HomeMy WebLinkAbout562 STURGEON DR - Building Permits. �
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PERMIT TYPE
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CITY OF COSTA MESA
B{/ILDING DIVIS/ON
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-0856 • w.wi.ci.cosla-me .w.us
FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER. P07-00540
JOB ADDRESS
vicinity:
SCOPE OF WORK
PLUM
562 STURGEON DR CM
REPLACE WATER HEATEf2 �
OWNER: CHOCANO, MARIA ` �
PHONE: 714d34-6501,. � � _ � .
APPLICANT: HENRY QUAKE ' � _ '
PHONE: 909-605-2017: � , . "
CONTRACTOR: PLUM6-1N-TIME PLUMBING SERVICES INC
Address: 3959 GUASTI RD UNIT 8
City/State: ONTARIO,CA '- ZipCode: 97767-
PLUMBING PERMIT FEE SUMMARY
PLAN CHECK FEE: $0.00
PERMIT FEE: $35.80
TOTAL FEES: $35.80 ' '
e
STATUS:
DATE ISSUED:
ISSUED BY:
Suite/Unit:
ISSUED
10I15/2007
SOK
Atldress: 562 STURGEON DR
City/State/Zip: COSTA MESA, CA �
Address: 3959 GUASTI RD :UNIT B
City/State/zZip: ONTARIO, CA . ' . " '
License No. 895793
� PHONE: 909-605-2011
CELL:
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NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPEC710NS: In order (or the work authorized under this permit to be considered legal, such vrork must comply with all applicable codes, and all
required inspections and final approval must be obWined. Failure to obtain inspections and fnal approval will result in the expiration of this permit.
GOOE/. IN$VECTIONTYGE DRTE INiRIRLS COQE/ INSPECTIONTYPE ORTE INTIi1qL5
1616 Fixed Syslem Final Fire Prevenlion 206 Final Mechanical IQ�
12fi6 Pool Spa Final 208 Final Plumbing P/� b �?�
200 Final Re-RoOf ' 270 Final Elaclncal
201 Final Block/Retaining Wall � 212 Final Fire Prevenlion
202 Final Factory Fire Place 220 Final Planning Approval
ZA3 Final Sign 222 Final Site
204 Final Demolition � 250 Final Buildinq/Oaupancy
,
WORKERS' COMPENSATION DECLARATION:�
I hereDy aKrm under penalty of perjury one of the following declaralions:
❑ I have antl will maintain a certificate of consent to selFlnsure for vrorkers'
compensation, as provided for by section 3700 of Ihe Labor Code. for the
p�eA�o ance of the work for which this pertnit is issuetl.
IJ' I have and will maintain vrorkers' compensalion insurance, as required by
sectqn 3700 of the Labor Code, for lhe pedortnance of the work for which this
permit is issued. My workers' compensation Insurance carrier and policy
number are:
Carrier: �h�P.fCC. U.�n�.-Sr�i7Si"fY 5+�5�C0-
(Thissed'anneeE�rol�erompletetlalnape�mauvalve0a(onan�ndred lars(E100)aless.)
Policy Number: ���(_� 3� Z`[S� �
❑ I certify that in the peAormance of the vrork for which this permit is
issued, I shall not employ any person in any manner so as to become subject
to the workers' compensation lavrs of Cali(omia, and agree Ihat if I should
become subject to the workers' compensation provisions of Section 3700 of
the Labor Cotle, I sha forthwith comply with these provisions.
�(/� i !S �
nfs i9�aNre Dale
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 DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that 1 am licensed under provisions of Chapter 9(commencing
with Section 7000) ot Division 3 of the Business and Professions Code, and
my license is in full force and effect.
Lic. # � S % Class #
�/s"o
Gonlractor'S SiB�alure Dale
CONSTRUCTION LENDING AGENCY:
❑ I hereby affvm lhat t�ere is a construction lending agency for the
peAormance of the work fa which this pertnil is issued. (Sec. 3097, Civil Code).
Lenders Name:
Lender's Address:
Signature Date
OWNER-BUILDER DECLARATIONS:
I hereby aKrtn that untler penalty of perjury that I am EXEMPT FROM THE
CON7RAC70RS LICENSE LAW for Ihe following reason (Sec. 7037.5.
Business antl Professions Code: Any city or counry which requires a permit to
constmct, aller, impmve, demolish, or repair any sVucWre, pnor to its
issuance, also requires t�e apD�icant for such permit to fle a signed statement
[hat he or she is licensed purSuaN to the pmvisions of the Contractors
License Law (Chapter 9(commencing vnth Seclion 7000) of Division 3 of the
Business and Professions Code) or that he or she is ezempt therefrom and
the basis for [he alleged exemption. Any violation of Seclion 7037.5 by any
appliwnt for a permit subjects the aDPlicant to a civil penalty of nol more than
five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wdges as their sole
compensation, WILL DO THE WORK, and the struclure is not intentled or
oHered for sale (Sec. 7044, Business and Professions Cotle: The Contractors
License Law tloes nol apply to an owner of property who builds or improves
thereon, and who does such work himself or herselt or lhrough his or her ovm
employees, provided that such improvements are nol intentled or oftered for
sale. If, however, the building or improvement is sold within one year of
completion, the owner-builtler will have the burden of proving that he or she
did not build or improve for purpose ot sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to construcl the project (Sec. 7044, Business and
Professions Code: The contractors License Law dces not appy to an rnmer of
property who builds or impmves thereon, and who contracts (or such projecl with
a contracta(s) license pursuant to the Cont2ctps License Laws.j.
❑ I am exempt under sec.
Business and Professions Cotle for this reason:
SignaWre oa�e
905]�G8�3/0))
Owner ID venfied by driv� O 1'es ❑ No
Driver's License No. Expires:
Venfca�ion ot Ownership by (type o( document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby certAy Ihat no excavalion frve (5) or more feet in depth into wfiich a
person is required to tlescentl, will be made in connection with work au[honzetl
by Ihis pertnit, and that no building sWCWre, scaffdding, falsework, a Cemolition
or dismantling Ihereo(, will be more �han thirly-six (36) feet high. (Chap. 32, Grp
2, M 2, Sec. 347, Ttle 8, Califomia Administrative Code).
❑ As owner-builder, I will not employ anyone lo do work which would
require a permit trom Ihe Division of Industrial Safery, as noted above, unless
such person has a permit to do such vrork (rom ihe division.
Apollcanfs SiqnaWre
Division of Industrial Safety Permil Number. _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
7. Will the applicant or present or fulure building occupant need b(le and
certify a Business Plan for emergency response ro release or threatened
release of a hazardous material4 ❑ Ves ❑ No
(Section 25505 of the Califomia Health and Safety Cotle requires, with some
enceptions, Iha[ a Business Plan be filed with the Costa Mesa Fire
Department by every 6usiness which has at any one time during a reported
year a quantity o! hazardous matenals equal ro or greater than a weight o(
500 pounds, or a volume of 55 gallons, or 200 cubic feet o( compiessed gas
at standartl temperature and pressure).
2. Does or will the applicant or present or fuWre building occupant need to file
a registration fortn lor acutely hazartlous materials? ❑ Yes ❑ No
(Section 25533 of lhe Califomia Health and Safery Code, with some
exceplions, requires registration with the Costa Mesa Fire Department by
each business v+hich at any one time has on hand a quantity of aculely
hazardous materials equal to or greater than a weight ot 500 pountls, or a
volume of 55 gallons. or 200 cubic feet of compressed gas at stantlard
temperaWre and pressure).
3. Does or will the applirant or present or tuture building occupant need to
prepare an RMPP (Risk Management and Preven[ion Program (or acutely
hazar0ous materials)? ❑ Yes ❑ No
(Section 25534 of Ihe Califomia Heallh and Safery Code provitles that the
Costa Mesa Fire Department may require the prepa2tion, certifcation and
filing wit� the Fire Department of an RMPP by businesses which are required
b register acutely hazardous materials with the Fire Department.
4. If an RMPP is presently required, has Seclion 25534 0! the California
Health antl Safely COtle been fully Complietl with7 ❑ Ye5 ❑ No
5. Does or vrill the applicant or present or fulure building occupant require for
the work which is the subject ot this application a permit for such construction
or modi6cation from the South Coast Air Ouality Management District or from
any other air pollution control district or agency? ❑ Yes ❑ No
(Sectbn 658502 ot the Califomia Govemment Cotle 2quires that the requested
inlormatbn be fumished on applications tor nornresi0ential Duilding pertnits).
6. Will any part of the faciliry to be wnstructed under this pertnit be within
1000 leel (rom the outer boundaries of a school? ❑ Yes ❑ No
pf yes", the facility must meet the requirement of Sections 25534 and 42303
of lhe Cali(omia Health and Safety Code�.
7. If a permit from the South Coast Air Qualiry Management District or other
air pollution control dislrict or agency is required for the work which is the
5ubjec� o( this application, have all of lhe disclosures prescribed by Cali(omia
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. Qf'yes", attach certificate of compliance from Ihe appropriate air polNtion
control offcer).
CERTIFICA7E OF COMPLIANCE: I certity that under penalty of perjury the
information given above is correct. I agree lo comply with all state laws and
city ordinances regarding Hazartlous Materials and Emissions.
SignaWre Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalry of perjury that 1 have read this application and state that
the information given is correcL I agree to comply with all state laws antl ciry
ordinances relating to 6uiltling construction, and authorize representatives of
the Ciry of Costa Mesa to enter upon the above4escribed property for
inspeclion purposes. I agree not lo occupy or allow occupancy of any building
authodzed by this permit until fnal inspection.
SignaWreolLeg r�s) Oate
i� �O�/ S�o7
❑onze0 Pp01it'ant Oale
(7�a) 7ea-s27s • Fax Pia> �sa•as�
CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
.IobAddress: 562 STURGEON DR
Suite:
Vicinity:
ParcelNunmber: 47802227
Applicant: DE LA JARA, JOSE
Address: CHOCANO, MARIA
562 STURGEON
Owner: DE LA JARA, JOSE
Address CHOCANO, MARIA
562 STURGEON
Contractor.
Address:
Zip:
Arch : . .
Atldress:
BUILDING PERMIT
2oning: R1 R1
Phone: 714-434-6501
Zip: 92626
Phone: 714-434-6501
Zip: 92626
Phone:
License:
Eng:
Address:
Phone:
Zip License: Zip:
SCOPE OF PERMIT
TEAR OFF INSTALL 1/2" CDX AND INSTALL LIGHT WEIGHT ROOF. ICBO# 3682, 3.4PSF.
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total:
$0.00
$87.25
$0.50
$0.00
$0.00
$0.00
$87.75
SETBACKS
MAINSTRUCTURE Front 0-0
'� ACCESSORY Front 0-0
PARKING Existinq: 0
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Left 0- 0
Pr000sed: 0
�
PERM NUMBER
699-00535
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 04/79/1999
Issued: 04/19/1999
ISSUED BY: �
Calc Valuation:
Claim Valuation
Right 0- 0
Right 0- 0
Phone:
License:
$3,465.00
$3,465.00
NOTICE: The work authorized by this permit shall compty with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This pertnit shall automatically expire and become void if work is not commenced within 780 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 vrork must comply with all applicable codes, and all
requlred Inapectiona end final approvel must be obtained. Feilure to obtain inspections end final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (7/4) 7545628
,\
WORKERS'COMPENSATON DECLARAnON: .
I hereby eflirtn under penelry of per�ury one oi the lollowing declaratians:
❑ I heve entl will malntein a cetltlicate ol consent to setl-Insure tor warkers' compensation, es O�ovidetl tor Dy sectlon 3700 at the Lehor Cotle, tor ihe pertortnance of t�e
work for which Uis pertnit Is Issuetl.
❑ I �ave antl will malntain woAcers' compen5ation Insurence, as required by section 3700 of Ihe Lebo� Code, for Ne pedormance of Ne work for which this permit Is iuue0.
My workars' compansation Insurance carrier and policy number ere:
Cerrier: - Policy Number:
(Trils sectlon neetl not be camp/eted i! the perm/t /s ve/ued et one huntlred dollers ($100) oNe55J
❑ I cenify ihat In the pertormance of tha work tor which this permit is Issued, I shall not employ eny person in eny manner so as to bacame subjeci to t�e workers'
compensation laws ol Califomia, antl agree that if I should becoma sub�ect to Ihe workere' compensetion provisions oi Section 3700 oi ihe Lebor Cotle, I shall torthwith
comply with ihese p�ovisions.
Applicent SignaWre: Date:
WARNINO: FAILURE TO SECURE WORKERS' COMPENSNTION COVERAGE IS UNUWFUL AND SMALL SUBIECT AN EMPLOVER TO CRIMINqL PENALTIES AN� CIVIL FINES UP TO ONE HUNDRED
TTIOUSAND DOLLNPE (5100.000�, IN ADDITION TO THE COST OF COMPENSATION, OAMACaES AS PROVIDED F-0R IN SECTION 31060F THE LABOR CADE, IMEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aflirtn ihat I am licensed under provisions of Chapter 9(wmmencing with Section 7000) of Division 3 ot the Business end Professions Code, entl my license is In full
force end eflect Lic. M Class q
COn�rec�or5 Signature: Dete:
CONSTRUCTION LENDING AGENCY:
❑ I hereby aHirtn that there is a constructian lentling agency tor t�e pertormance of ihe wark lar which ihis pertnit is issuetl. (Sec. 3097, Civil Code).
Lender's Neme: Lenders Atltlress:
Signeture: Date:
OWNER•BUILDER DECLARATIONS:
1 here6y eHirtn thet under penalry ot perjury ihat I em EXEMPT FROM TME CON7RAC70RS LICENSE LAW tor the following reason (Sec. 7031.5, Business and Professions
Code: Any city or county which requires a pertnit to construct, elter, improve, demolish, or repeir eny structure, prio� to Its Issuence, also requires the applicant for such permit
to tile e signetl stetament thet he or she is licansed pursuant ta ihe pravisions of Ihe Conirectors License Lew (Chapter 9(commencing wlth Section 7000) of Divislon 3 01 Ihe
Business antl Professions Code) or that he or she Is ezempt therefrom entl the Dasis for ihe alleped exemption. Any violatlon of Section 7037.5 by eny epDlicam for a permit
su Jecls Ihe applicant to e ciWl penalry of not more lhan five hundred dWlers (5500).):
I, a5 owner oi the pmperry, or my em0loyees wit� wages as Ihelr sole cnmpensation, WILI DO THE WORK, end Ihe structure is nol intantletl or ottared for sale (Sec.
7044, Busineu antl Professions Cotle: The Contrectors License Lew does not appty to an owner oi Droperty who builtls or improves thereon, and who does such work
himself or harself ar thraugh his ar her awn employees, provitletl that suc� improvements era not intendetl or oNered lor sale. If, however, the building or improvament is
sold within one year oi completioq the ownervbulltler will have the burden of proving ihat he or she tlitl not build or improve tor puryose of sale.).
❑ I, as owner of t�e properry, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the proJect (Sec. �044, Buslness and Professlons
Cotle: Tha conVactors License Lew does not epply to en owner of property who builtls or improves Ihereon, en0 w�o contrecis for suc� pro�ect with a contrector(s)
license pursuent to ihe Coniractors License Laws.).
under
tlnverslicense. (�{es ❑ No
Busineu antl Profeuions Coda for this reason:
Verification of Ownershlp by (rype of tlaument, i.e. - D�operty ta�c bill or
DIVISION OF INDUSTRIAL SAFE7V PERMIT CERI7FICATON:
❑ I hereby cetllfy Ihet no excavetion five (5) or more teet in tlepih Into which a person is requlred to descentl, wlll be metle in connection wit� work authorizetl by thls
permit, and that no bullding struMure, swftolding, felsework, or demolition or dismentling thereol, wlll be more than t�irty-slx (36) feet high. (C�ap. 32, Grp 2, Art 2, Sec.
3C7, TLLIe B, Califomle Administrative Cade).
❑ As owner-builder, I will not employ anyone to do work which would requlre a permit irom the Division of Indusinal Safery, es noted ebove, unless such person has a
permit ta do such work irom Ihe di+nsion.
Signature: Date:
Division of Intlustnal Sefery Pertnit Number:
CERTIFlCATE OF COMPLIANCE AND AUTTIORQATON OF ENTRY: I certity under penalry ot perjury that I have reatl this application antl state ihat the information given is
correct.l a9rea to comply with all state laws and ciry ordinances reletinq to Dullding constructlon, end authonze representetives ofthe Ciry of Costa Mesa to anter upon the
ebove-described property i9[.Ins�eelle'r�n ree not to occupy or ellow occupency of any bullding authorized Dy this permit untll final Inspection.
� \ �'
Signature Ot Le aLOwne Date
And/Or Authorized Applicant . Date
COOE I. INSPECTIONME
1818 Flaetl System Finel Fire Prevention
1266
200
201
202
203
204
244&d6
Poal Spa Final
Finel Re-Root
Final BIaWRetaining Wall
Final Fedory Fire Place
Final Sign
Finel Demoli�ion
o"� u�eis
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COUE I INSPECl10N TYPE
208 Final Mechanical
208 Final Plumbing
210 Final Electncel
2tt Final Fire Preventlon
220 Final Planning Approvel
222 Final Site
250 FlnalBuilding/Occupancy
P..sIIE 1L��5
��
JOB AD
INSPECTIONS
or
Final
una�
BUILDING
Date I GROUP
SUBCONTRACTOR
,::� .
;' ; ' 25486
� COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA� CALIFOiiNIA 92828
For App(IcaM to FIII In ComplNaly
TYP.E OR PRINT
■u��oiNa r� (02 S�U C-�l,z--O �.
AOOREDY
COSTA MESA, CALIFORNIA
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US'EOF �
EXISTIN6 BLDO.
6ETBACK lJN6 PROM i
OR
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DESCRIPTION OF WORK
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MAR 2 5 1966
For Offin Use Only
11[C61'T' NO. �
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6CY ANP AOp6[ YO COY. IUPPOG[ O� 66TA�LI8HIN0 A P[pMIT F68 ONLY.
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1 PERMIT FEE
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
ForApplicant to Fillin Completely
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I hereby aeknowlMpe thet 1 heva �oe0 Mis eppllceHon antl �tate
that tha ebov� Informetlon is cor�act end aprea to comply with
ell lews repuleHnp b�iltlinp con�trNctlon, anE I shell not employ
any person in vlolation of Me workmen'� compenmtion lew� of
Me Sten of CelNornia.
I hereby cenify t�et I em proparly Iicanutl et e eonbector untler
tha Stata ot CalHornle Bu�in�u and Prof��slom Cotla, Dlvi�lon 3,
Chepter 9, antl that wc� Iic�nwt e�o �� ���� forca anE Nfxt, or I
am exempt from t�a provl�ion� of the Stete of Callfornie Business
entl Proteeslon� Cod�, QDlvid//oJJn 3, Chapter 9.
Sipnetureo}�'�� 9���/� (/_ ' _
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Avtho�iz�tl Ap�nt
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APPLICATION FOR BUILDING PERMIT �-� ��
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VAROS APPROVED
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VAR.
VALUE
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THE AMOUNTSNOWN UNDER VALUATION IS FOR �
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VALUATION
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TOTAL FEE $ �//