HomeMy WebLinkAbout3126 MADEIRA AVE - Building Permits CITY OF COSTA MESA
BUILDING DIVISION
F°r t� 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci,costa-mesa-ca.0
o. FOR INSPECTIONS CALL: (714)754-5626
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PERMIT NUMBER. B08-00246
PERMIT TYPE B_ROOF2 STATUS: ISSUED
APN: 13916503 DATE ISSUED: 08127/2008
ISSUED BY: YH
JOB ADDRESS: 3126 MADEIRA AV CM Suite/Unit:
Vicinity:
Squares: 0 Valuation: $7,000.00
SCOPE OF WORK: REROOF:TEAR OFF EXISTING WOOD SHAKES, INSTALL 1 LAYER OF 301$FELT,7/16"OSB&30 SOB'S OF
40 YR.TIMBERLINE ASPHALT SHINGLES ON 4:12 PITCH ROOF.
OWNER: PYCHA,EDITH MAY TR Address: 3126 MADEIRA Unit:
PHONE: City/State/Zip: COSTA MESA,CA
APPLICANT: ELIASON,DEBRA Address: Unit: :
PHONE: City/State/Zip: ;)246
CONTRACTOR: SANTIAGO ROOFING License No. 576276
Address: 417 ASSOCIATED RDUnit: A-225 PHONE: 714-529-0440
City/State/Zip: BREA,CA 92821 CELL:
ARCHITECT: License No. PHONE: •
•
ENGINEER: License No. PHONE:
FEE SUMMARY
Reroof Plan Check: $0.00
Reroof Permit Fee: $139.25 •
Reinspection Fee: $0.00
TOTAL FEES $139.25 •
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord.No.92-28,§1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
COPE S INSPEC1ON TYPE pslE INTMALS SOPP I INSPECTION TYPE PEE IN11ML$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 pool Spa Final 208 Final Plumbing
t
200 Final Re-Root 9 Op G WI/ 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition _ 250 Final Building/Occupancy
WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive. .ense. 0 Yes ❑No
1 hereby affirm under penalty of perjury one of the following declarations: Driver's License,No. Expires:
O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
ca. I have and will maintain workers'compensation insurance, as required by •
section 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a
lumber are: person is required to descend,will be made in connection with work authorized
by this permit,and that no building structure,scaffdding.falsework,or demolition
Carrier FLA
or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
(This seceder need not be competed the permit is valued at one hundred Mears($100)or less) 2,An 2,Sec.341,Title 6,California Administrative Code).
ceOlicy Number:
aS / 4-18Oy
0 As owner-builcer, I will not employ anyone to do work which would
O 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 Lab. Code,I sh-ll„ hwith comply with these provisions.
7.017 -61 Division of Industrial Safely Permit Number:
AppGram's Signature Date_ _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CML 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 Safely 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. /' ?G a registration form for acutely hazardous materials? 0 Yes 0 No
.# S7 ,7&O Class-# ` 3 / (Section 25533 of the California Health and Safety Code, with some
0. .Q_ / - Q�d- 7 �`2' exceptions, requires registration with the Costa Mesa Fire Department by
At:
`(�L o /�V7f each business which at any one time has on hand a quantity of acutely
Con 's Signature - Date hazardous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? ❑Yes 0 No
(Section 25534 of the Califomia Health and Safety Code provides that the
Lender's Address: Costa Mesa Fire Department may require the preparation, certification and
filing with the Fire Department of an RMPP by businesses which are required
to register acutely hazardous materials with the Fire Department.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 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 C No
issuance,also requires the applicant for such permit to file a signed statement (Section 65650.2 of the California Government Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits).
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes ❑No
applicant for a permit subjects the applicant to a civil penalty of not more than (If'yes",the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I. as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec.7044,Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes ❑ No
thereon,and who does such work himself or herself or through his or her own
employees, provided that such improvements are not intended or offered for 8. (If"yes",attach certificate of compliance from the appropriate air pollution
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 riot build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
(rimer of the property;am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions.
❑ I, as
LICENSED CONTRACTORS to construct the project(Sec.7044, Business and
Professions Code:The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjure that I have read this application and state that
0 I am exempt under sec. the information given is correct. I agree to comply with all state laws and city
• ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason:• the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection. , , -
/� Signature ori,, al Owner(s) Dale
Signature Date (�// t„ {i ,YA ay-o305746(3/07) g
And/or Authonzed Applumnl Date
OWNER SYCA4IORE LAND CO. . ' DATE 5-25-59
JOB ADDRESS 3126 Madeira Ave. BUILDING PERMIT NO. 94.26
GENERAL CONTRACTOR Palgren VALUE $ 16,936.00
1 To. LOT 11 TRACT 3363 FIRE ZONE DESCRIPTION OF WORK Res.w/att.Gar.
INePECTIONS 446...11 DATE _I GROUP I & J TYPE V ZONE R 3.
'/-CLS
Underground Soil AU.G. Wate 4495 G IP�� PERMITS ISSUED
Underground Gas ., SUBCONTRACTOR DATE NUMBER
Overhead Water and Gas
Rough Heating I.N/ /,`1-�;,p AJ/3/..a `�„ ,-.S9 ZO3 /l-,
Rough Plumbing kir_ /5 i6. Cd4-v 1nA✓/ -h'f /5,-99G
Miscellaneous
Prop. Swr. Line' House Con.k St. Swr %1 -17-5 f2,,,,,aaSr (ki-.Cs/ 9-/E- 59 7..93,1_, I 0
Sprinkling System - 1/ _ Vet
Heating, Final
Plumbing Fixtures / _ t
a
Final Gas Test / / Ce
Construction Pole
Underground Power •
•Rough Wiring /U/ `if In % /27^v�,j f'/,;,-lti/. 7-/4/C S_l 5'6.;L/ ,i
Trenches Forms - Steel 6, - 1' _.. '
Floor System Rrf'E6 '-25-f
Steel Reinforce Chimney Re-Rod '
P Beam
S. .hing 'MJ- r -/-ft
Frame and Flashing ( Ala' - Pt^
Lathing, In If Out JJ4?,< $-.49_,I-D
Plaster, brown coat 11'61d- /0^26-'7V
Plumbing Fixtures, Final Al 44 ,--1C-Cts
Electric Fixtures, Final (4> L1120
Building, Final ( 4
OCCUPANCY I
Form 410-3M-4-59
9426iii-U
z_i ti 1-
COSTA MESA BUILDING-SAFETY DEPARTMENT tMA( 2 I
P.O.BOX 317 COSTA MESA, CALIFORNIA V ril'ii,'' DEPT,
1r0llQ1n .{=C:.
FOR APPLICANT TO FILL IN COMPLETELY APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING
ADDRESS .1/6174S d ._,
COSTA MESA. CALIFORNIA
fOR Off/CE USE ONLY
OWER Sycamore Land. Co• RECEIPT NO. I .p�RAR•-JI�
MAIL RECEIVED BY ADDRESS 10835 Santa Monica Blvd. .—.
�'`��� 3=DATE RECEIVEDDATE ISSUED
1�� / MAY 2 5 155E
CITY Los Angeles TEL.Br2328 BUDREIN
Nr
ORARNEER L.C. Major NOO . COSTA MESA, CALIFORNIA
ADDRESS 11015 S • Paramount Blvd. FIRE JA
ZONE iP (iT•OU�1
STATE APPROVED :!Y
CONTRACTOR Malgren Const LIC.NO/33 JQf By / .....,74,71:
CONTRACTOR I cDA r
7 ADDRESS 1 QRQCj Samta Monica Blvd. ZONING
LEGAL LOT I I A3 3 ZONE a NO.OF TUBE OF NEW
DESCRIPTION NO, 11 BLOCK TRA O 1 PLANS BUILDING
•
APPROVED //0 t 2
A.P.NO. BY L� DATE DcL/U /
SIZE 1 NO.OF BLOCS. Q YARDS EVES / /
OF LOT 100.00 X 70.00 NOW ON LOT REQUIRED ALLOWED
USE OF (CENTER LINE ST.)
EXISTING BLDG. FRONT CO
FT. IN,
SETBACK LINE FROM �p'� .1B AY'I
CENTER of STREET • ,3 O ' L REAR YARD R.SIDE J FT. IN.
SIDE YARD I LEFT 5' RIGHT 51
L.SIDE J FT. IN.
Y DESCRIPTION OF WORK REAR .c1/9FT. IN.
R NEW I X II ALTERATION I II ADDITION
REPAIR I II MOVING IL II DEMOLISH I
SIZE BUILDING 1'707 ROOMSNO.OF V STORIES 1
EXTERIOR WFni i uCCO ROOF w d shin 1f
COVERING bl• COVERING PP g
USE OF BUILDING AND WORK TO BE PERFORMED
Dwelling-new construction
A/
a .9 ^ R A.1-7-4 c M r d `�y7
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BUILDING CONSTRUCTION. /� VALUATION
SIGNATURE Otly e PERMIT FEE $ 3 4--
PERMITTEE SL��//H..
a ��/y'J��e $ /6 73 - PLAN CHECK $ /
AUTHORIZED AGENT ;i�`j//C
TOTAL FEE 5 S y--