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Home My WebLink About963 SPRINGFIELD ST - Building PermitsY`�5tn MgS9 o � ? , . v : �' J �' w °'a.,�c A' � CITY OF COSTA MESA � BlIILDING DIVIS/ON 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Pax p74) 754-4856 • w�wv.costamesaca.aov FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: M11-00117 PERMIT TYPE MECH APN: 14172122 JOB ADDRESS: 963 SPRINGFIELD ST CM Vicinity: CLOSET � . SQ. FT: 0 �. � � STATUS: DATE ISSUED: ISSUED BY: Suite/Unit: ISSUED 10/26/2011 RMD SCOPE OF WORK: MECHANICAL PERMIT TO REPLACE FURNACE <100K BTU LOCATED IN CLOSET AND DUCTING FOR A SFD. COMPLAINCE FORM3ATTACHED TO.PERMIT. OWNER: DOOIEY, JOHN J TR" .. PHONE: APPLICANT: ZAMORA, CARLOS � � - PHONE: 818-735•7876 � CONTRACTOR: SERVICE CHAMPIONS Address: 22911 SAVI RANCH PKWYUnit: Ciry/Stare: YORBA LINDA, CA ZipCode: �92887 MECHANICAL PERMIT FEE SUMMARY MECH ITEM FEE: . . - ' � $52.00 PLAN CHECK FEE: � . $0.00 INVESTIGATION FEE: , - , $0.00 REWSPECTION FEE: - . � � $0.00 TOTAL FEES: $52.00 Address: - 963 SPRINGFIELD ST Unit: City/State2ip: COSTA MESA, CA � Address: Unit: � - City/State/zZip: . _- ,. . � License No. 799170 ". .. PHONE: 714-777-7777 .. CELL: NOTICE: The work authorized by this permit shall comply with all appliwble handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 7, 12-21-92) EXPIRATION: PERMIT EXPIRES 160 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. FaiWre to obtain inspections and final approval will resWt in ihe expiration of this permit. LOOEt INSPECTIONTYPE DRTE IN1I11AL C OE INSPECTONTYPE ��qGl�� I� 7616 Fixed System Fina� Fire Prevention 206 Final Mechanical / � 1266 Pool Spa Flnal 208 Final Plumbing 200 Final Re-Roof 21 D Final Electrical 201 Final Block/Retaining Wall 2t2 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Flnal Demolition 25o Final Builtling/Occupan�y � WORKERS' COMPENSATION DECLARATION: � I hereby aRrm 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 providea (or by section 3700 of the Labor Code. (or the pertormance of the work tor which this permit is issued. � I have and will maintain vrorkers' wmpensa[ion insurance, as required by seciion 3700 ot the Labor Code, for the pertortnance of the vrork for which this permii is issued. My workers' compensation Insurance carrier and policy number are: carrier /Uo `�-��✓n (TMs seC�on necd �t be mmplQ�erJ d(�a peimRis valuerl at o� huMred 0.Vlars (4f00) orkss) Policy Number: � C!�ISG/CZ�� ❑ I certiry lhat in t�e pertormance of the work (or which this permii is issued, I shall noi employ any person in any manner so as to become subjecl to the workers' compensafon laws of California, and agree thal if I shoultl � become subject t R2�workers' compensation provisions of Section 3700 of the Labor Code, shall fort ql h compty with these provisions. r b Z�P �� A licants i aWre oate WARNING FAILURE TO SC_CURE WORKERS' COMPENSATION COVER4GE IS UNLAWFUL AN� SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP 70 ONE HUN�RED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRAGTORS DECLARATION: I hereby aHirtn ihat I am lic�nsed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license rs in II force and eftect. Lic. # � Class # � ZU I D Z�o-�� C ntraaoY S' awre —� Oate CONSTRUCTION LENDING AGENCV: ❑ I hereby aKrtn that there is a consWc[ion lending agency for the pertortnance of the work for Which this pertnit is issued. (Sec. 3097, Civil Code). Lentlers Name: _ Lender's Address: SipnaWra Dete OW NER-BUILDER DECLARATIONS: I hereby aKrm lhat untler penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, eusiness and Professions Cotle: Any city or counry which requires a pertnit to construct, alter, improve, demolish, or repair any strucWre, pnor to its issuance, also requires lhe apDlicant (or suc� permit to fle a signed statement that he or she is licensetl pursuant to the provisions of the ConVactors License Law (Chapter 9(commencing with Section 7000) of Division 3 of Ihe Business antl Professions Code) or �hal he or she is exempt lherefrom and the basis for ihe alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalry of not more ihan fve hundred dollars (5500).); ❑ I, as owner of the prOpetly, or my employees with wages as [heir sole wmpensation, WILL DO YHE WORK, and ihe structure is nof intended or oHered for sale (Sec. 7044, Business and Professions Code: The Coniractors License law tloes not appty to an owner of property who builds or improves thereon, and who does such work himsel( or herself or ihmugh his or her own employees, provided lhat Such improvemenis are not intended or offered for sale. If, however, the building or improvement is soltl within one year of completion, the owner-builtler will have the burtlen of proving that he or she did not build or impmve for purpose of sale.). ❑ I, as owner of the prOperry, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to wnsiruct the project (Sec. 7044. Business and Professions Code: 7he contractors License Law does not appy lo an ovmer of property who builds or impmves thereon, and who conhacts for such project with a wntraclor(s) license pursuant to the Contraclors License Laws.). ❑ I am ezempl untler sec. Business and Professions Code for this reason: SignaWre Date 305]<6 (3/0]� Dwner ID verifed by tlriver�se. ❑ Yes ❑ No Driver's License No. Expires: Verifcation of Ownership by (type of document, i.e. - property �ax Dill or deetl): DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: ❑ I hereby certiry [hat no excavation five (5) or more feet in tlepth inlo which a person is required to descend, will be made in connection vrith work authonzed by this permil, and ihat no building s�rucWre, scaffolding, falsework, or demoli�ion or dismantling thereof, vnll be more than �hirty-six (36) (ee� high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, Califomia Administrative Code). ❑ As owner-builtler, I will not employ anyone to do work which would require a permit from the Division ot Industrial Safery, as noted above, unless such person has a pertnit to do such work from the division. Applvant's SignaWre Division of Industrial Safety Permii Number _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or fuNre building occupant need to file and certiry a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of Ihe California Heal�h and Safety Code requires, with some exceptions, that a Business Plan be filetl with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantiry of hazardous materials equal to or grea[er than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of wmpressed gas at standard �emperature and pressure). 2. Does or will the applicant or present or fuNre builtling occupant need ro fle a registration form for acu[ely hazardous materials? ❑ Yes ❑ No (Section 25533 of the Cali(ornia Health antl Safety Code, with some exceptions, requires regisiration with Ihe Costa Mesa Pire Depariment by each business which at any one lime 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 wmpressetl gas at s[andard temperaNre antl pressure). 3. Does or will the appliwnt or present or tuNre building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutety hazardous materials)? ❑ Yes ❑ No (Section 25534 0( lhe Califomia Health and Safery Code provide5 lhat the Cosia Mesa Fire Depariment may require the preparalion, certifcation and fling wilh the Fire Department of an RMPP by businesses which are required ro register acutely hazardous matenals with the Fire Department. 4. If an RMPP is presently required, has Section 25534 of the California Health and Safery Code been fully complied with? ❑ Ves ❑ No 5. Does or will the applicant or present or fu�ure building occupant require (or the work which is ihe su6ject of this appliwtion a permit for such constmction or motliflcalion (rom the South Coasl Air �ualiry Management DisMct or from any other air polWtion control dislrict or agency? ❑ Yes ❑ No (SeCtiOn 658502 0( lhe Califomia GovemmeM Code reqUireS thal lhe reques[etl informalion be fumished on applications for non-resitlential building pertnits). 6. Will any part of the facility to be wnstmctetl under this permit be within 1000 feet from the outer boundaries of a school? ❑ Ves ❑ No Qt yes", the facility must meet the requirement of Sections 25534 and 42303 of ihe California Health and Sa(ey Code). 7. If a permit from lhe South Coast Air Qualiry Management District or other air pollution conirol district or agency is required for the work which is the subject of this applica[ion, have all ot [he disclosures prescribed by California Health and Safety Cotle Section 42303 been made? ❑ Yes ❑ No 8. Qf'yes", attach certifcate of compliance from the appropriate air pollution conhol offcer). CERTIFICATE OF COMPLIANCE: I certify thal under penalty of perjury the information given above is cortecf. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certiry undei penalry of perjury that I have read this application and state that the information given is correcL I agree to compty vnth all state laws and ciry ordinances relating to building consVuction, and authorize representatives of the City o( Cosia Mesa to enter upon [he above-desCribetl property for inspection purposes. I agree not to occupy or allow occupancy of any building authorizetl by this permit until fnal inspection. ignaWre gal neqs) oate (v Z�- <, ntllorAulhy tlAppl¢ant Oata AC,qlterations CF-LR-ALT-HV G Site Address: /� Enjorcemenf Agency: Dale: Permi! N: �� I�1 t �i103 S �l�l -i !C i� �-1 �rE L'� l� if.( /iqvy.i. D-2�b-ao �' U Cl f ui ment T Lis[ Minimum E�cienc Condi[ioned Floor Area Thcrtnostat Packaged Unit �X�Fumace �AFUEA�I� �COP � indoor Coil SEER_ Q HSPf SGrved by system �-Setback Conden ing Unit 8 EER _ Q Rcsistance ��0 sf (Ilno� otready presem, mv.sr be insmlledJ Other �u c � 1. Equipment Type; Choose [he equipment being insmlled i(more than one system use another CF-IR-ALT-IiVAC for each sys[em. 2. Minimum Equipmrnt Efficiencies: 13 S@ER, 78% APUG, 771{SPF (or rypical residential systems. HERS VF,RIFICATION SUMMARY Listcd below are three HVAC alteration Options. The installer decides whai work is being done and picks one of the appropriate Options. Hach Option lists the FfERS measures lhat must 6e conduc[ed. A copy o( the Corms shall be left on si[e for final inspection and a cOpy given to [he homeowner. At final, the inspeclor verifies that the work listed on ihis fortn was in fact the work completed by the installer. The inspector also veri�a that each appropriate CF-6R and registefed CF-4R fortns (no hand filled CF-4Rs allowed) a`e filled out and signed. Beginning Oc[ober (, 2010, a registered copy of the CF-iR and CFfiR shall also be on site for final ins ection. 1. HVAC Changeou[ Required Forms: • All HVAC Equipmcnt CF-6R forms: MLCH-04, MEC11- 25-FIERS � re laced CF-4R fortns: MECH-25 • Condenxr Coil and /or , CF-6R forms: MBCH- 25-HERS . Indoor Coil and /or CF-4R funns: MECH-25 • rurnace For Split Systems: RC, CCA> 300 CFM/ton,'CMAI�I For Packa ed Units: No testin required - � 2. New HVAC System Required Forms: • Cut in or Changeout with CF-6R forms: MECH-Oq. MECH- 25-HERS ncw ducts: (all new duc[ing CF-4R forms: MECH-25 � and all new e ui ment For Spli[ Systems: RC, CCA > 300 CFM/toq TMAH. For Packaged Units: No testing requirod � 3. New Ducts wi[h Replacement Required Forms: � • Includes replacing or installing all new CP-6R forms: MECH-?5-HF,RS ducting and/or ouldoor wndensing uni[ CF-4R fortns; MECH-?5 end/or indoor coil and/or Cumace. No[ all e uf inen[ chan ed. For Sptit Systems: RC, CCA > 300 CFM/ton, TMAH For Packa ed Uni[s: No tes[in re uired Confraetor (Documenta[ion Author's /Responsibte Designer's Declaration Sta[ement) . I cenify that this Cenificate of Compliance documentation is accurate and wmplete. • 1 am eligible under Divisioo 3 of the Califomi8 Business and Professions Code ro accept responsibiliry for ehe design iden[ified on ihis CertiFieate of Complfance. • I certify [ha[ the energy Peamres and perfom�ance speciCications for the design identified on this Certilicate o(Compliance con(orm to the rcquirements o(Title 24, Parts b and 6 of thc Califomia Code o(Regulations. .'1'he design fea��res identified on [his Certificate of Complinnce are consistem with �he information documented on other applicable compliance forms, worksheets, caleula[ions, plans and specifications submitted to [he enfo emen agency for appruval wi[h [he rmit a lication. � Nanic: . ��e� � Signamre: Company: � ei'f/ . Ua e: p- ZCv- Z9 / ! e 1�4N, t� t / Address: Za// �v �� l.icense: 7 gq,lZV � City/State/Zip: V Uv�N GeK�a � �fi' �V %i U� Phone: , � 1008 Re.ridentia! Compliance Forms dlorch 2010 �1 �618 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOx 1200 � GOSTA MESA, CALIFORNIA 926YE For Appllcant to FIII In Complafaly TYPE OR PRINT ��No (03 ��:,� ))/.�.L S 7RES8 Q. O� COSTA ESA. Y.IFORNIA size OF LOT USEOF BU DESCRIP710N OF WORK sf �! HEltBBY ACXNOWL[006 ANG BTATH TXAT TN8 A0� PLY WITN ALL CITY ORD/l 9UILDINO CONBiRUCT10N. � wunroeaco wasrn l•] i sr:r�2s-t-r�::,n6o �,y. ,,�, ,,59.��r APPLICATION FOR PERMR BUILDINf3 FOr Office Uss Only ZONING zo Ho, o� uae or nnv G �un� � euuo�no � ��,� 3 -% �� oucR�mox /4 P. NO. ��iy�S—� IiOTR: NO [AV! OV[RHANO 8HALL D8 LE88 THAN o. O ALLOWHD YARDHAPPROVBD MAIN BUILDINO .(PROM C/yL� -IITR6[TI �. � PRONT J L��F/f. � ' R. YID[ TT. , L.IIID b PT. .� R�R s �. oierwNcs sar. MAIN BLO VAR. �(' 1 c. u. r. �le MPROV[D 1//1 .I/ D7 � 1/ i rinu D XAVI RfAD TNIB APPLIGTION CORP6CT�AND AOR6[ TO COM. ANC fTwTi U1WY RWULATINO YARDB MPROVED ACC6D80RY BUILOINO DATH � 1 � ' � , w W � 2 /�36 �. �. �'3 � e TNH AMOUNS GNO 1 UNOHR VALUI�TION 19 FOR TH6 •UflPO9H OP [BTABLIBHINO A PEHMIi PEE ONLY. VALUATION � � PERMIT PE8 G �� k ,07�, � r� � .3 - w TOTAL FEF $ 7 / �