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Home My WebLink About2643 WESTMINSTER PL - Building Permits - •.- a ay' k CITY OF COSTA MESA • , i, BUILDING DIVISION t•r DEVELOPMENT SERVICES DEPARTMENT. PERMIT NUMBER �• PERMIT it4tPcmg�"P Boo-O 2 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COST SA,CA 92626 BUILDING PERMIT • • Job Address: 2643 WESTMINSTER PL Status: ISSUED Suite: Applied: 04/15/2000 Vicinity: Issued: 04(15/2000 Parcel Number: 43920109 Zoning: n Applicant: ROBERT WHITNEY ISSUED BY: S n Address: Phone: 949-548-0769 Zip: Owner: CHIPMAN, ADDIE Address 2645 WESTMINSTER AVE Phone: COSTA MESA,CA Zip: 92627 Contractor: WHITNEY ROOFING Address: P0 15396 Phone: (949)548-0769 NEWPORT BEACH,CA Zip: 92659 License: 406022 Arch : Eng: Address: Address: Phone: Phone: • Zip: License: License: SCOPE OF PERMIT T/OFF SHEATH AND REROOF 1150SF RESIDENCE W/COMP SHINGLES. SMOKE DETECTORS REQ PER 97UBC. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $3,800.00 Permit: $97.25 Claim Valuation: $3,800.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $97.75 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 Existing: 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 notcommenced 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 • urance carrier an'policy n • ber are: . / q Carrier: - i• a. ,/ Policy Number: dig C /O 0 (This section need not be co •Iet.d if the permit is vel d at one undred dollars($100)or less.) ❑ I certify that Irl the performance of the w r whic thi- permit is issued, I shall t employ any person in any manner so as t ecome subject to the workers' compensation laws of California,and ee if s••ul• •ecome subject to the rkers'compensation provisions of Section 3700 f the Labor Code,I shall forthwith comply with these provisions. �/ /(!/pb Applicant Signature: Date: 7 r WARNING:FAILURE TO SECURE WORKERS' P SATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALT S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(S100,000),IN ADDRION T THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR E,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATIO • I hereby affirm that I am licensed under• •vi-0's •t Chapte 9(commencing with Section 7...000)of Division 3 of the Business Business,afg P fession ode,and my license is in full force and effect.Lic.N / Class k p 7l Contractor's Signature: �./Are Date: !f / /� l CONSTRUCTION LENDING AGEN r Y: 1 ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,CMI Code). Lender's Name: Lender's 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 far 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 then a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification end filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application ap�JJermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes LJ No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any pan 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 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 AITTHO RATIO •F ENTRY:I ertify 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 law nd city • •' anc: rola g to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection ryoses.I -17,not•.occ •y or allow occupancy of any building authorized by this permi ntil final Inspection. ai Signature Of Le ', /' t --� And/Or Auth•.+'=•vs..' - t Date • CODE I INSPECTIONTYPF BBN INTIMAL£ CODE( INSPECTIONTYPF PATE INRTIAL£ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final !� �L//7 208 Final Plumbing 200 Final Re-Roof Moo �C 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 "0....UrvNLK YODER, MRS. UAIE o-i -oy JOB ADDRESS 2643 Westminster Place BUILDING PERMIT NO. 30627 Gr ZAL CONTRACTOR Alts Masonry DESCRIPTION of WORK Pvt. Block Wall AF .... i19-163-09 LOT(For) 68 TRACT 376 FIRE ZONE VALUE $ 350.00 INSPECTIONS Signature Date GROUP J TYPE 111 ZONE R-1 \SOIL SUBCONTRACTOR PERMITS ISSUED GAS .Date Number Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE fl HOUSE CON. ❑ SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE /(J IIJJ UNDERGROUND i ie POWER n V. I¢-47 ROUGH WIRING `] c Heating and Vent. TRENCHES FORMS STEEL REINF. K/C (.fl2 �( FLOOR SYSTEM BOND BEAM n STEEL REINFORCE n SHEATHING FRAME AND FLASHING LO" -'ANG - IN OUT n F ER, BROWN COAT STRUCTURAL, FINAL ,�,q( Electric �J�1�.e� ��JJJ .7 y HEATING, VENT., REFRIG. AND A.C., FINAL v.�Itf�Iy zed,/ .61_5;67 5C7/ PLUMBING, FINAL ANO GAS TEST n c t! ELECTRIC. FINAL / ,t /)•I -Ga( BUILDING, FINAL ,S& (D-1-Gf • 30627qJ 12-69----00 575 f*****5.00 CASA COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT REC� E(I�j�I/E�O BY DATE RECEIVED 7E ISSUED e BUILDING _ Vvrrl G - A2-'1z/2_ Go9 ADDRESS / 3 {')/Es tinvi tag p/c AGe" p (( '']] Q /_ Qau OWNER �'7 yODEC' A.P.NO. /� ( -/ �J- v / PERMIT,069 •C-� MAIL t� BUILDING , Z ADDRESS `/ 4M,E• ADDRESS al (,{/� �G- O 0 CITY G O STA z {C sig. NO. TRACT J / L7 I LOT &D BLOCK ZZ 4 CONSTRUCTION a•/D4/€ - NEW ADD ALTER REPAIR MOVING DEMOI ISH Oa. V) LENDER � J D BRANCH • p_rsn,L _IV) OWNER 7�"v r� /, g3 J ADDRESS / /f A/ - n,VALVE$35.0 ,2 m ARCHITECT TEL. USE (f% /F/- j(fL(.• J < OR ENGINEER NO. O tn FIRE .,t( Q W K ADDRESS A/� /J ( ZONE t[[[]]]v//(111/��'rod 7T�YPE �J GROUP �/9 JO CONTRACTOR 7)LIJ A/ AJO*'it y BY PME zz1e DATE/2-h7 m, ADDRESS ��wtp //. ��/��,( �� Win _/� TEL ) q ZOAE NO.OF USE OF NEW r` Cr CITY FUL I-L R On/- NO.sd&.-ib), i� PLANS1.„/ BUILDING W O STATE Q CITY YARDS APPROVED YARDS APPROVED j O LIC.NO. (�d SS 7) LIC.NO. MAIN BUILDING ACCESSORY BUILDING SIZE i NO.OF BLOCS. (FROM CIL STREET) �'J-�) OF LOT r i�f1LLNOW ON LOT FRONT FT. `) FT. USE OF EXISTING BLDG. SLOP'', r3 P z DA/Er /1 • tI R.SIDE FT. FT. I- SIZE OF NO.OF Z NEW BLDG. -- ROOMS -- STORIES- L.SIDE FT. FT. Q EXTERIOR WALL ROOF .�^ U COVERING l COVERING — REAR FT. •SFT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN& a o_ MAIN BGS. ACCESS. BLDGS. Q Po y. RL OC ✓ WA C L VAR.# C.U.P.# DATE APPROVED VEDO RAP; I- 02/14 ',ATE (4 ',ATE 7/ I Yb 5 z 0 ~.1 tI hereby acknowledge that I have read this application and state 7 that the above information Is correct and agree to comply with CC all laws regulating building construction, and I shell not employ F any person in violation of the workman's compensation laws of N the State of California. m 2 I hereby certify that I am properly licensed as a contractor under SQ. FT. - o the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 9 cc am exempt from the provisions of the State of California Business VALUATION r{ /) and Professions Cod ,Divi n 3,Chapter 9. (/`.(/ CO PERMIT FEE $ CV Signature of /-0a) Permittee a9 .,-"e--1 $ ‘550 PLAN CHECK S ------ E `o Authorized Agent /I u \ TOTAL FEE $ - 0