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HomeMy WebLinkAbout298 15TH ST - Building Permits CITY OF COSTA MESA os'"WsA BUILDING DIVISION AY O �t ``�- � ("0 77 FAIR DRIVE,COSTA MESA, CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us '. /,� FOR INSPECTIONS CALL: (714)754-5626 °°PO o PERMIT NUMBER: B11-00216 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 42516123 DATE ISSUED: 07/20/2011 ISSUED BY: KJB JOB ADDRESS: for T51 Sla'CM Suite/Unit: Vicinity: Squares: 4600 Valuation: $35,000.00 SCOPE OF WORK: TEAR OFF EXISTING ROOF OF A TRIPLEX BUILDING.APPROX 38 SQUARES OF CLASS B-MEDIUM SHAKE. APPROX 8 SQUARES OF FLAT ROOF. ICC INFORMATION WILL BE PROVIDED AT INSPECTION. NOTE:RESIDENTIAL RE-ROOF: Final approval of permit shall not be granted until access to dwelling unit(s)is provided for verification of the installation of smoke and carbon monoxide alarms by the City Inspector. See Attachment w/Inspection Card OWNER: KOVACH,EUGENE F TR Address: 2447 BUNYA ST Unit: PHONE: City/State/Zip: NEWPORT BEACH,CA APPLICANT: ALFARO, MARISELA Address: 5901 CLARA ST Unit: : PHONE: 562-862-5196 City/State/Zip: BELL GARDENS,CA CONTRACTOR: LANG ROOFING License No. 405427 Address: 5901 CLARA STUnit: PHONE: 562-862-5196 City/State/Zip: BELL GARDENS,CA 90202 CELL: ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $492.75 Reinspection Fee: $0.00 Bldg Std Admin Fund $2.00 TOTAL FEES $494.75 ,,, HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010-PER CMMC Sec. 13-279 Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 are thru 6:00 pm. Prohibitied all hours-Sundays and the following Federal holidays New Years Day, Memorial Day, Independence Day,Labor Day,Thanksgiving Day and Christmas Day NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODES. INSPECTION TYPE DATE INTITIALE CODES INSPECTION TYPE I DATE IN1ITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final rT 208 Final Plumbing L� 200 Final Re-Roof X I- a-I I' rn r� 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 drivse. ❑Yes D No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Wxpires: ? ❑ I have and will maintain 6lcertificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): comae ation, as provided for by section 3700 of the Labor Code, for the erf ante of the work for which this permit is issued. • I have and will maintain workers'compensation insurance, as required by sectio 3700 of the Labor Code, for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My worker ' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a is number are l a n n( person is required to descend, will be made in connection with work authorized (�(f�-(ij by this permit,and that no building structure,scaffolding.falsework,or demolition CCarrier:' or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Grp (This sectunn Ibem Ogg pe it is valued al one hundred dollars(S100)or less.) 7 /��_ t I 2,Art 2,Sec.341,Title 8,California Administrative Code). ----L-- - Policy N ber: (, L ❑ 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 workers' compensation provisions of Section 3700 of Applicant's Signature Date the Labor ode. I shat •rthwitJ`I�/.ly with these provisions. Aliu F- 1)20I(I Division of Industrial Safety Permit Number: Applican' Signature - (`Dat —4- HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECUR 'WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL 1UBJECT 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? ❑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. c_9-) a registration form for acutely hazardous materials? 0 Yes 0 No Cit-###—` .�l,s AJ _Cl-ss'#—" (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by 1, ���,� 4i s�� each business which at any one time has on hand a quantity of acutely r ornL rs Sigi - Date hazardous materials equal to or greater than a weight of 500 pounds, or a rte-- volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTR I TION LENDIN AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑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 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Govemment Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications for non-residential building permits). License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No thereon,and who does such work himself or herself or through his or her own 8 (If"yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code:The contractors License Law does not apply to an owner of Signature Dale property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ",,n/� Signature egal 0w/w/y�111�cr(sl /D'�ate� Signature Date — y I/ f�11 r r/I / /)wl r(s) �'//1'�I 3057.46(3/OJ) r I �VAVndd//pfr�A hCor_ized Apppp1fiicca/y//JI[r `D�a. 1eV -I -Prescriptive Certificate of Compliance: Residential CF-IR-ALT Residential Alterations (Page 1 of 5) Project Name: I Climate Zone t T if/ of Stories bit- 00. 1(to General information Site Address: 2G J C - I C i' ' S\ Enforcement Agency: Date: V 7 '4 _/ f Building Type D Single Family 0 Multi Family Circle the Front Orientation:N,E,S,W,or degrees t v 1 Project Type: 0 Alterations 0 Envelope 0 Fenestration ❑Roof 0 HVAC • Conditioned Flom Area(CFA): Replacement or Change Out 0 Duct Replacement 0 Water Heater NOTE: Thrs;fbrn+is not to be used jar/Veylr Constructed Buildings or Additions • Insulation Values For Opaque Sin:laces(for Furring use the Mass and Furring Strips Construction table below) Assembly Alteration ❑Opening of framed cavity alone-Alterations that involve the opening of the framed cavity of a wall,ceiling, (»ffloor must install the mandator),urinintum insulation value per§150.for the altered assembly. Fill in Columns A-C and enter mandatory insulation value in Column H. ❑Replacement of entire assembly-Replacement of an entire wall, ceiling, orJloor assembly requires the installation of Component Package-D insulation values in Table 151-C. Fill in Columns A-J. Opaque Surface Details For the furred portioned of Mass Walls see Furring Strips Construction Table below. •A • B C _ D F - F 1 c H... .1. p. .J Proposed See NoteStandard Values From JA4 Table Framing Thickness, Framed Continuous JA4 Proposed Tag/ Assembly Name Material Spacing, U- JA4 Table Cavity insulation Assembly Assembly ID' or Type' and Size2 or Other' factor4 Number' R-valuee _ R-Value' T Cell Values U-factory — Rote:Far lured assemblies.accounting for Continuous Insulation R-value,see Page JA4-3 and Equation 4-1. Far calculating furred wails use the Mass and ;Furring Carsnuction table below ' 1.For Tag/ID indicate the identification name that matches the building plans. 2.Indicate the Assembly Name or type:Roof/Ceiling, Walls,Floors,Slabs, Crawl Space,Doors and etc...Indicate the Frame type and Size:For Wood, Metal, Metal Buildings,Mass,enter 2x4, 2x6, or etc... see JA4 for other possible frame type assemblies. 3. Enter the thickness for mass in inches or Spacing between framing members enter; 16"or 24"0C;or Other for all other assembly description suck as Concrete Sandwich Panel,Spandrel Panel,Logs,Straw Bale Panel and etc.... 4. Based on the Climate Zone;enter the Standard U factor from Table 151-B, C or D for each different assembly Name or type. 5.Enter the Table number that closely resembles the proposed assembly. 6. Enter the R-value that is being installed in the wall cavity or between the framing; otherwise, enter "0". 7. Enter the Continuous Insulation R-value for the proposed assembly; otherwise, enter "0". d'.Enter the run and column of the ()factor value based on Column F Table Number and enter the Assembly U factor in Column J 9.The Proposed Assembly U factor, Column.1, must be equal to or less than the Standard U factor in Column E to comply. • • • Furring Strips Construction Table for Mass Walls Only A It • C B E _ FOB 1 3 K L M Proposed Properties of Masonry and Concrete Added interior or Exterior Insulation Walls From Reference in Furring Space from Reference • Joint Appendix Table 4.3.5,4.3.6.4.3.7 Joint Appendix Table 4.3.13 :=• e N U u1 L. o C G"q U O q Assembly --it, p c .e 2 1 ' k ° oe '5' 2. a, Final • Mass Name or JA4 Table e - '- m 2 ° k n v L Ti u Assemble dy Thickness' Type' Number' S <. C ,t O L� - u. Go _ LT- C Q i U-factor 3 Comment _ II1 I Registration Number: Registration Date/Time: HERS Provider: 2008 Residential Compliance Forms August 2009 Prescriptive Certificate of Compliant :sidential CF-1R-ALT , Residential Alterations (Page 3 of 5) Project Naine: Climate'Lome 11 Itl of Starlet ROOFING PRODUCTS (COOL ROOFS)§15.1(f)12 When the area of exterior roof surface to be replaced exceeds more than 50%of the existing roof area,or more than 1,000 ft', whichever is less, the new roofing area must meet tire roofing product "Cool Roof"requirements of§152(b)IHi, 152(b)1Hii, or 152(b)IHiiL Check applicable alternative or exception below If the roof alteration is exempt front the roofing product "Cool Roof'requiremem.r.Note:If any one of the alternatives or exception below is checked, the Aged Solar Reflectance and Thermal Eminence requirements for roofing products in ,,§)18(I) are not applicable. Do not fill table below. 0 Cool Roots Not Required in Climate Zones 1-12, 14,and 16 with a Low Sloped. Less or 2:12 pitch. ❑Cool hoof.; Not Required in Climate Zones I through 9 and 16 with a Steep-Sloped Roofs(pitch greater than 2:12)and product unit weight less than 5lb/ft. Alternatives to §152(b)111i and §152(b)Hli,Steep-slope roof Mitch > 2:12) ❑ Insulation with a thermal resistance of at least 0.85 hrfl'•°P/Bni or at least a 3/4 inch air-space is added to the roof deck over an attic;or ❑ Existing ducts in the attic are insulated and sealed according to§151(f)10;or ❑ In climate zones 10, 12 and 13,with 1 ft2.of free ventilation area of attic ventilation for every 150 ft2 of attic floor area,and where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge;or ❑ Building has at least R-30 ceiling insulation;or ❑ Building has radiant barrier in the attic meeting the requirements of§15 I(1)2;or ❑ Building has no ducts in the attic;or ❑ hi climate zones 10, 11, 13 and 14, R-3 or greater roof deck insulation above vented attic. Exception to §152(b)IHiii,Low-slope roof(pitch 5 2:12) ❑ Building has no ducts in the attic. Other Exceptions ❑ Roofing area covered by building integrated;photovoltaic panels and solar thermal panels arc exempt from the below Cool Roof criteria. .❑ Roof constructions that have thermal mass over the roof membrane with at least 25 Ih/ttc is exempt from the below Cool Roof criteria. Note: If no CRRC-I label is available,this compliance method cannot be used,use the Performance Approach to show compliance,otherwise, Check the applicable box below if Exempt from the Roofing Products"Cool Roof"Requirement: — Roof Slope Product Weight Product Aged Solar Thermal CRRC Product ID Number' 5 2:12 >2:12 < 51b/ft2 > 5Ib/ft& Type2 Reflectance3'4 Emittance SRI5 ❑ ❑ D ❑ ❑ - ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 0 04 ❑ ❑ ❑ ❑ 0 - ❑ ❑ ❑ ❑ ❑4 1. The CRRC Product/D Number con be obtained from the Cool Roof Rating Council's Rated Product Directory at www.coolroafs.ore/products/searchr.php 2. Indicate the type of product is being used for the roof top,i.e.single-ply roof asphalt roof metal roof etc. 3. If the Aged Reflectance is not available tithe Cool Roof Rating Council's Rated Product Directory then use the Initial Reflectance value from the sante directory owl use the egrratina(0.2+0.7(Pt,drt"t-0.2)to°blab,a calculated aged value Where p is the Initial Solar Reflectance. 4. Check box ifthe Aged Reflectance is n calculated value using the equation above. 5. Calculate the SRI value by using the SRU- Worksheet at hno://www.energy.ca.eov/title24/mrd enter the resulting value in the SRI Column above and attach(copy of the SRI- Worksheet to the CF-IR. To apply Liquid Field Applied Coatings,the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage recommended by the coatings manufacturer and meet minimum performance requirements listed in til 18(i)4. Select the applicable coating: ❑ Aluminum-Pigmented Asphalt Roof Coating LI Cement-Based Roof Coating C Other • Registration Number: Registration Date/Time: TIERS Provider: 2008 Residential Compliance Forms ' August 2009 Prescriptive Certificate of Compliance: Residential CF-IR-ALT • Residential Alterations (Pare of 51 , lh'ojecl Name: Climate Zone R r/ ^ # of Stories • HERS VERIFJ CATION SUMMARY The enforcement agency should par special anention to the HERS Measures specified in this checklist below. A completed and signed CF-41(Foam for all the measurer speci(iec/shall be submitted to the building inspector before final inspection. Duet Sealing & Testing HERS verification is required for this measure. • 0 YES C NO YES:In Climate Zones 2 and 9-16,if more than 40 linear feet of new or replacement ducts are installed in unconditioned space,the ducts arc to be sealed per tf 152(b)1Dii and the newly installed ducts are to be insulated pet §I s l(1)10. ❑ EXCEPTION: Existing duct systems that are extended, which are constructed, insulated or sealed with asbestos. D YES C NO YES:In Climate Zones 2 and 9-16,if the existing space-conditioning system(HVAC equipment and ducting)is replaced,the ducts are to be sealed per SI 52(h)1 Di. C YES C NO YES:In Climate Zones 2 and 9-16,if the existing HVAC equipment is replaced (including the replacement of the air handler, outdoor condensing unit of a split system,cooling or heating coil,or the furnace heat exchanger)the ducts are to be sealed per 152(b)lE. • C EXCEPTION:Duct systems that are documented to have been previously sealed confirmed through HERS verification iv accordance with procedures in the Reference Residential Appendix RA3. • • 0 EXCEPTION:Duct systems with less than 40-linear feet in unconditioned space. ❑ EXCEPTION:Existing duct systems constructed,insulated or sealed with asbestos, Refrigerant Charge- Split System HERS verification is required for this treasure. C YES C NO YES:In Climate Zones 2 and 5-15,when the existing HVAC equipment is replaced(including the replacement of the air handler,outdoor condensing unit of a split system A/C or heat pump,cooling or heating coil, or the furnace heat exchanged a refrigerant charge measurement shall be verified per§152(b)IP. Central Fan Integrated (CFI)Ventilation System and Fan Watt Draw The ventilation requirements of§150(0)do not apply to existing residential homes. Ducted Split Systems-Air Conditioners and Heat Pumps: Airflow' HERS verification is required far this measure. - C YES 0 NO YES:In Climate Zones 10 through 15,when the existing space-conditioning system(HVAC equipment and ducting)is replaced., the airflow and fan watt draw shall be verified per§152(b)1 Ci to meet the renuirements of§151(117B. Documentation Author's Declaration Statement . • I certify that this Certificate of Compliance documentation is.accurate and complete. Name: �, �fi /� \� fr �jA}/�e o I t/� /� Signature: ,�(n/1 /� , „np Company: / `� 1 LI til. • '�"' Dattee': alt /j-OP Address: 71OI Pq A If Applicable Cl.CEA or ❑ E(P,E • 1 (Certification t/): City/State/Zip: ' L fLsit p �/),^�. /-0 1 Phn6(�jj ii12_3 7z Responsible Building Designer's�jDeecllaration Statement C/ • 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. • 1 certify that the energy features and performance specification::for the building design identified on this Certificate of Compliance conform to the requirements of Title 24,1'arts 1 and 6 of the Cali'Ibrniti Cody of Regulations. • The building design features identified on this.Certificate of Compliance are consistent with the iaformation prnvidecd to dueument thin budding design on the other applicable compliance Iurms,worksheets,calculations,plan.':and specifications submitted W the cnlurcement agency lot apprcn'al with thin building permit application. Name: Signature: Company: Date: Address: License: • City/State/Zip: I Phone: Tor assistance or questions regarding the Energy Standards, counts(t/tc Energy Idol/int at: 1-00-772-33(1(1. . - _,._... lieeisu'atin, bete/Time: HERR Prm icier_ 4 CITY OF COSTA MESA a � BUILDING DIVISION 1.1 `^ "I ' DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER uI • PERMIT a� %awn`t. 00-00103 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 . MECHANICAL PERMIT Job Address: 298 E 15TH ST Status: ISSUED Suite No A Applied: 03/14/2000 Issued: 03/14/2000 Vicinity: Parcel Number: 42516123 ISSUED BY: CAA-\- Applicant: ROBINSON , WILLIAM . . . , , Address: PO BOX 13101 . , Phone: 949-589-1676 , LONG BEACH,CA { Zip: 90803 - _ /'.,.; , Owner: / ,KOVA�CH, EUGENE F TR Address:, "24478UNYASL' - - ,1,,, -. . Phone: ,,,NEWPORT BEACH,CA Zip: 92660 . Contractor: ROBINSON BROTHERS _ . , Address: , PO BOX 13101 - • : • Phone: 949-589-1676 LONG BEACH,CA - Zip: 90803 • - x License:- 702541 Arch/Eng : . . , N Address: - -. ' Phone: Zip: . j • License: SCOPE OF PERMIT .. • . REAPAIR DUE TO FIRE DAMAGE.NON STRUCT_URAL,WORK. . REF B00-00319,REPALCE FAU AND 3 VENTS FANS. ' - ._ • - , FEE SUMMARY/ / - .. ' -Quantity _ _ Quantity ISSUE FEE $23.50 - - Repair/Alt Absorbtion Unit•• _ $0.00 0 Inst FAU<100 k BTU i $14.80 1 Repair/Alt Refrigeration Unit $0.00 0 Inst FAU>100 k BTU. $0.00 0 - . '. Ventillation System $0.00 0 Repair/Alt Cooling/Heat 1' $0.00. 0 Evaporative Cooler - $0.00 0 Inst/Rep. Recess Wall Htr • . $0.00 0 . - Commercial Incinerator ' . $0.00 0 Refrig Sys<100 k BTU , $0.00 0 - . Domestic Incinerator . $0.00 0 Refrig Sys>100 k BTU $0.00„ 0 - - Compressors/Absorption Systems Gas Piping - ' $0.00 0 Up to 3 hp/100 k BTU $0.00 0 Factory Fireplace. - - $0.00 ' 0 - 3 To 15 hp/500 k BTU $0.00 0 Hood w/Mech Exhaust- $0.00 0 . 15 To 30 hp/-1,000 k BTU $0.00 0 VAV Box $0.00 0 - 30 To 50 hp/1,750 k BTU $0.00 0 Vent Fan/Single Duct $21.75 3 Over 50 hp/Over 1,750 BTU $0.00 0 Appliance $0.00 0 - Boilers Fire Dampers $0.00 0 Up to 3 hp $0.00 0 Smoke Dampers $0.00 0 3 To 15 hp $0.00 0 Inst or Relocate Appl Vent $0.00 0 15 to 30 hp ' $0.00 0 Air Handlers< 10000cfm $0.00 0 30 to 50 hp $0.00 0 Air Handlers> 10000cfm $0.00 0 Over 50 hp . . $0.00 0 Floor Furnace $0.00 0 Other Mechanical Fee Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES $60.05 COMMENTS/SPECIAL CONDITIONS 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 '-/ 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 I DECLARATIONS • WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 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: Carrier: Policy Number: (This section need not be completed If the permit is valued at one hundred dollars(8100)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' J compensation laws of California, nd agree tha 'f I s come subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith complywith these provi io /J c ARMING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EM• . - a •IMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND COLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE.INTEREST.AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby-I P'- -- I - :d urns prrv$visions of Ch-.ter 9(commencing with Section 7000)of Divisio . .. ' ess a •rofesslons Code,and my license is in full I. -=and eft: LLic.tt /�/�__' C. - Contractors '• - . -. f% racer_ - - Date: ray S 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(5500).): ❑ 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 en 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 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,Gm 2,Art 2,Sec. 341,Title B,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 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,ora 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 end 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. 4 If an RMPP is presently required,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,a�ppplication apgermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? L-1 Yes LJ 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 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: 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. Of Legal Owner(s) 3 D to oo And/Or Authoriz:d Applicant e CODE 4 INSPECTION TYPE DEL INTUTAL£ CODE! INSPECTION TYPE gig /IALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 442/m1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 2446-46 CITY OF COSTA MESA >4:j �0 BUILDING DIVISION PER NUMBER S. ""/ 'P DEVELOPMENT SERVICES DEPARTMENT ` PERMIT 00-00212 (714)754-5273 • Fax(714)754-4856• 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 298 E 15TH ST Status: ISSUED Suite No A Applied: 03/14/2000 Vicinity: A Issued: 03/14/2000 Parcel Nunmber: 42516123 ^ ISSUED BY: /� Applicant: ROBINSON , WILLIAM Address: PO BOX 13101 ; / ' r Phone: 949-589-1676 - - LONG BEACH;CA " Zip: 90803 - _ - ' , - Owner:7,;KOVACH, EUGENEFTR , ,, Address,' .2447 BUNYA ST- - _ / /'% - Phone: NEWPORTBEACH,CA Zip: 92660 - - , . i 'Contractor: ' ROBINSON BROTHERS Address: POBOX 13101 , - - .. _ Phone: 949-589-1676 • , • -LONG BEACH,CA / , - Zip: 90803_ . ' • >., License: 702541 .SCOPE OF PERMIT . • REAPAIR DUE TO FIRE DAMAGE. NON STRUCTURAL,WORK. , , REF B00-00319.,24 LIGHTS,AND 20 SWITCHES. - '" - F FEE SUMMARY - . Quantity" - • / Quantity , , ISSUE FEE - ' $23.50 - Temp Dist System/Lighting , $0.00 0 , Temp service test .. $0.00 Busway/100.9_ _ $0.00 0 Res.a/c package $0.00 Standing Section.- - • $0.00 0 New Res(1-2 units) - $0.00 0 Misc Electrical Equipment _I $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 . . ",$0.00 0 • up to 50 kva/kw ' $0.00 0 Recept Outlets $22.92 24 up to 100 kva/kw $0.00 0 Switches - $22.00 - . ' ;20- - over 100 kva/kw $0.00 0 Non Res Appl $0.00- ' ` 0 - Low Voltage Equipment $0.00 0 Res Appl $0.00 - . . 0 1 Low Volt Wiring System/Ckt $0.00 ' 0 Service to 200a ' $0.00 0 Misc.Conduit $0.00 0 Service to 1000a $0.00 ., 0 - Misc.Conductor $0.00 0 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0 Motors to 1 hp $0.00 0 .. Circus(mech 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 pane!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 $68.42 Intermed Pole $0.00 0 COMMENTS/SPECIAL CONDITIONS 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 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 per it. FOR INSPECTIONS CALL: (714)754-5626 O 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 44, 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 end policy number are: Carrier: Policy Number: (This action need not be completed I/the permit Is valued at one hundred dollars($700)or less.) di 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 Califomi ,and agree that' Did become subject to the workers'compensation provisions of Se n 3700 f the Labor Code,I shall forthwith �c•••y..n hese pr is' • } �1 Date: J /7 0V �TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJE EM TO CRI INAL PE TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLIARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR INS 06 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affi • . I am licensed under'revisions of Ch.•t 9( ,r•• encing with Section 700. a•: •rofessions Code,and my license is in full force:•.effect.Lic. , a / --i_ �r.{+ : •ntractars Sig..lure: iZ7%i am/S1 • _ •:tem _T� "- 0 CONST"• ' ENDING 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 driver's license. 0 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: 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? ❑Yes 0 No (Section 25533 of the Califomia 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 Califomia 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 U 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 Califomia 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 0 No 6 (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. ignatur ry e•- _.'mer- Date And/Or Authorized Appli -nt ate CODE 1. INSPECTIONTYPE DATE INT1T1AL$ CODE INSPECTION TYPE DATE INTnIALE 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing �z 200 Final Re-Roof 210 Final Electrical 5--/6-a9 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 lima!Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 2446-46 �S CITY OF COSTA MESA o¢ `""T1 BUILDING DIVISION • ' r PERMIT UMBER 1. 1 �-'-3:� ! DEVELOPMENT SERVICES DEPARTMENT +' �_ PERMIT �a„� 00-00130 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 298 E 15TH ST Status: ISSUED Suite No A Applied: 03/14/2000 Issued: 03/14/2000 Vicinity: A Parcel Nunmber: 42516123 ISSUED BY: CA / ► - Applicant: ROBINSON , WILLIAM . -"- ' - l/ Address: PO BOX 13101 ", - - Phone: 949-589-1676 - LONG"BEACH,CA ` _Zip: 90803 _ Owners 'KOVACH,' EUGENE F'TR - � . • Address// 2447 BUNYA ST- / - . Phone: . ,- NEWPORT-BEACH, CA Zip: 92660 - `Contractor: 'ROBINSON BROTHERS - ' Address: PO BOX 13101 . Phone:- 949-589-1676 - f . LONG BEACH,CA' • Zip: 90803 _ - . - License: 702541 - . "Arch/Eng: - _ - - - . • • " Address:- - • - Phone: Zip: . . . - _- -- i i • / . _ License: - i : - ' SCOPE OF PERMIT / . ` - -REAPAIR DUE TO FIRE DAMAGE. NON STRUCTURAL,WORK. _ ' REF B00-00319, 2 BATHTUBS,2 WASH BASINS„2 TOILETS. - - . . FEE SUMMARY AMT QTY - AMT , QTY • AMT QTY ISSUE FEE " $23.50 Laundry Tub/Washer ' $0.00 0 • • Sump Pump $0.00 0 Backflow irrigation $0.00 0 - :•. Landscape Irrigation $0.00 0 -.1 Swimming Pool $0.00 0 Backflow Prevents( $0.00 - 0 " . P-Trap - - -$0.00 0 Trap Primer $0.00 0 Bathtub - '$19.60 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 $19.60 2 Dishwasher $0:00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect • $0.00 0 Waste and Vent System $0.00 0 Drain, Rainwater $0.00 - 0 . Sewer Private Line $0.00 0 , Water Closet(Toilet) $19.60 2 Drain,Roof $0.00 0 Shower $0.00 0 Water Heater/vent $0.00 0 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 $0.00 0 Gas(1-4 outlets) $0.00 0 Sink, kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlet§) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 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: $82.30 COMMENTS I SPECIAL CONDITIONS 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) 1[\ EXPIRATION: Thispermit,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, 11 required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permi . FOR INSPECTIONS CALL: (714)754-5626 DECLARATIONS WORKERS'COMPENSATION DECLARATION: r ` 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: Carrier: Policy Number: (T.S 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 .ermit is issued, I shall not employ any person in any manner so as to become subject to the workers' �s of California, d agree t come subject to the workers'compensation provisions of Section 3 00 of the Labor Code,I shall forthwith ,Areir Gale- 3 - or) WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLO - •• - NALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereb .. . - _ ". under provisio 1 Ch;.t_ • . . encing with Section 7000)of Division . ._ • '.'ss and Proms.ions Code,and my license is in full ' e and effect.Lic.# • C Lai ss# ` Contractors '... . -. agreAr/rtr/ -_ Date: Sj MEM 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(5500).): ❑ 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 driver's license. 0 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). ..._..... will is orp future occupant need to fit a._.__.. acutely hazardous ado .... .......................... 2 Does or ithe applicant present or building occupant to file a registration form for hazardous materials? ❑Ves 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 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 ❑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? 101 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? 0 Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia 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? 0 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. //dgnatur- (!:.?. .•v 'f) D- • . •r Autho ed Applicant - Date CODE A. INSPECTION TYPE PAN INITIALS CODES INSPECTION TYPE DATE I TRIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing /115,- Final 200 Final Re-Root 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention r 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy , 2446-46 �9=4' CITY OF COSTA MESA _) I>4;r- .*a' -4 BUILDING DIVISION i 1.t `�""f ' DEVELOPMENT SERVICES DEPARTMENT PER T NUMBER 4. PERMIT ``"".ror000xasmalu� B00-00319 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 298 E 15TH ST Status: ISSUED Suite: A Applied: 03/14/2000 Vicinity: A Issued: 03/14/2000 Parcel Number: 42516123 Zoning: ^ ISSUED BY: U .,c__- Applicant: ROBINSON , WILLIAM _ Address: PO BOX 13101 - ' - ' - . '.</ _ • Phone: 949-589-1676 -LONG BEACH,-CA. Zip: 90803 Owner KOVACH, EUGENE F TR Address 2447 BUNYA ST-•. - - - - ' _ / :/ - - Phone: ': �.. • ' "1'- ,NEWPORT BEACH;CA - - Zip: 92660 - -� - Contractor: .ROBINSON_BROTHERS , A(dress: PO BOX"13101 - -� Phone:' 949-589-1676 -_ LONG BEACH,CA Zip: • 90803 License:. 702541-' , •Arch : - • - Eng: Address: - _ Address: Phone: - Phone: - ' " ' Zip: - , License: License: SCOPE OF PERMIT • • ' REAPAIR DUE TO FIRE DAMAGE. NON STRUCTURAL,WORK. ' " - - • FEE SUMMARY Plan Check: ' $0.00 7 - ' -/ Calc Valuation: $50,000.00 Permit: $644.25 _ = j - Claim Valuation: .- $50,000.00 . SMIP Res: $0.00 • SMIP Com: $0.00 Other: $0.00 - -- •Inspection: $0.00 ' Total: . $644.25 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 . Rear 0-0 Left : 0-0 Right 0-0 ACCESSORY 'Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existinq: 0 Required: 0 Proposed: 0 NOTES: 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 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 end policy number are: Carrier: Policy Number: (Thi section need not be completed/t the permit is valued at one hundred dollars($100)or less.) I certify that in the performance of the work for which this •: it i issued, I shall not employ any person in any manner so as to become subject to the workers' mpensation laws of California,a •a• ee that if •out e bject to the workers'compensati• provisions of Section 3 •• of the Labor Code,I shall forthwith •..- .. -.4•n ..e provision . / Applicant ignature: / .__ / Fee: '' OD -NING:FM • 0 SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL.SUBJECT• -• • •CRIMINAL PE TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND On I ARE($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 CONT: ' ' •- - •ECLARATION: I •- eby affi at 1 a licans:. under provisions• C .pier 9(commencing with Section 7000)of Divis• • the Business a • Pr •ns Code,and my license is in full , force and e-ect.Lic.If im Class a Contractor's Signature: J r��1W -- Date: aWI,60 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 em 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 properly,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 driver's license. 0 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 then 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 end 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 0 N (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. 4 If an RMPP is presently required,has Section 25534 of the Califomia 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 apgermit 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 LJ 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 ❑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? 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: 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 properly for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Sign •1 L - • Date d/Or Authorized Applicant Date CODE F INSPECTIONTYPE MIA INTITI41$ CODES INSPECTIONTYPF ME INTRIALS 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 'a u ,202 Final Factory Fire Place 220 Final Planning Approval '203 Final Sign 222 Final Site ` MT 204 ' Final Demolition 250 Final Building/Occupancy l 7-OD 2446-46 City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. P.0.Box 1200 Costa Mesa,California The Building located at ,on Pant- 15Th StraelI- has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group M1 Occupancy. Use of Building Garaoe Legal Description 425-161-23 (See reverse side for Metes and Bounds) Building Permit No 13 S7QfiA Electrical Permit No. E 53933 Plumbing Permit No. Mechanical Permit No. Number of apartments and/or guest rooms ISSUED TO: Building Official Tony C . - .. I rftna Rrtrarlr 244 Bunya by• ' \ ra Q26,&) Date December 12, 1991 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 lel U.B.C. CMF 1015-46 rev. 1/83 White-Owner;Canary-Numerical File;Pink -Bldg. Permit File • aPRokioDluss: If. E 15TH ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 052968 OWNERSNYXE: GENE KOVACK ADDRESS: 244 BUNYA PERMIT NO: B 052968 PLAN CHECK NO: 01519-91 S GOVT: N SUPP; N NB CA 92660 CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ADD ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : ADD TO GARAGE SQ FT: 219 ADDRESS: UNIT: CLAIM VALUE: 3, 000 . 00 CALC—VALUE: 3, 788 . 70 GROUP OCC; M-1 / PERMITne EUGENE KOVACH ( 714 ) 644-0335 ADDRESS: 2447 BUNYA COMMENTS : ADD TO GARAGE NB CA 92660 *****xNENENENE+E*>E***Nt*>ERE:E>ESE****+ ***NB **>E*>EaEN>E>t**RE>E*>FNr***RETE***x>F**x > ***+:*RE,E> ******** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING R EQUIREMENTS iW0f of Division 3 of the Business and Professions Code.and my license is in lull force and effect. SETBACKS CITY LIC.: STATE LIC.: CUSS: Date signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby allirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: 20 FT IN REAR: 12 FT IN FRNT; FT IN REAR : FT IN Compensationlnmance.or acedified copy thereof(Section MO.Lab.CS. LEFT: 16 FT IN RGHT: 16 FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ; PROV: PARCEL ; 42516123 ZNE; R2 REF NO: . Certified copy ishereby furnished_ 0 Certified copyisliledwith the chBuilding Division, PLANNING NOTES> ENCLOSING EXISTING CARPORT TO MAKE 1 CAR GARAGE. > date' I' Applicant ******************* ************************************************.3�'{E*******3E* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This senke need not be completed it the permit is for one hundred(5700)or less). D E V E L 0 P M E N •T S E R V I C E S R E Q U I R E M E N .1' S 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 .•• subjectto the wooers'Compensation Laws of California. ZONING APPROVED BY ' �� —' � DATE: Date: Signature; NOTICE:II.alter making this declaration,you should become subject to the Workers Compensation provisions of the Labor BUILDING APPROVED BY . - DATE Code.you must forthwith comply with Such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPL I CAT ION ISSUED 'BY -- -- DATE: 0 which this permit isissued(Section 3097.Civ.C). **********************- ' -----'"-- A. 7 ' ********** * LENDER: ., ****************************************' **************************W4********** ADDRESS: • LEGALIZATION:N F E E SJMMARY STRUCTURAL SEGMENT: Y OWNER BUILDER DECLARATION: thereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELEC'RIC MECHANIC FIRE SMIP/RES . GRADING (Section 7031.5 Business and Professional Code: My city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 63 . 00 5 0 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensedSMIP/NON-RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN 40 . 95 t,' and Professions Code)or that he/she is exempt therefrom and the basis fpr the alleged exemption.My Notation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of riot more than five hundred donors(5500). ISSUE FEE I, as owner of the property or my employees with wages as their sale compensation, will do the work, and the BUILDING—DIV—> PERMIT ISS .E PLAN—CHECK TOTAL PAID j' DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS—---> 63. 50 0. $0 40 . 95 104 . 45 104 . 45 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himsell/hersell or through his or her own employees,provided that such improvements are not intended or offered for sale.If, however the building or M REVENUE DIVISION TOTALS--> COLLECTED: 63 . 50 OVER/SHORT; 00 turpinepuepnseolsalejmnOne Year ofcompletion,the owner winhave the burden ofproving he/she did not buatlorimprove BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING ALAN-CHECK I,as owner of the property,am exclusively Contracting with licensed contractors to construct the project(Section 7044,Business 63 , 00 50 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'Slate License Law).I am aware ****************************************************************1E************** that proof of their Workers Compensation insurance should be provided to me. I N D I V I D U A L F E E BR EAK DOWN / ' xi I am exempt under Section:B P 7 0 4 4 "RC. roc imsror fe L RK Hn7044 9/ TYPE QTY DESCRIPTION UNIT COST TOTAL COST Date: Owner: 7SFR 219 RES—GARAGES TYPE V 17. 30 3, 788. 70 Ido hereby cerin hat 1 am a re of and understand the requirements of Caldor a Health an Safety Code Sections 25505.25533,and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a 4 permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from /M1. these provisions. I' Date: Applicant: � ' i.r I hereby certify that I have read this application ��i and state that the above information is correct.1 agree Io comply with all City and county 7- ordinances and state laws retaun tr udd:ngc str7hon and hereby authorize representatives of city enter upon ve.mentioned / _ properly for' 'Demon mugs fp-d/E_dry /Q 701.71 n7 ^: 7 •�' ..—.. Date Signature: G— e '`' Drivers License or Social Security v: 1641.46 White—Building:Green—Code Enforcement:Canary—Applicanq Pink—Revenue:Goldenrod—Assessor cat POOI1PA CONSTRUCTION ANC. PLANNING APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location • '2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ' ; 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement q..../5._91 tuft/ 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. I 57. APPROVAL TO COVER-GUNITE pr 7. Footings -irkigwd 58. Electrical Conduit-Undrgrnd. • 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 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 ❑Oil 23. Gas Pipe-Rough & Test • . 72. Underground Flush • 24. Roof Framing 73. Undergrnd.Storage Tank O Gas 0 Oil 25. Roof Sheathing - 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing q-,fit-'t( 4cad 76. Dry Standpipe • 28. Lathing & Siding ! 77. FIXED SYSTEM FINAL- 29. Insulation78, FIRE PREV. FINAL 30. Drywall Nailing jtue,..ct( dr-e'4C HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat ( ) , 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric j Notes: 34. Final Heating & Air Conditioning • 35. Final Gas Pipe-Test - 36. Hood or Canopy 37. Final Factory Fireplace , 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final I 41. Solar Domestic-Final 42. Backflow Preventer a 43. Backflow Irrigation 44. Landscape Irrigation System • 45. Sound Attenuation 1 • �I 46. Handicap Regulations J 47. FINAL STRUCTURE & BUILDING Acte-qt 6cyh _5�'o/tg' D - L' ��. --(.��/ J 48. FINAL PLANNING 1 • �yt� ;••49. Electric Release to Edison l 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY • No. Date PROJECT ADDRESS: gr E 15TH ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 053933 OWNER'S NAME: GENE KOVACK AODFnsS: 244 BUNYA PERMIT NO: E 053933 PLAN CHECK NO: N GOVT: N SUPP: N NB CA 92660 CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: ADD ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : ADD TO GARAGE SQ FT: ADDRESS: UNIT: PERMITTEE: ( 714 ) 644-0335 CLAIM VALUE: CALC—VALUE: GROUP OCC: M-1 / EUGENE KOVACH ( 714 ) 644-0335 ADDRESS: 2447 BUNYA COMMENTS: REF B052968GE NB CA 92660 ******+E*IE** ****************************>E******* kE**TE**********kE*E6>E****+E******* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: Date: signature: _ MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: thereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR : FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 38 .Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN• RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ: PROV: PARCEL: 42516123 ZNE: REF NO: ' i Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES> > ate: Applicant: ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)or less). DEVELOPMENT SERVICES REQUIREMENTS 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. ZONING APPROVED BY : DATE: Date: Signature: ' NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. ����---�--- I / CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPL I CAT ION ISSUED BY• ��—'� DATE: 0 f ea) which this permit is issued(Section 3097,Civ.Cl. ********************* •—•—•��.,—m "'�"' ************* *******ddcc.. LENDER: ********************************,*4E********** ********************************** ADDRESS: LEGALIZATION:N F E E S U M • ARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I herebyaffirm that l am exempt from theContractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC ECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 5 , 2 repair any structure.prior to Its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 5 SM I P/NON—RE$ and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 1 : . 00 I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE P AN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 5 . 25 15 , 00 0 . 00 20 . 25 20 . 25 • 00 does not apply to an owner of a property who builds or improves thereon.and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sate.If.however the building or REVENUE DIVISION TOTALS--> C�/ improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improveLL ECTED: 20 . 25 OVER/SHORT• 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC' MECHANIC FIRE $MIP/TOT GRADING PLAN—CHECK \` • " I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 20. 25 ❑ and Professions Code: The Contractors'Slate License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware ******************************************.*******.*******.****.***.****.*****.******.* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN GI I am exempt under Section: B P 7044 B.B P.C. tor thiss�easoe ALL WORK BY OWNER AR TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: =//g�4J owne ELE 3 FIXTURES LIGHTING 1 ST 20 EA, . 75 2 . 25 I do hereby certify„rat)am aware of and understand the requirements of Ca I omra Healt—h and Sal• ode Sections 25505,25533,and ELE 2 R EC EP T/O(JTL ET 1 ST 20 EA. . 75 1 , 50 25534 and that I or any future building occupant will/will not(circle one)need to comply with a• tale codes and the requirements fora ELE 2 RECEPT/$WITCH 1 ST 20 EA, , 75 1 , 50 permit for construction or modification from the Air Duality Management District.Residenlia onstruction applications are exempt from these provisions. END OF FEES _I Date: Applicant: _.---------------- I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state fans relating to building construction and hereby authorize representatives n is cit enter upon the above-mentioned . _ edlon purposes, NTE: TE: /r — - property for ins p J �� �� ff////JJ l'Y�I _ 11.1._ CJ'JIa�i•.• _ _ Date.R ( Signature:. .----- ,---) Driver's License or Social Security a: 1641-46 White—Building:Green-Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING POO, PA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1,"Temporary Electrical Service or Pole 52. Pool & Equipment Location : 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement .3. Electrical Conduit Utility-Undrgrnd. 54. Forms ' n .1'+4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding - . Steel Reinforcement 56. Rough Plumbing & Pressure Test: ..6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE '7. Footings 58. Electrical Conduit-Undrgrnd. r• ' 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. . 10. Structural Floor System 61. APPROVAL TO DECK '• 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater& Vent-Final .- 13. 13. Roof Drains 64. Plumbing System - Final r. 14. Rough Plumbing - 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPfROVED FOR PLASTERING 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_Strvctuie; _ .y "I -90. Underground Hydro 22. Ducts, Ventijatingl.. :r , - 71. Product Piping DGas 0Oil 23..Gas Pipe-Rough & Test " < •. I ' ` 72. Underground Flush 24..Rodf Framing ,, ••:- . . .73.• Undergrnd-.StoragerTank-0Gas 0Oil. 25. Roof Sheathing " '• ' `74.,Overhead Hydro - 26. T-Bar Ceiling (Structural) &•Monocoat _ 75; Dry Chemical _ 27. Frame and Flashing' a T ' _ '-' u ' 76. Dry Standpipe '', - LT 28. Lathing& Siding - - > .. 77.- FIXED SYSTEM FINAL- -•29. INAL-29. Insulation ' - . 78,-FIRE PREY. FINAL 1 • ,30. Drywall Nailing I . . HEALTH_DEPT. REQUIREMENT 31. Plaster Brown Coat; I 79:-FINAL INSPECTION" - "32. Electrical Power Meter-Final A80.. FOOD CERTIFICATE ISSUED • 33:"Final Electric - (at-q/ Cita'- ` Notes: ' 34. Final Heating'& P.ir.Conditioning ' r YYY�--=- ,` , 35.•Final Gas Pipe-Test- - - ? " ' - c ' • 36. Hood or Canopy . r 37.7:Final Factory Fireplace _ r - . 38. Final Plumbing . '- . . - •'39. Water Service-Final. ' 40. Gas Service-Final , I. L. , r _ ` : : 41. Solar Domestic-Final .• - 42. •Backflow Preventer - - - I :. ^, r 43. Backflow Irrigation, - ' -.44. Landscape Irrigation System,_ r � - . 45;:Sound Attenuation .i j _46.,Handicap Regulations „ ' - • , 47. FINAL STRUCTURE & BUILDING • �, • _ . ' . 48. ,FINAL PLANNING - - •�� LL ,• ;,, ' 49.-Electric Release to Edison > •h r. 50. Gas,Release to Southern California Gas Co _ I . - 51. CERTIFICATE OF OCCUPANCY . . - - No Date