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Home My WebLink About3085 KLONDIKE AVE - Building Permits - / 4'`5� 4 9 • CITY OF COSTA MESA BUILDING DIVISION Oiillir > I r,,,' ,� DEVELOPMENT SERVICES DEPARTMENT P RMIT NUMBER 4. 1.1114 PERMIT 602-01694 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.CthLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 3085 KLONDIKE AV Status: ISSUED Suite: Applied: 10/15/2002 Vicinity: RESIDENCE AND ATTACHED GARAGE Issued: 10/.15/2002 Parcel Number: 41806306 Zoning: R1 R1 Applicant: NGUYEN, CUONG ISSUED BY: _794_ Address: 14351 EUCLID ST#E Phone: (714)545-6994 GARDEN GROVE,CA Zip: 92843 Owner NGUYEN, NHANH THI Address 3085 KLONDIKE AVE - Phone: . COSTA MESA,CA ' . - Zip: 92626-2950 - , Contractor: ' VILLA ROOFING PROFESSIONALS INC Address: 14351 EUCLID ST#E - Phone: (714)545-6994 GARDEN GROVE, CA Zip: 92843 License:- 758361 Arch : Eng: . Address: - Address: Phone: - ' Phone: Zip: License: License: . SCOPE OF PERMIT REROOF:T/O WOOD SHAKES,7/16"OSB SHTG,2 30#FELT,APPLY"DURALITE SLATE TILES."ICB0#2656,5.8 PSF.24 SQUARES ' 'FEE SUMMARY Plan Check: $0.00 Calc Valuation: $7,300.00 Permit: $153.25 ‘ Claim Valuation: . -. $7,300.00 SMIP Res: . . ., $0.73 SMIP Com: ' $0.00 Other:. $0.00 Inspection: $0.00 Total: $153.98 PLANNING &ZONING SETBACKS y 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 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(6O) DECLARATIONS .y~,1 1. 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 ork for which this permit Is issued. 1 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. y workers'lcompensation Insurance car' r and policy number are: Carrier: -f�/( (Crst. 3 Policy Number: /62 7.-Z/ /27io/ 6 —0.-R (This section need not be completed it 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,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: /� Date: � ��0 WARNING:FAILURE TO SECURE WORKS P SATI ERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND COLLARE(5108000),IN ADDM O THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed and pr visions.f C pter 9(commencing with Section 7000)of Division 3 of the Business and Professions od',and my license is In full force and effect.Lic.# 7 Class# •i Contractor's Signature: f--�r Date: / / _ — CONSTRUCTION LENDING AGENCY: . O 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). Lender's 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 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 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 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(38)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? ❑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 aEEermit for such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency? Yes U 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? 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 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 propert for inspection p .osea.I agree not to occupy or allow occupancy of any building authorized by this rmit until final inspection. . . t 4 No. WILLIAMS.' INSULATION COMPANY OF CALIFORNIA 1201 E. Hunter Ave., Santa Ana, California 92705 (714) 972-9632 THERMAL INSULATION CERTIFICATION THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH CURRENT ENERGY REGULATIONS, CALIFORNIA ADMINISTRATIVE CODE, TITLE 24 STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT: Tract Name: Lot No. �'j Tract No. ,,(J t(Stg Block No. Street - r �(�� : /B (X ( C�City - EXTERIOR WALLS: R— Mfg. Owens Corning Thickness/Type 6" Value 19 Ceilings: Batts: • R— Mfg. Owans Cnrnin,XThickness/Type 'i" Value 11 Blown In: R— Mfg. _ Thickness/Type Value R— Sq. Ft. Covered _No. of Bags Used Value Floors: R— Mfg. _Thickness/Type ' Value Other R— . Mfg. _Thickness/Type_ _ _ Value - - General Contractor • California Contractors License No. f Date • Signature Title Williams Insulation Co.of California CalifornianiContractors License No. 267522 Date " X19"479 /7/'/ " Field Supt. Signature • Title JOB COPY-WHITE BUILDING DEPARTMENT-PINK GENERAL CONTRACTOR-YELLOW FILE COPY-GOLD r • rt4 "7r. I _• 79 '�' COSTA MESA BUILDING-SAFETY DEPARTMENT 3330 �'2/[i�/73- _ i,64.t KTT� P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 30' 044 ;I APPLICATION FOR 33STRUC00TUR04AL7PER7MIT For Applicant to Fill in Completely —Use Ink Only /J RECEIVED BY DATE RECEIVED.' DATE ISSUED . ' ADDRESS3hR 5 i./on s /�•/r�;r, ./ '' // ERMIT NO. OWNER Foley Construction Co. , Inc. A.P.NO.C.//Er-de/- MAIL ADDRESS///S3Db,. �owthi ^uL . MADRESS 2101 E. Fourth St. , #100 ADDRESS AUL- L. CITY Santa Ana NO. 543-9471 TRACT 105131 LOT 9 BLOCK CONSTRUCTION - NEW ADD ALTER REPAIR MOVING DFMOI NH LENDER x BRANCH OWNER Foley Construction Co. , Inc. ADDRESS 0362 �nry'�p VALUE 7/,�tp OR ENGINEER Hales-Langston NOARCHITECT L 547-0862 VSE ""'w-`l 0� $! `2,/oO� y ' /FIRE 1/� ADDRESS 777 S. Main St. , #105; Orange ZONE TYPE ✓ r 9GROUP - . APPROVED v CONTRACTOR Orner/Developer BY DATE , ADDRESS Sane . TEL. ZONE R.( IPOA' USE E _ I//h CITY Satre NO. 1\ CA q 6M+ STATE CITY YARDS APPROVED YARDS APPROVED J LIC.NO. Se LIC. NO. MAIN BUILDING ACCESSORY BUILDING 14 SIZE (FROM C/L STREW pi___ /lo r d OF LOT INOWONLOT FRONT 2.46 F . T. a USE OF EXISTING BLDG. N/A _B.SIDE .2 FT. O FT, to c--1 F Separate permits are required Cor L.SIDE jFT. 0 FT. electric,plumbing and heating work. / 1.14 - REAR 5� FT. FT. (.., USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& QD MAIN BLDGS. ACCESS. BLDGS. :aDevelopment of 41 single-family C URP DATE APPROVED a detached' residence units. _ay R 4:--. DATE 3--16—7/ cd cd ral 0.. 0 I hereby acknowledge that I have read this application and state 'o I:4that the above Information is correct and agree to comply with n\ „ L1, all laws regulating building construction, and I shall not employ HOLD tOR SPECIAL RLOUIREMENTS ° 4 t Z any person in violation of the workman's compensation laws of u� W*„ the State of California. AA A �f6[ & nt I hereby certify that I am properly licensed as a contractor under 2.549 SQ. FT. p�"/ .yw � the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR o*. Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A'PERMIT FEE ONLY: -^` am exempt from the provisions of the State of California Business VALUATION PERMIT FEE v and Professions Code,Division 3,Chapter . '7 Kn $ J, Signatureerm9y/ ^' . , A _ / ! (J £00, TAXet, cn PLAN CHECK $ O��i7V o �1 Permittee / r�!/C/ 'l� j(/ _ t/ U. Authorized Agent - TOTAL PAID $ /a_'7 9Z . - • . — Mir ,7z#7OW 82 3L27�79. 024BQpp T6 COSTA MESA BUILDING-SAFETY DEPARTMENT 3%2709 245.00CKT0 P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 arliffig 00004474 17 - ,1Q APPLICATION VIWTRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink Only RECEIVED BY DATE RECEIVED DATE ISSUED BUILDING . 4111 ADDRESS D i IP A /4 r' ., PERMIT NO. OWNER /f. , 4M1,44MIIW� / A.P.NO. MAIL BUILDING 3Q95 .�' to l. QGr • -v �/ ADDRESS ADDRESS TEL. CITY NO. TRACT LOT 5 BLOCK e CONSTRUCTION NEW ADD ALTER REPAIR MOVING OFMOI ISH LENDER //%��'j��,� ///finaJ ,t BRANCH OWNER 779-6( /I liTlr-M It ADDRESS VALUE • ARCHITECT TEL. USE $ • OR ENGINEER NO. FIRE ADDRESS ZONE TYPE GROUP APPROVED CONTRACTOR O BY DATE ADDRESS ZONE NO.OF USE OF NEW TEL. PLANS BUILDING CITY NO. F. STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING W SIZE INO.OF BLDGS. (FROM C/L STREET) P. OF LOT NOW ON LOT FRONT FT. FT. xt USE OF CA EXISTING BLDG. R SIDE FT. FT. vi _x+ ESeparate permits are required for L.SIDE FT. FT. electric,plumbing and heating work. A _REAR FT. FT. Ca F. USE OF BUILDING AND WORK TO BE PERFORMED F DISTANCE BET. BET.MAIN& QQ MAIN BLOCS. ACCESS.BLDGS. VAR.# DATE .a C.U.P.# APPROVED • APPROVED } —BY DATE 12,.a Q I hereby acknowledge that I have read this application and state n n IY that the above information is correct and agree to comply with n.co As all laws regulating building construction, and I shall not employ i Z any person in violation of the workman's compensation laws of E the State of California. - 3 I hereby certify that I am properly licensed as a contractor under SQ. FT. co the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR a Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEEEONLY: to am exempt from the provisions of the State of California Business VALUATION . ��O�] a PERMIT FEE $ l- and Professions Code,Division 3, Cha or 9. b T PLAN CHECK $ m Signature or/ -/��/—/I�.� IL 0 Permittee $ TAX $ a Authorized Agent TOTAL PAID $ ��// 1 U