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Home My WebLink About1956 KILLDEER CIR - Building Permits 11111 W CITY OF COSTA MESA 4 BUILDING DIVISION >:7 a,i DEVELOPMENT SERVICES DEPARTMENT PEEMIT NUMBER �t OK* : PERMIT +1y� �+• B03-00148 aaaim (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1956 KILLDEER CI Status: ISSUED Suite: Applied: 01/30/2003 Vicinity: ROOF Issued: 01/30/2003 Parcel Number: 13947308 Zoning: R1 R1 Applicant: TAYLOR, ROB ISSUED BY: Address: 408 10TH STREET Phone: 714-374-3877 HUNTINGTON BEACH,CA Zip: 92648 Owner MCCLOSKEY, MARY PHILLIPS Address TR COSTA MESA,CA Phone: 1956 KILLDEER Zip: 92626 Contractor: TAYLOR ROOFING Address: 408 10TH STREET Phone: 714-374-3877 HUNTINGTON BEACH,CA Zip: 92648 License: 784622 Arch : Eng: Address: - Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT_ TEAR OFF EXISTING WOOD SHAKE LOCATED FRONT AND D SIDES OF RESIDENCE. INSTALL 7/16"PLYWOOD,30#FELT,AND 30 YEAR COMPOSTION SHINGLES.2,100 S.F. • FEE SUMMARY Plan Check: $0.00 • - Calc Valuation: $4,200.00 Permit: $111.25 Claim Valuation: $4,200.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $111.75 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 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 2446-46(e/00) DECLARATIONS ( D WORKERS'COMPENSATION DECLARATION: . I hereby affirm under penalty of perjury one 01 the following declarations: • i O I hake and this ea ceissuete 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: is 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 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,a agr7Ifjall,1 shg0Id become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisio I/^1 Applicant Signature: Date: I' 3 WARNING:FAILURE TO SECURE WORKERS'COMPENSATI N COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed u der provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.ft ZZ Class N ( "3G Contractors Signature: Date: f- 3n -O .- 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: 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 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 properly 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. 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: I 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? 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 ❑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? 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? IYes Al 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 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. Ignatura lJLLe �;gal O ner(s) • Date �� 1' 3O O 3 nd/Or Authoriz Applicant Date CODE I fNSPFCTION TYPEPATE INTITIALS CODE F INSPECTION TYPE PATE INTITIALS • 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final .I4 208 Final Plumbing 200 Final Re-Roof Z' -f� 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 Lot 23 • rtt F(tUtIVEU 91842 MAR 8 1 1964 . COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P.O.BOX 317 COSTA MESA,CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING For Office Use Only ADDRESS 1956 Killdeer Circle RECEIPT NO. €81T�J2 COSTA MESA. CALIFORNIA i IWpp RECEIV DBY DATE RECEIVED CAT11654054 OWNER Pemba Subdividers, Inc. 3' 37 J BUILDING MAIL 2850 Mesa Verde Drive ADDRESS ADDRESS - // CICosta Mesa Nc 5490395 ZONE TYPE GROUP ive ARCHITECT EL ABYPROVED DATE G OR ENGINEER E.G. Kaltenbach ND.5478046 ADDRESS 1833 E. 17th St. , Santa Ana ZONING ZONENO.OF I USE OF NEWS nags ram. CONTRACTOR•� I WI1LT 3 a M C R-1 PLANS 2 BUILDING / W/ Rttoar. LEGAL ADDRESS DESCRIPTION Lot 23, Tract 5289 CITY A.P.NO. none p p NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STC.NO.'`�.ATE 1187331/8� `' TE 90'TO SIDE&REAR P.L. OF LOT 2..Y.LW!O/JS O I NOW ON LOT 0 EAVES SIZE `,r/ 6 NO.OP BLDOS. ALLOWED (U.B.C.REQUIREMENT) USE OF X ( X YARDS APPROVED YARDS APPROVED EXISTING BLDG. MAIN BUILDING ACCESSORY BUILDING (FROM C/L STREET) SETBACK LINE FROM CENTER OF STREET 501 REAR YARD 441 FRONT FT. SIDE YARDI LEFT 51 I RIGHT 7' R.HIDE 7FT. FT. DESCRIPTION OF WORK L.SIDEFT. /7FS/(//Fr. Fr. X REAR NEW ALTERATION _ ADDITION / 'T. DISTANCE BET. BET.MAIN Q REPAIR _MOVING DEMOLISH MAIN SLOGS. ACCESS.BLDGS. VAR.# DATE 5 ZELDING2' 139 NO.OF ROOMS 6 STQRIE$ 1 C.U.P./# APPROVED EXTERIOR WALL,Stung COVE Shake e APPRO ,[�fi� 7 7 c r6t COVERING rol COVERING Shingle BT I� DATE S•! > USE OF BUILDING AND WORK TO BE PERFORMED CO Single family with attached garage. L House 1,741 sq.ft. / .dam_ ' 7 n Garage 425 sq,ft. Plan 41-BR /��C� o I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN U ER VALUATION IS FOR THE F AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL CITY ORDINANCES AND STATE LAWS R OULATING VALUATION 0 BUILDING CONSTRUCTION. / N PSIGNATURE ERMIITTEF OF 112/)/2/0 /,�F✓ PERMIT FEE $ (�J O /'` p m c , 304'= AC 33_ is o y/ Q — AUTHORIZED AGE TOTAL FEE $ / /