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Home My WebLink About1680 LABRADOR DR - Building Permits CITY OF COSTA MESA :4;00/t) BUILDING DIVISION > % ,.,,.' DEVELOPMENT SERVICES DEPARTMENT P RMIT NUMBER 1.. /I " sPERMIT -" o.m�M" 803-00633 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.usNG PERMIT n FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1680 LABRADOR DR BUStatus: ISSUED Suite: Applied: 04/16/2003 Vicinity: Issued: 04/16/2003 Parcel Number: 13918306 Zoning: R1 R1 Applicant:ddressAR270 W POMONA O, ARMANDO ISSUED BY: Address: 2702 W POST Phone: (714)754-4107 SANTA ANA,CA Zip: 92704 Owner: JOHNSON, THEODORE R III Address 1680 LABRADOR DR Phone: COSTA MESA,CA Zip: 92626-2360 Contractor: RB ROOFING Address: 2702 W POMONA ST Phone: (714)7544107 SANTA ANA,CA Zip: 92704 License: 772680 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING COMP AND INSTALL 25 YEAR COMP SHINGLES.REPLACE/REPAIR SHEATHING ONLY AS REQUIRED.INCLUDES ATTACHED GARAGE. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $4,000.00 Permit: $97.25 Claim Valuation: 54,000.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $97.75 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 fora 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 2448-48(8/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 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 w for which this permit is issued. I have and will maintain workers compensation Insurance,as required by section 3700 o1 the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carer and policy number are: / / Carder: A%b%r .14-'441.14-'441Y/bPolicy Number: C O O t/,/P.)Qt (This section need not be completed If the permit is valued at one hundred dollars($100)or less.) o 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 provl ons. �,/� Applicant Si s /o-/� "� �_ Date: (,//- a/l//[/� WARNING:FAILURE TO SECURE WORKERS'COMPENSATION OOVERAOE IS UNLAWFUL AND SWILL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIE AND dViL FINES UP TO ONE HUNDRED THOUSAND DOLtARE(S100,000),IN ADDITION TO 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 under provisio.of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,ag&I my license Is in full forceer t and effect.Lac.N �i j Classat : N 117)7 Contractor's Signeture:e Date: � � 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,CMI Code). Lender's Name: Lender's Address: Signature: _ Date: OWNER-BUILDER DECLARATIONS: I hereby atlina that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tot the following reason(Sac.7031.5,Business and Professions Cale: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 DMsion 3 of the Business end 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(5500).): ❑ 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. ❑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: O 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,faisework,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 DMsion 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 end 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 Depanment. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject ofthis a plication a, rtnIt for such construction or modification from the South Coast Air Ouality Management District or from any other air pollution control district or agency? Ul Yes 0 No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 WIII any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a Schad? ❑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 Cale Section 42303 been made? ❑Yes ❑No h. _r 6 (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.l agree to comply with alt 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 ell 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. Signature Of Legal ner(s D A4MAN�o J ei)Aa D Wild" And/Or Authonzed Applicant Date CODE I 111SPECTIONTYPE PAIS I IM FOE. pfsPECRON TYPE • DASE MALS 1616 Fixed System Final Fire Prevention _ 206 Final Mechanical 1266 Pool Spa Final -z 208 Final Plumbing 200 Final Re-Roof 41-2 T'19N 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 OWNER MESA VERDE ESTATES • DATE 12_9-5A _ JOB ADDRESS 1680 Labrador Dr_ BUILDING PERMIT NO. 8207 GENERAL CONTRACTOR L. G. Robinson • VALUE $ 15,662.00 AP. No. LOT 72 TRACT 3115 FIRE ZONE DESCRIPTION OF WORK Res & Att/gar - GROUP I g= J TYPE V ZONE Al PLAN NO. 82G, INSPECTIONS DATE SUBCONTRACTOR - PERMITS ISSUED DATE NUMBER Trenches /./Forms /i Steel Alit /- 4a.y Floor System • Steel Reinforce Chimney Re-ly Bond Beam _14.- e • Frame and Flashing 6-.:- -/ Lathing, In Outl�f+.. g .g -0 ' Plaster, brown coat g>t i !j.-Sot Underground soil kit/ WIG Pipe Tesj i ' -jr--_5-91Top Out t-I•bty _ / Furnace _ .l-1J�n -S• 3 - �, T/ Gas Vents P �, Rough Plumbing M/S 3-v,;sr/ ,N4 .EQ iit2 ,9-1.4_41 . Pie—c-, /6 -2a-a—/ ` Cesspool .Septic Tank / Prop. Swr. foe- Hd�sr¢un. St. Swr. '3/4 Ici rlw4--&. — 3/1 3 f /.4S'y7 l Sprinkling System Heating Final 44-/5s-/Q'-S"7 Plumbing Fixtures, Final /V)/S.S"/9"4V \7t 1 Final Gas Test/ /ilc4S /8 S9 1 Construction Pole Underground Power • r Rough Wiring nAlr- a/ill/ IMP2M �� \ Fixtures, Final +flail I OCCUPANCY 1- S ,"") Form 210-5M-1-57 I.• LAC°)`'Ism ',I. 8• 207 COSTA MESA BUILDING DEPARTMENT FIIV„P:CE DEPT. P.O.BOX 317 COSTA MESA. CALIFORNIA CITY OF C ern. MESA FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT BUILDING 1686 Labrador Drive BUILDING ADDRESS COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY RECEIPT NO. JERMIT NO. OWNER Mese Verde Estates b'a. D J MAIL RECEIVED BY DATE RECEIVEDDATE ISSUED ADDRESS 1701 Gisler St. --)11.Y77 . /,,2 —f-S G la--C/—SL CITY Costa Mesa TNO: KI 5-1751 ADDRESS ARCHITECTLIC" �• R. Shelley OR ENGINEER y NO. C-2170 COSTA MESA. CALIFORNIA ADDRESS Long Beach 6E9-0908 FIRE ZONE CITY LIC. ZONE NOP O5 TYP ROUP CONTRACTOR L.G. RobinsonNO. 1123 A ' %.T" 1701 Gisler S}. TEL. APPROVED ADDRESS NO. BY DATE LEGAL LOT CORRECTIONS DESCRIPTION NO. 72 BLOCK TRACT 31 15 A.P.NO. SIZE 70x 100 ND.OF BLDGS. N OF LOT NOW DN LOT one USE OF C EXISTING BLDG. SETBACK LINE FROM 5REAR YARD 20+ CENTER OF STREET 0+� SIDE YARD RIGHT 59+ LEFT 5'+ DESCRIPTION OF WORK NEW X II ALTERATION H ADDITION REPAIR MOVING DEMOLISH BUILDING tau e / NO.OF SIZE 1578 ROOMS 7 STORIES I EXTERIOR COVERING WALL St UccO COVERING Rock & Asph6lt USE OF BUILDING Residence and attached garage. 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI ATION AND STATE THAT THE ABOVE IS CORRECT ApD AGREE TEKCOM Y WITH ALL CITY ORDINANCES AND STATE LAW EGULATIND BUILD G CONSTRUE- _ TION. �f VALUATION on SIGNATURE PERMITTEE OF % / ¢N"IA `f-,1 Y 1N'✓i N+--i/ PERMIT FEE S a C. s 3 ,E--) /O l0/� PLAN CHECK S i 7_ JJ J AUTHORIZED AGENT ( TOTAL FEE S J.Q •�C� Vefr