HomeMy WebLinkAbout2424 SANTA ANA AVE - Building Permits (3) t
r - CITY OF COSTA MESA '
,ham BUILDING DIVISION
A
),5t'r�_i, 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
Fr .L...I. I
'? O FOR INSPECTIONS CALL:(714)754-5626
PERMIT NUMBER:408-00188
PERMIT TYPE: B_COMBO STATUS: ISSUED
Sub Type: RES_ALT DATE ISSUED: 05/01/2008
ISSUED BY: RMD
JOB ADDRESS: 2424 A204 SANTA ANA AV CM Suite/Unit: A204
APN: 93489004 ` Zoning: . , , - - - -
Vicinity: KITCHEN •Primary Occ: R-3. _
Const Type: V-B SO FT: 0 Valuation: $5,500.00
•r
SCOPE OF WORK: MINOR INTERIOR KITCHEN REMODEL TO INCLUDE THE INSTALLATION/REPLACEMENT OF 2 LIGHT
FIXTS, 2 OUTLETS, 9 SWITCHES;1 DISHWASHER, 1 KITCHEN'SINK, 1 WATER LINE, SPLIT COLO:VALVES FOR SINK AND
DRYWALL WORK.
OWNER: NUNN, KATHALEEN M .ii Address: 2424 SANTA ANA AVE#204A - • " Unit A-204
Phone: I ' City/State/Zip: COSTA MESA,CA
APPLICANT: LEL DANAF,'TALAL - Address: 17165 NEWHOPE ST' Unit :UNIT J
Phone: 714-444-2648 ii . .. City/State/zZip: FOUNTAIN VALLEY,CA - •'
CONTRACTOR: ROVICS CONSTRUCTION INC - License No, 800996
Phone: 714-444-2648Address: 17165 NEWHOPE STUnit: - UNIT J
Cell: - - - City/State:- FOUNTAIN VALLEY, CA - ZipCode 92708
ARCHITECT: , - _ License No. - - -PHONE:
ENGINEER: License No. - . PHONE:
COMBINTATION PERMIT FEE-SUMMARY • . ' • - -
Building Plan Check: -$0.00
Building Fees: -
- $125.25 -
Electrical Fees: $37.80 - ..---
Mechanical Fees: $0.00 - - -
Plumbing Fees: - $62.70- , - _ -
SMIP Residential: • - • $0.55- , - .
SMIP Commercial: $,Q.00
TOTAL FEES: $226.30";: --
"Refer to fee receipts for all fees paid for project
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord. No.92-28,§1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
QIn INSPECTION TYPE 4ATF, INTTALS CODE t INSPECTION TYPE gitm IN11AL$
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 p /�� � V
204 Final Demolition 250 Final Building/Occupancy (/�- i/a/oR C
f
WORKERS'COMPENSATION DECLARATION: 0 Owner ID verified by drive E 0 Yes 0 No 1
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
0 I have and will maintain a certificate of consent to self-Insure far 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
numberma re: Fri f o e person is required to descend,will be made in connection with work authorized
L ll ` 4p\ by this permit,and that no building structure,scaffolding,falsework,or demolition
Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
(This sectb not be completed�if hepermi is valued at one hundred dollars($100)or less) 2.Art 2Sec.341,Title 8,California Administrative Code).
Policy,Nu`mber: ® O (V/
/ 5–j ) ^ 2 0 ?
❑ As owner-builder, I will not employ anyone to do work which would
❑ 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 worker 'compensation provisions of Section 3700 of
the Labor Code,I shall forth ' omply with these provisions. / Applicant:Signature Date
0, c/ /D 9 Division of Industrial Safety Permit Number
Applica s sgnawre "Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILUR 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 force and effect. a registration form for acutely hazardous materials? ❑Yes ❑No
Li`cc#> i O + ' Cal ss# (Section 25533 of the California Health and Safety Code, with some
_ exceptions, requires registration with the Costa Mesa Fire Department by
—,..• ' � Ib 0 0 . each business which at any one time has on hand a quantity of acutely
actor'ssir 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
CONST-- ION 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 10No
Lender's Address: (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.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the Califomia
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑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? 0 Yes ❑No
issuance,also requires the applicant for such permit to file a signed statement (Section 658502 of the Califomia Govemment Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be furnished 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 Califomia 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 Califomia
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
property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions.
El .1, as owner of the
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 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 agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection.
Signature of Owner(s) /Daate �/
Signature Date 7 I1 ` / O ( /O ,{
3057-46(3/07) V/( U
GnE/_Authorized Applicant L Date
I
I
t
•
f .
I. RESIDENTIAL KITCHEN LIGHTING WORKSHEET WS-5R
Project Title ,
�(/I Date /
r\ I Che � Q �V1 �dc �� frl�ycy
o5-4 ( // 2oo2
At least 50°%o of the total rated wattage of permanently installed luminaires in the kitchen must be in luminaires that are high
efficacy luminaires as defined in Table 150-C. Luminaires that are not high efficacy must be switched separately.
Kitchen Lighting Schedule. Provide the following information for all luminaires to be installed in kitchens.
Luminaire Tye Hiatt Efftcacy? Watts x Quantity = High Efficacy Watts or Other Watts
/,, r e cc ) Yes re" No ab'" t 3 x_1_ = _7,4(1 or n U
Yes❑ No❑ x = or
Yes❑ No❑ x = or
Yes❑ No a x = or
Yes❑ No❑ x = or
Total: A: 4 B:
. COMPLIES IFA >B Yes,n' No n
Rules for Determining Residential Kitchen Luminaire Wattage
Screw Base Sockets§130(c)1
(Not containing permanently installed ballasts) The maximum relamping rated wattage of the luminaire, as listed on a
permanent factory-installed label (luminaire wattage is not based on type or wattage of lamp that is used).
Permanently or Remotely Installed Ballasts§130(c) 2
The operating input wattage of the rated lamp/ballast combination based on values published in manufacturer's catalogs
based on independent testing lab reports.
Line Voltage Track Lighting (90 through 480 volts)§130(c) 3
1. Volt-ampere(VA)rating of the branch circuit(s)feeding the tracks; or
2. The higher of
• The wattage (or VA) rating of an approved integral current limiter controlling the track system or
• 15 watts per linear foot of the track;or
3. The higher of
• 45W per linear foot of the track or
• The total wattage of all of the luminaires included in the system.
Low Voltage Track Lighting (less than 90 volts)§130(c)4
Rated wattage of the transformer feeding the system, as shown on a permanent factory-installed label
Other Lighting §130(c)5
(Lighting systems that are not addressed in§130(c) 1-4)The maximum rated wattage, or operating input wattage of the
system, listed on a permanent factory installed label, or published in manufacturer's catalogs, based on independent testing
lab reports.
EXAMPLE
RESIDENTIAL KITCHEN LIGHTING WORKSHEET WS-5R
Project Title Date
Kitchen Lighting Schedule. Provide the following information for all luminaires to be installed in kitchens.
High Efficacy
Luminaire Type (y/n) Watts x Quantity = High Efficacy Watts or Other Watts
CFL-I Yes 26 x 5 = 130 or
MR-16 No 55 x 2 = or 110
x = or
X = or
x = or
Total: A: 130 B: I10
COMPLIES IFA >_B Yes 0 No❑
Residential Compliance Forms • April 2005
II
LMANDATORY MEASURES SUMMARY: RESIDENTIAL (Page2of2) MF-1R
Space Conditioning,Water Heating and Plumbing System Measures: (continued) Enforce-
NAV Designer ment
5. Insulation must he protected from damage,including that due to sunlight-moisture,equipment maintenance,and wind. 0 0 0
6.Insulation for chilled water piping and refrigerant suction piping includes a vapor retardant or is enclosed entirely in ❑ ❑ ❑
conditioned space.
7.Solar water-heating systems/collectors are certified by the Solar Rating and Certification Cnrpnrntinn 0 0 0
• §150(m): Ducts and Fans
1.All ducts and plenums installed,sealed and insulated to meet the requirement of the CMC Sections 601, 602,603,604,605
and Standard 6-5;supply-air and return-air ducts and plenums are insulated to a minimum installed level of R-1.2 or enclosed
entirely in conditioned space.Openings shall be sealed with mastic,tape or other duct-closure system that meets the applicable 0 0 0
requirements of UL 181.UL 18I A.or UL 181 B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is
used to seal openings greater than 1/4 inch,the combination of mastic and either mesh or tape shall be used.
2.Building cavities.support platforms for air handlers,and plenums defined or constructed with materials other than
sealed sheet metal.duct board or flexible duct shall not be used for conveying conditioned air.Building cavities and
support platforms may contain ducts.Ducts installed in cavities and support platforms shall not be compressed to cause
reductions in the cross-sectional area of the ducts.
3.Joints and seams olduct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes
unless such tape is used in combination with mastic and draw bands.
4.Exhaust fan systems have back draft or automatic dampers. 0 0 0
5.Gravity ventilating systems serving conditioned space have either automatic or readily accessible.manually operated o
dampers.
6.Protection of Insulation.Insulation shall be protected from damage,including that due to sunlight,moisture,equipment
maintenance.and wind.Cellular foam insulation shall be protected as above or painted with a coating that is water 0 0 0
retardant and provides shielding from solar radiation that can cause degradation of the material.
7.Flexible ducts cannot have porous inner cores. 0 0 0
§1 11: Pool and Spa Heating Systems and Equipment.
I.A thermal efficiency that complies with the Appliance Efficiency Regulations.on-otTswitch mounted outside of the ❑ ❑
heater.weatherproof operating instructions,no electric resistance heating and no pilot light
2.System is installed with:
a.at least 36"of pipe between filter and heater for future solar heating 0 0 o
b.cover for outdoor pools or outdoor spas 0 0 0
3 Pool system has directional inlets and a circulation pump time switch 0 0 0
§115: Gas tired fan-type central furnaces.pool heaters,spa heaters or household cooking appliances have no continuously a ❑
burning pilot light. (Exception Non-electrical cooking appliances with pilot< 150 Btu/hr)
I l8(i): Cool Roof material meets specified criteriat
0 0 0
Residential Lighting Measures:
§I50(k)I:HIGH EFFICACY LUMINAIRES OTHER THAN OUTDOOR HID contain only high efficacy lamps as
0
:
outlined in Table 150-C.and do not contain a medium screw base socket(E24/E26) Ballast for lamps I 1 warts or greater
are electronic and have an output frequency no less than 20 kHz z�-
§Ii01k)I:HIGH EFFICACY LUMINAIRES-OUTDOOR HID'contain only high efficacy lamps as outlined in Table Er
0 .
ISO-C. luminaire has factory installed HID ballast LJ
§I501k)2:Permanently installed luminaires in kitchens shall be high efficacy luminaires.Up to 50 percent of'the wattage,as
determined in§ 130(c).of permanently installed luminaires in kitchens may be in luminaires that are not high efficacy .--./ .
luminaires,provided that these luminaires arc controlled by switches separate from those controlling the high efficacy L7
luminaires.
§I50(k)3:Permanently installed luminaires in bathrooms,garages.laundry rooms utility rooms shall be high efficacy
luminaires.OR are controlled by an occupant sensors)cenitied to comply with Section 119(d)that does not turn on Le 0 0
automatically or have an always on option.
§150(k)4:Permanently installed luminaires located other than in kitchens.bathrooms,garages.laundry rooms,and utility
rooms shall be high efficacy luminaires(except closets less than 700:1:OR are controlled by a dimmer switch OR are ry ❑ 111controlled by an occupant sensor that complies with Section 119(d)that does not tum on automatically or have an always Ild
on option.
§I 50(k)5:Luminaires that are recessed into insulated ceilings are approved for zero clearance insulation cover(IC)and are r--./
certified airtight to ASTM E283 and labeled as air tight IAT)to less than 2.0 CFM at 75 Pascals. Yd
§150(k)6:Luminaires providing outdoor lighting and permanently mounted to a residential building or to other buildings on
the same lot shall be high efficacy luminaires(not including lighting around swimming pools/water features or other K 0 .
Article 680 locations)OR are controlled by occupant sensors with integral photo control certified to comply with Section l{d
119(d).
§ISO(k)7:Lighting for parking lots for 8 or more vehicles shall have lighting that complies with Sec. 130, 132,and 147. EV ❑ 11Lightine for parking garages for 8 or more vehicles shall have lighting that complies with Sec. 130. 131.and 146.
§150(k)8: Permanently installed lighting in the enclosed,non-dwelling spaces of low-rise residential buildings with four or 0
more dwelling units shall be high efficacy luminaires OR are controlled by occupant sensorts)certified to comply with Er
Section 119(d)
Residential Compliance Forms April 2005
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CITY OF COSTA MESA •
BUILDING DIVISION
F- •
77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mes a.us
Ira • FOR INSPECTIONS CALL:(714)754-5626
PERMIT NUMBER. P07-00454
PERMIT TYPE PLUM STATUS: ISSUED
• DATE ISSUED: 07/09/2007
-'-%'ISSUED BY: RMD
JOB ADDRESS: 2424 C105 SANTA ANA•AV CM= ' Suite/Unit: C105
Vicinity: C105
SCOPE OF WORK: WATER'HEATER CHANGE OUT FOR UNIT C105.
r<
OWNER: FARRELL, LAWRENCE J TR - ;,. Address: 2314 REDLANDS DR
PHONE: City/State/Zip:, ' NEWPORT BEACH,CA
APPLICANT: HICKS, KEVIN Address: •- ' 360 MEMORIAL:DR
PHONE: 866-293-3031 City/State/zZip: CRYSTAL LAKE, IL
•
CONTRACTOR: PLUMB IN TIME - .. License No. 868068
Address: 360 MEMORIAL DR _ PHONE: 866-293-3031
City/State: • CRYSTAL LAKE,-IL ZipCode: 60014 CELL: •"�
PLUMBING PERMIT FEE SUMMARY '.
•
PLAN CHECK FEE: $0:00
•
PERMIT FEE: $35.80
•
TOTAL FEES: $35.80
•
•
•
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 S. INSPECTION TYPE OA1E INITNALS CODES INSPECTION TYPE DATE INTTnALS
1616 Fixed System Final Fire Prevention 206 Final MechanIcal p
1266 Pool Spa Final 208 Final Plumbing th-i -ri? EN/
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
• WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive ,Ise. ❑Yes ❑No
I hereby affirm under penally of perjury one of the forruwing declarations: ' Driver's License No. Expires:
O 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. t • -
❑ 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 0 I hereby certify that no excavation five(5)or more feet in depth into which a
number are: 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
Carrier 0,S CI et-,-- nSV 2ct^Cte__ or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Gm
(This section need not be completed Arhe permit is valued al one hundred dollars(5100)or less.)
�1"" 2,Art 2,Sec.341,Title 8,California Administrative Code).
Policy Number: \UQ Cosi I Lv"7,3c9
❑ As owner-builder, I will not employ anyone to do work which would
❑ 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 sub'ect to the workers'compensation provisions of Section 3700 of
the L or de,I shallcor. mpensaticomply with these provisions. Applicant's Signature Date
`. 1 Ir L -119/02 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 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
l force and effect, ) a registration form for acutely hazardous materials? ❑Yes ❑No
Lic.# D�fp
Class# 0_3(O (Section 25533 of the California Health and Safety Code, with some
J exceptions, requires registration with the Costa Mesa Fire Department by
�fi-rim 1� � �` /U� each business which at any one time has on hand a quantity of acutely
Contractor'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)? 0 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 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 ❑ 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? 0 Yes ❑No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be furnished 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? 0 Yes ❑No
thereon,and who does such work himself or herself or through his or her own B (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 burdenof 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
❑ 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 occupy or allow occupancy of any building
authorized by this .ermit until final inspection.
ature of Le al wner(s) , Dat
Signature Date '-' (C -4 !/i/t-1 .
3057-46(3107) • �-� l "
And/or Authorized Applicant Date
ADD RE5 OF3llusa: 2424 SANTA ANA AV too C-ad/ CITY OF COSTA MESA - BUILDING PERMIT B93 -opa • 7
avxl:IrsNwElvleceim BACK MESA HOA PERM NO: B 086945
ADO 2424 SANTA ANA AV
C .M. CA 92626 PERMIT NO: B 086945 PLAN CHECK NO: N GOVT: N SUPP : N
APPL.MAILING ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH
ARCHITECT OR ENGINEER: UC.NO: JOB DESCRIPTION : REROOF W/1 LAYER COMP . OVER EXIST. SQ FT: 1 , 300
ARM OR ENG.'S ADDRESS: ONT:
CLAIM VALUE: 1 , 300 . 00 CALL-VALUE: 1 , 300 . 00 GROUP OCC: R-1 /
co+n*ciarstas RELIABLE ROOFING ( 714 ) 964-6441
CaDRACTOWSMa1T10 20351 MEANDER LN COMMENTS : EXIST. 1 LAYER OF COMP .
ADDREss: H. B . CA uCNO.: 347940 **********-*********-**********************it*-************************************
92646 WIT: Z ONING REQU IR EMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm elder penally a perjury that I em licereed wider proelsirs a er g 5 ETB ACK S
(commencing with Section 7000)of Division 3 at the Business and Professors Code,end my Icense is in hg face and effect.
CITY LIC.NO.:O38567 uc.c s: C 39 uc.NO.: A-'941 XP: 091 MAIN BUILDING ACCESSORY BUILDING
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
i / Ca"°tl° LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDS DECLAR ON:I hereby affirm under penally d perjury that I em exempt Iran the Contractors license Law for the
folkeweg reason(Section 7031.5 Bmnen end Professions code:Any city a county which require*a penal to canewd.eller,impress. PARKING REQ• P RO V: PARCEL: 9 3 4 8 9 014 Z N E: REF NO:
demolish,or meal any structure,Prior imams.s imae,also requires the applicant for such permit to fib a signed statement that he or she ,n.,
Scemed pursuant to the provisions of the Contredors License Lew(Chapter 9(commencing with Section 7000)d Duction 3 d the PLANNING NOTES>
siness and Professions Coder or that he or she is exempt therefrom and the basis for the alleged exemption.MY violation d Section > 111
.,p1.5 by any applicant lore permit subleas the applicant to a dW penally of not mere then fire hundred dollen MOOD. ********************************************************************* ********
❑ I es owner of the properly or my ecimbyees will wages as thei sole compensation,will do the work.and the structure is nor Mended DEVELOPMENT SERVICES REQUIREMENT; S
or Offered for sale(Section 7044.Business and Professor Code:The Contractors License law don not appy loan Owners progeny
who builds or Mamma thereon,end who does such work himself or herself or through he a her own employees,provided that such rt.,
leaw/mat are rd Sendai ea offered for salt n,however,the'alailer or inawemert is sold within oneYaw d mmple'en,Ne ZONING APPROVED BYDATE:
owner-builder th
er win hame burdend tensing ovirg ho or she ddit bead or improve for the pups of sale).
❑ 1.es ovmer of the progeny,res exclusively contracteig with licensed contractors tocontact the project(Section 7044.Business and BUILDING APPROVED BY DATE:
Professions Code:The Contractors License law does nit apply to an owrw a property who builds or improves thereon and who -- -
contracts such for sprojects with a Contractor(*)licensed pursuant to the Contractors License Law).
❑ lamexempt under Section: B.aP.C..f«this reason: APPLICATION ISSUED BY : DATE: a
****************************************** ********************* sw**
Dope: Owner LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
I do hereby certify that I an.aware of and understand the requirements of California Health end Safety Code Sections 25505,25533.end
25534,and that I or any tenure building omupa t will/wil not(circle one)need to comply with said stale codes end the requirements for
epemm la construction or modification from the Ai Gueoy Management District Residential construction appicatonsweexempt from Nene BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provision.. PERMIT 43 . 00 h . 50
Date: Applicant: ra SM I P/NON—RES
WORKER'S COMPENSATION DECLARATION:I hereby tarn under penally el perjury othe following dedmati ns: PLAN _
ISSUE FEE r
❑ I have end wil maintain a canificate of consent to selbinswe for workers'compensation.es provided for by Section 3703 of the Labor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
Code.for the penamerrc.aNwork
permit is TOTALS----> 43 . 50 0 . 00 0 . 00 43 . 5043 . 50 . 00
)Ei I have end wil maintain workers' asworkers'compensation insurance, required by Section 3700 d the Labor Code,for the performance of the • '
work for whichthis permit is issued,My workers'compensation insurance carrier and policy number are:
Carrier: STATE FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 43 . 50 OVER/SHORT: . 00
Pay Number. 4ti 9bUN11ii /9 01 /01 /99 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
his section need not be completed I the perm*is for one hundred dollars(5100)or len.) 43 , 00 . 50
❑ I many that in the performance of the work for which this permit is issued,I shall not employ any Person In am manner so to
become°ubnd to the workers'compensation laws ofa,and that if shoukl •..•h1,, subject lob ,a..' *******************************************************************************
compensations dirro/Ke labor Code.Calif,1 aha wan oo ryy p• i. /� INDIVIDUAL F E E BR E AK D .O W N
Data: Applicant:
�� TYPE QTY DESCRIPTIO N UNIT,
tCOST TOTAL COST
Warning:Failure secure eo compensationa' coverage b unlawful,and shell sub fan employer to admin. Ince and
civil fines W W one hundred thousand dollars(5104000),In a dudes to the cost of compensation,damages as provided for In
Section 3706 of the Labor Code,Interest and aUomay's/sea SFR 1300 REROOF BY VALUE RESIDENTIAL NOZONE .1 .00 1 , 300 .00
CONSTRUCTION LENDING AGENCY:I hereby affirm under penally of perjury that there is a construction lending agency for the END OF FEES .n
performance of the work fa which the perms is issued(Section 3097,Civ.C).
LENDER'S NAME: r
LENDER'S ADDRESS:
I candy that I have read this application end stale that the above information•-coned.I agree to comply with an city and many ordinances '
and state laws relating to building canmudon and hereby authorize alive of this city to enter upon the above-mentioned property
...-
for inspecgn purposes.ERIC BOLO IN - .
6 t ��'g� B2-12-1998/04:29ERT 281-8945
' PERMITe986945
819634
a- � Dre
reAge°� •m actor
(5151 d6.WP) Whire-Buidig S Safely:Oreemfle:Canary-Applicant;Pink-Revenue:Goldenrod-Assessor
I.-
. CONSTRUCTION AND PLANNING POOL ,PA �.
APPROVALS Permit # Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Serviceor'Pple 52. Pool & Equipment Location ; 'I
2. Soil Pipe-Undrgrnd. j 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd.- 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test • J
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER•GUNITE r a „.f
7. Footings 58. Electrical Conduit-Undrgrnd. Y
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test � ,
) I
•9. Water Pipe-Undrgrnd. /:"r 60. Backwash Lines, P-Trap, C ;Undrgrnd. _ -
10. Structural Floor System . . 61. APPROVAL TO DECKJ....2 -7
: 11. Property Sewer Line & Housekohrection 62. Backwash & Receptor-Final
12. Sewer Cap �'J 63. Heater & Vent-Final '�1
13. Roof Drains ...-- . 64. Plumbing System - Final._ )
14. Rough Plumbing --2.�. 65. Electrical-Final - 2'-'
15. Rough Electrical-Conduit ..."266. Solar System-Final '
16. Rough Electric Wiring �/1 67. Fencing & Access Apprcr al-5
17. Rough Wiring Sign 68. APPROVED.FOR PLASTER NG
1C-i 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts,in Structure • 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough& Test 72. Underground Flush .
24. Roof Framing 73. Undergrnd.Storage Tank 0Gas OOil
25. Roof Sheathing - 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical • •
27. Frame and Flashing 76. Dry Standpipe
28. Lathing& Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy 1
37. Final Factory Fireplace
38. Final Plumbing
7-
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer Z.. /7_(7t q - Oji � yz4T1' -Z GO-
43. Backflow Irrigation G-
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations i t-
47. FINAL STRUCTURE & BUILDING y..1/1.457 j -...1:1-•
•U s.
48. FINAL PLANNING • a ••v
' . 49. Electric Release to Edison - t'
b
-y.
50. Gas Release to Southern California Gas Co 2
51. CERTIFICATE OF OCCUPANCY
No. Date