Ckt - $0.00$0.00 0 Service to 200a - $27.25 '' , 1 • Misc.-Conduit - , $0.00 0 Service to 1000a $0.00 .0 _ -Misc.iConductor - $0.00 0 Service over 1000a 1 $0.00 0 " " Circus(gen or ride) $0.00 " 0 Motors to 1 hp $0.00 0 ' ' ,Circus-(meth ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 . 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 " Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 0 - , Plan Check Fee $0.00 Pole Light Pkg .$0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $150.35 Intermed Pole $0.00 0 COMMENTS/SPECIAL CONDITIONS • • • 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 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 work for which this permit is issued. O 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 carrier and policy number are: Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($l00,000),IN ADDITION TO THE(MST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3705 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.# Class# 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: Lenders 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 •= :roperty, am EXCLUSIV Y CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code:The •ntrac •rs L'-ense Law does „' apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license p uant t•the/Infractors Lice: Laws.). ❑ I am e :met u a s:,•. Business and Professions Code for this reason: Signature: / Date: 3' /- 1rGJ Owner ID ve •-•^•y drive'- ' • 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 WIII 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 wit 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 Califomia 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 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 ❑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 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 Califomia 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: CE- 7 A 7 . I a! l OMPLIAN AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is cor ove-d '.':d pro`ly W)ins,.all' tion pulaws os a/9ordinances / rcuupy 9rto albwl�g •ancy of any building authorized by representatives perm t unci City final inspeatiopMesa� er upon the Alta( f?'moi'` [/�4 - - /- lir •ignature Of Le.;I Owner(s1 _ / / `C- Date A And/Or Authorized Applicant / Date CODE tINSPFOTInN TYPF • DATE IN ALS oaf INSPFrIInN TYPE CATS HMIS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing [, Al 200 Final Re-Roof 210 Final Electrical 8/3) ' / 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 j.� �1'l• CITY OF COSTA MESA F y ! .�,i BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT PER NUMBER a. 99-00109 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 2535 SANTA ANA AV Status: ISSUED PM Suite No A Applied: 02/22/1999 Issued: 02/24/1999 Vicinity: Parcel Nunmber: TPN98096 Applicant: CERNICH, ERIC Address: Phone: Zip: Owner: MESA BUNGALOWS, LLC Address 3535 E.COAST HWY.,#155 Phone: 949 722-8120 CORONA DEL MAR,CA Zip: 92625 Contractor: Address: • • Phone: Zip: License: Arch l Eng: Address: Phone: Zip: License: SCOPE OF PERMIT PLUMBING FOR NEW SFR, REF: 998-01825:2 TUBS, 1 DW-1 SHOWER, 1 SINK, 2 WASH BASINS, 1 SET, 1 TOILET, 1 W/H, 1 WATER SERVICE,6 OUTLETS, 1 SEWER CONNECTION, 1 WASHER AND 1 LAWN SPRINKLER SYSTEM. FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $22.00 Laundry Tub/Washer $8.75 1 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $13.25 1 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $17.50 2 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 $17.50 2 Dishwasher $8.75 1 Sewer Cap for Demo $0.00 0 Wash Basin Set $8.75 1 Drain,Floor $0.00 0 Sewer Connect $22.00 1 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $26.25 3 Drain,Roof $0.00 0 Shower $8.75 1 Water Heater/vent $11.00 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 $8.75 1 Gas(1-4 outlets) $5.50 1 Sink,kitchen $8.75 1 Water Softener $0.00 0 Gas(Over 4 outlets) $2.00 2 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $8.75 1 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: $198.25 COMMENTS/SPECIAL CONDITIONS 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 2 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)754-5628 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 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 carrier and policy number are: Cartier: Policy Number: (This section need not be completed i1 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 FINES UP TO ONE HUNDRED THOUSAND DOLIARE($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.Lie.# Class# Contractors 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). Lenders Name: Lenders 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, es owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code:The co -•tors LI se 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 pur ..nt t••the y tractors License :ws.). ❑ I am ex: pt u •er s2. Business and Professions Code for this reason: Signature: Date: 3- / -ff' Owner ID v:''-: •y driv: I' Yes 0 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,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: I 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 ❑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 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 end 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 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 O No (Section 65850.2 of the Celifomia 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 (II'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health end 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: CERT ATE • % PUANCE '• •AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application end state that the Information given is corn .I agr:: /amply with : state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the a•eve-dose 5;/ property for•• pct.".urposes.lag .:not t• u. • :flow • up of nnnyy"bbuuildin authorized by this permi til final inspectio�(y. Ifs L r ' AS, de / ..4111 G�/ �/ � / ( Sign: re Of L�Tj/9 III• ee/r((ss+) IQ Date ! And/Or Authorized Applicant /-1 LL( Date CODE 6 INS PFr:TInN TYPF DATE MEALS CODE• INSPECTION TYPF DATE ii ALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical �1 1266 Pool Spa Final 208 Final Plumbing 3 i[ 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 • CITY OF COSTA MESA ,� BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT � PERMIT PERMIT NUMBER %bumfB98-01825 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2535 SANTA ANA AV Status: ISSUED Suite: A Applied: 10/08/1998 Vicinity: Issued: 03/01/1999 Parcel Nunmber: TPN98096 Zoning: Applicant: MESA BUNGALOWS, LLC Address: 3535 E.COAST HWY.,#155 Phone: 949 722-8120 CORONA DEL MAR,CA Zip: 92625 Owner: MESA BUNGALOWS, LLC Address 3535 E.COAST HWY.,#155 Phone: 949 722-8120 CORONA DEL MAR,CA Zip: 92625 Contractor: Address: Phone: Zip: License: • Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT CONSTRUCT 1 SFD OF A 10 SFD PROJECT:TRACT15732 LOT 6 PLAN 2A: 1962 SQ FT HOUSE(804 1ST FL& 1158 2ND FL)426 SQ FT GARAGE,4 BDRM&2 1/2 BTHM, 1 F/P ICBO#WILL BE GIVEN PRIOR TO ISSUANCE. SEE DR-98-08/T-15732. 3 OF OPEN PARKING SPACES PROVIDED IN THE DRIVEWAYS OF 2537,2539,2541. FEE SUMMARY. Plan Check: $201.05 Cab Valuation: $169,062.00 Permit: $1,237.25 Claim Valuation: $o.00 SMIP Res: $16.91 SMIP Corn: $0.00 - Other: $0.00 Inspection: $0.00 Total: $1,455.21 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 55-0 Rear 14-4 Left 5-0 Right 10-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 30 Proposed: 31 NOTES: • • • 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 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 carrier and policy number are: Cartier: Policy Number: (This section need not be completed/f 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 MID SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(S1 ,000),IN ADOPTION 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.Lic.4 Class q 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: Lenders 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 imsell 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 propel am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions Code:Tip o rectors L'dd nse Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) licens= •ursu- t to the tractors Licenn- :cos.). ❑ I a •exam., nder 5',. / a Business and Professions Code for this reason: Signet e: . '/ Date: 3 -/'f/ Owner II .. • drive • =nse. • 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,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 Califomia 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 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 ❑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 Califomla Health and Safety Code). 7 It 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: CERTIFIC OF OM CE AND TION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given Is correct. gree co with all state I and city ordinances relating to building construction, • d authorize representatives of the City o •osta Mesa to enter upon the abov ascii pr rfy for inspecti rpyegs.I agree to llo pantyyf�y ••uilding authorized by this pe .i until fin: .pe ion. c /'�7/_z' (fj tet. //. . A* Signature Of Legal Owner( // / / Date „s-� And/Or Authorized Applicant j - Date CODE L INSPft:TION TYPE DAIS MISS CDOEI INSPECTION TYPF DATE It ALS 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 Signm 222 Final Site LI _ 204 Final Demolition 250 Final Building/Occupancy Nis(4 9 /(_7l�� 2446-46 • • • FINAL GRAI?ING.CERTIFICATION Project Address: • 23-3-3-4 A Add At . Lot Number: 10716 ?le71 /V"./5732 Permit Number: 298—d /eszS • By Civil Engineer: • I certify to the satisfactory completion of grading in accordance with the.approved plans, specifications, local and state codes. All drainage devices required by the gradin permit, • • grading plan and grading ordinance have been installed. Adequate provisions have been made for drainage of surface water from each•building•site. The Minimums are: • 25 .Fall from structures within 5 feet from exterior walls. • I5-% Fall for asphalt surfaces and landscaped areas. - 0.55 Fall for concrete surfaces to approved disposal areas. The final monuments as shown on the recorded-tract map were set. All final grading eleva- tions are within ± HO of the designed elev-tions. • Supervising Civil Engineer �f(Cy( • Reg. No. 3/72a • (s 5.amrt) •• . • Date /%/9/• p • • • QsofESS104/4 C0 N0. cP RCE31120 m tu EXP 1213112000 • qTF OF CAO` • STA'.22 and siN . Insulation Certificate 535 St, (-a Aho Ac 1205/ A NSA • Number and Street City bwtiIA / 5732 67 Comity Subdivision Lot Number Description of Installation ROOF If Material 15/-4+ Brand Name nthZKt — (or-n /h Thickness(inches) Cj t/21` Thermal Resistance(R-Value) k --741) CEILING �L /� Batt or Blanket Type /:7t Brand Name 6(2)44 S - 1 012n Irk C Thickness(inches) ail/2_11 Thermal Resistance(R-Value) J2'3 0 Loose Fill Type Brand Name Contractor's minimum installed weight/ft` lb Minimum thickness inches Manufacturer's installed weight per square foot to acheive Thermal Resistance(R-Value) EXTERIOR WALL 1 Material 13 /4Tt Brand Name QWot S Jan iK y Thickness(inches) 3r"2 rThermal Resistance(R-Value) R- 13 oni Material 13 44+� � , Brand Name bt,vtk 5 ,- con •( Thickness(inches) /4 " Thermal Resistance(R-Value) te-I ejj SLAB FLOOR Material Brand Name Thickness(inches) Thermal Resistance(R-Value) Width(inches) FOUNDATION WALL Material Brand Name Thickness(inches) Thermal Resistance(R-Value) Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance wit: the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the California Administrative Code. MI5 SI/ 4(D, S t LLC -7S' 1L/ t. G .eral one Jar(Builde?) License Number . � A ,gpaN;e . Title _, Date '"`..._ .: 17rvtl . . Gns ` nl , Z2 (Sl `7 for(lnsuTation Installer)'[ • Lic Number ( a Signature and Tide Date January 1, 1995 Compliance Forms