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Home My WebLink About1175 KINGSTON ST - Building Permits 1- - J FST- CITY OF COSTA MESA 4 BUILDING DIVISION • • > y, DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER / PERMIT �• B02-01880 444.0RSs) 41. (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.BUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1175 KINGSTON ST Status: ISSUED Suite: Applied: 11/18/2002 Vicinity: ROOF Issued: 11/18/2002 Parcel Number: 41204244 Zoning: R1 R1 Applicant: SELL, RON ISSUED BY: L Address: 18032 LEMON Phone: (714)528-1758 YORBA LINDA,CA Zip: 92686 Owner: AETNA FINANCE COMPANY Address SUITE 360 - - LA PALMA,CA - — Phone: �a 1.CENTERPOINTE DR Zip: 90623.. - . ", '' Contractor: SELL ROOFING COMPANY . - Address: .• 18032 LEMON - I .• Phone: (714)528-1758 1"1 tt; • ' YORBA LINDA;CA - " , Zip: 92686 License: 323842 Arch : - Eng: Address: . Address: - • - , Phone: 'Phone: Zip: License: - - - License: - - SCOPE OF PERMIT REMOVE EXISTING ROOF. INSTALL 1/2"OSB, EAGLELITE, ICBG#4660.2,700 S.F. INCLUDES ATTACHED GARAGE: 'FEE SUMMARY . Plan Check; - ' $0.00 - - --- -Calc Valuation: $8,900.00 Permit: $167.25Claim Valuation: $8,900.00 SMIP Res: • $0.89 , SMIP Com: $0.00 - -- - - - - - Other: $0.00 - Inspection: ' $0.00- - ' Total: $168.14 PLANNING &ZONING SETBACKS :: - MAIN STRUCTURE Front •0-0 , ,�4 - Rear 0-0 - Left , 0-0 Right 0-0 ACCESSORY Front . 0-0- Rear 0-0 Left 0-0 Right 0-0 PARKING -'Existing: - 9 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 2446-46(6/00) DECLARATIONS CM I f • - ' WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: O 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. T 351'have and will maintain orkers'compensation Insuranjjpjjjqqq.as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. My workers'compen nncepernerr and p number are: /.s ` ` a err:- Policy Number:=%AJ C v (� S�� (This section need not be completed if the permit is vat d at one hundred dollars($100)or less.) YI' ❑ I certify that in the performance of the work for which this ermit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation California,and a hat if I sho become bject to the workers'compensation provisions of Section 3700 of th bor Cgtle,I shall forthwith comply with these provisions. l � Q Z Applicant d� i -A y A/ WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER'TO CRIMINAL PENALTIES AND CIVIL NES UP TO ONE HUNDRED THOUSAND DOLLARE(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST.AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby.affirrmhata.a%licensed under provisi 1 hapter 9(commencing with Section 7000)of Division 3 of the Business and Profe ions e d my license is in full i. r- 2 Itotce..and'effeCETIC7# 77 ^Cfass'.Y� — �/ Contractor'sSignature:_ Z k -Date: /c9 ^ ( -7J 5f- 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'tea civil penaltyo not more than five hundred ollars($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 lierrowri 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 cry/net-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). O I,as owner of the property,ani 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 drivers 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? 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 en 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? 0 Yes LJ No (Section 65850.2 of the Califomia 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? 0 Yes 0 No 8 (If ayes',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 stat and city or ' ances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspe n oses.I a not upy or allow occupancy of any building authorized by this permit until final inspection. Si ature 01......�al TOwners) �// /� r--.i� end/Or At. Konz=Applicant--' 1,ODE I INSPECTION TYPE MIL 1NTITULE CODEC IN$PECI'IONIYPE UTE IWWTiT 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 7--9)j 7 208 Final Plumbing 200 Final Re-Roof 5i/ 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 CITY OF COSTA MESA RECUFST EOR OCCUPANCY TRACT NO. /o271 DATE: P f LOT NO. 41/ ADDRESS // The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. By executing this agreement, the undersigned acknowledges that he/she/they was/were advised that this tract has not been given final inspection nor has _ . it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the City at the time the Final Tract Map was approved. - The City assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the City harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition(s). /J _ n BY X X.t A9—KLL-1,Vff4A (Signature of Purchaser) I BY /47 ittd (Signature of Developer and/or author';e , representative BY \L (Signature o'1Lender) y r. .• ; HOME SAVINGS F, L: • ASSOCIATION t. 1 4/79 ll 6730 1(/ 14/79 311 .94 TL COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 RECEIVED BY Irfi y%s/ate For Applicant to Fill in Completely- Use Ink Only ■�'/7/Y 1/V�I�1 BUILDING A.P.NO. 04:c-Ar)-----01- 6) ADDRESS Tract 10278, Lot 44 BUILDING �/ OWNER OR ADDRESS 1175 $ ..411-a6-1-,:n, s-f- TENANT McLain Development Co. UNIT OR MAI ADDRESS 1470 Jamboree Rd. SPACE NO. TR.NO. LOT .BLK. CITY Newport Beach NO. 640-6800 10)27 NEW ADD ALTER (REPAIR MOVING DEMOLISH CONSTRUCTION / LENDER v BRANCH • OWNER • ADDRESS VALUE ARCHITECT TEL. USE $ OR ENGINEER Corbin/Yamafuji NO. 752-5567 t • ADDRESS 3661 Spruce St. . Newport Bch. ZONEPDIV-irlp TYPE GROUP APPROVED CONTRACTOR McLain Development Co. BY DATE ADDRESS 1470 Jamboree Rd. TEL. CITY Newport Beach NO.640-6800 E- STATE CITY APPROVED SETBACKS i-dg LIC. NO. 273875 LIC. NO. 18873 SIZE NO.OF BLDGS. OE. (FROM C/L STREET) WOF LOT I NOW ON LOT F )O __FRONT FT. Q USE OFS • &I EXISTING BLDG. R.SIQE `' FL r I-, Separate permits are required for L.SIDE FT. Cc electric,plumbing and heating work: REAR 427 T. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION M D DATE . Q Single family residence' APPROVED 3'. New house a.-BY OVED//1W/e SATE 16 451 W t a W 0 I hereby acknowledge that I have read this application and state t. o y! that the above information is correct and agree to comply with 0 O Q. all laws regulating building construction, and I shall not employ - 4 any person in violation of the workman's compensation laws of 2 {Sid the State of California. FT .I hereby certify that I am properly licensed as a contractor under SQ. ‘.1/4p. m 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: n am exempt from the provisions of the State of C lifornia Business I g VALUATION PERMIT FEE $ //f�0� n - and Professions Code, Division 3,Chapter 9. / .V� (_,O Signature Permittee of v �j."~ .PLAN CHECK $/�1/ 4 LL ` or $ boa TAX $ O,Ct�`•w..)`{'� UAuthorized Aganate i TOTAL PAID 311-1