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Home My WebLink About901 MAGELLAN ST - Building Permitsa ! .. 4 GTY OF COSTA MESA � o�`" F=, BUILD/NG DIVIS/ON i�� 77 PAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us F J � FOR INSPECTIONS CALL: (714) 754•5626 ��'°"°"°fi PERMIT NUMBER: 609-00139 PERMIT TYPE B ROOF2 STATUS: ISSUED APN: 14132206 DATE ISSUED: 0713012009 ISSUED BY: BJK JOB ADDRESS: 901 MAGELLAN ST CM Vicinity: RESIDENCE AND ATTACHED GARAGE Squares: 2250 Suite/Unit: Valuation: $4,500.00 SCOPE OF WORK: REROOF RESIDENCE WITH ATTACHED GARAGE: T/O EXISTING WOOD SHINGLES, 1/2" CDX SHTG, 2 LAYERS 15# FELT, APPLY 30-YEAR ASPHALT SHINGLES. PITCH 3:12 2250 SQ FT OWNER: THORNE DON R AND LINDA PHONE: 949-632-8125 � APPLICANT: MAYES. MATT PHONE: 949-274-2173 CONTRACTOR: OW NER-BUILDER Address: Unit: City/State/Zip: ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: Reroof Permit Fee: Reinspection Fee: Bldg Std Admin Fund TOTALFEES so.00 $111.25 $0.00 $1.00 5112.25 Address: 901 MAGELLAN ST City/Slate/Zip: COSTA MESA, CA Address: 901 MAGELLAN ST Ciry/State/Zip: COSTA MESA, CA License No. License No. License No. 000000 PHONE: CELL: PHONE: PHONE: Unit: Unit: : NOTICE: The work authorized by this pertnit shall wmply with all applicable handicap access requirements undei Califomia staWtes and relaled 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 authonzed 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 fnal approval will result in the ezpiration of this permit. CODE�. INSPECTIONTYPE DaTE INTITIRLS COOEt INSPELTIONTYPE . 04TE INIITIRLS 1616 Fixed System Final Fire Prevention 206 . Final Mechanical 1266 Pool Spa Final '/ 20B Final Plumbing 200 Final Re-Roo/ �—Z'1 —0� l4, 210 Final Electncal 201 Final Block/Retaining Wall 212 Finai Fire Prevention 202 Final Factory Fire Place 220 Final Planning Appmval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy � WORKERS' COMPENSATION DECLARATION: I hereby affrm untler penalty of perjury one of the tollovring declarations: ❑ I have and vrill maintain a certificate of wnsent ro sel6lnsure for vrorkers' compensation, as provided for by section 3700 of Ihe Labor Code, for �he pertormance of the work for which this pertnit is issued. ❑ I have antl will maintain workers' compensation insurance, as required by section 3700 of Ihe Labor Code, (or the perlortnance Of Ihe work for which this pertni� i5 issued. My workers' compensation Insurance carrier and policy number are: Carriec (inis sMqn need �pl Ue romp�eteE d(na pemM is valuetl al one nunWed tlWars (5100) a less J Policy Number: ❑ I certify [hat in the peAormance of the vrork for which this permit is issued, I shall not employ any person in any manner so as to become su6ject to the workers' compensation laws of Califomia, antl agree ihat if I should become subject to Ihe workers' compensation provisions of Sec�ion 3700 of the La6or Code, I shall forthwith comply with these provisions. Appl¢anfs Signature Da�e WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby a(frm that I am licensetl under provisions of Chap�er 9(commencing wi[h Section 7000) of Division 3 of the Business antl Professions Code, antl my license is in full force and effect. Lic. # Class # Conlratlors $ignaWre CONSTRUCTION LENDING AGENCY: ❑ I hereby affrtn ihat there is a constructbn lending agency for the peAortnance of Ihe work for wfiich ihis permit is issued. (Sec. 3097, Civil CodeJ. Lender's Name: Lender's Address: SiB�awre Date OWNER•BUILDER DECLARATIONS: I hereby aKrm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW fo� the follovnng reason (Sec. 7031.5. Business and Profes5ion5 Code: Any city or county which requires a permit to constmct, alter, improve, demolish, or repair any SlrucWre, prior to its issuance, also requires the applicant for such permit to fle a signetl statement thal he or she is licensed pursuant lo the provisions of the Contracrors License Law (Chapter 9(commencing with Section 7000) o! Division 3 of the Business and Professions Code) or that he or she is exempl lhere(rom and lhe basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects Ne applicant to a civil penalry of not more than five hundretl dollare ($500).): ❑ I, as owner of the property, or my employees with waqes as their sole compensation, WILL DO THE WORK, and the strucNre is not intended or offered for sale (Sec. 7044, Business and Professions Cotle: The Contractors License Law tloes not apply to an ovmer of property who builds or improves thereon, and who tloes such work himself or hersel( or through his or her ovm employees, provided that such improvements are not intended or otferetl for sale. I(, however, the builtling or improvement is sold wilhin one year of completioq the owner-builder will have the burden of proving that he or she did not buiid or improve for purpose of sale.). I, as owner of the property, am EXCLUSIVELY CONTRACTING WI7H �'L CENSED CONTRACTORS to constNct lhe projec[ (Sec. 7044, Business and Professions Cotle: The con[2ctors License Law dces not apply to an owner of property who builds or improves thereon, and who cont2cts (or such project vrith a contractor(s) license pursuant to Ihe Cont2ctors License Laws.). ❑ I am exempt untler sec. Business and Professions Code for this reason: �'3o-ai [$ignaWreT ___ ��a�e . r• ` 305�-G6 (3/W) Owner ID verified by driv r s license. �Yes ❑ No Driver's Cicense�.No. Expires:, ^ ��" �-� Verifca�ion of Ownership by (type of tlocument, i.e. - propeny tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify ihat no excava�ion frve (5) or more (eet in tlepth into which a person is required to descend, will be made in connection with work aulhorized by ihis pertnit, and tha� no building structure, scaffdding, falsework, a demolition or dismantling thereof, will be more than ihirty-six (36) (eet high. (Chap. 32, Grp 2, M 2, Sec. 341, Ttle 8, Cali(omia Administ2tive Code�. ❑ As ovmer-builder, I will not employ anyone to do work wliich would require a permit (rom the Division of Intlus�rial Salety, as noted above, unless such person has a permit to do such work from the tlivision. Appli[an(s SgnaWre Dale Division of Industrial Safe�y Permi� 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 t�reatened release of a hazardous malerial? ❑ Yes ❑ 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 Depanment by every business which has at any one time during a reported year a quantiry of hazardous materials equal to or greater than a weiqht o! 500 pountls, or a volume of 55 gallons, or 200 whic feel of compressetl gas a� standard tempera�ure and pressure). 2. Does or will the applicant or present or future building cecupant need to file a regisiration (orm for aculely hazardous materials? ❑ Yes ❑ No (Section 25533 of the Califomia Health antl Safety Code, wiM some exceptions, requires regisUa�ion wi�h �he Costa Mesa Fire Department 6y each business which at any one time has on hand a quantity of awtely hazardous materials equal to or greater than a weight of 500 pounds, or a volume o( 55 gallons, or 200 cubic (eet of compressed gas at standard temperature and pressure). 3. Does or wiil the applicant or present or (uture building occupant need to prepare an RMPP (Risk Managemen[ and Prevention Program (or acutely hazartlous materials)? ❑ Yes ❑ No (Section 25534 of the Califomia Health and Safery Code provides that the Costa Mesa Fire Department may require ihe preparation, certification antl filing with Ihe Fire Departmen( o( an RMPP by businesses which are required to register acutely hazartlous materials with lhe Fire Department. 4. I/ an RMPP is presently required, has Section 25534 of Ihe Calilornia Healm ana Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the appliwnt or present or tuNre building occupant require for Ihe work whiGh is lhe subject of this appliwtion a permit for such wnstmction or modification from Ihe South Coast Air �uality Management District or from any other air pollution conlrol tlislrict or agency? � Yes ❑ No (Section 658502 of the Califomia Govemment Cotle requires that the requested informa�ion be fumished on appliwtions for noo-residential building pertnits). 6. Will any part o( the facility to be constructed under this permit be within 7000 leet from the oUter boUntlaries o( a SChool? ❑ Ve5 ❑ No Qf �yes", the facility must meet the requirement o( Sections 25534 and 42303 Of lhe Califomia Heal�h antl Sale�y Code). 7. If a permit from the South Coasl Air Quality Management Districl or other air pollution control disVic[ or agency is required (or lhe work which is the subject of this appiication, have all of the disclosures prescnbed by Cali(ornia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. Qf'yes", anach certi�cate of compliance from the appropriate air polNtion control offcer�. CERTIFICATE OF COMPLIANCE: I certify that untler penalty of perjury the information given above is correct. I agree to comply with all state lavrs and ciry ordinances regarding Hazardous Materials and Emissions. Siqnawre Da�e CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the in(ormation given.is�correct:l agree to comply with all state laws antl city ordinances relating to building constmction, and authonze representatives of the Ciry of Costa Mesa to enter upon the above-described property (or inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspec[ion. igna re pf L gai vmer(s) oa�e '�/ �_ 3 0-0� Analor Aumorize� nooi�wm.� oa�e ' � % �_`� ^- -�� Costa Mesa City of Costa �VLesa BuiCding l�ivision 77 Fair Drive, Costa Mesa, CA 92626 714-754-5273/Fax 714-754-4856 OWNER BUILDER VERIFICATION Permit # � / ��Q/(� � Disclosures & Forms for Owner- Builders Applying for Construction Permits IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has een sub tted in our name listing yo elf as the build r of t /�/' property improvements specified at ,// f�-��%,� �' ✓.� i£7` /j2(a..'Z,� We are providing you with an Owner-Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval ot the permitting authority. Read and rnrtra! each statement below to srgnrfy you understand or venfy this informatron. �1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner- Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am ware of the limits of my insurance coverage for injuries to workers on my property. 2. I understand building permits.are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. � 3. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. �5. I understand if I employ or otherwise engage any persons, other than Califomia licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. 1L6. I understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. V 7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is pertormed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. 3148-30 CALBO Jan 1, 2009 OB Packet template 1 of 2 : . � �'' 8. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. '="9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California DepaRment of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. vi0. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the partv leqallv and financiallv resoonsible for or000sed consiruction actiaiitv at the followina address; �agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by�ll applicable laws and requirements that govern Owner-Builders as well as employers. ��12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner-Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the agency is required fo be presented when the permit is issued to verify the property owner's signature. Signature of property owner �--- � Date: O y � Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the' property owner to apply for a construction permit for the Owner-Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my project. r Scope of Construction Project (or Description of Work): �,� ��% �i�//_=.�if O,f— ��(l � T� „ Project Location or Address: Name of Authorized Agent: Address of Authorized Agent: TeINo /7/�� I declare under penalty of perjury that I am the property owner for the address listed above and i personally filled out the above information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other venfication acceptable to the agency is required fo be presented when the permit is issued to verify the propeRy owner's signature. Property Owner's Signature: �/�,�+��,�� ---"` Date: �� /� � 3148-30 CALBO Jan 1, 2009 OB Packet template 2 Of 2 � � y%D�3_`�tv COSTA MESA BUILDING•SAFETY DEPARTMENT P. O. BOX 9f7 COBTA MEBA. CALIPORNIA For Applieanf fo Fill In Complefely YYPE OR PRINT ADDRe�ss 901 Ma ellaa Street COSTA MESA. CALIFORNIA � MAIL � ARCH Corone del Mar NE�x 34220 NO. OP OLD6B. . � L �j � ,�_ u b�� l� h C, =.1�-.l (�� DEC 9 1960 �ar ss, �z.9�?��1i3�� APPLICATIONiFOR P.ERMI7MC',�..�. BUILDING For Office Use Only RlCEIPT NO. �Pgp�A�� Np:� tJ �! rtecerv o er o �g,wecerveo o�re iesu�o 1'r/ �.1— %�o CI�1:� U l��ti OD E'66 901 lfaggllan Street COSTA MESA. CALIFORNIA FIRE ZONE APPROVED ZONING zoHe I xo. oF I uee ov rv [J l PLANB 2 BU�LDINO i �3 �ecwt �I: �- / / �f 86TBACK LINE FROM � / (CHNT¢N LIN6 9T.) cetaiea oP s'rHeei REAR YARD FRONT SIDE YARD I LEFT S� I RIGHT S/ R SIDE I DESCRIPTION OF WORK ,r REPAIR I II MOVING BUILDING NO. OF SIZE ROOM6 E%TERIOR WAL IROOF COVERING COVEF U6H OF BUILDING ANO WORK TO E � i HBPHBY ACNNOWLEDPe TH�T I HAV¢ RHAD THIB M�LIGTION AN� 8TAT8 THAT THE ABOYH IB CORRECT AND A E6 TO COM• PLY WITH ALL CIiY O �NANCE6 AND 8TAT6 I.�W REOULATINO BUILDINO CONBTRUCT� N. 81GNATURE OF / PERMITfE AUTHORIZED AGENT V � � E� TN[ AMOUNT BXOWN UNDeR V�LUATION 18 FOR THG PURPO86 OP EBTABLIBHINO A PHRMIT FEH ONLY. $ IL` 6�O-� I FLqN CHECK $ %/• OO